The Ontario government created a COVID-19 Long-Term Care Commission in the summer of 2020. This commission was directed to research and report on the failures that led to a ravaged long-term care system in the province, and provide recommendations to prevent such an outcome in the future.

The report of the commission was released in April, and, as we recently released our own policy report on elder care, we were very interested to see the recommendations. While critics rightly continue to call out years of government avoidance and care home mismanagement which put long-term care in its dangerously vulnerable position, many advocates celebrated the recommendations resulting from the report. We were thankful to see much overlap between the commission’s report and ARPA’s report, and a general focus on listening to and advocating for residents in long-term care and their families.

Here are some of the report’s key recommendations that align with ARPA Canada’s recommendations:

• The report recognizes the need to respect choice in long-term care. Diverse social, cultural, religious, and spiritual choices are explicitly recognized.
• Various suggestions for how to support and increase family and home-based care, including increased home care funding to help those who wish to age at home, are included.
• We recommended that provincial governments designate close family caregivers as essential workers, ensuring they maintain access to visiting their loved ones in care even during times of crisis. The commission’s report makes the same recommendation, recognizing the value of these informal caregivers in formal care settings. The report recommends that anyone who wants to qualify as an essential caregiver should be given annual basic training, such as how to properly wear personal protective equipment.
• Minimum staffing requirements should be implemented for long-term care homes. Training for staff should recognize the increasing medical complexity of long-term care residents as we come to grips with an aging population where people live longer and develop more co-existing conditions. The report recommends funding to train more personal support workers in order to increase staff supply for long-term care homes.
• Long-term care facilities should focus on resident quality of life and engage residents in activities they find meaningful, which includes visits from family and friends. The report calls for residents to have regular access to and assistance with technology, as well as spaces where they can have private conversations.
• A recognition that “mission-driven entities” (p. 13) are best positioned to offer excellent elder care. Both for-profit and not-for-profit models are supported, with the caveat that the owners/operators should be personally invested in providing elder care, not simply managers hired by an outside investment company.

One note of concern is the report’s recommendation that long-term care homes be required to have access to clinicians able to provide “palliative and end-of-life care in the home as needed” (p. 45). As medical assistance in dying (MAiD) is considered by some to be end-of-life “care,” this recommendation may include a desire for all long-term care homes to offer euthanasia on site. The priority given to palliative care access, though, is positive and encouraging, as the holistic approach of palliative care provides emotional, physical, and social support for both residents and their families.

Overall, the report shows genuine care for our elders and concern that they are respected and protected as they walk through a particularly vulnerable stage of life. Critics are quick to point out that the problems in long-term care homes were well known and this type of crisis was inevitable. So there is definitely skepticism – probably justified – about the government’s ability to improve on the state of long-term care in the province when past governments have failed to do so. Indeed, the stalling at the committee stage of the More Than a Visitor Act indicates a reluctance by the provincial government to enact meaningful change.

Nevertheless, the recommendations of the commission’s report are solid and there is a clear desire not to let COVID-19 be a major step backward for long-term care in terms of prioritizing resident quality of life. The more voices that can speak positively into this conversation around elder care the better. We can play a role by bringing a Christian perspective on elder care to our elected representatives and encouraging them to act.