Neglected No More: The Urgent Need to Improve the Lives of Canada's Elders in the Wake of a Pandemic

by Andre Picard

A NATIONAL BESTSELLER
SHORTLISTED FOR THE BALSILLIE PRIZE FOR PUBLIC POLICY

It took the coronavirus pandemic to open our eyes to the deplorable state of so many of the nation's long-term care the inhumane conditions, overworked and underpaid staff, and lack of oversight. In this timely new book, esteemed health reporter André Picard reveals the full extent of the crisis in eldercare, and offers an urgently needed prescription to fix a broken system.

When COVID-19 spread through seniors' residences across Canada, the impact was horrific. Along with widespread illness and a devastating death toll, the situation exposed a decades-old the shocking systemic neglect towards our elders.

Called in to provide emergency care in some of the hardest-hit facilities in Ontario and Quebec, the military issued damning reports of what they encountered. And yet, the failings that were exposed--unappetizing meals, infrequent baths, overmedication, physical abuse and inadequate personal care--have persisted for years in these institutions.

In Neglected No More , André Picard takes a hard look at how we came to embrace mass institutionalization, and lays out what can and must be done to improve the state of care for our elders, a highly vulnerable population with complex needs and little ability to advocate for themselves.

Picard shows that the entire eldercare system--fragmented, underfunded and unsupported--is long overdue for a fundamental rethink. We need to find ways to ensure seniors can age gracefully in the community for longer, with supportive home care and respite for family caregivers, and ensure that long-term care homes are not warehouses of isolation and neglect. Our elders deserve nothing less.

Genres: Nonfiction, Audiobook, Canada, Health Care, Medicine, Health, Book Club

208 pages, Paperback

Published March 2, 2021

Reviews

[Geoffrey Kelley · Rating 4 out of 5]

André Picard has written a timely book on the tragic truths revealed by the COVID pandemic on the deep problems faced in providing elder care to our seniors in Canada. Staff shortages, lousy working conditions, poor pay for work that is too often part-time, forcing immigrant women ( the vast majority) to take on two or three jobs—these are some of the challenges faced by the dedicated people working with our elders. Coupled with aging and often poorly designed buildings, built years ago to accommodate many people under one roof, and chronic underfunding, and you have the house of cards that collapsed in many places during the pandemic. Picard rightly points out that these issues have been studied to death, so we do not need a new series of public inquiries into the failures of our elder care. We need a game plan now, as governments emerge from the pandemic and start planning for our post-COVID future.
My only caveat, as a retired politician, is the ease with which Picard indicates governments should simply invest more. That is true, but citizens should also stop voting for political parties ( even on occasion the one I was part of) that promise to lower taxes. With the demographic reality facing our country, this is completely irresponsible. Picard on occasion hints that if we could reduce “bloated bureaucracy” monies could be saved and reinvested. But what is needed is much more than could ever be found in the eternal battle against “ government waste”. Improving salaries and working conditions for nurses and orderlies, reducing patient-staff ratios, revamping old buildings or building new ones, strengthening home care will cost billions of dollars. It is impossible to find this money unless all of us are willing to pay more taxes. An unpopular truth, but a truth none-the-less!

[Conor · Rating 5 out of 5]

Andre Picard is passionate about the state of elder care in Canada and it shows through his writing. This is an expertly written book about an important subject no one thinks about enough.

[Karen · Rating 3 out of 5]

A comprehensive look at the dismal state of elder care in Canada. The title speaks of the author’s desire, not the reality in our fragmented, difficult to access system. There are lots of interesting tidbits of information in this book. For example, the three places in Canada offering best end of life care are Victoria, Edmonton, and Windsor.
The book is interesting and depressing. It reads like what it is — an extended piece of reportage by a newspaper columnist.

[midori · Rating 5 out of 5]

"Dementia is the only disease where people are still locked up. Why isn't the public outraged that thousands of people - their mothers, their grandmothers- are in locked wards, deprived of their dignity and their liberty?"

An incredibly rich policy piece regarding the state of congregate care in Canada. Unsurprising that this is so well done given Picard’s history as a health care journalist, but I am so impressed nonetheless.

