Page - 455 - in VULNERABLE - The Law, Policy and Ethics of COVID-19

455Privatization and COVID-19: A Deadly Combination for Nursing Homes casual staff and on the workers with less formal credentials. This is particularly the case for those called personal support workers or care aides.26 These trends result in particularly dire consequences when residents and workers are exposed to COVID-19. The Nature of Nursing Home Work To understand the impact of COVID-19 on nursing homes, it is neces- sary to understand the nature of the work, and how it has intensified with increasing privatization, decreased staffing, and increased resi- dent acuity. According to the Canadian Institute for Health Information, 62% of residents have dementia, with a third experiencing severe cogni- tive impairment. Three quarters have some bladder incontinence and over half have bowel incontinence, while 40% exhibit some aggressive behaviour.27 The Ontario Long Term Care Association28 reports that the actual severity is much higher, with significant overlaps in these categories: • 90% have some form of cognitive impairment • 86% need extensive help with activities such as eating or using the washroom • 80% have neurological diseases • 76% have heart/circulation diseases • 64% have a diagnosis of dementia • 62% have musculoskeletal diseases such as arthritis and osteoporosis • 40% need monitoring for an acute medical condition • 21% have experienced a stroke • 61% take 10 or more prescription medications. 26. Katherine Zagrodney & Mike Saks, “Personal Support Workers in Canada: The New Precariat?” (2017) 13:2 Healthcare Policy 31, DOI: <10.12927/hcpol. 2017.25324.>. 27. Canadian Institute for Health Information, “Profile of Residents in Residential and Hospital-Based Continuing Care, 2018-2019” (2020), online (pdf): Canadian Institute for Health Information <https://www.cihi.ca/en/access-data-reports/ results?f%5B0%5D=field_primary_theme%3A2054&f%5B1%5D=field_primary_ theme%3A2061&f%5B2%5D=field_content_format%3A2166>. 28. Ontario Long-Term Care Association, “This Is Long-Term Care 2019” (2019) at 3, online (pdf): Ontario  Long-Term  Care  Association  <https://www.oltca.com/ OLTCA/Documents/Reports/TILTC2019web.pdf>.