Deficiencies at P.E.I. long-term care homes worsened impact of COVID, report says
'Capacity to provide safe and effective care was compromised,' especially at onset
P.E.I.'s long-term care homes "were not sufficiently prepared for a pandemic" when the COVID-19 crisis began, leading to the quality of care for residents deteriorating, according to an external panel appointed by the provincial government.
The panel headed by mediator and retired lawyer Michele Dorsey reported on its work Thursday, after interviewing and surveying long-term care residents, operators, staff and unions as well as health administrators and Island families who had loved ones in the system.
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"It was traumatic," Dorsey said in an interview. "People struggled to provide care that they felt was safe. Residents felt their world had fallen apart. Sometimes they were confined to their room for 14 days at a time, not able to leave a small space. The impact of that for a senior is significant."
The report's executive summary said the impact was particularly bad during the first six months when the virus was deadly and there was no vaccine.
"In interviews with us, many people spoke of the traumatic impact of attempting to work safely amidst the threat of mass mortality in the long-term care system," the report said. "This fear was well-founded and not exaggerated, as LTC homes in other provinces reported critical conditions, resident deaths, and staff infections."
The report said many people who were interviewed said "the LTC system was deficient in several areas prior to the pandemic, which worsened the impact of COVID-19."
Two of those areas were staffing levels that "had not kept pace with the increased complexities of today's resident population," and the fact that neither the homes nor the province's health-care system had the data needed "to manage the system or a major event such as a pandemic."
'Worsening frailty' as activities limited
As well, the report went into detail about how the lockdowns and the elimination of visits at the start of the pandemic left residents distressed and damaged their physical, social, and mental well-being. Residents couldn't move around within their buildings, let alone leave them for outside gatherings and appointments, and family visits were eliminated for a time.
"Reduced activity resulted in worsening frailty, and also increased time in bed that contributed to reduced mobility, changes in skin integrity, and increased falls," the report said.
It recommended that in any future infectious disease plan, administrators should strive "to balance residents' right to live at risk with the rights of others to live in safety," perhaps by letting residents spell out in advance whether they value visits more than 100 per cent protection from a virus.
P.E.I. homes have 1,100 residents
About 1,100 people live in P.E.I.'s long-term care homes, with the beds evenly split between those that are publicly funded and operated by Health P.E.I. and those offered by privately owned and operated homes.
The report made 17 recommendations for improvement, including putting public and private care homes under a single legislative act so that they don't have different accreditation and inspection regimes.
Many people spoke of the traumatic impact of attempting to work safely amidst the threat of mass mortality in the long-term care system.— External review panel report
The panel also wants to see infection prevention and control measures beefed up. One startling finding was that the province didn't ensure private care homes had access to assessments from a registered nurse with extensive infection prevention and control (IPAC) experience until February 2022 — nearly two years after the pandemic began.
The review panel also urged the province to make sure staff are treated and compensated fairly, no matter where they work.
One resident's partner-in-care described feeling sorry for overworked LTC workers at one home, seeing "stress and sadness sketched on their faces."
As the pandemic wore on, the panel said staff vacancy rates were regularly 30 per cent or higher, and "COVID-19 outbreaks among staff resulted in further absenteeism that destabilized operations."
When the COVID-19 pandemic was declared in March 2020, the report said, P.E.I.'s long-term care homes were already facing challenges that included:
- Staff levels that were "insufficient to balance the demands of the pandemic with resident care."
- Operators were having a hard time staffing their facilities due to "restrictions on staff mobility between workplaces."
- High stress levels that led to workers feeling burned out and leaving the long-term care field entirely.
"We heard accounts of health-care providers working with little sleep, stricken with concern that residents and coworkers might die if the virus infiltrated the homes' defences and afraid for their own and their family's safety."
The report noted: "The LTC sector experienced not only death but suffering, fear, uncertainty, and, at times, hopelessness. We have done our best to honour these experiences."
The panel did not provide a listing of how many illnesses and deaths were linked to COVID-19 among P.E.I. long-term care residents and staff. Dorsey said that was not part of the group's focus.
'Crucial' that province act soon, Opposition says
In a news release Thursday afternoon, Liberal Leader Hal Perry said the review is a step in the right direction, but called on the government to put the recommendations in place immediately.
The King government cannot take its typical wait-and-see approach," Perry said.
"It is crucial for the government to begin immediately implementing recommendations from the report to provide resident-centred care; address workforce recovery, recruitment, and development; strengthen infection prevention and control; and improve oversight and accountability."
The Green Party pointed out that Premier Dennis King originally promised this review would be finished by early 2023.
"The report, and its delay, raise questions about government's commitment to the well-being of Island seniors, as well as government's ability to implement and enforce provincial and national long-term care standards," Green Leader Karla Bernard said in a news release.
Health and Wellness Minister Mark McLane thanked the panel members for their work in a news release issued as the report was made public.
"I am pleased that our department is already working on many of the initiatives noted in the report, and look forward to sharing more on this progress as we move forward," he was quoted as saying.
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