⭐ PART 3 — The Long-Term Care Collapse

⭐ PART 3 — The Long-Term Care Collapse

How a System Designed for Safety Became a System That Produces Suffering

By Canadian Citizens Journal

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⭐ The Collapse Was Not Sudden — It Was Engineered Over Time

Long-term care in Canada was never perfect, but it was functional. Families believed their loved ones would receive support, safety, food, cleanliness, and human dignity. Workers believed they were entering a field built on compassion.

That system no longer exists.

What remains today is a crisis that did not arrive overnight. It emerged from:
• years of policy erosion
• staff shortages
• cost-cutting
• regulatory neglect
• declining infrastructure
• and the increasing expectation that under-resourced workers should perform impossible tasks under impossible conditions

The long-term care collapse is not a failure of individual workers.
It is a systemic failure — one that now directly intersects with MAiD.

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⭐ The Collapse Began Long Before the Public Noticed

For years, public officials framed LTC problems as “unexpected” or “pandemic-related.”

The truth?

Every structural weakness was there long before 2020:
• chronic understaffing
• inadequate training
• low wages that pushed workers out
• reliance on part-time staff
• unsafe worker-to-resident ratios
• aging, deteriorating buildings
• provincial budget restrictions
• increasing pressure on workers to perform unpaid tasks
• arrival of residents with higher and higher needs

These conditions were not new.
They were ignored until they became impossible to hide.

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⭐ The Turning Point: Higher Needs, Lower Support

A silent shift took place across Canada:

LTC homes began receiving residents with far more complex needs than the facilities were designed to manage.

Homes built for “moderate care” suddenly had residents with:
• advanced dementia
• severe cognitive decline
• unpredictable behaviours
• total dependence for mobility
• palliative-level needs
• complex medical conditions
• inability to weight-bear safely

Workers everywhere reported the same thing:

Resident acuity skyrocketed — staffing did not.

Families were never informed that these homes were now functioning as de facto hospitals without hospital staffing.

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⭐ When Assisted-Living Quietly Became Pseudo-LTC

A second failure grew in parallel:

Assisted-living was transformed into long-term care by stealth.

Across Canada, workers were instructed to accept residents who clearly required full nursing-home support.

Staff reported:
• residents unable to stand or transfer
• residents requiring two-person lifts in buildings not equipped for it
• residents with severe dementia wandering or unsafe
• residents with behavioural outbursts
• residents needing constant supervision in units never designed for it

When staff objected?

They were told:

“You don’t have a choice. If you refuse, you won’t be working here.”

This was never part of the original job description.
It was a restructuring done quietly — without public awareness.

And it placed LTC-level residents into environments incapable of meeting LTC needs.

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⭐ Environmental Decline: Buildings Working Against Residents

The collapse is not just medical — it is environmental.

Across LTC facilities, residents experience:
• rooms kept cold due to energy-saving timers
• inconsistent heat
• poor ventilation
• broken equipment left unfixed
• cracked floors and fall hazards
• bathrooms unsafe for mobility
• dim lighting
• noise disturbances
• overcrowded dining areas
• shared bathrooms with hygiene risks

These conditions accelerate decline — creating suffering that looks “medical,” but is actually structural.

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⭐ Food and Nutrition: The Silent Crisis Nobody Talks About

One of the most overlooked components of LTC collapse is the quality of food.

Workers consistently report:
• meals residents cannot chew
• food undercooked or unsafe
• overly tough meats
• insufficient portions
• improperly prepared dysphagia textures
• lack of nutrition
• rushed feeding due to staffing shortages
• dehydration risks
• residents refusing meals because they are unappealing

Residents pay thousands monthly for meals they often cannot eat.

Malnutrition becomes normalized.
It is rarely documented properly.
Families never see the internal numbers.

And malnutrition is a major driver of decline — including “eligibility” for palliative pathways and MAiD.

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⭐ Medical Decline Accelerated by System Failure

After 2021, workers across many facilities noticed a sharp increase in:
• mobility loss
• cognitive decline
• balance issues
• infections
• poor recovery from illness
• emotional deterioration

At the same time, LTC was stretched beyond capacity — creating a perfect storm:

More decline + Less support = More suffering

No national review was launched.
No public explanation was provided.

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⭐ Staffing Breakdown: A System That Breaks Its Workers

The collapse is clearest through the experiences of workers.

Across Canada, LTC staff report:
• being assigned unmanageable workloads
• covering multiple floors or buildings
• working injured or sick under pressure
• being denied adequate time for proper care
• crying in bathrooms or parking lots
• being punished for speaking out
• being threatened with job loss
• experiencing burnout and physical injuries

Some facilities run with:

⭐ One worker responsible for an entire floor — or more.

This is not care.
It is triage.

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⭐ How the Collapse Creates “Eligibility” for MAiD

When suffering is caused by:
• poor nutrition
• unsafe environments
• untreated pain
• preventable infections
• cold rooms
• lack of mobility support
• emotional despair
• social isolation
• rushed or incomplete care
• under-staffing

the system eventually classifies that suffering as:

“Grievous and irremediable.”

The suffering becomes the qualification.

Even though the system itself created it.

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⭐ The Collapse Is Not Just a Crisis — It Is a Pipeline

Canada’s long-term care collapse directly feeds into MAiD eligibility.

The suffering produced by institutional decline now looks identical to the suffering used to justify assisted death.

This is what families always suspected.
This is what workers have whispered about in break rooms for years.

It is not an accident.
It is structural.
It is the pipeline.

https://open.substack.com/pub/canadiancitizensjournal/p/part-3-the-long-term-care-collapse