The Current - Why Canada's long term care system can't keep up

Episode Date: April 16, 2026

Long term care workers in Nova Scotia are on strike, demanding more pay and better working conditions. Adults 85 and older are one of Canada's fastest growing age groups. It's estimated that long term care capacity will have to almost double in the next decade to meet demand. We look at the demands on long term care workers and what staffing issues mean for residents with Ty Loppie, long term-care worker and Vice President of Young Workers CUPE Nova Scotia, and Andre Picard, health columnist for the Globe and Mail and the author of Neglected No More: The Urgent Need to Improve the Lives of Canada's Elders in the Wake of a Pandemic.

Hi, Steve Patterson here, host of The Debaters, part stand-up, part quiz show, and part comedy competition. We take on the most pressing questions on the minds of all Canadians, like, is carpet superior to hardwood? Listen to the debaters, wherever you get your podcasts, and prepare to be, well, floored. This is a CBC podcast. Hello, I'm Matt Galloway, and this is the current podcast. More than 12, go, go, go. 2,200 long-term care workers have walked off the job in Nova Scotia after their union rejected the latest offer from the province.

The CBC spoke with workers on the picket line in front of a long-term care home in Sydney River, Cape Breton. We don't feel like our workers are supported, and we don't feel like they're making a living wage. You're continually short. You can't staff. It's left on those that are in the building to pick up the slack, and sometimes, you know, it's hard. I've been here almost 20 years and don't even make $20.

an hour. You start your shift, you're running for supplies most days, trying to get people up, get them ready. Sometimes there's only two people on the floor. It's very frustrating. And it's hard on the clients when they want to get up, start their day like anyone else. I find it funny that during the COVID, we were all heroes, and now we became zero, so we're completely forgotten about. If it wasn't for us people with the seniors, where would they be today? Without raising their wages, where are they going to be tomorrow? Canada's population is aging and the long-term care system is straining to keep up. And that's in part because staffing long-term care homes is increasingly difficult.

In a moment, we'll talk about the pressures on the long-term care homes across this country and what that means for aging in this country. But first, I'm joined by Tai Lopi, Vice President for Young Workers at Coupie, Nova Scotia. She works at St. Vincent's nursing home in Halifax. Tag good morning. Morning. I'm going to get to the demands of your union in just a moment. But how would you describe what it's like to work as a long-term care?

worker in Nova Scotia? So currently, there is a lot of pressure on all of our staff, all the different classifications from support services to CCAs and personal care workers to our LPNs. If one of us is short, then it affects everyone's job. And we're trying our best for our residents, but it's hard to give them the care that they need. We heard from a number of those workers in Cape Breton who say that they're not making a living wage that in many ways they're struggling just to make ends meet. Does that sound familiar? Yes. If you ask anyone working in long-term care, they will give you the same answer.

Tell me a little bit about the toll that that takes on you. There's a lot of people leaving the workforce. They started off in this job and they were making a good wage at the time, but the cost of living has increased, so they're finding work elsewhere. We have a lot of people that work multiple jobs just to make ends meet. You can really see the strain on our workers and on our residents. And people are tired. They're burnt out. You're working in that field.

Can you just, for people who are listening, it may not understand it, just describe the gap in terms of what you make versus what life costs for you in Halifax. It's an expensive city. Yes. So our lowest paid members make $18 and 77 cents an hour. the cost of living in Halifax is between $28 to $29 an hour. That's a living wage, what they call a living wage.

Yes. And so what do you have to give up in your own life to try to make ends meet? Working multiple jobs, deciding if you want to pay your electricity bill or for groceries, it's especially hard on people with children. Like, I don't have any kids, but we have a lot of, like, single parents. And they're trying their best, but it's just, it's not sustainable for them. You've hinted at this, but what does all of that mean for those who are the residents of those long-term care homes in terms of the quality of care that they get? So our workers were there for our residents 24-7.

We can't give them the person-centered care that they deserve. they're getting almost the bare minimum. And it's really hard trying to explain to your resident that they have to wait to get their care because you have a list of five other residents. You're picking up after support services if they're short or if the CCAs are short, then support services are trying their best to answer call bells for our residents. But there's only so much that they can do for them. Our recreational therapist don't have the time and funding to be able to have activities for residents.

So people with dementia that's detrimental to their minds, it causes them to deteriorate faster. One of the things in being part of organized labor is that you can withdraw that labor to try to make the point about some of the things that you're talking about. Given the fact that those residents rely on your work, did you have any concerns about going out on strike, given the needs of those residents? Definitely. So all of the facilities on strike have an essential service agreement, which is a contract between the union and the employer, to determine the minimal amount of staff needed to provide safe resident care. So some of our units that would normally have for CCAs are down to two. As the strike continues, you'll hear more about the residents are becoming agitated. They're noticing a difference in their care.

Families are noticing a difference. Our staff are trying their best, but there's only so much you can do with minimal staff. We have guidelines in our agreements for certain emergencies, like we're not putting our residents health at risk, but we are drawing back on the extra things that we do. Like we don't have our hairdressers, or you might be getting a bed bath instead of a tub bath. So they'll notice that change for sure.