[Steve Tripp · Rating 5 out of 5]

I have a relatively healthy mother in her late 80's and a relatively healthy mother in law in her early 80's. I'm nearly 60 and have some inherent genetic flaws and a ticker that's not perfect. My wife is 60 and also in relative good health. I'm thankful for all that. So why is a book about the elder-care system in Canada pretty much the scariest book I've read in the last 2 years? With our aging population and the weakness the COVID 19 pandemic has shown in this system, we'll be showing our naivete (or stupidity) if massive reforms don't become a big election issue next time we vote federally ... I know after reading this book, I'll be more vocal. .... thanks Mr. Picard!

[MargaretDH · Rating 5 out of 5]

Andre Picard is Canada's premier health journalist, and his examination of how Canada cares for its elders is just as I expected - thoughtful, compassionate and well-reasoned.

As in many countries, Canada's long term care facilities were especially hard-hit by the pandemic, and Picard uses this as a lens into how elder care works in Canada today. Many seniors are happy and healthy and living full lives, and have the ability to care for their spouses. But as a small but significant percentage of Canadians age, their health issue mean that they need a significant amount of personal care and assistance, up to round the clock supervision and assistance.

In Canada, we of course have a public healthcare system, but because of the way the Canada Health Act is written, eldercare is not covered. When our healthcare system was conceived, aging people were generally dying at home, until they needed to transition to a hospital, where they died shortly after. Plus, much of this happened during the baby boom, when much of healthcare was focussed on babies, mothers and children. Now, with better treatments for cancer, heart disease and things like organ transplants, people are living much longer. Long term care, also known as nursing homes, provide fulltime care for people who cannot care for themselves. Long term care is mostly utilized by elderly people, but many also have younger residents who have, for example, been in catastrophic accidents that leave them incapacitated. A limited amount of home care is also covered. But beyond that, assisted living facilities, access to personal care workers and even some long term care is not covered and can be extremely difficult to navigate. It can also be expensive, and where you are geographically in Canada makes a great deal of difference in what you can access. Finally, care is usually delivered in institutional settings designed with efficiency as a first priority and dignity and comfort as afterthoughts.

Picard digs into the facilities, access to homecare, the added wrinkle of dementia, the staffing of facilities and home care agencies, access to palliative care, and the struggle of being a caregiver and advocate for a loved one. Then he makes a set of recommendations about how Canada can serve our seniors better.

This is an extremely approachable book with lots of stories and evidence. It also makes some substantive policy recommendations that are well thought out. The only thing stopping us from implementing them are that they would be significantly more expensive, and would require a significant piece of legislation from the federal government.

This isn't a book about how to navigate the eldercare system, but it's a great snapshot of how difficult it can be. This is a slim book, and I would recommend it for everyone. Whether you're about to become a caregiver, are planning for your own retirement and care, or a person who has never thought about this at all, I think there's something here for you.

[Kathleen · Rating 4 out of 5]

Neglected No More: The Urgent Need to Improve the Lives of Canada's Elders in the Wake of a Pandemic by Andre Picard

It took the coronavirus pandemic to open our eyes to the deplorable state of so many of the nation's long-term care homes: the inhumane conditions, overworked and underpaid staff, and lack of oversight. In this timely new book, esteemed health reporter André Picard reveals the full extent of the crisis in eldercare and offers an urgently needed prescription to fix a broken system.
"We need national staffing standards - a care guarantee - and monitoring to ensure the regulations are respected...We must solve the workforce crisis."
Caregivers, Home Care, Palliative Care, Funding, Structure, Regulation, Advocacy/Information all need to be addressed. 4.7 stars

[Amanda Cox · Rating 4 out of 5]

An account of elder-care, including during the pandemic period, with a Canadian context

This book was heart-breaking and emotional. The way our country treats older people, especially within institutions, leaves a lot to be desired. The book makes a lot of good points about the challenges we face and our options moving forward to make improvements. Not a "fun read" but an important topic.

[Ally MacDonald · Rating 3 out of 5]

Interesting perspectives on current health care/LTC system, and how to improve it, but the author makes it seem like things are an easy fix at times. Good information on history of LTC and funding formats across provinces and world wide.

[Sara · Rating 4 out of 5]

Quick read which was nice for a heavy topic. Learned a lot about ltc and Eldercare. Gave me new appreciation and understanding of homecare and the patient /person perspective of care needs as people age.

[Shaun Bona · Rating 5 out of 5]

“Neglected No More” is an evaluation on eldercare that lays out the divergent complexities of assisted living, home care, long-term care, and palliative care.

