Opinion: It’s time for Quebec to keep its promises on elder care

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A $19-million settlement agreement has been reached in a class-action suit against the federal and provincial governments, as well as the West Island health authority, over care provided to war veterans at Ste. Anne’s Hospital in Ste-Anne-de-Bellevue. The case is a big win for the veterans and their families, but it does not resolve the bigger problem: The long-term-care system as a whole needs an overhaul and a significant injection of funds.

This facility, now a Centre d’hébergement de soins de longue durée (CHSLD), was a jewel when administered by Veterans Affairs. It provided a quality home “milieu” that met the policy orientations outlined by Quebec’s Health Ministry in 2003. Personnel was well trained and well paid, and communicated with veterans in the language of their choice. A family atmosphere prevailed. Medical and nursing care, social services and equipment were ample and of good quality. Elderly residents suffering from multiple chronic diseases and severe functional impairments were provided with a comfortable environment.

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However, the situation began to change in 2016, when Ste-Anne’s Hospital was transferred from the federal government to the Quebec government. Under the oversight of the Health Ministry and administration by the West Island CIUSSS, services were considerably reduced, including the number and presence of doctors, nurses and nursing assistants. The number of medical specialists, as well as clinical testing services, also diminished. Care teams were decimated. Remaining staff became demotivated. The quality of food deteriorated.

The result: a reduction in quality of life for the residents, who experienced more feelings of isolation and abandonment. In essence, they began to receive an inferior level of care — the kind commonly found in other CHSLDs, as Quebecers have come to learn. Then came COVID-19, which made things even worse.

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The class-action suit was initiated by Wolf William Solkin, who moved into Ste-Anne’s Hospital in 2013. It charged that both levels of government and the West Island CIUSSS failed to respect aspects of the contract signed for the hospital’s transfer, including obligations to maintain previous levels of care and services. Sadly, Solkin died just shy of his 98th birthday and a few days after the two sides had reached the out-of-court settlement.

Now, more than two years after the last election, we are waiting for the Coalition Avenir Québec government to deliver on its campaign promise to overhaul the entire CHSLD network with a system of “Maisons des aînés.” The stated goal is to move away from the institutional setting of CHSLDs to a more modern and “humane” living environment for seniors.

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It all sounds good. But this province — and the Health Ministry in particular — has a long track record of trumpeting lofty principles that aren’t put into practice. It is now time to implement in a concrete way quality long-term care services based on those principles. If the government wants to be taken seriously, its new plan must include the following:

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It’s time for Quebec to end decades of unfilled promises made to the frail and elderly.

François Béland is a professor at the public health school of the Université de Montréal, senior investigator at the Lady Davis Institute of the Jewish General Hospital and past member of the Gerontological Advisory Council of Veterans Affairs; Daphne Nahmiash is president of Handicap Vie Dignité, a community organization that defends the rights of residents in long-term care in Quebec.