Rethinking Long-Term Care.

Area of Science:

• Public Health
• Gerontology
• Health Policy

Background:

• The COVID-19 pandemic disproportionately affected Canadian long-term care (LTC) residents, with 80% of first-wave deaths occurring in these facilities.
• Second-wave mortality in LTC settings remained high across most Canadian provinces, underscoring the pandemic's persistent impact.
• Long-standing issues in LTC, including underfunding, inadequate space, staffing shortages, and infrastructure deficits, are believed to have amplified the pandemic's effects.

Purpose of the Study:

• To examine the impact of the COVID-19 pandemic on the long-term care sector in Canada.
• To identify systemic factors contributing to the high mortality rates in Canadian LTC facilities during the pandemic.
• To compare care hours in Canadian LTC facilities with international benchmarks.

Main Methods:

• Analysis of COVID-19 mortality data in Canadian long-term care facilities.
• Review of existing literature on LTC funding, staffing, and infrastructure.
• Comparative analysis of direct care hours provided to residents in Canada versus the United States.

Main Results:

• Canadian LTC facilities experienced exceptionally high COVID-19 mortality rates, particularly during the first wave.
• The pandemic's impact was exacerbated by pre-existing systemic weaknesses within the Canadian LTC sector.
• Canadian provinces provided fewer average direct care hours per resident (3 hours/day) compared to the United States (4 hours/day).

Conclusions:

• The COVID-19 pandemic exposed critical vulnerabilities in Canada's long-term care system.
• Urgent reforms addressing funding, staffing, space, and infrastructure are necessary to improve resident safety and care quality.
• International comparisons highlight potential areas for improvement in care delivery standards within Canadian LTC facilities.