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Dementia care needs to be at the forefront of LTC reform

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Joanna Carroll

With high vaccination rates in our long-term care homes, the devastating blow of the pandemic for seniors and their families appears to be behind us. 

But as we loosen COVID-19 restrictions and reopen the province, we cannot lose sight of the promises we made to improve long-term care homes. While changes are certainly needed (and coming) to prevent devastating outbreaks in the future, if we want to truly build back stronger for our seniors, dementia care must also be part of the conversation.

Nearly 90% of long-term care residents in Ontario have some form of cognitive impairment, and nearly 70% of seniors are diagnosed with dementia. Still, in a report produced by Ontario’s Long-Term Care COVID-19 Commission, experts found that some homes' medical directors do not have any training in cognitive issues. 

Read: Dementia: Everything has changed, nothing has changed

The Commission points out in their report that long-standing calls for more staff to care for a “population that suffered from more dementia and other complex medical issues'' than prior generations were not supported by a robust plan. 

These gaps in care became glaringly obvious as soon as the pandemic hit. Dementia or Alzheimer's disease was the most common comorbidity associated with COVID-19 deaths in 2020.

Residents with dementia are being underserved. And the gaps are only going to widen, with the number of Canadians who experience dementia expected to double within a generation

Research shows a lack of advance care planning for people with dementia leads to unnecessary hospital transfers and more invasive medical care at end-of-life. This is not only traumatizing to residents and their families, but it also prevents seniors from having the best possible quality of life. 

So how do we protect some of the most vulnerable members of our society? We need a strong plan—one that’s ready to execute and ensures everyone gets the best care. 

To start, we must enhance training and implement a standardized care strategy to improve the quality of life for long-term care residents with dementia. Staff work incredibly hard to care for residents and support families. They deserve to be supported with tools to help them do that. This requires further training staff on how to respond to dementia-associated behaviours in a safe, effective way and to avoid prescribing potentially inappropriate medications

Through working with passionate long-term care teams, I’ve seen first hand the value of support tools to guide staff through best practices and protocols on how to care for people with cognitive impairment. And I’ve heard from them about the impact on seniors in their care.

Educational supports that are designed to address the mental well-being of seniors are shown to have a positive effect on people with dementia, including cognitive functioning and mood. Further, data shows that focusing on training staff to use a “person-centred care approach” to address dementia is linked to a reduction of physical restraints and use of antipsychotic drugs. 

It’s no surprise that when training in cognitive issues is prioritized, it not only improves residents’ health outcomes, but it also makes it easier for staff to do their job. 

But none of the innovative efforts made by long-term care staff to keep residents safe and healthy can be implemented on a widespread scale—and sustained—if they are not supported. 

The Canadian Institute for Health Information found that Ontario long-term care homes experiencing staffing shortages were more likely to have a higher risk of mortality during the first wave of COVID-19. This finding further underscores the need for governments to commit to hiring more long-term care workers, and continue to invest in training those workers on cognitive issues.  

Read: Ontario doctor wants public medical cannabis coverage, citing benefits to dementia patients

Burnout and the often precarious nature of long-term care work affects staff, leading to worker shortages and costly turnover. We know that when workers are equipped with the best tools to do their job, resident outcomes improve and so does job satisfaction. 

The COVID-19 pandemic has shined a big, glaring light on the shortcomings in seniors care. It’s imperative that we take this opportunity to fundamentally improve the way we approach dementia. Anyone who has been touched by dementia knows of the frustration and heartbreak it brings. The well-being of residents with dementia, the staff that care for them, and the family members that love them needs to be at the forefront of long-term care reform. 

We must keep our promise of building back stronger. Our aging population deserves it.

By Joanna Carroll, Chief Administrative Officer and Seniors Care Lead at health tech company Think Research

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