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Widening the Story – Artifact 3

Long-term care facilities during COVID-19

Slark and Charlebois call for an end to all residential institutions, including long term care (LTC) institutions. As of 2021, there were 626 long-term care facilities in Ontario serving over 77,000 residents.1(footnote) As disability scholars Liat Ben-Moshe, Chris Chapman, and Allison C. Careyhave written in their book, Disability Incarcerated: Imprisonment and Disability in the United States and Canada, these institutions, which confine people and intervene in their lives, exist to disappear all those who do not fit “a narrow conception of normalcy.”2(footnote) COVID-19 has exposed the dehumanizing and death-making role of institutions. Studies show that during the first wave of the pandemic in 2020, LTC residences were the site of over 80% of COVID-19 deaths in Canada.3(footnote) According to one Ontario study, as of January 14, 2021, 7,090 long-term care residents contracted COVID-19 and there were “3,211 resident deaths, totaling 60.7% of all 5,289 Ontario COVID-19 fatalities, and ten LTC worker deaths.”4(footnote) As of Oct 28, 2021, CBC reported 3800 residents of long-term care facilities in Ontario had died due to COVID-19.5(footnote) Despite the outrage and grief about the injustice,6(footnote) the provincial government has allocated 60% of government contracts for building new long-term care facilities to for-profit operators.7(footnote)

The high number of fatalities in long-term care facilities was not an unexpected crisis, as the news reported, but “the product of a long-standing, routinized pattern of quotidian policies and practices.”8(footnote) Triage practices and protocols in many places around the globe led to prioritizing the lives of those deemed most productive to society, leaving many elderly to suffer the course of the pandemic on their own.9(footnote) Despite the Canada Health Act (CHA) that governs health insurance in Canada “to protect, promote and restore the physical and mental well-being of residents of Canada and to facilitate reasonable access to health services without financial or other barriers” (Government of Canada 2020), it is the provinces that have jurisdiction over long-term care. According to the Registered Nurses’ Association of Ontario, since 2010 (one year after the closure of Ontario’s largest institutions for people labelled with intellectual and developmental disabilities) only people with “high or very high physical and cognitive challenges” have been eligible for admission to long-term care homes in Ontario.”10(footnote) As a result, currently 90% of residents have a form of cognitive impairment and 86% need assistance with daily living. Yet, as medical anthropologist Ellen Badone has shown, Ontario Premier Mike Harris seriously undermined the care residents receive through his deregulation of LTCs and his significant spending cuts to social services between 1995-2000.11(footnote)

During the COVID-19 pandemic, conditions for residents deteriorated when their loved ones could not provide support and social connection.12(footnote) Many family members believed their loved ones died from “total neglect” (not enough nutrition and hydration) due to understaffing —not contracting COVID-19. The separation of residents of institutions from their families, friends, and loved ones is deeply problematic and an ongoing point of advocacy for survivors of residential institutions, who wish to have care from those they know and trust integrated in their long-term care home living.

In responding to the criminal conditions of Ontario’s long-term care during the COVID-19 pandemic, Remember Every Name describes the conditions in these facilities as “eerily similar to those once seen at the Huronia Regional Centre and this makes it clear we must continue to move away from institutions and toward community based models of care where all people can live in real homes and individualized support is provided so that families can stay together and no child has to be set apart.”13(footnote)

Footnotes

  1. Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,” Medical Anthropology 40, no. 5 (July 4, 2021): 389–403, p. 392, (Source). ↩

  2. Liat Ben-Moshe, Chris Chapman, and Allison C. Carey, eds., Disability Incarcerated: Imprisonment and Disability in the United States and Canada (New York: Palgrave Macmillan US, 2014), 6, (Source). ↩

  3. Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,” 389. ↩

  4. Nathan M. Stall et al., “COVID-19 and Ontario’s Long-Term Care Homes” (Ontario COVID-19 Science Advisory Table, January 20, 2021), 5, (Source). ↩

  5. Mike Crawley, “Solution to Long-Term Care in Ontario Is Not More Legislation but Stronger Enforcement, Say Advocates,” cbc.ca, Canadian Broadcast Corporation, October 28, 2021, (Source). ↩

  6. Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,”391. ↩

  7. This comes as studies show for-profit long-term care facilities during the COVID-19 pandemic held greater risks of fatalities for residents due to a myriad of reasons, including less hours of care for residents, less money allocated to the care of individuals in residence, overcrowding, less equitable working conditions, and lower pay for staff. See “Ontario Making Historic Investment to Modernize Long-Term Care,” ON government press release, accessed November 3, 2021, (Source), and Mike Crawley, “Solution to Long-Term Care in Ontario Is Not More Legislation but Stronger Enforcement, Say Advocates,” cbc.ca, October 28, 2021,; Nathan M. Stall et al., “For-Profit Long-Term Care Homes and the Risk of COVID-19 Outbreaks and Resident Deaths,” Canadian Medical Association Journal 192, no. 33 (August 17, 2020): E946–55, (Source); Michael Liu et al., “COVID-19 in Long-Term Care Homes in Ontario and British Columbia,” Canadian Medical Association Journal 192, no. 47 (November 23, 2020): E1540–46, (Source) ↩

  8. Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,” Medical Anthropology 40, no. 5 (July 4, 2021): 389–403, 391, (Source). ↩

  9. Ellen Badone cites examples in Quebec, California, and the UK. Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,” Medical Anthropology 40, no. 5 (July 4, 2021): 389–403, p. 392, (Source). ↩

  10. Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,” 392. ↩

  11. Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,” 393. ↩

  12. Ann Fudge Schormans et al., “Social Isolation Continued: Covid-19 Shines a Light on What Self-Advocates Know Too Well,” Qualitative Social Work 20, no. 1–2 (March 2021): 83–89, (Source). Ellen Badone, “From Cruddiness to Catastrophe: COVID-19 and Long-Term Care in Ontario,” 393. ↩

  13. “Remember Every Name Survivors Group: Huronia Regional Centre History,” accessed December 3, 2021, (Source). ↩