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A Call for Pansystemic Change in Canadian Long-Term Care

May 27, 2020 by Rudy P. Friesen MAA (ret.), FRAIC, Hon FAIA, LEED AP
Rudy P Friesen, is the founder and Partner Emeritus of ft3 Architecture Landscape Interior Design. A retired architect and advocate for aging better in community, he continues to be a tremendous advocate for change in how we, in Canada, care for our elders. His interest and research in ‘elderhood’ has led to numerous conference presentations around the globe.

Exposing the cracks

In a few short months, COVID-19 has achieved what no individual, organization, or advocacy group was able to do in decades, and that is to fully expose the cracks in the way we care for our older adults. Before this pandemic, media reports would appear almost daily describing a broad range of problems in Canada’s long-term care facilities. But nothing changed.

Now we are learning that more than 80% of COVID-19 deaths in Canada are connected with long-term care and seniors homes. These homes are being called “death pits.” Horrific problems are being described in detail. Lately we’ve heard calls for everything from government ownership, to more public funding, to national standards. But so far, the solutions offered do not go beyond tinkering. Yes, staff remuneration needs to be boosted, multi-resident rooms need to be eliminated, and adequate PPE and testing need to be provided. And yes, the care of our elder population must be made a higher priority by our governments. But these are all missing the point, veering away from the fundamental issue.

What we really need is pansystemic change – culture change, policy change, design change, care delivery change – to achieve (1) better quality of care for our older adults in a (2) more economical way, one that doesn’t bankrupt our economy or our citizens, while providing (3) freedom of choice to those who need care. There are good examples that point the way.

Link to the complete white paper.