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Let’s Build A Better Seniors Residence

Our world has changed. Our world must change. While all aspects of a pandemic is devastating, hopefully we will have the opportunity to learn, to learn to be better, to do better and to treat others better, lest we repeat. Let’s build a better residence for our seniors.

The COVID-19 pandemic highlighted that seniors in residences were the most vulnerable and consequently resulted in the most deaths. The first person to die of COVID-19 in Canada was a, 80 year old resident of a long-term care home in Vancouver. Throughout Canada (even worldwide), entire facilities were infected and then locked-down or perhaps the internal propagation of the virus was enhanced because of a lock-down. Health Canada[1] reports that 80% of all COVID-19 cases were related to community transmission.

Canada-wide, 50% of deaths due to COVID-19 were in seniors’ homes.[2] In Quebec alone, 70% of all COVID-19 deaths are in long-term care and seniors’ residences[3] and nearly 1/3 of these deaths were concentrated in just 6[4].

Sadly, caregivers were prevented from attending to, or visiting, their loved ones. Families were treated as outcasts and strangers and even worse, forced to experience their parents dying, alone. The indignity of not being able to hold a loved one’s hand, to comfort them as they pass, is intolerable. This is not how an intelligent, affluent, democratic society, should be treating our seniors. We need to be better prepared. We can do better.

Government run facilities seem to fare better than private, for profit facilities, at least procedurally, but failed just as poorly at protecting patients and clinicians. While the profit motive in private care often manifests in reduced labour and increased part-time or low-cost resources, public employees also suffer from similar fears.

So, what can we do to change? What needs to change?

Acute care is the shining star of universal healthcare in Canada. Chronic care and long-term care, less so. Pandemics, zero. The unintended or unexpected consequences of the pandemic, will force a revolution in long term care. We must take better care of our elderly because one sure thing in life is that we will all be elderly.

Let’s address some of the major challenges which have resulted from this experience.

…the lack of adequate “time to care” is one of the most important obstacles to high-quality care in for-profit homes[5]

Employees were afraid to come to work

To care for seniors is our ultimate gift, a dedication, an act of love. To be so fearful of contracting a disease and transmitting it to others, our families and patients in our care must be painful. How do we help our health care workers, our front line caregivers return to work? How do we attract more people to choose this career path? We must protect them, their families and their patients. Personal Protective Equipment must be readily available (reasonable cost and access) and testing must be quick. Continually testing and evaluating the health of both caregivers and those within their care will reveal who needs special care and result in reduced stress and better service to those in need. In our rapidly aging society, demand for caregivers exceeds supply, so increased salaries and better use of automation can go a long way to help.

Preventing a pandemic is much less costly in lives and cost than trying to cope with it after the fact.

Patients were unfed, soiled, alone, neglected

Clearly those who need assistance, must receive it. Suffering the indignity of wearing diapers is only surpassed by remaining unkept and soiled for days. We need to alert caregivers, escalate issues, and notify concerned family at all times. This sense of decency transcends religions, cultures, languages and nationalities. Digital health sensors exist to detect moisture, general health, falls and panic. Let’s use them.

Caregivers and families could not communicate with their loved ones

The pain of not knowing about the status of one’s parent is extremely disconcerting. There is not reason we can not remotely monitor our loved ones. Video cameras, smart phones, stand-alone appliances exist to assist us in continuous communications, anywhere in the world. We need to address privacy rules and laws and relax them for the sake of decency. Caregivers and employees must get used to being monitored while the rights of families to monitor their loved ones are respected. Access to family should be a fundamental right, not a privilege specified by bureaucrats.

Volunteers were given access and priority over existing family members and experienced caregivers

In what world would we believe that a stranger, a volunteer with no prior experience, should have full access to our loved ones, quarantined or not. Caregivers must always remain connected to those under their care. A recent case of a volunteer not knowing how to entice a senior to eat, ended up with the senior admitted to hospital for malnutrition and dehydration, without COVID-19. Again, caregivers, whether family members or professionals, best know those under their care.

Medication adherence ceased

One of the major activities for any caregiver is the management and dispensing of medications, often 4 times daily, to each patient. Chronic care patients and seniors are the most vulnerable to the effects of COVID-19, yet maintaining good health with proper medication adherence, cleanliness and nutrition is the most difficult to administer during a pandemic. We need to augment manual activities with digital health. That means using automated medication dispensers, video conferencing, telemedicine, sensors with fall detectors and vitals measurements to manage, maintain and notify in real-time.

Automation is not afraid of a virus. Automation works 24×7. Automation allows caregivers to reduce their stress and better monitor and manage a population of chronic and aged patients. Let’s make better use of the technology we already have to take better care of our seniors, our pioneers, our parents.

A better seniors residence

What constitutes a better residence? I’m not concerned with the physical construction, real-estate or decoration of a seniors room. I am focussed on the actual care and well-being of a senior to lead a long, healthy and happy life. After spending most of their life as a productive, contributing member of society, it is now in their senior years that society must return the favour and take care of them.

In an ideal world, seniors need round the clock care. The cost of care must be limited to balance need with affordability. In addition to enhanced sanitization measures, maximizing the use of automation will alleviate many problems with communication, monitoring, medication consumption and care. However, nothing replaces the touch of a caregiver, the love of a family member, the care and concern of family. We need to mandate a circle of care, inclusive of family, care providers and automation where possible.

A better seniors residence is one where seniors can finally relax and enjoy the fruit of their lifelong dedication and devotion to others, without worrying about healthcare, cost or family.

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