We appear to be having a moment of clarity. On Tuesday, Ontario Premier Doug Ford decreed long-term care workers could no longer work in multiple homes, not in the age of the coronavirus; the province will redeploy nurses from the hospitals which are not yet overrun. Ontario’s public health officials will finally roll out more coronavirus testing for long-term care homes Wednesday. The federal Minister of Health, Patty Hajdu, talked about reimagining how we value those who care for people, and how we should let people grow old.

“The silver lining for us is for us collectively, with the province and territories, to think about how we will make sure that everyone has an opportunity to age in dignity with the care that they deserve at the end of their life,” Hajdu said. “I think that this is an opportunity for Canada to think about how we value those who serve the most vulnerable in our societies.”

Dignity. Care. We are told to respect our elders. Some of us, at least.

But Hajdu’s idea raises bigger questions, and the biggest is this: what is the worth of a life? What of a life at the end? What do we deserve?

When we put parents into long-term care homes, we put them away. That’s a hard way to look at it, but it’s often what it is. We choose the best care we can afford, or they can. If they had a good pension, maybe they can afford a place with decent food. If they didn’t, maybe they shared a room. Baths might be infrequent. Staff is likely limited, even when they try their best.

Either way, life gets harder, and we put them away, and we hope they are taken care of.

This has ruthlessly put the lie to that. The COVID-19 pandemic provides a mirror. The homeless; First Nations reserves without clean drinking water; migrant workers; prisons. The most vulnerable have the fewest defences.

And worst of all, long-term care homes for a virus perfectly built to prey on the elderly. We are already learning which ones were the worst, the darkest. Pinecrest in Bobcaygeon, where 29 died. Eatonville Care Centre in Etobicoke, where at least 27 have died. Seven Oaks in Toronto, 22. Of Ontario’s 626 long-term care homes, 114 are infected. Participation House in Markham announced Tuesday that 37 of 42 residents are infected, plus 12 staff. Those are the front lines.

And in Quebec, Herron in Dorval, where staffers abandoned their posts, and 31 died. In La Presse, it was reported that geriatric specialist Dr. Nadine Larente arrived at Herron to find residents dead and discarded, and immediately called her family to help. Her husband and three teenagers came to feed residents; her 17-year-old daughter stayed there until 1 a.m. There is heroism in some people, and astonishing grace.

But the weaknesses in the system have been apparent for over a decade. The SARS report in 2003 mandated nurses should work in one facility only, but many long-term care workers — as many as 50 per cent — work in multiple facilities. B.C. banned the practice on March 27, over two weeks ahead of Ontario and Alberta. Facilities heavily rely on personal support workers, or PSWs, who are not medically trained, and start at $15 an hour. You can say they should be paid more, which is true.

The system, though, often stretches those PSWs, and doesn’t include enough medical supervision and care. In the face of COVID-19 — which stresses actual hospitals — and with either limited personal protective equipment or limited training in how to use it, is it any wonder that someone making $15 per hour would, faced with the nightmare of a sudden sea of feverish and deathly ill residents, simply walk away?

“Think about how quickly the patients will go downhill, and they absolutely know that they aren’t equipped to look after them, and (if) the hospitals won’t take them, then they have to look after them in place with no skills at all,” says Joy Parsons-Nicota, who has 45 years of experience as a registered nurse, a nurse practitioner, and as a nurse-educator at the University of Ottawa, specializing in geriatrics, and who also recently spent three years working part-time at a Kingston long-term care home. “You wouldn’t treat animals like that. No pain medication, no IVs when they’re dehydrated.

“I had been working part-time as my retirement gig in long-term care, and ... it made me physically and mentally ill. I saw so many good nurses come and go, and what a tough challenge the PSWs had, and what we ask of them: if a family member couldn’t look after a family member with dementia, they would bring them in and one PSW with eight-months training would be asked to look after eight to 10 people with dementia, get them up and washed and to the dining room and fed, all for $15 an hour.

“I saw such a change in long-term care in the last 20 years, and the cutbacks.”

Less and less nursing care. Elderly people who become more frail while on waiting lists. A system that runs near capacity, but without the same level of funding and commitment as hospitals.

So Tuesday, Ford announced the province would spare no expense, and would send nurses. Hopefully, they aren’t pulled away. Maybe this system will all be reimagined after this is over, and we will treat the elderly with the dignity and care they deserve, in preparation for generations without as many pensions, or home equity. We will have to find a way to pay for that.

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My father had dementia and we put him in long-term care, and the last time I saw him, he had a moment of clarity. How are you, I said. Sad, he said. Why? I said. Getting old, he said. It was a rarity, that clarity, in the occluding fog of the end of his life.

It’s hard, getting old. We can do better. It was always clear, but never more than now.

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