Chapter Five: Evolving Care for Elders and Needed Health Care Reform
This is an excerpt from the book A Physician in the Political Arena: Ethics, Duty and the Pandemic. The final chapter showcases potential solutions for elder care and improving health care in our country -- drawing from the lessons learned in the pandemic and assessing the current state of long-term care. It is a diagnosis for evolving care for the elderly. In this parting chapter I advocate for improved elder care: commitments for health care investments in infrastructure, staff increases in nursing and personal support workers, and more research into dementia care.
The full text of the chapter can be found online at MerrileeFullerton.com.
Looking forward
My tenure as Minister of Long-Term Care from July 2019 to June 2021 was deeply moving -- on many different levels. Since that period, I served in cabinet as Minister of Children, Community and Social Services. In June 2022 I was successfully re-elected in the provincial election, and then in March 2023 I departed Queen’s Park and exited politics.
Today I am focused on making meaningful contributions to the public discussions on elder care and the necessary reform of the health care system in Canada. It is important to bring forward what we have learned from the COVID-19 pandemic and to have a dialogue about potential solutions for elder care and improving health care in our country.
I will be carrying forward my experience to advocate for improved elder care: commitments for investments in health care infrastructure, staff increases in nurses and PSWs, introduction of new technologies and more research for an aging population, including research for dementia care.
Canada’s health care system is in urgent need of reform – not just some tinkering around the edges but a substantial review and revision that will transform health care to sustain Canada’s aging and growing population.
A society is judged by the way it treats its most vulnerable, including people in their last years of their lives. For an advanced country such as Canada, our elderly deserve the best that our society can offer -- and this should be held as a prime objective.
In Ontario the average length of stay for a resident in a long-term care home is less than two years, and the average age of a resident is 84. The Long-Term Care COVID-19 Commission of Ontario was informed that approximately 22,000 people die in long-term care every year. The provincial government -- and our society -- needs to focus attention on how our elderly can be best cared for with dignity and respect in their last years of life.
It is remarkable that long-term care homes and the challenges they face do not garner more attention. With a growing number of residents who require complex care, our long-term care sector needs to be a topic of considerable discussion within governments, health care advocates and community groups. It has a direct impact on the overall functioning of acute care, community care, and the well-being of families. Long-term care absolutely needs to be considered central to finding solutions for the reform of Canada’s health care system.
The solutions for elder care must also include a robust system for palliative care. It is disturbing that the federal government offered assurances for a national framework and action plan, but failed to establish any right to palliative care. Instead, it legalized euthanasia and is extending the right to euthanasia. Throughout Canada, access to palliative care remains problematic while, at the same time, it has become easier to seek support for medically assisted death.
Canadians need to debate the issues on accessible health care. This book is a first step to regaining my voice in the public arena to advance improved elder care and to call for much needed health care reform….
Advocating for elder care and reform of health care
Health care is in crisis and will be in crisis in Canada for years despite efforts now being made.
It must be acknowledged that we are not done with COVID-19, and SARS-CoV-2 is not done with us.
Here is a quick overview of the issues I will be raising with the hope they may prompt further medical discussions and insights into the actions and necessary reforms that are so urgently required. My central concerns remain with elder care and the state of long-term care in Ontario, and throughout the country.
There are six main areas of concern I plan to address in my writings and presentations.
The impact of COVID-19 and Long COVID
Assessing the state of long-term care
Improving long-term care
Government objectives for long-term care
Improving care for elders
The urgent need for reform of Canada’s health care system
You can read Chapter Five: Evolving Care for Elders and Needed Health Care Reform here.