Thank you for the question. Through the chair, I'm going to separate the question in two and speak first to what I think are the underlying causes of these issues. Then I will certainly provide some comment on your question about the private homes with respect to municipal homes.
The first question is a very important one because, if anything, COVID-19 has exposed various issues in long-term care. When we look at the issues, certainly we will hear about things like staffing ratios, funding and increased complexity of resident needs, which are part of an ongoing discussion about change in long-term care. These are very important, and they're absolutely necessary. However, I want to dive a little deeper, because there are also cultural issues that are at the core of how we approach long-term care. These, I'd like to highlight a little more for the committee.
For a variety of reasons, long-term care has become inherently task based. Our staff rush to bathing, to feeding and to documenting. It's one resident after another, on a very strict schedule, with very little time for anything further. The issue is that when we approach long-term care like a set of tasks—a checklist, if you will—we make the needs of the person who's living in that home secondary to the completing the task. In many cases, it becomes fear-based care by the staff member and not the emotional-based care these seniors deserve.
Here are some thoughts about solutions. We hear a lot about person-centred care; it gets tossed around all the time. But at the core, it does offer solutions, so while we're looking at funding, we also need to look at creating a culture that enables staff to understand and meet the needs of unique people, the people living in the home, for their physical and emotional well-being. This is what helps to improve well-being, and it certainly avoids problems before they arise.
One example I'll give is that of a person living with dementia. We know that people with dementia sometimes wander or pace endlessly. This is an issue, both during the outbreak, because wandering can put them at risk of exposure, and in general, because they can become exhausted and it's a detriment to their own health in increasing their risk of falling.
A task-based approach looks at the wandering as a problem. The wandering becomes the problem. A person may recommend to put this individual on an anti-psychotic medication, or to restrain them, or to allow them to keep on walking all day.
A person-centred approach looks at wandering as the symptom and tries to understand why the person is wandering. We're not fixing the wandering. We're trying to understand why the person is wandering.
Through our work at the Region of Peel, we've implemented the innovative butterfly model of care for dementia care. For people who wander, what we've realized is that they wander because they need something. They're looking for something. They're looking for engagement, affection, security or love. They're also wandering because we put them in environments with long corridors that look endless to them, and they just keep walking. By understanding how we can support them through activity and conversation, we are creating a home environment, a safe one.
To close this, I'm going to suggest that when we enable true person-centred care, it isn't easy. It's not about the surface. It's actually about getting deep into the way we work and the way we think as the staff in those long-term care homes.
Some things need to be considered. We certainly need better staffing ratios so that staff have time to spend getting to know who is in their care, meeting with them, holding their hand and sitting with them. We need regulations that are less focused on documenting the completion of tasks and more focused on measuring the emotional care and well-being of those individuals. We need training programs and the funding to undertake them so that staff can have a better understanding of complex conditions like dementia and how to understand and meet individual needs.