National standards for long-term care emphasize quality of life for residents

Long-term care facilities should involve their elderly residents in decisions of all aspects of their care, according to a new set of guidelines published by the Health Standards Organization.

The document, known as the HSO Long-Term Care Services Standard, started development in March 2021. Janice Keefe, director of the Nova Scotia Centre on Aging, served on the technical committee that led the research.

“The need to develop new standards really came following COVID-19 and its devastating effects in long-term care,” Keefe said. “In the first wave, 50 per cent of the deaths were in long-term care. So there was definitely a need for some changes.”

The 59-page document specifically calls for long-term care facilities to establish policies and procedures for ‘resident-centred care.’

“The standard focuses on promoting good governance; upholding resident-centred care and enabling a meaningful quality of life for residents; ensuring high-quality and safe care; fostering a healthy and competent workforce; and promoting a culture of quality improvement and learning across long-term care (LTC) homes,” the document said.

The policies aim to protect the patients’ autonomy and communicate their rights and responsibilities within the care home. There are guidelines for safety and infection control procedures, abuse prevention and reporting strategies, trauma-informed approaches to care, and training in obtaining informed consent.

Overall, residents should retain the ability to make choices about their own care, the report said.

Keefe said, “This should be a place where people can have quality of life, as they live out the last years of their life. Their preferences need to be taken into consideration as we deliver care to them.”

The new standards acknowledge the stress of working in LTC, providing guidance for policies around compensation and benefits, training and adequate staff-to-resident ratios.

“We have to think about their working conditions, we have to think about their pay scale,” said Keefe. “We have to think about the whole gender issue: is this of less value because they’re women, caring for residents who are mostly women? So there’s a cycle here that we’re trying to identify and to try and change, to have better standards for Canadian nursing homes.”

Gary MacLeod, chairman of the Halifax-based organization ACE Team (Advocates for the Care of the Elderly) said steps can be taken to make the LTC system attractive to potential employees.

“You can only throw so much money at it, but it certainly helps a lot to make the atmosphere a place where people feel good about doing their job,” he said.

Active since 2006, ACE Team regularly communicates with the provincial government on LTC legislation. The group provided their own list of recommendations for elder care provision in 2022.

“It’s really exciting because it actually matches up,” said Paul Jenkinson, a retired social worker who helped author the ACE recommendations.

“If the government was to say very clearly, ‘We accept this document without reservation,’ then we could also go out to all the facilities and say, ‘Hey, this is the way it’s going to be.’ ”

In a statement to The Signal, the provincial Department of Seniors and Long-Term Care said, “the department has just received the full report and staff are reviewing it now. We will explore every opportunity to work with our partners in the federal government to further strengthen our continuing care and long-term care system in Nova Scotia.”