As the 6th wave hits Ontario, families must be allowed to visit those in long-term care: advocates

Long before the COVID-19 pandemic, Maria Mikelenas-Mcloughlin remembers watching her mother's well-being deteriorate in long-term care.

In the late 1990s, she saw her mom's twice-a-week baths reduced to a weekly sponge bath, says her mother was fed unidentifiable "mush" by staff and dealt with harassment from other residents. 

Those visits were an essential reprieve — one many seniors have been denied during the pandemic. 

While past treatment of seniors in long-term care raised some concerns, Mikelenas-Mcloughlin, 79, says, it's the future that now has her worried. Right now, the widow lives alone in Toronto, but with limited mobility, she knows that she'll eventually need help.

"The concern I have down the line is, will I be able to speak gently to the caregiver and say, 'Please turn me over softly?'"

Mikelenas-Mcloughlin, former president of the Etobicoke chapter of the Canadian Association of Retired People (CARP) is among the advocates calling on government, long-term care homes and health providers to ensure seniors don't face the same type of isolation now as they did in previous waves of the pandemic.  

Their concerns are mounting as Ontario records an estimated 100,000 to 120,000 daily cases during this sixth wave of the virus. 

Throughout the pandemic, seniors were identified as among the most vulnerable to serious illness and became some of the first to get vaccinated. 

At the same time, some of those living in long-term care settings experienced neglect and lived in alarming conditions after certain provincial facilities became overrun by COVID-19, according to discoveries made by the Canadian Armed Forces and documented in a May 2020 report. 

Lisa Levin, the CEO of AdvantAge Ontario, a non-profit long-term care provider, says that some seniors in care have compared the pandemic to being in "solitary confinement."

"What people didn't realize is that when seniors' homes were in outbreaks, not only were they not able to see their families, they couldn't even see the other residents in the homes," she said. "They were literally in their rooms and unable to get out."

Since the majority of residents and staff are vaccinated, Levin said she believes people can afford to lower their guard if they follow all the precautions.

"We no longer need to keep seniors isolated from their families," she said. "We have learned that doing that has been almost as devastating as COVID itself."

Still, she says, the virus remains a threat. 

During the pandemic, 4,431 long-term care residents have died, according to a government tally — a figure that represents more than a third of all deaths in Ontario due to COVID-19. 

"Even though many people are so done with it, it is still here … So we need to do everything we can to protect them."

Poor communication led to distress for seniors

Craig Thompson, Ontario's patient ombudsman, says a common theme throughout the 3,595 complaints the office received from 2020 and 2021 were related to restricting visits to long-term care homes and poor communication between management and families. The complaints suggest that both issues led to the physical, emotional and cognitive decline of seniors.

"We're talking about a very vulnerable population, so we will continue to see the impacts of those restrictions for some time to come," he said.

"It's not enough just to put in the measures to keep people safe. You have to mitigate the risks" connected to the restrictions, he said. 

Ontario plans to eliminate all remaining COVID-19 restrictions on April 27, including masking in long-term care homes, retirement homes and health-care settings. As of April 12, there are 140 long-term care homes and 117 retirement homes with ongoing COVID-19 outbreaks in the province. And as of March 14, COVID-19 vaccinations are no longer mandated for workers in the sector.

Bill VanGorder, the senior spokesperson for CARP, says that since the government is showing no sign of adopting further restrictions, the onus is on families' health providers to advocate for seniors.

"What we need is consistency and an ability for patients and their families, our residents and their families, to be able to help make the decision. Seniors want decisions made with them — not for them."

He said clear communication is key, noting that providers must avoid inconsistency with rules, because it can lead to confusion and anger.

Ministry to 'adjust measures as necessary'

The patient ombudsman recommends that health organizations adopt the "least restrictive" limits on visitations based on risks and evidence, that policies be clearly communicated and that visitation exceptions be provided on compassionate grounds, according to a report released in March.

The Ministry of Health, meanwhile, says it is monitoring long-term care homes and, in consultation with the chief medical officer of health, will "adjust measures as necessary to keep homes safe for residents and staff."

"We understand the mental and emotional hardship these measures have had on [long-term care] residents, as well as their family members and loved ones," a ministry spokesperson said in an email. 

According to the ministry, all visitors, regardless of their vaccination status, are allowed to enter a long-term care facility. There are no limits on the number of individuals permitted at outdoor visits, but long-term care homes can restrict the number of visitors per resident based on available space. 

Indoor visits have increased to four visitors or caregivers per resident at a time, and requirements for testing, active screening, masking and physical distancing remain in place.

As of April 5, about 92 per cent of eligible long-term care residents have been vaccinated with their third dose, and more than 72 per cent of eligible residents have been vaccinated with a fourth dose, the ministry says. More than 87.6 per cent of eligible long-term care staff have received a third dose of a COVID-19 vaccine. 

Now that the pandemic has put long-term care in the spotlight, Mikelenas-Mcloughlin hopes more people realize the fears that seniors have lived with for decades.

"It should be aging with dignity and respect — and having a voice in that," she said. "Not being put off in a corner."