COVID-19 and the Senior Population

The senior population in Canada is rapidly growing, and overall, seniors are living longer and healthier lives when compared to previous generations. According to the Government of Canada, in 2014, over six million Canadians were aged 65 and older, which was 15.6% of the population. It is estimated that by 2030, seniors will reach 9.5 million and make up 23% of the Canadian population. Also, by 2036, the average life expectancy for women will rise to 86.2 years, and for men 82.9 years for men. A large majority of the seniors in the country are also active later in life, with approximately 80% of seniors participating in at least one social activity.

However, 2020 has been a year that has significantly impacted the senior population. Specifically, seniors living in long-term care homes, assisted living, retirement homes, and independent senior living communities across the country. Older people are especially vulnerable to the COVID-19 virus, especially the elderly Canadians living in long-term care facilities. According to the Journal of Aging and Social Policy, by mid-April of 2020, nearly half of the COVID-19 deaths were tied to nursing homes. The high mortality rates were not only the case for public long-term care facilities in the country but also privately owned facilities. The pandemic drew attention to numerous facilities across the country and existing policies protecting seniors. Unfortunately, one of the hardest-hit demographics in the country were seniors.

The CBC published an article in July exploring the number of deaths in seniors’ homes, gathering information from all retirement homes that reported ten or more COVID-10 related deaths between March 1 and May 31, 2020. Unfortunately, the accuracy of the number of deaths may never be known as provinces and territories used different methods for determining whether a death was related to COVID-19, per the CBC. Some jurisdictions required a lab test to confirm the presence of the virus, while others used a combination of symptoms and a likelihood of having been exposed. Overall, deaths occurred within the public, non-profit, for-profit, and private senior living and long-term care sectors.

COVID-19 and the Senior Long-Term Care Sector in Canada

Long-term care homes across the country have been significantly impacted by the pandemic. According to the Canadian Institute for Health Information, at the end of May 2020, more than 840 outbreaks and more than 80% of all COVID-19 deaths occurred at a long-term care home. Compared to other countries, the overall mortality rate with the virus was relatively low, but Canada had the highest proportion of deaths occurring in long-term care homes for seniors. Per the report, long-term care residents accounted for 81% of all reported COVID-19 deaths, compared with an average of 38% in other countries mentioned in the report.

There was also a significant variation among Canadian provinces and territories. May 25, 2020, Newfoundland and Labrador, Prince Edward Island, New Brunswick, and the territories had no reported deaths in retirement homes and long-term care homes. However, long-term care deaths represented over 70% of all COVID-19 deaths in Quebec, Ontario, and Alberta, and 97% of all deaths in Nova Scotia. As a proportion of COVID-19 cases in Canada, about one in five were among long-term care residents.

Canada, as a country, has a higher proportion of seniors aged 65 and older living in long-term care homes when compared to other countries. Also, the population of long-term care residents in the country tends to be older, with 91% of long-term care and retirement residents over the age of 65 and 74% over the age of 80. It was clear that the COVID-19 pandemic made the vulnerable more vulnerable, especially among the senior population in long-term care homes, nursing homes, retirement homes, and other senior care facilities.

Some experts believe the pandemic put a spotlight on the already existing crisis within the long-term care system for seniors. Early in the pandemic, the Canadian public witnessed outbreaks occurring within long-term care homes across the country. Quebec, Ontario, British Columbia, and Alberta were some of the hardest-hit provinces. Long-term care facilities in Quebec made headlines more than once, with 31 deaths at a private long-term facility in Herron, Quebec, and a significant outbreak at in Laval north of Montreal. Two months into the lockdown in Ontario, a long-term care home in Pickering saw 77 deaths from a home that 233 beds. Further investigation into these facilities found poor living conditions, short staffing, and even neglect, which has been a common trend within many long-term care homes across the country.

For-Profit Senior Housing and COVID-19 in Canada

Senior housing in Canada includes government-subsidized and long-term care homes and private pay retirement living, generally speaking. The population is aging; the predictions show a need for 240,000 new spaces by 2046, per an article published by the CBC. The growing demand in senior care has created more investors from Canada and the United States because of long waitlists with long-term care homes and government funding, ensuring steady income. Rent within some of these facilities can reach as high as $6,000 to $7,000 per month because of hospitality services and private pay health care services. Across the country, senior living homes have been consolidated by real estate investment trusts, institutional investors, and private equity firms.

The biggest owners of senior living facilities in Canada are two of the largest healthcare real estate investment trusts in the United States that have ownership with 255 homes. Unfortunately, the countless seniors on waitlists for government-subsidized senior living are forced to now pay for private senior living, sparking the ongoing demand for investment into long-term care facilities. The COVID-19 pandemic pointed out that for-profit facilities in Canada and the United States have lower staffing levels, lower quality of care, and poorer resident outcomes, which was pointed out in an article published by Health Services Research and many other journal articles.

In an article written for the site The Conversation, which exposed the increased number of deaths within the for-profit sector—the author found worse fatalities in for-profit homes than any other type of senior living in Canada. For example, in Ontario, for-profit senior living owns around 54% of the beds, 73% of deaths occurred in these homes. Public homes in the province own 20% of the beds but only had six percent of deaths. Per the article, there were 875 deaths in Ontario’s nearly 24,000 financialized long-term care beds. The information that has been collected over the many months during 2020 has pointed out an increased need for affordable, safe, and accessible long-term care for seniors.

What Happens Next for Long-Term Care and Senior Living in Canada Post COVID-19

According to an article published by Ryerson University, there has been a need for change in Canada’s long-term care system and senior living options for some time. However, few governments have paid attention, and as a result, over 7,000 seniors died in long-term care homes because of COVID-19. The virus spread through nursing and retirement homes across the country. At the time of this article, in July of 2020, over 80% of all COVID-19 deaths were connected to long-term care homes in Canada.

Many organizations have been advocating for change and were not shocked by the numbers, having known what state some of the long-term care facilities were in. The article points out that much of the problem is with the universal health care system in Canada. When the health care system was built 50 years ago, it was for a younger population focusing on access to doctors and hospitals, not long-term care. As of 2020, Canada developed a ‘patchwork system’ where models of care and funding vary with each province and territory.

Some of the challenges that face long-term care and senior living in Canada are ward rooms with four people and an over-reliance on nursing homes. It is recommended that more care is provided at home and in the community. Also, Canada has an underpayment of Personal Support Workers, and most are only offered part-time hours. Most Personal Support Workers work at multiple senior living homes, which contributed to the spread of the virus. More needs to be done to support aging Canadians with a variety of services.

CONTRIBUTORS TO THIS ARTICLE

Marcel Gemme

Marcel Gemme

Author

on January 25, 2021

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