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The Holland Christian Homes long term care home in Mississauga, Ont., on May 26, 2020.Fred Lum/The Globe and Mail

Ontario Premier Doug Ford pledged last year to make air conditioning mandatory in every nursing home, including residents’ bedrooms. But his government has awarded construction contracts for new facilities that do not include cooling systems throughout the building.

Under the province’s building standards, new nursing homes are not required to install air conditioning in residents’ bedrooms, leaving the elderly more vulnerable to dehydration and heat-related illness on sweltering summer days.

The standards, which have not been revised since 2015, are out of step with Mr. Ford’s promise that newly built facilities will be “state of the art.” His government awarded contracts in March alone to construct 36 new homes and refurbish 44 existing ones.

However, the design model for new long-term care homes excludes residents’ bedrooms from a requirement to have a “mechanical system to cool air temperatures” in common areas, such as dining rooms and lounges.

Long-term care advocates are surprised the government did not update the design model last year, when Mr. Ford announced a series of new nursing home construction projects.

Jane Meadus, a lawyer with the Toronto-based Advocacy Centre for the Elderly, said officials with the Long-Term Care Ministry told her at the time that they had no plans to revise the model.

“It’s quite ridiculous,” she said. “What if you’re bed-bound?”

As recently as May 27, Long-Term Care Minister Merrilee Fullerton also made no mention of the design model during a news conference, where she announced that all 626 of the province’s homes have designated cooling areas served by air conditioning.

However, in response to questions from The Globe and Mail, a spokeswoman for Ms. Fullerton said on Tuesday that the ministry is now planning to update the model for newly built homes by requiring them to be fully air conditioned, including residents’ rooms.

“Most recently approved homes have air conditioning in resident rooms as part of their design and for those that don’t, we are working with operators to get units in every resident room,” Amber Irwin said in an e-mail.

Neither the Long-Term Care Ministry nor the Ontario Long-Term Care Association, which represents a majority of homes, would say how many projects exclude air conditioning in residents’ rooms.

The coronavirus pandemic has highlighted many problems in long-term care, including chronic staffing shortages and outdated homes with multibed wards that made it difficult to isolate residents sickened with COVID-19. The virus killed 3,781 residents in long-term care in Ontario.

The lack of air conditioning in older homes in Canada’s two most populous provinces came under a microscope during a heatwave last summer, when residents in many homes fighting outbreaks of COVID-19 were confined to their rooms.

Physicians said elderly people are more vulnerable to heat.

“With age, your sensation of thirst decreases,” said Amit Arya, a palliative care physician who works in long-term care homes in the Greater Toronto Area. “By the time an older adult is thirsty, they might already be mildly dehydrated.”

In Quebec, only a third of nursing homes had air conditioning in each resident’s rooms before the pandemic. The province embarked on a crash program last year to improve the situation, installing window units in residents’ rooms or parking mobile cooling units outside the building.

In Ontario, just under 13 per cent of long-term care homes had no air conditioning at all last year. Mr. Ford promised last July to make air conditioning mandatory throughout every long-term care home, including residents’ rooms. Eleven months later, only 60 per cent of the province’s homes are fully air-conditioned. The rest have designated cooling areas, with air conditioning in the dining room and other common areas.

The common areas are not easily accessible for many residents, who end up spending the majority of the day in their rooms, said Vivian Stamatopoulos, a professor at Ontario Technical University who specializes in family caregiving.

In those homes that are not fully air conditioned, staff are expected to monitor the temperature in residents’ rooms on hot days. But Dr. Stamatopoulos said it is “just ludicrous” to expect workers to find the time to do temperature checks, when many homes are already short-staffed.

Nick Puopolo has waged a year-long fight to get air conditioning installed at Woodbridge Vista Care Community, a nursing home north of Toronto where his mother, Saveria Puopolo, has lived for the past four years. He called public attention to the sweltering conditions in the home last summer by installing a thermometer in his mother’s room and reporting the temperature and humidity readings.

The home will soon have air conditioning, he said, “because I’ve been in the media constantly since last July.”

Nadia Daniell-Colarossi, a spokeswoman for Woodbridge owner Sienna Senior Living, said the company is in the process of installing a new custom-built unit at the home, which will provide 100 tonnes of cooling power, including to the 224 rooms for residents.

Sienna, a for-profit chain operator, is also participating in the Ontario government’s program to add 30,000 new long-term care beds to the current stock of 78,000 beds and refurbish others. Sienna has received the go-ahead to replace a home in North Bay with a newly built 160-bed home.

Of the 80 projects the government awarded in March, 35 went to for-profit operators and 45 went to not-for-profit homes, including those owned by municipalities.

With a report from Tu Thanh Ha

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