COVID Blog: The Horrors of the Nursing Home-Industrial Complex in Canada

by Shelley Lynn Tremain

In Canada, no aspect of the COVID-19 state of emergency has demonstrated the egregious effects for seniors and younger disabled people of neoliberal austerity measures and government indifference to the lives of elders and disabled people more than the entirely predictable tragedy unfolding in nursing homes and long-term care facilities in the provinces of Ontario and Quebec, beginning in early March of 2020.

In May, as case numbers continued to grow, the provincial government of Ontario issued a call to the Canadian Armed Forces to assist with the dire situation in nursing homes and long-term care facilities throughout Ontario, following the lead of the government of Quebec, which had already done so a month earlier. By that time, the situation in these Ontario facilities had spun out of control, with a rising number of COVID-19 cases amongst both their senior and younger disabled residents and staff.

By June, close to 2,000 deaths had occurred in nursing homes and other long-term care institutions in Ontario, while more than 80%—that is, more than 6,000—of the total number of COVID-19 deaths in Canada by that time had occurred in such institutions, with nursing homes in the province of Quebec the hardest hit. By late April, more than 1000 of the 1350 COVID-19 deaths that occurred in Quebec were related to long-term care facilities. After months of escalating numbers, the Quebec coroner’s office called for a public inquiry into the COVID-19 deaths in these institutions.

Even U.S.-based newscast CNN, in a July report that focused primarily on the effective response to COVID-19 of the current federal government of Canada, drew attention to the large number of deaths that have taken place in nursing homes and other long-term care facilities across Canada, informing the American public and indeed the global community of the horrific conditions within these institutions  that COVID-19 has exposed.

The vast majority of COVID-19 deaths in Canada have occurred in for-profit facilities, leading to  widespread demands for the Canadian government to “take control of long-term care.” These demands have steadily increased since the release of a whistleblower report about six Ontario nursing homes—five of which are for-profit homes—filed by medical personnel of the Canadian military deployed in these facilities. Among the violations that these medical personnel cited were the following: cockroaches and rodents in some facilities; lack of personal protective equipment, lack of hygiene, and under-staffing in virtually all of them; inadequate cleaning and sanitizing of resident rooms; slow response to resident calls for assistance; dirty linen or no linen on resident beds in one of the facilities; and inadequate staff training with respect to infection control in many.

Should publicly funded nursing homes and other long-term care facilities be advanced as the solution to the decades-old crisis in these institutions, in Canada and elsewhere?

A recent segment on CBC’s The National compared the nursing-home system in Australia with the nursing-home system in Canada. While more than 6,000 people have died from COVID-19 in long-term care in Canada, only 29 people have died from COVID-19 in nursing homes in Australia. Australian nursing homes, both for-profit and government-operated, are subject to considerable government regulation and inspection. In short, living conditions are reportedly better in nursing homes in Oz, whether publicly or privately owned and operated.

Yet, even adequately staffed nursing homes that are well kept cannot be the proper response to the question of how societies should provide long term supports and services to seniors, elders, and younger disabled people. On the contrary, the nursing home-industrial-complex must be recognized as an institutionalized mechanism that contributes to the reproduction of ableism and ageism. Indeed, we should regard up-scaled regulation and renovation of nursing homes as a kind of gentrification of these apparatuses of power, gentrification designed to ease the minds of the community-at-large about the fact that it has removed sectors of the population from their homes and communities. In other words, we know that gentrification in all its forms, but acutely in the case of the nursing home, effectively leaves intact the apparatuses and the systemic injustices that continue to harm the people that these superficial changes are claimed to help. The removal of seniors and younger disabled people from their communities and society at large—that is, their segregation in nursing homes and other “long-term care” facilities—takes away from them the prospect of lives that they deserve to live.

The COVID-19 pandemic has shone a spotlight on the fatal consequences of these systemic injustices and many others. We must ensure that these deadly consequences spur on larger and more critical cultural discussions about the institutionalization of various constituencies, discussions that in turn must motivate significant social and political changes of the practices and policies that govern the lives of the disabled people, seniors, prisoners, immigrants, Black people, and other people who comprise these constituencies taken away from the community in the name of care and safety.

Links to articles and sites referenced, in order of appearance:

The Star, 82% of Canada’s COVID-19 deaths have been in long-term care, by Tonda MacCharles. May 7, 2020.

The Globe, How Quebec’s long-term care homes became hotbeds for the COVID-19 pandemic, by Tu Thanh Ha. May 7, 2020.

CBC News, Quebec coroner’s office orders public inquiry into COVID-19 deaths in long-term care homes. July 17, 2020.

Twitter thread in reference to a segment on CNN Live News, posted by Ian Hanomansing, @IanHanomansing. July 3, 2020.

CBC News, COVID-19: Majority of region’s long-term care deaths occurred in for-profit homes, by Julie Ireton. June 10, 2020.

CBC News, Military report reveals what sector has long known: Ontario’s nursing homes are in trouble, by Adam Carter. May 27, 2020.

CBC News, The National: Australia’s COVID-19 successes shine a light on Canada’s troubled long-term care sector, by Terence McKenna. June 13, 2020.

About the Author:

Shelley Lynn Tremain has a Ph.D. in Philosophy from York University in Toronto and was the 1997-98 Ed Roberts Postdoctoral Fellow at the World Institute on Disability and University of California at Berkeley. Shelley was the recipient of the 2016 recipient of the Tanis Doe Award for Canadian Disability Study and Culture and the 2017 recipient of the Tobin Siebers Prize for Disability Studies in the Humanities. She coordinates BIOPOLITICAL PHILOSOPHY, a philosophy blog that focuses especially on the underrepresentation of disabled philosophers in academic philosophy.

Link to BIOPOLITICAL PHILOSOPHY blog website

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