Good elder care policy requires good data

Few people who have spent time inside a long-term care home would be surprised at the numbers the Citizen revealed this week. Sixty-six cases of reported resident abuse in 2016 at local long-term care homes. Five hundred and sixteen notices of non-compliance with provincial orders in these same facilities. We already know long-term care is both difficult to deliver and under-resourced; the numbers seem to bolster that conclusion.

But how to put them into real-life context? If you or a relative are contemplating long-term care, how alarmed should you be? The truth is, no one knows. As reporter Drake Fenton writes, while Ministry of Health and Long-term Care inspection reports for each facility are public, they exist in a vacuum: comparisons between homes, though possible in a limited way, are difficult to make. Meanwhile, the number of complaints and so-called “critical incidents” in long-term care has been steadily rising provincewide: It was 1,300 in December 2013; 2,800 in March 2015; and 3,370 in April 2107. No one can say why the increase has occurred.

In 2015, the Office of the Auditor General of Ontario noted that the ministry was slow to post inspection reports for long-term care facilities on its website. It’s doing better now, the auditor said recently. The ministry has also added to its website a feature that gives comparisons of LTC homes against the provincial average in a few areas, such as the number of non-compliance orders issued to the home; when it was last inspected generally; and how many follow-up or “targeted” inspections it had.

If you or a relative are contemplating long-term care, how alarmed should you be?

In Ottawa, however, only 17 of our 27 local long-term homes are captured on that particular website; you have to search the rest under pre-amalgamation geographic listings such as Nepean, Gloucester, Vanier etc. In addition, as the auditor general notes, the website “still does not show how many non-compliances and compliance orders are outstanding, and whether or not (and when) they were rectified.” As well, you’ll have to go to a different site to look at the detailed results of inspections — to find out if apparent breaches of the rules were serious, such as neglect of a patient, or less so, such as missed snacks.

There is no single, accessible portal to let members of the public compare data from the ministry with helpful information also collected by the Canadian Institute for Health Information, Community Care Access Centres, Local Health Integration Networks or Health Quality Ontario, each of which has an interest in long-term care. “As a result, it is still not possible to compare homes against each other without consolidating data and information from various sources,” says the auditor. And even if a stressed family navigated all these sites and agencies, it still wouldn’t be able to compare, say, food, hygiene or programming from one facility to another — all things that help us judge the quality of life a loved one may experience in care.

By the way, the ministry also “does not effectively ensure” the quality of its own inspectors’ work, adds the AG. It’s improving, but it’s still not really measuring its own performance in long-term care against its targets.

What Ottawans, and all Ontarians, need are effective, easy-to-understand, public report cards on long-term care homes. Good policies need good data. Families trying to make hard choices need such data in digestible form. Is this really too much to ask?