“Could be worse. Not sure how, but it could be.”
Thinking of the fiasco that is long term care in BC/Canada it is hard to imagine a more perceptive observation than this aphorism by Winnie-the-Pooh’s often pessimistic friend Eeyore the stuffed donkey.
It is difficult to imagine, indeed, how long-term care could have gone further wrong: institutions of supposed “care” leading the way in the COVED-19 death count; institutions that are supposed to be our frontline care providers being the frontline in spreading the deadly disease; institutions of supposed frontline care being the last to provide meaningful information to public health officials, clients, staff and the public; deaths that don’t get noticed let alone reported for over a day, inexperienced relatives of clients pressured into picking up services that inadequate, exhausted staffing can’t possibly provide; clients sitting in soiled clothing for extended periods because there is no one available to clean them up; workers paid such low wages for professional services they are forced to work a more than one centre thus assuring the rapid spread of disease from one institution to others; the army called in because there is no one else in Canada who is able/willing to work in such depressing and dangerous circumstances.
Yes, Eeyore, it could be worse but—as you say—it is most difficult to imagine how.
The thing that is particularly stinging to me is I have a personal connection to this unfolding tragedy in BC. My son and family live a few blocks from the Lynn Valley Care Centre(LVCC) and from my visits with them I have developed a friendship with someone who until recently was a LVCC staff member. Despite the meager income, I know she valued working there partly because she lived in nearby North Vancouver and partly because she felt good about assisting those who needed her help. She was not planning to resign after the news about LVCC leading the way in BC COVE-19 deaths but the inability to find out what exactly was going on and what management was doing to ensure necessary services while protecting clients, their visiting family members, and staff aroused more anxiety than she could handle.
While Eeyore might have trouble imaging how COVED-19 management could have gone worse than it did at LVCC, LVCC BC COVED-19 mismanagement is simply one particularly poignant example of the failing of for profit long term care in BC/Canada.
What were they thinking? The very most fundamental purpose of for profit corporations is to make money for investors. As we see so clearly in this crisis, the point of for profit corporations is not about serving clients nor protecting the public interest/health—it is about providing the lowest cost services to provide the highest possible return to investors. If it could be a more fundamentally flawed management strategy for providing quality care, it is hard to imagine how and impossible to support with examples.
For profit interests at LVCC meant that vital information about COVID-19 spreading to staff was not communicated to employees until desperate for information a small group of them confronted the centre’s director of care. Only then did they learn that one staff member had already tested positive for the deadly virus.
According to my friend contracted out wages at LVCC are so low that employees have to work a several institutions to pay rent and buy groceries. It was this working at several sites that brought the virus to LVCC that soon became the site of Canada’s first COVED-19 fatality.
The situation became desperate. Relatives of LVCC clients felt compelled by the dire circumstances to help out with essential chores that would otherwise have been neglected—despite Vancouver Coastal Health’s warning of the need to restrict visits to one resident only.
Information from management remained mum at a time when there should have been clear instructions on what employees of LVCC and its subcontractors needed to do to be compliant with instructions coming down from the now alarmed public health authority.
Information, when it did come, was filtered (garbled) though various levels of LVCC management and subcontractors. What was hardest for my friend was the uncertainty about flawed information and the uncertainty of bringing home the virus to family and friends. Overcome with the pessimism of Eeyore she did her two weeks of isolation and quit.
As Eeyore observes so poignantly, it’s hard to imagine how it could be worse. It is very hard to imagine how those who instituted the privatization of care homes could have thought it would do anything other than get worse for clients and employees. Surely it did not come as a surprise when in 2012 LVCC ditched the union and turned staffing over to a private firm that laid off employees then rehired them at $2 less per hour; cut sick days to a third of what they had been and halved paid vacations. It’s just what private ownership does; cuts services to pay for profits to investors. The well being of clients and staff is minimized to optimize return on investment.
You might ask yourself what was the BC Liberal government thinking when in 2002 it allowed long-term care homes to contract out services. But you know they were clearly not thinking about the well being of clients and staff and now it turns out they were not thinking about the implications for the lives and health of BC residents. As it turns out they were completely off in their thinking that cutting the conditions for quality services was good for business—generally. While a few companies made big profits and amassed huge real estate portfolios for a few years, the BC economy is now in the tank. Most businesses are bleeding and many will go under because the short term profits of a few companies was put before the well being of those needing long-term care and before employees that need to make a living wage and before the economic well being of businesses that cannot prosper in an environment where we all have to stay home and go out only for short shopping trips to buy essentials.
It could get worse—while, as Eeyore suggests, that is most difficult to imagine; you know it will get worse if the BC Liberals get back in government because that is the only value they actually care about—short term profits for corporations.