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COVID-19 in Long-Term Care Homes, Part 2

Senior man covering his face with his hands. Depression

Last April, we wrote about the outbreak of COVID-19 in long-term care facilities, and the impact on residents and family members, of various protective measures and restrictions imposed either by the facility itself, or pursuant to various government directives[1].  One measure taken by long-term care facilities was a significant restriction on visitors, including support workers and family members.

On April 30th, 2021, a report was released from Ontario’s Long-Term Care COVID-19 Commission (the “Report”), detailing Ontario’s insufficient preparedness for the COVID-19 pandemic within long-term care homes. Amongst other issues discussed, the report criticized the government’s restrictions on visitors, including those, such as family members, who provided informal care and support to residents.

At the beginning of the pandemic, the Ontario government restricted those who could visit long-term care homes to “essential visitors”, defined as either people performing essential support services or those visiting a resident who was dying or very ill.  Since then, the definition has been expanded so as to allow access to more individuals, such as family-member caregivers.  However, despite the eventual easing of access restrictions, the access prohibition in place throughout much of the pandemic had significant repercussions.

According to the Report, restricting family members and loved ones from visiting long-term care residents created a large burden upon long-term care staff. As the Report explains, family members and loved ones provided an essential service for many long-term care residents by caring for their daily physical and emotional needs.[2]  Without their critical assistance, staff members had difficulty in practising effective infection prevention and control (IPAC) measures and meeting the basic living needs of residents.[3] Moreover, the access restrictions led to many long-term care residents being confined to their rooms without human interaction for long periods of time.[4] These problems were exacerbated by the glaring under-staffing recorded at many of Ontario’s long-term care homes.

The outcome of the access restrictions, the Report explains, was a sharp decline in the cognitive and physical functions of residents, an increase in levels of depression, and deterioration of physical health due to insufficient nutrition and hydration intake. This ultimately led to many residents dying alone in isolation, with no one to ease their passing.[5]

The earlier blog on this topic identified that the restrictions imposed on visitors could be a violation of resident rights.  The Report confirmed that some care homes were unable to provide care in accordance with the fundamental principal of the Long Term Care Homes Act, 2007 and the Residents’ Bill of Rights incorporated under the Act.[6]   The Report provides a list of recommended amendments to the Long-Term Care Homes Act, 2007 to help ensure that residents are afforded proper care and that such a situation does not occur again.[7]

The lesson to be learned, from a legal standpoint, is that residents of care homes and retirement residences have rights that cannot be ignored, even in a pandemic.  Any restrictions must balance the health and welfare of residents against the potential risks to other residents, family, staff and third parties.  When there is concern about a resident’s safety and security, it is always recommended that legal advice be sought.

 

[1] See: https://www.pallettvalo.com/whats-trending/covid-19-in-long-term-care-homes-and-retirement-residences/

[2] Frank N. Marrocco, et al., “Ontario’s Long-Term Care COVID-19 Commission Final Report” (April 30, 2021) [the “Report”], at page 22.

[3] Report at page 169.

[4] Report at pages 22-23, 169-170.

[5] Report at pages 23, 170, and 178.

[6] Report  at page 191.

[7] Report at pages 232-235.


The author would like to thank Lucas Morini, Student-at-Law, for his assistance with this article.


 

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