Something has to change: Dr Samir Sinha weighs in on aged care regulation

27 March, 2024 3 min read


We are privileged to have one of Canada's most influential voices for older people coming to #IDC2024: Dr Samir Sinha.

Samir is a highly regarded clinician and international expert in the care of older adults.

He is the Director of Geriatrics at Sinai Health System and the University Health Network in Toronto, a Professor of Medicine at the University of Toronto, and the Director of Health Policy Research at Toronto Metropolitan University’s National Institute on Ageing.

Samir brings decades of experience guiding government policy on aged care, and will discuss some of the challenges faced in both the Australian and Canadian regulatory systems.

"Regulations can sometimes not produce what we want for people with dementia," says Samir.

"The over-regulation of aged care and the management of risks that come with it – where the ultimate goal is ‘safety’ – can result in a situation where people end up merely as a list of boxes to be ticked, rather than as humans."

The over-regulation of aged care...can result in a situation where people end up merely as a list of boxes to be ticked, rather than as humans.

Dr Samir Sinha

During the COVID pandemic, Canada sadly led the world in deaths in long term care. This started a national movement to change the system. Samir has been hands-on at both the care coalface (as Director of Geriatrics of the Sinai Health System) and as a member of various senior government advisory groups.

He's seen close-up how governments can swing the pendulum too far in the other direction, over-burdening an already under-staffed sector, essentially setting facilities up for failure, and ultimately reducing quality of life for those in their care.

"Any time there’s something on the news about someone getting hurt, there are more regulations introduced, and practices become more risk-averse," says Samir.

"Instead, risk appetite needs to be matured and nurtured, and encompass the right for people to live with risk."

And the most impactful solution, according to Samir, can be summed up in one word - staffing.

"Staffing is the answer," he says.

"If you have enough staff, you have a fighting chance that people will get appropriate relationship-centred care, not tick-a-box care.

"If you really want to deliver high quality care, you need to give residential homes a chance by allowing them to staff themselves adequately.

"Yes, if you manage people well there will be less falls, for example, but at the moment they barely have the staff to get people fed and watered.

"Pay parity for well-trained and well-supported staff will lead to the provision of better resident-centred care."

At IDC2024, Samir will seek to address some of these complexities (in both countries) driven by staff pay inequities and risk management, as well as data collection and procedural requirements, and he’ll cast a vision for a future that treats high-quality staff as an unequivocal priority, allowing care providers to treat patients as whole human beings.

He will be drawing on some of the research presented in a report he co-authored for the National Institute on Ageing (NIA), Enhancing Care for Older Adults in Canada and Down Under, which outlines several opportunities to improve the organisation, governance, and delivery of services in both Canada and Australia.

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