Chair, Expert Advisory Panel
My mum spent the last years of her life cared for at Revera’s Leaside Retirement Home. Sadly, she had suffered a series of strokes that left her bedridden and with grave difficulties communicating. My dad tried heroically to keep her at home with home care, but she needed two people to help her in and out of her bed and wheelchair. She clearly required the congregate living assistance that an organization like Revera could offer.
Dad moved across the street from the Leaside home so he could visit her twice daily without fail. On weekends we would push her wheelchair to the local coffee shop, where Mum would enjoy watching her family chat even though she could not contribute much to the conversation.
My dad also spent the last months of his life in the Leaside home as he went through the final terrible stages of Lewy body dementia. We were surprised that he passed away before Mum, but she left us not long after, with her family around her bed as she died.
When COVID-19 struck a devastating blow to the Canadian seniors’ congregate living sector, several personal reflections surfaced for me. How difficult the visitor restrictions would have been for Dad, as they would have put a stop to the daily visits that defined his last years and expressed his love for his wife. How frightened Mum would have been, missing Dad and finding herself isolated in her room and seeing caregivers wearing masks.
But most of all, I thought about how terrible it would have been for Grace (a pseudonym), the care leader of the team on Mum’s floor. Grace and her team cared for their residents with personal conviction. The thought of being unable to provide the best care for her residents – without provincial testing and without support from the barricaded health system surrounding her – would have devastated Grace.
So when Tom Wellner, Revera’s President and CEO, asked me to help organize an Expert Advisory Panel (EAP) to review the Revera experience during the first Canadian wave of COVID, it was easy to say yes. We were fortunate to recruit national and international experts in public health, infection prevention, infectious disease, geriatric care, labour/management principles and architectural design to serve on this EAP.
These esteemed panel members did their jobs well. They demanded transparency from Revera’s team, and they got it. Revera’s governing board was well represented at panel meetings. The board’s representative insisted that the panel should push management for everything the panel needed to critically evaluate the Revera experience during the first wave of this pandemic.
When, after nearly three months of investigation, the experts presented their advice in the dry, clinical and scientific prose that we would expect, Revera commissioned a respected journalist and author to create this document: an accessible report that is mainly for the families of seniors who had been so isolated from their loved ones while COVID-19 turned all our lives upside down.
Although I’ve worked in the Canadian health system for more than 40 years as a surgeon and an administrator, I nonetheless learned a tremendous amount from chairing this panel of wise experts, who gave their time generously and provided Revera with important advice. The panel met bi-weekly and it was always difficult to complete our agenda in the time allotted, since every member completed their homework between meetings and came ready to contribute.
The answers as to how this COVID tragedy occurred in Canadian seniors’ congregate settings, and specifically in long term care homes, are complex – but the reasons for why it happened are clear. In the health system’s preparations for COVID, seniors’ homes were forgotten in the push to ensure that our hospitals were not overwhelmed. Our public health response was fragmented and confusing – especially in Ontario, where our Revera panel focused most of its attention. The province did not initiate testing of residents and staff in our homes until months following COVID’s arrival, after most of the deaths in seniors’ home had already, tragically, occurred.
Finally, COVID exposed longstanding weaknesses in Canadian seniors’ care. Some homes suffer from shortages of personal support workers and nurses, and many of our buildings were proven to be unsafe for congregate care. Managing an insidious virus that spread, often asymptomatically, both in the communities where personal care staff lived and in the four-bedded rooms where some residents slept, was an impossible task.
This report was being finalized as Canada heads into a second COVID wave and outbreaks are returning to seniors’ homes. We hope this report will be useful to Revera and other operators, and we know that the excellent team at Revera will continue to learn and improve day by day in the company’s continuing response to COVID. We understand that no management team can prevent this virus from getting into a seniors’ home if the disease is already highly prevalent in the communities where staff live. We hope the report will be useful to residents and families in understanding the challenges that COVID has presented.
But most of all, I hope this report is read by Revera staff and all the healthcare workers who put their lives on the line caring for our loved ones during COVID. The vast majority of these people went to work worried for their health and their families’ health. Having experienced how Grace’s team looked after my parents with such personal commitment, I am also sure that their fears were magnified by the moral distress they would experience when they could not adequately protect their residents.We need to do better for our parents and grandparents. We also need to do much better for the people who look after them. From my perspective, this report is dedicated to Revera’s employees, residents, their families, and everyone on the front lines of the senior living sector who are working through the worst pandemic in living history. Thank you for what you do.
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This report is dedicated to Revera’s employees, residents, their families, and all those on the front lines of the senior living sector who are working through the worst pandemic in living history.
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