As the number of deaths from COVID-19 continues to rise amongst seniors in long-term care facilities across Canada, new restrictions are being implemented in Alberta at the advice of the province’s Chief Medical Officer of Health to manage the pandemic devastating our most vulnerable population.
There are over 400,000 Canadians living in residential care facilities throughout the country. The average age of these residents is 82 years old, with many of them suffering from multiple medical conditions and ingesting an average of 10 medications per day. Most of the elderly residents require constant care to assist with activities such as toileting, feeding and simply getting out of bed.
The majority of these seniors, approximately 70%, have been diagnosed with dementia. Identifying COVID-19 in those suffering from dementia is problematic as the diagnosis often relies upon the recognition and reporting of symptoms. Furthermore, older adults tend to have atypical signs of the virus, including the absence of cough or fever.
Residents in nursing homes are also more vulnerable given that they have more compromised immune systems, share common areas and are subject to frequent visitors and workers entering from outside the facility.
Bobcaygeon Seniors Home Suffers COVID-19 Outbreak
The town of Bobcaygeon, a small Ontario community made up of 3,500 people, is the perfect example of just how vulnerable nursing homes are to the COVID-19 pandemic. Pinecrest Nursing Home has fallen victim to an outbreak of the devastating virus, which to date has killed 29 residents, one visiting spouse and infected 24 staff members. More deaths are expected.
Pinecrest Nursing Home is in an old single-storey building. Up to four residents occupy each room separated only by curtains. The facility itself was understaffed long before COVID-19 began to spread in Canada. It was nearly impossible to isolate residents given the space limitations of the ageing building.
Pinecrest Administrator Mary Carr wrote in a statement:
Pinecrest plans for and prioritizes infection control – whether it is the flu or the common cold. Unfortunately, the severity of COVID-19 has presented unique challenges for our staff and our facility. At the beginning of this outbreak, we followed existing outbreak management plans, including the isolation of symptomatic residents. However, due to the size of the home and limited front-line capacity, we have been faced with unprecedented circumstances.
Challenges Facing Nursing Homes During COVID-19
Dr. David Fisman, an epidemiologist who has been studying computer modelling with recent data, describes the risk to seniors in long-term care facilities as “skyrocketing” and “somewhere between 10 to 20 times higher than the same cohort outside long-term care”.
One of the biggest issues in providing care in nursing homes is the chronic understaffing in these facilities. Many individuals employed in nursing homes are immigrants who only work part-time without access to paid sick leave. In these circumstances, it is challenging for them to stay home when they are ill.
Furthermore, some of the nursing home staff are employed at multiple facilities and this can result in workers spreading COVID-19 between residences.
Another issue is that the physical buildings are often dated, which poses challenges for disinfection, physical distancing and isolating residents who become infected.
Nursing homes may also struggle with properly outfitting their staff with personal protective equipment, including face masks.
Alberta’s Tougher Rules Begin This Week
Alberta’s Chief Medical Officer of Health, Dr. Dena Hinshaw, recognizes that there have been several outbreaks in long-term care facilities and has put measures in place to prevent further outbreaks and manage the current ones.
Dr. Hinshaw has ordered a province-wide ban on visitors to long-term care centres, licensed group homes and other facilities to limit the spread of COVID-19. She stated:
I know this will have a profound impact on the lives of those residents and their families; this is not a step that we take lightly. I am asking all Albertans to reach out and support their loved ones through the phone, video and any other means possible.
In an effort to limit exposure across care facilities, Dr. Hinshaw has also announced that workers at long-term care facilities will no longer be allowed to work at multiple locations. There has been at least one case of cross-contamination from continuing-care sites in a staff member who worked at both Father Lacombe Care Centre and McKenzie Towne.
It has also been ordered that all workers will be required to wear masks at all times when providing direct patient care or working within two metres of any individual in patient care areas. This is to protect patients from workers who may not be aware that they have COVID-19. According to Dr. Hinshaw, shipments of masks to long-term care facilities were made available earlier this week.
Continuing care facilities are also required to monitor residents for an expanded list of symptoms that now includes muscle aches and a hoarse voice.
Earlier this week, federal Seniors Minister Deb Schulte also provided new guidelines for all long-term care facilities in the country, including:
- Restricting visitors and volunteers to only those deemed essential;
- All staff, volunteers and visitors are required to wear a mask while inside the facility;
- All facilities should provide training on infection control measures such as proper hand hygiene and use of personal protective equipment;
- Where possible, employees should only work at one facility;
- All “non-essential” outings should be cancelled;
- Residents and staff should follow the physical distancing protocols, including during meal times.
As the province of Alberta’s response to the COVID-19 pandemic is rapidly evolving, we will continue to follow the developments and update any changes in this blog.
In the meantime, our business remains open and operational as the law firm of Cuming & Gillespie Lawyers is operating under the suggested social distancing guidelines recommended by the Canadian government and health professionals.
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