A Prescription To Reform Canada’s Broken Eldercare System
A Prescription To Reform Canada’s

Broken Eldercare System


80% of COVID-19 deaths in Canada occur in people over 70
Canada's health care system is often cited as an example to other countries. Canada’s Kovid-19 response is more ideological and science-based than countries like the US or the UK. Its biggest failures during the ongoing epidemic were ruthlessly exposed: the unacceptable rate of Kovid-19 deaths among the elderly living in long-term care facilities.Many adults die alone, without family or friends, and often without palliative care. And no one was responsible for this deadly outcome.

How did Canada fail to protect its elders? Has the country with large elderly and aging populations failed to learn from other countries (especially those who died quickly in the epidemic of European countries) and taken basic measures to protect seniors from Kovid-19? Why the Canadian Healthcare System ignores the needs of adults and the organizational care model, on home-based care, is highly preferred by seniors. Is Canada eligible for palliative care and medical assistance at the time of death?

By reading Andre Picard without neglect, my answers came. Andre Picard is an award-winning health columnist at The Globe and Mail, Canada's national newspaper and author of six books. Named the Canadian Public Health Association Canada's first "public health hero", Picard is highly regarded for his health reporting and policy analysis.

Neglect is a more powerful, well-researched, eloquently written book that gives its adults in Canada a deeper understanding of why and how they fail. It shows how the root causes of the current crisis have long been clear before the outbreak. I interviewed Picard to understand the bigger picture and understand his recipe for improvement.

Not yet overlooked: An urgent need to improve the lives of Canadian adults ... [+] Pandemic, Andre Picard, 2021, Penguin Random House Canada

Andre Picard
On Madhukar: Andre, before Canada's first lockdown in March 2020, you sounded the alarm and warned that senior care facilities could be particularly vulnerable to Kovid-19. Your worst fear arose later. Your book shows how cluttered and under-regulated Aldercare is in Canada with infrastructure and accountability. This may come as a shock to people outside of Canada as Canada’s universal health care system is receiving high praise around the world. Can you explain why Canada has failed at ElderCare on universal health care and many other social security measures?

Andre Picard: Canada is one of the lowest rated universal health care systems in the world. The publicly funded health insurance program covers 100% of hospital and physician care, but only a fraction of other health services, such as home care and long-term care. Although we do not have private hospitals in Canada, half of long-term care homes are run privately. Despite subsidies for some 'hospital-like' services, care home residents can pay anywhere from $ 200,200 to $ 15,000 per month. Those who cannot pay are usually kept in a ward room with 3-4 rooms. Canada has a Social Security Network, but it is gone.

On Madhukar: As you point out in your book, hundreds of reports and commissions have pointed out systemic problems in the elderly and the epidemic has only revealed these. For a country with such a large population, why age and neglect? It is an aging country and by 2030 about one-third will be Canadians. Why don't policy makers and people see this as their problem? After all, everyone needs age or help, sooner or later.

Andre Picard: Historically, adults have a) families, b) religious-based charities and, c) the workload for the homeless, through a penal system. We never shy away from whirlpools, which only occasionally cause problems when a crisis arises. To make matters worse, public policies are not in line with the realities of the new population, such as the aging population and small families. This is far more harmless negligence than malicious negligence, but the end result is the same.

On Madhukar: Aging at home, and dying with dignity at home, is what everyone wants as you say in your book. I know I like that too. So, why is institutional seniority so important in Canada? Explains the lack of attention to home-based care and support?

Andre Picard: Canada's health system is very hospital - centered. The home care program is mostly an extension of intensive hospital care; This allows patients to get out of bed quickly and easily. As a result, the home care model is very work-oriented, and has strict limits on hours - no one can receive more than 90 hours of care every 30 days. It is not suitable for high need senior citizens, so the default situation is institutionalized. There are also political facts: buildings appear, ribbon cutting ceremonies are good political photo-ops. Works invisibly in the context of home care.

Andre Picard is a health columnist and ... [+] author of six books in Canada's national newspaper The Globe and Mail. Follow him on picardonhealth

Andre Picard
On Madhukar: Is Canada enough to ensure the quality of death? How is Canada medically assisted in dying? What reforms are needed in this area?

Andre Picard: Hospital deaths are the leading cause of death in Canada, another example of the health system being hospital-centric. Between 16% and 35% of Canadians eligible for palliative care actually have access and vary greatly by commu