Hill Times June 1, 2020
The Canadian Forces Health Services Group has stepped into the gap in long-term care homes in Ontario and Quebec, and voiced alarm at the state of care for seniors. Thankfully the professionalism and caring of this core group will have a huge impact for seniors trying to live in long-term care, but won’t be able to change the rich companies and boards which are making money off the pain of seniors.
This is what happens when the health-care system is privatized.
In First Nations communities and cultures we use the word Elder. This is not a word used interchangeably with “senior.” An Elder is an earned role with prestige and honour, based on decades’ of learning. Traditionally we treated and cared for our Elders as if they were equivalent to the Minister of Health, with caretakers and supporters. Elders were compensated for sharing their knowledge just like one might pay an expert consultant for their time. Compensation now has shifted to money, just like all other compensation for experts with decades of experience. There may be a lesson from Indigenous cultures to rebalance Canadian society’s perception of seniors.
It is truly ironic that in the past two months governments all over this country figured out how to act quickly, but in this crisis in long-term care, the mantra has suddenly returned: let’s report on it.
Indigenous peoples know all too well what happens when the response to crisis is “let’s study it.” There’s a saying in Indigenous health that we are “studied to death.” May I suggest a lesson from Indigenous health’s experience in attempting to bring about change? Do not let governments respond to this crisis in long-term care with the empathetic commitment to study the matter. There have been all too many reports done already on long-term care.
As any good op-ed writer, I have ideas. Dump the private companies in long-term care, it just leaves a bad taste. The model was attempted, and it failed. Move on. Regulate long-term care funding through non-profit organizations with health expertise.
We will have to face the fact that we haven’t paid the workers enough, clearly. Regulate long-term care through accrediting bodies at arm’s length from governments just like nursing, and with appropriate salary and benefits.
But here’s a thought, and it comes from one of the most successful programs in the past two decades in Indigenous health. The Aboriginal Head Start program was started in the 1990s as a centre-based early childhood education program to rapidly strengthen culture and early education outcomes for Indigenous kids, and in its first decade it had amazing results. The mantra of design for this unique program was ‘this is not a Band-Aid program’ (Band-Aid program being just enough money to keep people quiet but not enough to actually fix the problem). There’s a lesson here—we fund what we truly value, and we won’t fund what we don’t value. The long-term care fix is going to cost. But the status quo is truly horrible.
Another unique aspect of program design was that every Aboriginal Head Start had a board, and the majority of the board members were parents of kids in the program. It had immense returns: immediate accountability to the parents and families who needed the centre to succeed. Regulate that every board of a long-term care home must by law have majority members as family of clients currently living in the care home. This model would ensure accountability of care homes, increase connection of the home to the community, and possibly strengthen family ties as well.
It’s an Indigenous model of closer-to-home governance and accountability, and it’s an Indigenous model of giving time to care for our Elders. Every loss of an Elder is a loss of a library of knowledge and experience.