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Ageism and Ableism Leads to Maltreatment of Residents in Quebec’s Long-term Care Institutions

By Amaya Leduc Vega



The COVID-19 pandemic forced the government to look at a crisis that had been left in the shadows for a long time in Quebec: the maltreatment of residents in long-term care facilities, known as CHSLDs (“Centre d'Hébergement et de Soins de Longue Durée” in French). In fact, in the first wave of the pandemic, Quebec witnessed the highest COVID-19 mortality rate in Canada, with a staggering 91.9% of deaths occurring among people over 70 years old, 66.3% of which occurred in CHSLDs. This high mortality occurring in CHSLDs highlights the dehumanizing conditions of life seen in those institutions, such as outdated facilities, insufficient ventilation, and insufficient staffing.

This gap between the elderly and the rest of the population is due to ageism. Former Quebec Health Minister, Réjean Hebert, mentions that during the pandemic, CHSLDs ultimately became blind spots and people forgot about them. Hospitals were prioritized for resources such as masks and COVID-19 tests. Ultimately, the elderly were uncared for compared to the rest of the population. What struck Hébert most during the pandemic was the way that everyone seemed indifferent to how the elderly were treated in specialised centres. He remembers even hearing people mention during the pandemic that “the elderly should isolate themselves,” since they were the ones at risk. Others asked, “Why should the rest of the population suffer?” Not only did the government's complete disregard for the elderly in CHSLDs exemplify an ageist political decision, but also the lack of concern from the rest of the population reinforces ageist attitudes.

Hébert, who is now a professor of Health Policy Analysis at Université de Montréal, points out that, even before the pandemic, “there was a re-allocation toward other priorities,” which was created by an exodus of doctors and nurses outside of CHSLDs. These faculties stopped becoming the priority, and hospital care was prioritized. This ageist government decision in a time of crisis favored funding for the care of the younger population and left the elderly in understaffed residences, with caregivers unable to meet residents’ basic needs adequately.

Even now, in the post-pandemic period, maltreatment in CHSLDs remains an issue. A living example of someone who is suffering from this injustice is Daniel Pilote, a 56-year-old man with muscular dystrophy. He lives in a long-term care institution in St-Jean-sur-Richelieu, and he reported that he’s “been rough-handled by staff that has about 10 minutes to wash and dress him each day.” Pilote also expressed fear that “no one [would] get to him in time should his breathing machine fail.” His fear highlights the grave consequences of understaffed CHSLDs created by insufficient government resource allotment, causing the possible death of patients.

Another case is Brigitte Lavoie, the sister of a resident from Residence Floralies LaSalle in Montreal, further exposing the reality of CHSLD residents. She says that whenever she would visit her sister, who has been staying in Residence Floralies since 2020, it was like “living a nightmare.” Her sister, who is intellectually disabled and incontinent, would have clothes on that weren’t hers, feces stains would be on her bed, her feet were extremely dirty, and her diaper was often unchanged. As we can see, not only have ageist government policies contributed to this poor quality of care, but caregivers are also at fault for ableism and discrimination in favor of able-bodied individuals. Since Lavoie’s sister is intellectually disabled, busy caregivers took advantage to provide her with less than the bare minimum of care.

Despite Brigitte Lavoie’s complaint in February 2022 concerning ageism and ableism to the Regional Health Board’s Complaints and Service Quality Commissioner, nothing was done to improve the situation. Two months later, still nothing had changed. This reflects the systemic failure to prioritize the well-being of residents, and how neglected they are compared to the rest of the population. Despite complaints, no authority figures took any significant action to improve the quality of care of CHSLD residents.

The crisis that is happening in CHSLDs requires a concerted effort to address ageism and ableism in society. CHSLD residents are as worthy of adequate care as any hospitalized patient. It is imperative that, as the younger generation, we value CHSLD residents and recognize that they have the same rights of care as anybody else. Even if they are older, or physically or intellectually disabled, it is unjust to provide care that is any different or any less than anyone else because, after all, “Old Age Matters” too.


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