The Admiral home in Dartmouth.

A flurry of announcements in the past week may provide optimism for seniors, provided governments and leadership hopefuls vying to become the next Liberal premier can be held to account.

For example, with COVID still infecting nursing homes in other provinces, Prime Minister Justin Trudeau has instructed Health Minister Patty Hadju to work with the provinces to introduce federal standards. Here’s the text from the PM’s letter to the Minister dated January 15:

In addition to the priorities set out in my mandate letter to you in 2019, as Minister of Health, you will implement on a priority basis the following commitments….

Working with the Minister of Seniors, work with the provinces and territories to set new, national standards for long-term care so that seniors get the best support possible.

Work with the Minister of Seniors to take additional action to help seniors age in place and stay in their homes longer.

In Nova Scotia, Progressive Conservative leader Tim Houston issued a news release Monday to say he had written to N.S. Health Minister Leo Glavine to find out how long-term care will be improved, and how any federal money has been spent.

Last August, Ottawa changed the criteria for the Infrastructure Canada Investment Program allowing the diversion of 10% of that funding to the COVID-19 Resilience stream. For Nova Scotia, that effectively meant up to $82.8 million became available to spend on upgrading or maintaining schools, nursing homes, and hospitals — projects in the health and education sphere. (This money was in addition to tens of millions of federal dollars flowing through the “Safe Restart” program.) 

“I understand people are busy,” said Houston. “But when months go by without hearing any plans for seniors, I start to worry that they are being forgotten once again.”

The Department of Health has been preoccupied since late December figuring out how to get limited amounts of COVID-19 vaccine out of cold storage and into the arms of health care staff and nursing home residents. That’s underway. On Monday, the Halifax Examiner asked the government how many health and education projects it had submitted for approval to Infrastructure Canada.

“The province has identified a number of priority projects in both education and healthcare fields, including some long term care facilities,” replied Peter McLaughlin, a senior communications advisor for the Transportation and Infrastructure Renewal Department. “We are working with the federal government to have those projects approved and announced.”

Pressed to confirm whether any of these projects have yet been submitted to Infrastructure Canada, McLaughlin said he was unable to provide further comment. Nor could he provide an estimate of the value for the total projects. The criteria for the federal program says each project must be “shovel ready” by September of this year and cost less than $10 million. 

Stay tuned. Seniors continue to be the fastest growing demographic in this province.

Promises, promises

Last July, Houston and the PC party announced a plan for long-term care that includes the addition of 2,500 new beds at an estimated cost of $465 million, and the hiring of 2,000 more caregivers. Yesterday, Liberal leadership candidate Randy Delorey released his Seniors’ policy and agreed to provide cost estimates as requested by the Examiner, as follows:.

• Create a provincial dental care program covering routine and emergency care for low-income seniors. 

Former Health and Wellness Minister Randy Delorey. Photo: Communications Nova Scotia

Delorey says “the estimated cost of this program will be between $5-10 million per year. This starting estimate is based on pro-rating Ontario budgeted amounts for a similar program of $90 million, applied to a population 1/15th of the size. Details of qualification, logistics and rollout will be determined in consultation with the Department of Community Services (who offer some existing coverage), Seniors groups, and the Nova Scotia Dental Association”.

 “Low-income” remains to be defined, may include those receiving GIS.

• Cover at least $500 for hearing aids for low-income seniors.

Delorey says “the estimated initial budget will be $3 million in the first year as the program begins and responds to built-up need, and $2 million per year going forward. Again, we will consult carefully with Seniors groups, Government agencies, and Audiology and ENT professionals to determine the most effective and evidence-based qualification criteria”.

• Making long term care safer and healthier for seniors, including ensuring rooms have no more than two residents and building new facilities to single room standards.

This is the same commitment Delorey made before stepping down as Minister of Health after three years. About 46% of all nursing home rooms are shared by two people today. Delorey says during his tenure as minister, the wait list to enter a nursing home decreased from over 2000 to 1500. He says he is “committed to completing the approximately 200 new beds (13% of the wait list) and 200 replacement beds currently in the system, as well as continuing to provide new beds and replacement beds that meet new standards in a way that keeps the list declining steadily.” 

Kousoulis and Rankin commit

Labi Kousoulis

Liberal leadership contender and former Advanced Education and Labour Minister Labi Kousoulis unveiled his Seniors’ policy several weeks ago. Kousoulis wasn’t available yesterday to discuss the costing of his plan but his main promises are as follows:

As premier, I am committed to building enough modern long-term care beds to remove seniors from the waitlist within our hospitals and provide every senior in need with proper living accommodations. Seniors deserve dignity and should not live in fear towards what conditions their living accommodations are in. I will also work with seniors to ensure that long-term care accommodations have enough staff who are fully trained.

Kousoulis has also promised to construct “purpose-built seniors housing in regions across the province” and create a housing committee that includes a Seniors’ Advocate.

Leadership candidate and former Environment Minister Iain Rankin is making fewer promises to Seniors than his two rivals. He is committed to:

Work to improve the standard of care for seniors in long-term care by making capital investments in our facilities, while also examining additional ways to reduce social isolation amongst our senior population.

Iain Rankin. Photo: Twitter

Asked to explain how he would go about doing that, the Examiner received this response from Rankin: 

It is clear that a capital investment in long-term care facilities is necessary and I am committed to make that happen. While I cannot comment on exact numbers as that is not information I have access to at this time, I am committed to developing a strategy to define the number of facilities that must be replaced over the next 15 years based on a risk assessment. The Department of Health should develop a risk assessment tool to consider factors like shared rooms, bathroom to resident ratios, tub to resident ratios, and hand hygiene sinks.

By starting with an objective risk assessment, a replacement list could be created in order of highest to lowest risk. I would also request an analysis of capital/emergency funding approved for older facilities over the last 10 years to determine the effectiveness of facility renovation versus replacement.

Both Delorey and Rankin say they support the move by the federal government to develop a consistent standard of care for nursing homes throughout the country.

In 2018 Nova Scotia signed a 10-year bilateral health funding agreement with the federal government focused on mental health and home care,” said Rankin. “The Prime Minister has now indicated his desire to negotiate a funding agreement with willing provinces specific to long-term care. That is something I would enthusiastically welcome in order to improve the standards in long-term care homes in Nova Scotia.”

During a virtual convention on Feb. 5- 6, 8,100 Liberal delegates will choose a successor to Stephen McNeil.

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Jennifer Henderson is a freelance journalist and retired CBC News reporter.

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