What is your union asking for? A livable wage. Which would be what? I mean, what's the dollar figure that you're looking for, if I can put it that way? When we went into negotiations, we were asking for a, a $5 increase for all classifications, similar to what P.E.I and New Brunswick have gotten for their

health care workers. The Nova Scotia government immediately said no to that. The offer that they gave us would have only given our support services a little over a $2 wage increase over the course of four years. The government has offered, as I understand it, a pay increase of at least 12% with retroactive pay going back to 2023, and the government says that this matches the wages of workers in home care, but also in hospitals. From your perspective, why isn't that enough? So 12% of an increase for our support services would only be about 61 cents on top of like the 1877. Right. So 61 cents an hour? Yeah. More, right. The offer for the hospital workers and home care is from 2023, so it doesn't keep up with inflation.

It's an outdated contract. We asked the Nova Scotia government for comment on this, and they sent this a statement that reads in part, the province has supported these long-term care providers to put forward a fair, competitive package for employees in the sector, but the statement goes on to say that QP, that's your union, rejected the offer without giving members the opportunity to vote on it. What's your response to then? The way that we bargain within QP, we have a lead table, and our bargaining committee is elected by our membership. They trusted us to negotiate the best deal for them.

They're also aware of the offer. It wasn't a secret. We had town hall meetings to keep our members informed. They didn't agree with the offer, so everyone was. voted for a strike. Can I just ask you finally, you're the VP for young workers at KP Nova Scotia, right? Yes.

How much hope do you have for the future of your profession? You are the future in many ways. And you wonder why, if there's conditions are as difficult as you're describing, why young people would want to enter that profession. Do you worry about that? Yes. I've been in, I've worked in long-term care for six years. I would love to continue my career in long-term care, but if things don't change, I can see myself leaving.

And I don't see a lot of younger workers wanting to stay or even enter the field because it's not worth it at this point. Ty, I'm glad to talk to you. Thank you very much. Thank you. Ty Lope is the VP for young workers at Kupi, Nova Scotia and works at a long-term care home. She is on strike. and she was in Halifax. Hi, Steve Patterson here, host of The Debaters, part stand-up, part quiz show, and part-comedy competition.

We take on the most pressing questions on the minds of all Canadians, like, is carpet superior to hardwood? Listen to the debaters, wherever you get your podcasts, and prepare to be, well, floored. The challenges facing long-term care workers are not unique to Nova Scotia. In Ontario, staff at Extendacare, which is one of that province's for-profit long-eastern term care providers are also fighting for better working conditions in pay. Kupi says that they are preparing for what the union calls a summer of action after negotiations with extended care's management stalled.

Lisa Freeman has been a personal support worker for 19 years and is a union representative. I'm kind of fearful for long-term care to tell you the truth. We see a lot of people going, a lot of good people leaving because they can't afford to live anymore. It seems to be a high turnover of staff, and that leaves the remaining staff burnt out and overwork. I really do think there's an underlying core value of taking care of people. We're dealing with the most valuable and the most vulnerable people in our society. I really think that you have to have that baseline of care to enter this work. So I do see a lot of people leaving, which is, I think, is a detriment to the sector. Adults 85 and older are one of Canada's fastest growing age groups, and it is

estimated that long-term care capacity will have to almost double in the next decade to meet demand. Andre Picard is the health columnist for the Globe and Mail and the author of Neglected No More, the urgent need to improve the lives of Canada's elders in the wake of the pandemic. He's in Vancouver. Andre, good morning to you. Good morning. We just heard from long-term care workers talking about what their job is like. How typical are their experiences based on what you know? Sadly, it's very typical. These are issues that exist and they've been exacerbated since COVID. over the country. Why is staffing still such a challenge in these long-term care facilities? Because it's very difficult work. It's back-breaking work. It doesn't pay very well, as you

heard. There's no job stability. Very little full-time work, so people have to juggle between facilities, very few advancement opportunities. The workloads are difficult. There's a lack of training. We're seeing cutsbacks in immigration. A lot of this is a racialized workforce, a woman, young women's workforce. And they have a lot of opportunities elsewhere. I hear over and over people leaving for better jobs at McDonald's because the pay and the benefits are better. So it's, it's very, very difficult out there. As you understand it, why is it so difficult to pay these workers more? If the work is so important and also really difficult, why aren't we paying, we broadly, why aren't we paying them more?

Well, that's almost an existential question across society. You know, the hardest jobs in our society are often the lowest paid, and that's very true in health care. There's a real pyramid. I guess it's just not valued. People don't have education. You know, they don't have MD or RN after their name. It's seen as grunt work, but it's so essential.

The health system could not function without workers at that level. They really hold up the rest of the pyramid. And so if the pyramid, if the foundation of that pyramid is on shaky ground, what does that mean, particularly the staffing issues, for the quality of care that residents get across this country? Well, you know, there's a famous quote in the field from Pat Armstrong, who's a sociologist at York University, and she said, the conditions of work are the conditions of care. So as the workplace deteriorates, as the work becomes more difficult, the care becomes worse. it's really become, unfortunately, in long-term care, it's become kind of factory work. You do these tasks one after another quickly. You don't interact with the patients.