A health reporter and columnist for the Globe and Mail, André Picard recounts the history of eldercare through to the present. He references and quotes interviews, reports, and studies that expose a dearth of improvements in various disciplines and facilities.

Picard’s research disclosed that Canada has the worst record among wealthy nations for COVID-19-related deaths in long-term care. As COVID-19 spread through seniors' residences, the effect was not only horrifying but exposed a long-standing, scandalising, and pervasive neglect towards elders.

Picard highlights the more often-than-not dedication of caregivers, underlining barriers with which they continuously grapple. Taken-for-granted caregivers are overwhelmingly racialised women, often new Canadians, and low-waged. The Canadian eldercare foundation is fabricated from agism, ethnic intolerance, and sexism.

Oppositely, Picard also points us toward many viable solutions for improving access to quality care options that are required to meet the diverse needs of our current and future elders.

Throughout his clear as crystal study, Picard provides pragmatic information on eldercare in Canada alongside solutions for changing a broken and tampered system.

[Robyn · Rating 5 out of 5]

A really well-done overview, with the fine eye Picard brings to his health reporting. Anyone who’s had anything to do with this “system” will see their frustrations reflected here, with fair and thoughtful consideration. It ends on a hopeful note, with a series of interlinked recommendations that would be hard to disagree with.

[Jeff Goodes · Rating 5 out of 5]

An excellent summary of the dismal state of seniors care in Canada. Ends with a call to action to increase home care. We must listen and act.

[Christopher Neal · Rating 4 out of 5]

Neglected No More: The Urgent Need to Improve the Lives of Canada's Elders in the Wake of a PandemicHealth reporter’s indictment of eldercare a wakeup call for action

André Picard’s Neglected No More: The Urgent Need to Improve the Lives of Canada’s Elders in the Wake of a Pandemic, couldn’t be timelier. Short-listed for the Quebec Writers’ Federation’s (QWF) 2021 Mavis Gallant Award for Non-Fiction and the Balsillie Prize for Public Policy, this indictment of Canada’s dysfunctional eldercare system—or non-system—is clear and concise about its problems, and judiciously focused in its recommendations for reform.
My reading of this tour-de-force by Picard, the Globe and Mail’s health reporter and columnist, coincided with daily reporting of testimony at a Quebec coroner’s inquest into over 5,000 deaths in the province’s long-term care homes during COVID-19’s first wave. They accounted for 90 percent of Quebec’s COVID deaths, and witnesses corroborated Picard’s analysis as to why this occurred. Eldercare in Canada, he writes, is disorganized, poorly regulated, suffers from inadequate staffing, outdated infrastructure, non-existent accountability, and rampant ageism.
This is not new. Over 150 task forces, inquiries, parliamentary hearings and reports have documented the decrepit state of long-term eldercare, Picard reports, “yet very few of the recommendations ever get implemented.” The pandemic has been tragic, but its salutary legacy may be exposing the deadly neglect to which seniors, especially the most vulnerable, have been subjected.
Picard makes the case for immediate action based on recommendations repeatedly made, and just as repeatedly ignored. The central idea in his book is that most people want to spend their last years at home and not, as Montreal filmmaker Janet Torge is quoted as saying, “dumped all together with a bunch of strangers in a building that smells like piss.”
For all the talk about a “grey tsunami” as baby boomers age, however, Picard reminds us that only 350,000 Canadians, or seven percent of those over 65, live in long-term care. The majority who enjoy good health and have the good fortune to be spared dementia, he argues, can continue to live at home—provided they have proper community support, including financing to help their family members care for them as they age into frailty.
This would be more humane. It also makes economic sense. Picard cites Ontario, where studies show that 20-50 percent of those in long-term care, at $180 a day per patient, could live at home, given proper community and caregiver support. Instead of financing institutional care, that money could be directed to home caregivers who could use it more creatively. The point resonates, not just for elders, but for everyone, as Picard notes, “at some point, almost every Canadian will become a caregiver.” Usually family members, and usually women, their unpaid care’s minimum-wage equivalent value is over $25 billion. Government subsidies or insurance schemes for family and community caregivers are the rule in Norway, Sweden and Germany, whose systems offer lessons for Canada, Picard argues.
He concludes with an appeal to “unleash an all-out effort to improve the care of elders,” that matches the urgency of the wartime nuclear-bomb “Manhattan Project” approach to deal with COVID-19. It is nothing less than a reveille for seniors, and those who care for them, to demand action now.

