Eldercare: urgent action needed to protect seniors’ rights

A new report co-authored by an UdeM professor makes recommendations to help ensure that the rights of seniors in long-term care are respected.

"We encourage people to exercise, eat right, do everything possible to prevent disease. But if they succeed and reach old age, their reward is often inadequate care or neglect. There’s something ironic, even hypocritical, about the mindset behind this."

That’s how Anne Bourbonnais , a professor in the Faculty of Nursing at Université de Montréal and a researcher at the Montreal University Institute of Geriatrics Research Centre, sums up the current situation in Canada’s long-term care (LTC) facilities.

Holder of the Canada Research Chair in Eldercare and the Research Chair in Elderly and Family Nursing Care, Bourbonnais co-authored a report on LTC nationwide published in January by the Royal Society of Canada.

The document makes evidence-based recommendations for policy-makers to improve long-term care in the aftermath of the COVID-19 pandemic.

The recommendations include: sufficient funding to ensure a minimum level of care, workforce support strategies, the elimination of systemic discrimination, effective data systems and provincial accountability.

’A great deal of discrimination’

Bourbonnais, the report’s sole co-author from Quebec, believes LTC should have two main essentials: respect for human rights and a well-supported, well-trained workforce. "The elderly face a great deal of discrimination in Western societies, including Canada," she said.

"It’s partly due to unrecognized ageism. Care for this segment of the population is not highly valued and governments don’t provide the necessary resources. As a result, seniors are not always considered full human beings and treated as such, in accordance with the Canadian Charter of Rights and Freedoms and the Universal Declaration of Human Rights. And people in long-term care facilities generally can’t go out and demonstrate for their rights."

In Bourbonnais’ view, this discrimination is not only age-based but also gender-based. Women are over-represented in LTC settings as they have a longer life expectancy than men.

In Canada, the majority of care workers looking after these women are also women, often immigrants or refugees. "They don’t always have decent working conditions and often don’t have the training to cope with increasingly complex care needs," Bourbonnais noted. "It’s dismaying to see that it’s the least supported people who are looking after the most vulnerable."

Cognitive disorders on the rise

As is well known, people in Quebec and the rest of Canada are living longer and the population is aging. The number of people living with a neurocognitive disorder in Canada is projected to increase by 187 per cent over the next 30 years.

"Dealing with cognitive disorders requires considerable expertise," Bourbonnais noted. "You can’t have a healthcare system that relies exclusively on home care, which is and will continue to be inadequate."

Home care depends on the support of family caregivers. But families have changed. The nuclear family of two parents and multiple children is no longer the norm, Bourbonnais observed. Today, it is common to see a single child who has parents, step-parents and grandparents.

"In Quebec, there’s a lot of talk about medical assistance in dying, dying with dignity," said Bourbonnais. "But before we die, it would be good to have some quality of life.

"As things stand, if there were another pandemic, we wouldn’t really do better in senior residences than we did in 2020. It’s very sad to think that so many people died or suffered and we won’t really be any better prepared as long as the recommendations in this report, among others, aren’t implemented."