You don't have that human touch that people so desperately need and want when it's, they're especially being cared for in their homes, but they're being cared for like widgets. What does that look like if you don't have that human touch? Well, it's a pretty sad existence. Imagine living in a facility, someone comes in routinely to change your continents, pad to feed you and they don't have time to talk to you. They have to rush through. They have to get you in and out of the bath in record time when you'd like to just linger a bit. It's not a nice life. There are other elements to this just in terms of where people are living, right? That if you don't have the staff, we can talk about the number of beds, but if you don't have staff, people can end up living in hospital, for example, because there isn't space and there isn't the staff there to care for. for them. Yeah, we have huge waiting lists for long-term care, despite I've not described it as a very

great life, but they're a huge wait list because a lot of people as they age need 24-7 care. So if they can't get a spot in a facility, then they end up by default in hospitals because they can't be taken care of at home. So there's a euphemism in healthcare. It's called ALC, alternate level of care, and essentially means you're living in a hospital. So the alternate is actually no care, and you just live there. And people often live there months, sometimes years, without any programming, without any friends. You just lie in a hospital bed and you get fed. And there's currently about 7,500 people, about 10, 15 hospitals worth of people just living like that in hospitals who don't need to be there, but there's no alternative.

We don't have a uniform system of long-term care in this country. There's public, there's private, there's unionized, there's people who are working in a non-unionized environment. What do we know in 2026 about which model is providing the best outcomes for residents but also for staff? Yeah, there's a real mix of ownership. People make a lot of ownership because we don't like that key word in Canada private. But the reality is the ownership is the least of our problems. There's really good care out there. There's fabulous homes.

Some are private, some are public, some. Some are not-for-profit. Some are municipal. Some are family-owned. There's a real mish-mash out there. And some of them are good. Some of them try to be good and can't get staffing. And some of them are terrible.

But we can't forget that a lot of people do get good care. We know this care is essential, but we don't have the mix right. We don't have the model right. You talked about immigration as well and the impact of immigration. We know that temporary foreign workers have become a huge part of staffing for long-term care. And the federal government, in the face of backlash publicly, around immigration numbers and the numbers of temporary foreign workers here limited the number of those workers allowed into Canada.

What is that going to mean for what we're talking about? We're just starting to see the impact of this. It's going to have a devastating impact on long-term care homes, on home care, on janitors who work in hospitals. These are the people who are the backbone. A lot of them are temporary foreign workers, their new immigrants. And we're going to lose that.

And it's just going to exacerbate all this. all these problems that we have. There's really this perfect storm out there happening in long-term care. You have an aging population, growing complexity of care, chronic staff shortages, constant turnover, shrinking resources. All the bad things are happening at once, and they're happening in the wake of COVID, which created tremendous trauma. I can't forget about 30,000 people died in long-term care homes in Canada.

everyone who lives there who survived has seen death on a scale that's unimaginable. Are we at all prepared for, again, you have a, I said in the introduction, adults 85 and older are one of the fastest growing age groups in this country. You have baby boomers who are going to age into that demographic or are already there where they require care. Are we at all prepared for that? We're unfortunately not prepared at all for it. You know, we don't have adequate 24-7 care for those who need it. We don't have adequate home care for people who need a little bit of help. And we have a demographic that desperately wants to age in place.

And we don't have a society built for making it easy to grow older in your family home or in a community. So there's all kinds of little things that need to be done. And they need to be done 30 and 50 and 10 years ago. And we just haven't prepared. You know, the baby boom is not a secret. It started about 70 years ago and we haven't prepared. And so where does that leave us? I was thinking back yesterday as I was getting ready for this conversation,

to the number of conversations you and I've had about this. We talked about your book, but we've talked about this over the course of the pandemic. I looked at some of the articles you've written from 2019 saying we can no longer ignore the crisis in long-term care. From 2022 saying that there's a moral and social importance to fix long-term care. Are we going to do that now, do you think? It's getting late. It's getting difficult to do it. You don't have to be all hands on deck pretty soon.

There's going to be tremendous political pressure. This is a group older people vote, but they haven't voted en masse to demand this kind of care. But it's going to have to happen. All the pressures are building. And it's scary. I'm not a young person, as you know, Matt. And it's scary to be getting older now and to think, what am I going to need in 10 and 20 years? And is it going to be there?

And the answer right now is no, unless we change quite dramatically. Andre, good to talk to you, as always. Thank you very much. Pleasure. Thank you. Andre Picard is the health columnist for the Globe and Mail and the author of Neglected No More, the urgent need to improve the lives of Canada's elders in the wake of the pandemic.

You've been listening to the current podcast. My name's Matt Galloway. Thanks for listening. I'll talk to you soon. For more CBC podcasts, go to cBC.ca slash podcasts.