Prelim senior care report shows organizational lapses, data problems, structural flaws

Broad disorganization of care and information lapses to those responsible was partly to blame for many of the more than 5000 first-wave deaths in Quebec CHSLDs according to the preliminary report of Quebec’s health and welfare commissioner (CSBE) Joanne Castonguay.

Castonguay found in her lengthy report an absence of a strategy establishing a uniform quality of care for seniors, managers without the tools or abilities to manage the crisis and the lack of basic information required to establish staff scheduling or simple material needs.

Castonguay’s report shows how the large-scale human disaster, which resulted in dead, and dying, abandoned seniors lying unfed and unattended in their own waste could have been avoided and noted that many calls for action have been presented over decades to improve the situation with little action. The pandemic simply magnified the already present and remarkable lapses in the system with a fatal result. She also noted the lack of assurance of proper funding of long-term care, and that the previous Barrette health system reform did not improve the situation, noting the creation of Integrated health and social service centres (CISSS) and the disappearance of previous regional health agencies created a lapse in expertise and a loss of important data.

“Without reliable and timely data and without an efficient assessment of the quality of care and services offered to the elderly, the government cannot make informed decisions and put in place adequate policies focused on results for the population” wrote Castonguay, adding solutions such as an “integrated care package” for each patient, already exist and have been repeatedly reiterated by experts, committees and researchers. “Now, we have to find how to put them into practice on a large scale to cope with the aging of the population and its impacts.”

Her final report will be produced before the end of the year and will include analysis of the pandemic management and recommendations.

Reaction by Quebec’s largest health and social services union, the Federation of Health and Social Services (FSSS-CSN), was swift and harsh, saying the report illustrates major gaps in the organization of care for seniors, with several observations in line with Federation demands in recent years. “This preliminary report shows the relevance of having watchdogs to analyze the network” said Federation president Jeff Begley, who also noted “the Couillard government abolished the Health and Welfare Commissioner (CSBE)!... The government will need to listen to these recommendations, because as the CSBE says so well in its report, a better organization of senior care would have placed us in a much better position to face the pandemic.”

The offer of elder care is disparate and there is a lack of consistency and coordination reads a union statement, noting the report found chronic underfunding for people with loss of autonomy; lack of valuation of staff work and mismanagement leads to numerous departures and growing use of private agencies and overtime; chronic absenteeism due to staff overload and stress; and the lack of a comprehensive strategy for improving care.

Read the full report at https://www.csbe.gouv.qc.ca/en/publications.html

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(1) comment

Canadad

Thanks for sharing this extremely important report. It merits further legal investigation of how "partly to blame" this miscommunication and disorganization have been. These deaths represent ~50% of QC covid deaths and ~20% of Canadian covid deaths. These deaths also triggered an unprecedented lockdown and an indefinite state of emergency. Quebec citizens, who have been subjected to involuntary medical intervention and isolation, have a right to know the degree to which government failure is responsible for their current situation.

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