[Mike Smith · Rating 4 out of 5]

"As of September 30 [2020], Canada had recorded 9,262 Covid-19 deaths, and of that total, 7,609 were in residential care homes. That's 82 percent--twice the average in the thirty-seven OECD countries (of which Canada is one)." By March 30 2021, the percentage of COVID-19 deaths in nursing homes was 69%, while the international average was 41%. This book is about why Canadian care homes, also known as nursing homes or long-term care (LTC) homes are providing such inadequate care for our elders and what we should do to fix them.

The book, written by long-time health journalist Andre Picard, is divided into two major sections, cleverly titled "Neglected" (chapters 1 to 8) and "No More" (chapters 9 to 12). Chapter 1 begins with anecdotes about families who lost members to COVID-19 in LTC homes, mainly in Quebec and Ontario. The next chapter then looks at the history of LTC homes (which has been a challenge for governments for at least 400 years). Chapter 3 examines government funding of LTC homes in Canada today and what services homes provide. Chapter 4 looks at home care, which would allow elders to live in their own homes. Unfortunately, in Canada, home care is a patchwork of private companies focused on accomplishing specific tasks within allotted time periods. The specific and challenging needs of elders with dementia are the topic of Chapter 5. Chapter 6 is about the workers who provide care and the challenges they face, such as low pay, few benefits, and high stress. Chapter 7 covers the burden on family members who care for their elders. Finally, Chapter 8 addresses palliative and end-of-life care, which can be hard to find in Canada.

Chapter 9 begins Part Two by reaffirming that the goal of elder care should be to keep elders in their homes for as long as possible. This could include small group homes with permanent staff instead of large, institutional LTC homes. Chapter 10 is a brief survey of how other countries care for their elders and what we might learn from them. Denmark in particular took steps in the 1980s to revamp their elder care services so that they really are an integrated system now. Chapter 11 examines how we care for elderly veterans and whether that largely successful approach could be extended to all elders. The final chapter, Chapter 12, is a "prescription for reform" that recognizes several areas needing improvement, including staffing, support for family and other unpaid caregivers, updating and funding long-term care homes, home care, palliative care, overall funding, the patchwork structure of Canadian elder care, modernizing applicable laws and regulations, advocating for and informing families about their options, and supporting the communities where elders live.

Picard's writing is straightforward and readable. Like any good reporter, he uses individual stories to illustrate the broader challenges and opportunities in LTC. Given his criticisms of LTC, his recommendations are sensible. Picard does not, however, explain where the funding will come from to pay staff, build new facilities, and invest in the tools and technologies that would make our senior years happier and more satisfying. As citizens, I guess it's up to us to demand that our politicians make elder care a priority. As taxpayers, it's also up to us to put our money where our mouths are.

[Tony Discenza · Rating 5 out of 5]

The author offers an in depth look at the past, present and future of care for our elderly in Canada and how an already challenged system is impacted by the Covid pandemic. Problems and concerns already existing for decades are exposed in a harsh and deadly manner by a pernicious virus. If we are among the fortunate we will be spared the complexity of navigating the bureaucracy of care for the elderly. Many of us will confront this complicated labyrinth for our loved ones or ourselves and require assisted care in our future. In either case we should all be aware of the system of elderly care in Canada and aspects of it that need to be addressed and conditions redressed. Andre Picard takes us through the situation through his research, interviews with professionals and poignant stories of individuals and families and their experiences with caring for elderly loved ones in LTC and other models of care for our greatest generation. At a moment in history when our most vulnerable continue to be so cruelly impacted, an understanding of how and why is needed and Picard puts forward solutions to problems that have been allowed to worsen for decades. As the title suggests, it is time to act. Please read and pass along the book to someone about whom you care.

[FellowBibliophile KvK · Rating 3 out of 5]

Does well to point out how there is no national insurance for home care or long-term care in Canada, and how the disabled have suffered atrociously as a result of it.

Also does well to contrast British Columbia's Dr. Bonnie Henry of the Royal Canadian Navy who took action and banned PSWs working at multiple sites during the pandemic in contrast to Francois Legault's ultranationalist CAQ allowing this to go on in Quebec.

