Ford government promises four hours of daily care for nursing home residents by 2024-25

The Ford government has announced a promise to ensure long-term care residents get an average of four hours of direct care a day from personal support workers and nurses by 2024-25.

Premier Doug Ford said at a press conference Monday that the government will increase the time with staff each resident gets by more than 30 per cent and ensure staff have enough time to give residents the proper medication, to bathe and change them, and to assist with calls to family.

"To our residents and to their families and caregivers: four hours a day will make a world of difference," the premier said.

The promise answers a call the NDP and the unions and associations that represent nurses and personal support workers have been making for years. It comes as long-term care staffing levels have been decimated by the COVID-19 pandemic and the government has faced criticism for being slow to respond — it has failed to lead recruiting drives, as other provinces have, to recruit the thousands of workers the system needs.

And it can't come soon enough for a resident of a Toronto long-term care home who spoke with QP Briefing on Monday.

"It would change things dramatically," said the resident, who asked that his name be withheld so he could speak about life in his long-term care home without angering the staff he depends on.

The resident said he estimates he gets a total of about an hour and fifteen minutes with personal support workers and nurses on a regular day. Some are wonderful, some are not, but they're always rushed, he said.

The resident said he's a "special case" — severely visually impaired and dependent on staff to move in and out of his wheelchair.

"So life can be pretty quiet," he said.

The resident spoke about the parts of his routine that are missed when the staff don't have enough time — like asking for someone to dial his phone for him and being refused.

Before the pandemic, a staff member would bring him back to his room for a nap after breakfast. But now there isn't time — he'll ask someone recline his wheelchair, but he says he still can't sleep like that. At night, the nurse who comes to give him Tylenol will normally wash his eyes, which makes him more comfortable, but the replacement nurse won't take the time.

With four hours of hands-on care a day, there would be time for more than that. "They'd be able to help you do things. They'd read to you and talk to you," he said. "It'd be a big help."

But when told of the government's four-year timeline for the plan he said, "I'll be dead by then."

The resident who spoke with QP Briefing now has regular in-person contact with his daughter, who has been deemed an essential caregiver, so she's been allowed to visit him inside again, replacing the window visits of the first wave.

But when his long-term care home went into outbreak he had a mild fever and was confined to his room for 14 days, he said.

Asked for details of what his life was like then, he said little — staff wore masks, shields in gowns, and they came in only to deliver meals. He isn't sure exactly how long he was left alone for any one period but said he was lonely.

"Very lonely, and I'll tell you, my memory's not as good as it was," he said. "I think being alone has affected my memory."

Asked what he'd like people to know about life in long-term care, the resident said it would be to "die early" and not live to his age, 93.

"I'll tell you, it's like they're putting us in storage, to store us away until we die," he said.

He said giving staff more time would help change that. He also said another reason he is "so damn lonely" is his wife doesn't live in the long-term care home with him — that the government needs to find a way to ensure that couples who need different levels of care can still live together.

Ford and Long-Term Care Minister Merrilee Fullerton made the staffing announcement in advance of the provincial budget, set to be tabled Thursday. They didn't attach a price tag to the announcement but acknowledged "unprecedented" efforts to educate and recruit the tens of thousands of new personal support workers and nurses will be required.

The plan announced Monday promises targets set over the next four years to achieve the four-hour standard by 2024-25, with progress on the targets measured and reported regularly. A staffing strategy on how to achieve it will be released in December, Fullerton said.

According to a recent report, Ontario long-term care residents had an average of three hours and twenty minutes of care by PSWs and nurses as of 2018, based on an accounting of paid staff hours, which includes time that does not amount to hands-on care, including vacation and sick time. However, an estimate Ford cited aligns with one from the Registered Nurses' Association of Ontario that put the average time of actual care, prior to COVID-19, at 2.71 hours.

Since then, the loss of staff has been acute during the pandemic, said RNAO CEO Doris Grinspun. She called on the government to move faster and said with the help of organizations such as hers she believes it could increase the average time of care for each resident by nearly an hour by the end of the year and meet the four-hour mark next year.

Grinspun said she fears the announcement was merely an election promise and noted that former premier Kathleen Wynne made a similar vow shortly before her party was defeated in the 2018 election.

Meanwhile, the opposition parties at Queen's Park voiced the same concern — that the province is moving far too slowly.

NDP Leader Andrea Horwath said the government needs to move quickly. "It would be an awful shame to say to these folks, you're not going to get the benefit of this but the people who come after you may."

Liberal Leader Steven Del Duca also said staffing hours need to increase quickly. "Ford has all the power and frankly the resources to make that happen, and he's choosing not to."

Green Leader Mike Schreiner also said residents can't wait four years for more staff. "Nothing in this government’s record suggests they are in a hurry to fix long-term care."

The Ontario Long-Term Care Association welcomed the announcement and said it would work with labour partners and the health-care system to "find our way through the staffing crisis."

"Today’s announcement means Ontario’s seniors will receive the additional care they need and deserve, especially important as our resident population grows and their needs continue to increase in complexity," said CEO Donna Duncan. "It will take all of us to make this a reality, and we look forward to working with the government to create a workforce with thousands more skilled health care workers to join long-term care homes to serve our seniors."