{"id":67647,"date":"2020-07-06T17:05:04","date_gmt":"2020-07-06T21:05:04","guid":{"rendered":"https:\/\/newsroom.carleton.ca\/?post_type=cu_story&p=67647"},"modified":"2025-10-17T16:19:32","modified_gmt":"2025-10-17T20:19:32","slug":"carleton-researchers-at-forefront-of-long-term-care-studies-amid-covid-19-pandemic","status":"publish","type":"cu_story","link":"https:\/\/carleton.ca\/news\/story\/carleton-researchers-at-forefront-of-long-term-care-studies-amid-covid-19-pandemic\/","title":{"rendered":"Carleton Researchers at Forefront of Long-Term Care Studies Amid COVID-19 Pandemic"},"content":{"rendered":"\n
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\n Carleton Researchers at Forefront of Long-Term Care Studies Amid COVID-19 Pandemic\n <\/h1>\n \n <\/header>\n <\/div>\n\n \n <\/path>\n <\/path>\n <\/svg>\n <\/div>\n\n \n\n <\/div>\n<\/section>\n\n

In mid-May, the Ontario government announced than an independent commission will begin a comprehensive review of the province\u2019s long-term care system this September.<\/p>\n\n\n\n

At the time, more than 1,300 residents of Ontario long-term care (LTC) homes and five staff members had died because of COVID-19 \u2014 approximately two-thirds of all deaths in the province directly related to the pandemic.<\/p>\n\n\n\n

\u201cThe system is absolutely broken,\u201d Premier Doug Ford said during a press conference.<\/p>\n\n\n\n

For Carleton Social Work Prof. Susan Braedley<\/a>, who has been researching LTC for more than a decade, that declaration wasn\u2019t news.<\/p>\n\n\n\n

\"Prof.
Prof. Susan Braedley<\/figcaption><\/figure>\n\n\n\n

Through a series of regional, national and international projects with an array of collaborators, including Health Sciences Prof. Renate Ysseldyk<\/a> and several Carleton students, Braedley has seen how to nurture healthy living and working conditions in seniors residences \u2014 and what happens when we don\u2019t.<\/p>\n\n\n\n

\u201cIt\u2019s taken an incredible amount of death to bring appropriate attention \u2014 finally \u2014 to conditions in long-term care,\u201d she says. \u201cIt\u2019s frustrating that it took so much death for this to happen. But there\u2019s a policy window now, an opening, for change. And people in the research community are lining up to help.\u201d<\/p>\n\n\n\n

Responding to the notion that Ontario is experiencing two parallel coronavirus outbreaks, one in the general community and one in LTC, Braedley says that these are not two distinct worlds.<\/p>\n\n\n\n

The virus may have a more devastating impact on elderly people, but LTC employees live in the community, and the working and living conditions within the LTC system \u2014 the heart of Braedley\u2019s research \u2014 have made it impossible to prevent transmission.<\/p>\n\n\n\n

\u201cThey\u2019re not separate pandemics,\u201d she says. \u201cThey\u2019re connected by workers.\u201d<\/p>\n\n\n\n

\"Helping
Prof. Renate Ysseldyk<\/figcaption><\/figure>\n\n\n\n

Elder Care Plummets Amid Privatization<\/strong><\/h2>\n\n\n\n

The quality of elder care in the province started declining dramatically in the late 1990s, according to Braedley, amid the privatization drive of former premier Mike Harris. The system tilted not only toward private for-profit LTC facilities, but also residences owned by corporate chains.<\/p>\n\n\n\n

Bed supply became limited at the same time as a rapidly aging population increased demand, leading to long wait lists, with admission reserved for those who most needed care. Meanwhile, the provincial government removed legislated requirements to provide guaranteed hours of care for each resident. The result has been greater resident needs with no corresponding increase in staff hours or resources.<\/p>\n\n\n\n

Moreover, even public non-profit facilities ramped up outsourcing of services to private companies that could \u201cthermalize\u201d food that had been cooked and frozen offsite or clean clothing and bedding more cheaply than unionized staff. (Laundry, in particular, can lead to cross-contamination and disease transmission if not done safely, yet saving money trumped quality of care for many LTC operators).<\/p>\n\n\n\n

Cumulatively, these changes led to the perfect storm that the pandemic exposed, says Braedley, who focused on children and mental health as a social worker for 17 years before deciding to go back to graduate school in 2003.<\/p>\n\n\n\n

She earned her PhD at Toronto\u2019s York University, with postdoctoral work supervised by Sociology Prof. Pat Armstrong<\/a>, a double Carleton grad and one of Canada\u2019s leading LTC researchers.<\/p>\n\n\n\n