Also, correctly points out that a core problem is the lack of funding. In this regard, however, he overlooks--or ignores due to his political alliances--other key issues, such as, as David Levine points out in Health Care and Politics , Quebec local community centres (CLSCs, bastions of the ultranationalist base), sabotaging and sinking a viable proposed home care programme offered by the hospitals out of concerns over turf protection.

Likewise, with Jane Philpott in [ Health For All, he makes comparisons to Scandinavia without understanding that Denmark, like Norway, a) has a much smaller population than Canada, b) constitutes a fraction of Canada's square mileage, and--most crucially--c) gives away only a fraction of the foreign aid that Canada does.

[Maureen · Rating 4 out of 5]

Picard wrote here about the urgent need to improve the lives of Canada's elders. He suggests wise recommendations that should be prioritized including staffing, caregivers, Long Term Care homes, home care, palliative care, funding, structure, regulations, advocacy and community. He strongly says not to rush out and build more facilities the same as we have but rather to take the time to change them to smaller, more friendly facilities. I am still pondering his one suggestion: "We need to stop with the elder apartheid and integrate care homes into the community. Facilities should be shared with daycares and schools. Being around older people, including people with dementia, should be a daily part of living, not an uncomfortable anomaly." (p. 178).
My favourite lines: “We need to reform eldercare, we need to focus on getting value for
money.”(p. 173) “Elders have borne the brunt of the Covid-19 pandemic, and they should be the greatest beneficiaries as we come out on the other side. We need to create an environment where seniors can thrive. " (p. 179-80)

[Tom Axworthy · Rating 5 out of 5]

This is a must read book: in just a little over 200 pages ,Andre Picard the health reporter for the Globe and Mail summarizes the results of many past studies, international comparisons and daily news stories to outline the shocking dimensions of Canada's Eldercare crisis.The essential point, he writes, is that Covid has demonstrated tragically the dimensions of a long known problem, it did not create them. We have known about the silver tsunami about to hit our society for a long time but until Covid decision makers simply ignored it.But demography is destiny and now we all know the consequences of shoehorning elders into Long Term Care homes without adequate staff, standards or training.Canada spends 80% of its eldercare health resources on institutional care and 20% on home care.In Denmark those percentages are exactly reversed. Picard concludes with a multi point action plan to turn our current failing system on its head: every government and political leader in Canada should take this agenda and implement all of it.

[Rukhsar (rukhsandbooks) · Rating 4 out of 5]

This book has been on my list since it was released. I’ve attended many events where Andre Picard has spoken and I knew as a healthcare leader I had to read his book.

But my heart just wasn’t ready to face the cold heart truths Picard was going to share (especially as I finished my masters and switched jobs to try and make the world a healthier and happier place). I finally told myself enough is enough and borrowed the book from the library.

It’s sad, but much of what Picard shared was shocking but not shocking to me because I have experienced it in both my personal and professional life. As predicted, he shares some cold hard truths and brings attention to some critical issues with eldercare in Canada and beyond. The book emphasizes that we need to do more than just take note of what is happening and instead initiate sustainable action.

If you're looking for a thought provoking read that does not sugar coat the reality of aging in Canada, I highly recommend this.

[Donald Leitch · Rating 4 out of 5]

André Picard has analyzed the state of elder care in Canada. In his book, he discusses the weaknesses in the system that have been identified through previous government studies and how these weaknesses became tragically clear during the COVID pandemic. It is these past failures to act that make the book a frustrating read. Solutions have been identified over and over again in past reviews and studies. We fail to learn. Included in the analysis, Picard traces the evolution of elder care from the Victorian era work house to today including the structural separation of elder care from health care. Picard also provides an interesting synopsis of the elder care systems in a number of other countries. Picard’s book is an accessible must-read for anyone wishing to understand Canada’s elder care systems.

[Carole · Rating 5 out of 5]

Neglected No More: The Urgent Need to Improve the Lives of Canada’s Elders in the Wake of a Pandemic by André Picard is an unblemished look at what awaits all of us because it is inevitable that we must grow old. This book was obviously written by a renowned journalist because the research into eldercare was meticulously done. There are numerous examples of choices or lack thereof a senior citizen must make as the end of life approaches. Although extremely detailed I found myself becoming frightened. The pandemic has highlighted the abject neglect of so many of our elders in many countries. Canada is no different. And there does not seem to be political will to improve on care for our older citizens. This is a book to be read as we age because we still have time to make changes to a society that casts aside and mistreats so many. Food for thought. Highly recommended.

[Shannon · Rating 4 out of 5]

A great analysis of the state of elder care in Canada (and around the world) both before and during COVID with some useful suggestions for ways governments can make improvements going forward. Along with facts and figures, the book is also interspersed with personal anecdotes from caregivers and their experiences with different types of care facilities and options. The inadequate government support (as highlighted during the COVID pandemic) means that it is often left to those with money to be able to best care for their elderly relatives. The author argues that when we devalue elder care, we devalue our elders,” and “we need to create an environment where elders can thrive not just survive.”

[Enid Wray · Rating 5 out of 5]

Short, sweet, and to the point. This is perhaps one of the most important books likely to be published in Canada this year. It should be sent as ‘priority reading’ to every politician across the country… and to every voter who has bought into populist (conservative) politics and preaches from the ‘no more taxes’ playbook.

We must build a more compassionate, caring society that places value on citizens of every age, especially our elders… and one that values the work done by those in the caring professions!

Our social contract is broken. Let’s seize the day - and the opportunity presented to us by COVID - to come out of this proud of the changes we’ve made.

4.5

[Georges Tormen · Rating 4 out of 5]

Dure, la réalité dure !

Il y a un devoir d'intelligence comme il y a un devoir de mémoire! Comment ne pas prendre le temps de comprendre la vie quand elle est rendue à l'autre bout de son âge? Comment ne pas la valoriser de la naissance à la mort? Vieillir, c'est vivre d'une vie plein et entière; ce n'est pas un fardeau, une surcharge, une dépense inutile. André Picard a dépeint chirurgicalement la manière dont nos dirigeants à la tête de la société et du gouvernement nous démontrent leur inaptitude à agir conformément aux principes et aux valeurs humanitaires. J'ai été bouleversé et je me suis dit qu'il y avait aussi beaucoup à faire pour changer les mentalités et nous sortir de l'inertie. Devoir d'agir et devoir de partage! Aussi!

[John Lawson · Rating 4 out of 5]

Andre Picard, the always excellent health reporter for the Globe and Mail, does a postmortem on the long-term care crisis that killed so many during the Covid 19 Pandemic in Canada. After reading the book it's completely understandable why so many thousands of seniors died in long-term "care" facilities. You cannot call them homes in many cases. He challenges both the way we claim to honour and care for elders as well as the government response – or lack of it – to the real needs and wishes of senior population in Canada. A difficult and sobering read – but important. I hope this book will provide ammunition and incentive to begin to heal this broken system.

[Kbeckermann · Rating 4 out of 5]

If you've never read Picard's columns, I highly recommend this. It isn't as well researched as some of his other books but none-the-less is solid. He is direct, succinct and names the issues and provides context for the current state in Canada. This is typical assertive and ironic Picard.

If you are a regular reader of Picard and well-versed on the issue in Canada (like me) it provides some additional historical background but there is little new. I always enjoy his bluntness which made it worth reading.

[Kirby · Rating 4 out of 5]

Everyone needs to read this book. It provided easy, practical information on eldercare in Canada as well as solutions for changing a broken system. Eldercare, although not something you might think is important, impacts everyone of us and the horrific neglect given to our elders is sad and appalling. Drastic societal changes are needed because if not we will continue to fail our grandparents, parents, ourselves, our children, grandchildren and every generation that grows old. Become aware of what is happening and start advocating for change.

[Marilyn Cox · Rating 4 out of 5]

For those who are unaware of the state of elder care in Canada, Picard’s book is an excellent primer. There’s nothing new here but the author does a good job of packaging what we know in a concise format. Since the printing of this book, the public outrage over the deaths in LTC during the pandemic has already waned. As Picard points out, we know how to turn this around, but the public will to move forward is lacking. Ageism (the most tolerated form of discrimination) is the real culprit but not adequately addressed in this book – this is a human rights issue and nothing less.

[Vontel · Rating 4 out of 5]

Picard challenges all of us, and through us our governments, to make major corrections in the care of our fellow beings, whose ranks we will all join as we age, as do our parents & siblings. Well written analysis of the effects of the Covid pandemic exposing the extreme challenges of care of (or serious lacks in the care of) the elders of Canada. These chasms between needs & care, funding provided, and regulations & accountability have been known for a long time. Covid merely showed the extreme deficiencies in the generally inadequate systems (or non-systems).