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May 12, 2021

Silas: It’s Time to Reimagine Aging in Canada

Long-term care
Safe Staffing
"Ensuring the health and wellness of seniors will require a complete reimagining of how we approach the care of older people."

By Linda Silas | President, Canadian Federation of Nurses Unions

As we mark National Nursing Week amidst an ongoing global pandemic, many across Canada recognize the successes and commemorate the sacrifices nurses made in their tireless work caring for our loved ones, including our most vulnerable seniors.

We’ve known for many years that Canada’s population is aging rapidly and that we face significant challenges in ensuring that everyone has access to high-quality care as they get older.

Many of these challenges are the direct result of decades of underinvestment and a fragmented regulatory regime. The current patchwork of services and the reliance on for-profit care in many parts of the country has resulted in soaring costs, inadequate facilities, insufficient staffing, and few protections for the health and safety of residents and workers.

Last summer, we saw the release of the Canadian Forces’ disturbing reports of the conditions in many private, for-profit long-term care facilities in Quebec and Ontario during the first wave of COVID-19.

The reports shocked the Canadian public and decision-makers and highlighted the deplorable conditions faced by too many seniors. The sad reality, however, is that these problems had persisted for decades out of the public eye.

The tragedy that unfolded in long-term care during the COVID-19 pandemic was the culmination of an approach that has long put profit before people, with too many employers failing to meet basic labour and care standards in favour of padding their bottom line. The result is that workers – often racialized women – face the impossible challenge of providing quality care while contending with high resident-to-staff ratios, limited resources and few workplace protections.

It should have served as a wake-up call for our federal, provincial and territorial governments.

Robust national standards for long-term care services are long overdue, and they must be implemented through an enforceable process like federal legislation.

Population aging and the increasing need for care services are global issues. Other countries are rising to the challenge of providing quality care for older adults, and Canada can and must do the same.

Part of ensuring our nation’s future health and economic prosperity will depend on addressing this challenge in a forward-thinking, coordinated and sustainable way that promotes the physical and emotional health of older adults.

We know that most Canadians want to age in their own homes and communities, and – where additional care is needed – have access to safe home-like environments where they are treated with respect and dignity. This makes a great deal of sense from both a social and economic perspective. However, many older adults in Canada have few options that support healthy aging in community.

To make this a reality, we must adopt an integrated approach that views care as a continuum of services responding to seniors’ diverse needs and capabilities.

Patient acuity is a critical part of caring for older adults. The term refers to the physical and psychological status of the patient or resident – specifically, the measurement of the patient’s illness severity and the intensity of nursing care required. Current data supports a minimum staffing level between 4.1 and 7.44 hours per resident day, depending on patient or resident acuity.

Nurses confirm that patient acuity and complexity have been steadily rising for decades, with few corresponding adjustments in facilities and staffing. This means that as Canadians live longer, our approach to aging has not kept pace with the changing needs of our population.

Our system lacks the flexibility to adjust available nursing hours to changes in patient acuity, as well as the political will to develop systems that match nurse staffing levels to patient and resident needs.

With aging an inescapable reality, it makes little sense for governments to avoid addressing the issue or to hand off responsibility for the care of seniors to private, for-profit companies, whose ultimate focus is generating profit for their shareholders.

Going forward, ensuring the health and wellness of seniors will require a complete reimagining of how we approach the care of older people.

As we observe National Nursing Week, we must recommit ourselves to ensuring that as Canadians live longer, they also have the opportunity to live better.

The Canadian Federation of Nurses Unions calls on federal, provincial and territorial governments to join nurses, health care workers and stakeholders to re-examine how we care for our seniors, and to invest in innovative strategies and best practices to ensure that Canada represents the leading edge of seniors’ care today and into the future.

Our loved ones deserve nothing less.


Watch the CFNU’s recent live panel, Aging Reimagined: