'A tinderbox': Why some advocates worry long-term care facilities could be devastated by COVID-19

As Toronto monitors outbreaks of COVID-19 at three long-term care homes across the city, some worry the facilities could be "devastated" if the pandemic drags on for an extended period.

Toronto-based seniors' advocate Laura Tamblyn Watts said this was the case in other countries, particularly in Europe, and the same seems to be happening in the United States.

"Long-term care is a tinderbox. It is a fairly enclosed environment of people who are already the frailest that we have in the country, and we know that the testing is not being done on every older adult there," Tamblyn Watts told CBC News on Thursday.

"We estimate that there are significantly more COVID-19 patients [in long-term care] than have been reported. When you think about what happened in Italy and in Spain, we saw that there was not the rigorous testing of people in enclosed long-term care systems, and we think that that is happening in Canada as well. 

"We know that there are a very limited number of ventilators and limited number of places in ICU, and when it comes down to triage, older adults are at the bottom of the list," Tamblyn Watts added.

'Resources are stretched thin,' advocate says

Tamblyn Watts said the main problem facing long-term care centres has to do with inadequate human resources.

It's a problem has existed long before the COVID-19 pandemic, she said.

"I'm extremely worried about the spread there. We know that their resources are stretched thin and we also know that more dollars are being allocated. But the problem isn't that they necessarily don't have enough money," Tamblyn Watts. 

"While we do need more money, the problem is that we don't have enough people to provide the care and we didn't even [have that] before the crisis. 

"It's not like we can just magically create new nurses and new personal support workers, we already were short of them, so money may not be the answer," Tamblyn Watts added.

'Basic need of care' not being met, says son of patient

The son of a patient at a long-term care home in Oshawa, Ont., who spoke with CBC News on Thursday, described the situation there as unacceptable. 

Bruce Townley said his mother, who is 92 and blind, is currently in isolation with a cough and a low-grade temperature and hasn't had a shower for about eight days. 

"Because she's not able to leave her room, she's not able to get the basic care that you'd expect from a reputable seniors care facility," Bruce Townley said.

"I find that totally unacceptable… and that impacts her mental health as well. They're not meeting her basic need of care," he said.

"The entire facility is in lockdown so there's no one from the outside that can visit, check on her to bring her anything that she would need, so that's obviously elevating her anxiety," he said. 

"It's been very trying and traumatic on her, as it's probably [been] on a lot of the patients," he said.

On Thursday Medical Officer of Health Dr. Eileen de Villa said the city is concerned by the outbreaks at three long-term care facilities, including the Seven Oaks long-term care home in Scarborough, where two residents have died.

"The spread of COVID-19 in the long-term care setting is especially concerning because we know the residents of these settings … are especially vulnerable," de Villa said.

Social isolation damaging for older persons

Tamblyn Watts said studies have shown that social isolation is damaging for older persons. That's especially the case for people with dementia who might be terrified and may not understand why everyone is walking around in personal protective equipment or why they're not having their regular visitors.

"People in long-term care have to be attended to in a more creative way — things like social distancing sing-alongs; sitting in their hallways [where they can] see people; they can have a movie projected against the window or against the wall," Tamblyn Watts said.

"We're recommending if people can use video conferencing to set up a regular schedule with staff so that staff can help to support the older persons."