Elise Stolte: The tragedy lives on. If we value our oldest, we'll put in effort to actually fix continuing care

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Tragedy is defined by small moments and raw emotion.

After three months of interviewing seniors and their families about the pandemic, several of those stand out. One is the anxiety: Don Brown calling his daughter 30 times each afternoon, wondering why she’s not visiting as his brain struggles to understand the masks and tension in his dementia ward.

Then there’s longing and tenderness: Laurence Babiuk, pre-pandemic, quietly entering his wife’s long-term care room to simply hold her, cuddling on the bed.

I still choke up thinking of Heather McKeown on the phone with the doctor, with only minutes to decide whether, with asthma, she should risk her life to see her mom or let her die alone. What a complicated grief.

These are memories that live on.

Did it really have to be this way? No, I don’t think so. That’s not necessarily to blame the health and government officials making quick decisions as a mystery virus loomed. There’s a bigger issue here, a structural one. And if we value our oldest the way we value our youngest, we’ll put in the time and energy to figure it out.


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We’ve created a system that pushes people into an overburdened institutional care system, even when they and their families want them to stay at home. For home care, Alberta Health Services contracts with large private companies whose staff are run ragged trying to get from house to house to perform a series of small tasks. It’s often not enough. People are burning out trying to care for a spouse or a parent in addition to their other responsibilities.

But we know there’s a better way. In a recent AHS Edmonton Zone pilot project (The Invoicing Model), officials found they can actually save money by spending more to prevent caregiver burnout.

That pilot project was brilliant. I shared the results in Part 1 of Cracks to Chasms on family caregivers. AHS substantially increased the number of hours a caregiver could have someone come into the home to spell them off, and at the same time allowed clients to book all their care directly with the company or worker of their choice (rather than through AHS-contracted private companies).

At the end of the project, 57 of the 66 people at highest risk of being forced out of their homes were still there.

The pilot cost on average $37,600 per year per client. But a long-term care bed costs the health-care system $75,000 a year, in addition to the room and board paid for by the resident. When you look at it that way, it’s clear why many OECD countries spend a larger percentage of their elder-care budget on community-based services than Canada does.


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Of course, some people want to move into assisted living, and then up into higher levels of care as they need it. That can be less lonely and ideally, it means professional help is close by if someone needs it unexpectedly.

But in older facilities with semi-private rooms, viruses spread quickly. And even pre-pandemic, only 18 per cent of family members of residents in long-term care told the Health Quality Council of Alberta there was always sufficient staff on site.

Plus, the cost to residents varies widely and doesn’t seem transparent or well-regulated. For example, when Linda Tymchuk needed a place for her father urgently, the for-profit dementia care centres she toured varied in price from $3,800 to $7,800 a month. He ended up paying $5,000, then moved to a public facility as soon as space opened.

There he pays less than $2,000, she said, and seems more calm and happy than he has been in years.

It’s unclear why price varies so much. The health-care portion is paid for by Alberta Health, yet union officials privy to negotiations say health-care aides make up to $5 less in some private facilities.

Sandy Sereda
Sandy Sereda, executive director of Caregivers Alberta. Photo by David Bloom, Postmedia.

A long-awaited provincial review is ongoing and much needed. Officials surveyed the public in January, interviewed stakeholders and are due to release an update this spring. New legislation has been promised for the fall.

At Caregivers Alberta, executive director Sandy Sereda is hopeful. “COVID has brought caregiving more to the front of conversations than it’s ever been before. (Government officials) are reaching out and asking hundreds of agencies for input.”


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Sereda’s organization supports people trying to care for a loved one.

Unfortunately, the cabinet communications team cancelled the interview I set up with Richard Gotfried, the MLA overseeing the review, and the promised replacement interview with Health Minister Tyler Shandro didn’t materialize. When I squeezed a question in at an unrelated news conference, Shandro said the changes will make the continuing care system “more patient-focused rather than institution-focused … (with) more supports and more care for residents.”

I hope Sereda is right to be optimistic. I hope ideology doesn’t create blinders, and those writing policy listen to residents, family members and front-line staff as much as facility operators and shareholders. I really hope all the pain and heartache experienced by our older seniors during the pandemic finally moves us to action.



This article is part of Groundwork, an Edmonton Journal pilot project in engagement journalism that saw more than 700 seniors, caregivers and family members contribute through surveys and emails this winter to help shape our coverage. This was meant to ensure our reporting was focused on issues that matter most to our community, building trust and opening the work of journalism to new voices and insight.

Read more at edmontonjournal.com/groundwork. Our final series on COVID-19 and continuing care ran Tuesday through Friday this week. As a final event, join us live for a Q&A at noon May 4 with Caregivers Alberta.

Help us evaluate the project and plan next steps here.


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