Report of Quebec Ombudsperson on Pandemic and Long-Term Care- Pierre
Soublière - On December 10, Quebec Ombudsperson Marie Rinfret published her progress report regarding the province's residential and long-term care homes (CHSLDs) entitled "COVID-19 in CHSLDs during the first wave of the pandemic: Learning from and moving to uphold the rights and dignity of CHSLD residents." The report is part of an ongoing investigation which began May 26 and continues until fall 2021. At the heart of the Quebec ombudsperson's mission is respect for people and for their rights. The progress report is based on the observations and testimony of 1,355 people, 16 briefs presented by unions, users' committees and others, as well as talks with residents, family members, CHSLD staff, managers from the Integrated Health and Social Services Centres (CISSSs) and Integrated University Health and Social Services Centres (CIUSSSs), as well as complaints and incident reports. From the get-go, the Ombudsperson states: "The lessons to be learned from the pandemic are clear and concrete. Any delay in decision-making so as to go into action would now be unacceptable. The rights and dignity of people living in the CHSLD's must be at the heart of the issues." As of May 12, the death toll of CHSLD residents reached 2,059. The report brings to light, on the basis of living testimony, the totally inhuman and criminal situation which prevailed in the residences during the first wave. The devotion of health workers, who were affected both physically and psychologically, is underlined throughout the report. Between March 1 and June 14, there were 13,581 health workers who became infected with COVID-19, which represents 25 per cent of the reported cases during the first wave. Eleven of these workers died, a tragedy and a huge blow to the morale of their co-workers due to the loss of colleagues who were close to their hearts.
The report points out the suffering and dilemmas of caregivers who were no longer allowed to assist patients and family members, or to be by their side in moments of great distress and agony in most deplorable conditions. The report states: "The pandemic alone cannot justify the dehumanization of care and services or breaches in protecting our society's most vulnerable persons." The report prioritizes measures to be taken so that staffing is stable and sufficient. "Understaffing was one of the main weaknesses in CHSLD's during the first wave of COVID-19 [...] It is essential that there be a significant increase in human resources so that the health network has real room to manoeuvre, whether in normal times or in times of emergency." Required measures must "incite and persuade and be concrete and immediate." The report stresses the urgency of fixing the systemic lack of personnel, particularly health care assistants and nursing staff, in ways "which reflect the essential nature of these tasks." In conclusion, it is pointed out that during the first wave, "the current model for residential resources for vulnerable elderly people was stretched to the limit" and that it is obvious "that in many living environments and in the health care system, the means employed were sorely incapable of ensuring respect for the residents. Here, we are referring to respect of their dignity, their need to receive personalized care and their desperation because their loved ones could not be there." Regarding the urgent need to invest in a public health care system which puts human beings at the centre, the report reiterates: "Considering what the pandemic has taught us, there is no more excuse for delays in decisions that would enable action to uphold the rights of people living in CHSLDs." To its credit, the Quebec ombudsperson's progress report puts the human factor at the heart of the health care system. It is a timely reminder of the tragedy families went through during the first wave, and it keeps alive the discussion which was initiated at that time and which touched upon all aspects of the problems faced by seniors in general. It is another voice which, with that of the workers and their organizations, stresses the need to immediately improve the working conditions and wages of workers involved at all levels in health care as a necessary, essential step in humanizing the social environment and defending the rights and dignity of all. (Photos: Unifor)
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One
of the main factors at the heart of the tragedy, the report underlines,
is the working conditions of health care workers. For example, staff
mobility -- from one CHSLD to another and, internally, from one sector
to another -- was an established practice well before the pandemic and
an integral part of human resources management. It was
one of the main factors in spreading the virus within the
CHSLDs. Notably, the ministerial orders imposed during that period only
made the situation worse by giving the employer even more latitude to
force employees to move from place to place. The report also pointed
out that during the first wave, there was a lack of personal protective
equipment as
well as other basic equipment. On top of the fact that the CHSLDs had
little to no infection prevention protocols and certainly not the
equipment needed to be able to tend to older, bed-ridden patients
suffering from COVID-19, they were called upon to quickly and massively
receive people who were hospitalized, another factor which diminished
their capacity to contain outbreaks.