Shortage of nursing homes geared to ethnic groups a ‘disaster’ for aging immigrant population

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At home, Josh Suresh’s aging mother Indrani enjoyed meals like string hoppers, a rice noodle dish common in Sri Lanka where she grew up.

Other South Indian foods like idli and dosa were staples on her table.

But after being diagnosed with dementia and having to move into a long-term-care home in Scarborough in 2015, all those comforts were gone. Instead, Indrani was faced with dishes like boiled potatoes and pasta.

She wouldn’t touch them. She stopped eating altogether, losing 40 lbs. She also reverted to communication solely in her first language: Tamil.

Though the nurses at the home were “excellent,” said Suresh, they couldn’t communicate with Indrani, and were not equipped with the tools to help her. “She went into a shell.”

Shutting off seniors from their cultural needs can have a huge impact on their well-being, say experts who urge that any post-pandemic reforms of long-term care include not only the safety, staffing and physical space of these homes, but also ensure the elderly are treated like human beings. That includes incorporating all aspects of who they truly are, like language and culture.

COVID-19 has devastated Ontario’s long-term care homes, exposing gaps in care and leaving 3,706 residents and 11 staff dead. And as that toll rises in this second wave, families and advocates are demanding changes to a flawed system. In an increasingly diverse city like Toronto, that includes ensuring robust, culturally relevant care.

“In rebuilding our long-term care, I believe the cultural pieces should be built into the core conversation and core principles,” said Seong-gee Um, a researcher at the Wellesley Institute, a Toronto-based research and policy non-profit organization.

“Evidence confirms that the provision of culturally and linguistically specific care has a strong positive association with people’s health outcomes and well-being outcomes.

“It’s not something that’s nice to have. It’s something that should be required.”

The demand is there: The wait time for a bed in cultural or religious homes in Toronto is about 16 months on average compared to just eight months for all public long-term-care homes in general, according to the most recent data available from 2017.

According to a Wellesley Institute report last fall, out of the 20 long-term care homes in the province with the longest wait times, 12 were ethnospecific or religious homes. And five homes with the longest wait times in the province are mostly designated for Chinese Canadians and have a median wait time of two to four years.

Currently, within the five Local Health Integration Networks (LHIN) that cover Greater Toronto, there are only 33 homes with a cultural or religious designation out of the 200 in total. In the Mississauga Halton LHIN, alone, there are only three designated ethnocultural homes, catering to Italian, Lithuanian and Slovenian seniors, and no home for South Asians, despite that group making up close to a quarter of the population of Mississauga, and being the largest visible minority group in the city as of 2016.

And those wait times increase dramatically when looking at homes that service specific cultural groups. The five homes with the longest wait times in the province are mostly designated for Chinese Canadians and have a median wait time of two to four years.

According to a Wellesley Institute report last fall, out of the 20 long-term care homes in the province with the longest wait times, 12 were ethnospecific or religious homes.

For Suresh, a home for South Asian Canadians would have been his first choice, but that wasn’t available, as few homes geared for people of that background exist in the GTA.

“It’s a death sentence sending seniors to an environment they are not used to, with an environment they can’t relate to, people they can’t speak to, and people that can’t understand their cultural sensitivities,” said Suresh.