The Northwood nursing home on Gottingen Street in Halifax. Photo: Halifax Examiner

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For the first time in Nova Scotia, two eldercare advocacy groups have joined forces with unionized healthcare workers to push the provincial government to address chronic labour shortages and underfunding affecting thousands of seniors requiring nursing home care. Below is the coalition’s call to action:

                 Open Letter to McNeil Government 

Nova Scotians for Long-term Care Reform is a recently formed coalition initiated by family members of former and current long-term care residents, and now includes researchers, concerned citizens and healthcare workers and representatives. We seek to build a long-term care system built upon the norms of dignified, humane, holistic and accountable care. Long-term care residents, their families and friends have for too long been sidelined when it comes to developing policies and regulations. We are here to change that.

We watched with great interest last week as Nova Scotia’s Minister of Health and Wellness briefed the public on this government’s response to the two reviews into the Northwood COVID-19 crisis. Like many others, we want a public inquiry with a full and open airing of the facts. The residents of Northwood, their families and their caregivers have been through a terrible crisis, a pain that few of us can appreciate. If they want to speak and share this pain, we should be ready to listen and learn.

Canada’s COVID-19 death rate in long-term care is an international shame, providing regrettable evidence of a system that is inadequate to meet the needs of some of our most vulnerable citizens. The cause of this crisis, we believe, is not particular to Northwood, but rather endemic to a system that is underfunded, and that serves a population that is undervalued. The Northwood review did make important and valuable recommendations, though many of these are repeats of requests we should all be familiar with by now. The Health Minister’s response, on the other hand, was sorely inadequate.

The province has agreed to make targeted investments in infection control and occupational health and safety, as well as to reduce the number of rooms with three or more residents, and these are all necessary moves. When it came to the issue of establishing a staffing ratio, the Minister was evasive, citing a lack of local evidence. As the review clearly stated, there is ample evidence supporting the need for a minimum staffing ratio for Nova Scotia long-term care residents. There is an internationally established consensus on the need for a minimum average of 4.1 hours of care per resident per day. We have no reason to believe Nova Scotia is exempt. 

The recommendations in the experts’ review point to the underlying problem of critical staffing shortages that contributed so heavily to the Northwood crisis. Clearly, this is an issue we can no longer avoid. The lives of people we love are at stake. It’s not simply a matter of improving ratios; we need to make long-term care an attractive place to work by ensuring adequate wages and hours of work for essential support workers, and appropriate training for all staff.

This is only the beginning of the vision we have for our long-term care residents. In addition to appropriate staffing levels we must also focus our attention on improving the quality of life for residents by means of a person-centered approach to care. This means more meaningful involvement of family and community, improved access to outdoor time and green spaces, access to mental health support for those living in care, strategies to reduce isolation and so on.

As a coalition of concerned citizens, family members, and healthcare professionals, Nova Scotians for Long-Term Care Reform is focused on engaging the provincial government in constructive dialogue that will result in a better quality of life and standard of care for those who are most dear to us.

You can find Nova Scotians for Long-term Care Reform on Facebook. Please like and follow us at

Robert Silverstein, Chair
Advocates for Care of the Elderly (ACE Group)
Families for Quality Eldercare
Nova Scotia Nurses Union (NSNU)
Nova Scotia Health Coalition (NSHC) including Unifor
Nova Scotia Government and General Employees (NSGEU)
Canadian Union of Public Employees (CUPE)
Paul Curry (Member at Large)
Anne Gillies (Member at Large)
Jesslyn Dalton (Member at Large)
Ellen Gaudet (Member at Large)

The chair of the Long-Term Care Reform Coalition, Bob Silverstein, started a group in Cape Breton two years ago after his father-in-law died from complications related to a bedsore while he was a resident at a Cape Breton nursing home. John Ferguson’s death, and those of Chrissy Dunnington and Lorna Jones — who were residents at other Shannex nursing homes who also went into septic shock after their bedsores became infected — led to a public outcry and improvements to wound care and training in long-term care facilities. But for Silverstein, the bedsores were a wake-up call that revealed long-term care needed more attention and more money from government long before the pandemic hit last spring.

“Families for Quality Eldercare was focused on bedsores and more locally on Eldercare in Cape Breton,” noted Silverstein. “The coalition mission is to improve the quality of long-term care in Nova Scotia. Having the unions and other advocates involved will provide the voice needed to make a difference in Long-term care.”

The Nova Scotia Nurses’ Union supports any organization, effort, or recommendation that strives to improve long term care in this province,” said Janet Hazelton, president of the NSNU. “The NSNU is eager to see hours of care per resident increased to meet the needs of these vulnerable citizens. This has long been a goal of the NSNU, and, in light of the impact COVID-19 has had in long term care facilities the world over, we cannot afford to wait a minute longer to enact change.” 

The McNeil government has committed $37 million over three years to improve infection control and hire more cleaners and non-licensed staff in 133 long-term care homes. Advocates say that’s a drop in the bucket compared to the investment needed to increase the number of caregivers, reduce overcrowding, and improve the quality of life for residents. 

Where will the hundreds of millions of dollars to invest in change come from? While that answer remains is unclear, in a news release from the province Thursday, the Trudeau government announced a change to an Infrastructure Canada program that would allow Nova Scotia to spend $82.5 million in return for a whopping $828-million worth of capital projects. Ottawa will pick up 90% of the costs if Nova Scotia government pays for the remaining 10%. 

The re-allocation was made under the COVID-19 Resilience Infrastructure Stream. The news release from the province said “schools, nursing homes, and hospitals” would be eligible for funding and that could translate into hope for more than 1,500 people who are waiting for long-term care at this moment.

“Projects are still to be determined,” said Megan Tonet, communications officer for Nova Scotia’s Department of Transportation and Infrastructure Renewal. “The new stream has expanded eligibility criteria that includes health and education infrastructure. This allows us to focus on maintenance and rehabilitation of infrastructure, and increases our ability to modify, reconfigure or build public infrastructure assets that support COVID-19 resilience measures, such as physical distancing. Under the new terms, projects under the COVID-19 Resilience Infrastructure Stream must be less than $10 million and able to be started by September 30, 2021 and completed by the December 31, 2021.”  

If money is now available, all that is needed is political will.

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

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