Braedley has collaborated with Armstrong on a number of projects since then, including the Social Sciences and Humanities Research Council of Canada (SSHRC<\/a>) partnership \u201cRe-imagining Long-Term Residential Care<\/a>: International Promising Practices,\u201d from 2010 to 2018, and \u201cChanges Places<\/a>: Unpaid Work in Residential Spaces,\u201d a 2016 to 2020 study funded by a SSHRC Insight Grant that looked at the unpaid labour of workers, family members and volunteers in LTC in four countries, with eastern and central Ontario among the Canadian locations.<\/p>\n\n\n\n

Braedley also worked on a recent report on LTC models in Toronto, led a project on LTC privatization in Saskatchewan and is part of another major multi-year national research project, helmed by Halifax\u2019s Mount St. Vincent University and supported by a Canadian Institutes of Health Research team grant, looking at quality measures in LTC.<\/p>\n\n\n\n

All of this research informed an op-ed that Braedley published in the Ottawa Citizen<\/em><\/a> in late May.<\/p>\n\n\n\n

\u201cLet\u2019s be honest,\u201d she wrote. \u201cOur society has had a bad attitude toward care work. We have told ourselves it is work that \u2018anyone can do,\u2019 or that it comes \u2018naturally\u2019 to women and especially women from specific cultures. That is completely wrong, and this crisis shows it.<\/p>\n\n\n\n

\u201cWe have an opportunity,\u201d the op-ed concludes, \u201cto learn, address our past mistakes, and shape a system that offers safety, dignity and respect to older people and care workers. We will be glad we did.\u201d<\/p>\n\n\n

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Dedicated Staff in Difficult Conditions<\/strong><\/h2>\n\n\n\n

Until physical distancing restrictions were introduced to protect LTC residents, Braedley and her collaborators practised ethnographic research.<\/p>\n\n\n\n

They\u2019d spend a week or more at a LTC facility, from early morning until late at night, or sometimes a full 24-hour cycle, observing and talking to residents and workers as they went about their days and completed their tasks.<\/p>\n\n\n\n

Although abuse and neglect has been documented over the years, Braedley says that the vast majority of staff are dedicated and extremely hard working, despite very difficult working conditions.<\/p>\n\n\n\n

\u201cThere\u2019s no labour force I could imagine that\u2019s more caring than LTC workers,\u201d she says. \u201cThey work with people who are frail, in pain, suffering from dementia \u2014 and it takes tremendous skill to make them comfortable, to help them lead meaningful lives.<\/p>\n\n\n\n

\u201cYet these workers are often treated like they have no skills. They\u2019re paid poorly and are run off their feet. And they understand all of the common sense ideas \u2014 like the importance of healthy food \u2014 that are often ignored.\u201d<\/p>\n\n\n\n

In some LTC homes, workers are allotted 15 minutes to bathe a resident. That\u2019s 15 minutes to undress an elderly woman or man, help them into a mechanical lift, lower them into a bath, clean them while respecting their modesty and dignity, and then help them get out, dry off and get dressed, and then sanitize the tub for the next bath.<\/p>\n\n\n\n

\u201cThere\u2019s no way you can do that in 15 minutes,\u201d says Braedley, \u201cbut that\u2019s a typical window of time in a for-profit care home.\u201d<\/p>\n\n\n\n

She has seen workers skip breaks because they won\u2019t leave duties undone. She has seen them bring homemade treats and buy underwear for residents. And she has seen them risk their own physical and mental health, hurting their backs and shoulders and absorbing waves of stress, to care for people.<\/p>\n\n\n\n

\u201cWe assume that older people have relatives who are around and available to pay attention to them,\u201d she says, \u201cbut not everybody does. It\u2019s often workers who befriend residents.\u201d<\/p>\n\n\n

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Promising Practices in Canada and Elsewhere<\/strong><\/h2>\n\n\n\n

These days, with in-person research on pause, \u201cvirtual ethnography\u201d methods are in development for deployment when residents and workers are no longer in crisis mode.<\/p>\n\n\n\n

In the meantime, Braedley and her collaborators are trying to help by sharing information about some of the \u201cpromising practices\u201d they\u2019ve seen at creative and dynamic LTC homes across Canada and in countries such as Germany, Norway and Sweden.<\/p>\n\n\n\n

For example, facilities where residents cook fresh meals together \u2014 a social celebration of healthy food that can be the highlight of someone\u2019s day. Or homes with a safe, contained outdoor courtyard that residents can access by themselves, so they can get fresh air and exercise, or just sit under a tree and not feel like they\u2019re imprisoned, even if they\u2019re experiencing cognitive decline.<\/p>\n\n\n\n

\u201cSometimes, when you see people get outside, with a wheelchair or walker, you see the joy,\u201d says Braedley. \u201cIt\u2019s often the simple things in our everyday lives that we take for granted that are restricted in LTC. But it doesn\u2019t have to be like that.\u201d<\/p>\n\n\n\n

This contrasts sharply with LTC homes with signs that tell residents not to talk to dining room staff \u2014 because they\u2019re outsourced external contractors, not workers who might get to know and develop caring relationships with residents.<\/p>\n\n\n