Low-need seniors less likely to enter nursing homes
Saskatchewan seniors with lowcare needs are less likely to be admitted to nursing homes than in other jurisdictions.
About one in five (22 per cent) of Canadian seniors admitted to long-term care might have been able to stay in their own homes if appropriate supports such as home care had been available, according to a new report from the Canadian Institute for Health Information (CIHI).
Seniors in Transition: Exploring Pathways Across the Care Continuum studied over three years more than 59,000 seniors whose care needs were assessed by healthcare professionals.
The analysis looked at seniors who enter residential care following an initial assessment, which is used to determine eligibility and priority for placement in continuing care.
“We wanted to find out what fraction of those that are assessed as low to moderate (care) enter residential care,” said Steve Atkinson, manager of analytics and special projects for CIHI’s western office.
In Saskatchewan, 16 per cent of seniors with low to moderate care needs went into long-term care as compared to 33 per cent in Manitoba — which had the highest admission rate. British Columbia had the lowest rate at 15 per cent.
Saskatchewan has taken steps to improve community-based services.
“We offer appropriate assisted living options, enhanced homecare, programs such as Home First, Seniors House Calls, and day programs that do not require the intensive services typically provided in long-term care,” according to a statement from the Ministry of Health to the Leader-Post.
The Home First/Quick Response program was designed to improve homecare for intensive short-term needs to keep seniors in their homes; facilitate appropriate discharge from acute-care facilities; prevent unnecessary emergency room admissions, involve service providers in the system to support seniors in their homes and prevent admission to special-care homes.
Health-care workers in the Seniors House Calls program provide home-based care to those at risk for poor health outcomes, including repeated hospitalizations and ER visits.
Recently, the Regina Qu’Appelle Health Region announced transitioning 30 long-term care residents with lower care needs to an assisted living environment with community support.
Long-term care is typically the most expensive service in the continuing care spectrum.
The CIHI report looked at many factors that influence a placement into residential care.
Those factors included higher levels of cognitive or functional impairment, a senior living alone or caregivers unable to continue to provide support.
“Just by being in hospital when that assessment occurs strongly influences the probability of being placed into residential care,” Atkinson said.
Typically hospitalized seniors have been through a lengthy acute care stay and are still continuing to convalesce, he said.
To get a true reading of their needs, it’s better for seniors to be assessed after they get home.
Growth in Canada’s senior population has been steady for 20 years, but within the next two decades the number of those 75 years and older is expected to double.
As the senior population grows, health systems will face higher demands because of increased chronic conditions and greater expectations from seniors about remaining home as long as possible.
The CIHI report notes: “If we assume that health services will be provided in the future as they have been in the past, health systems would need to double existing residential care capacity over the next 20 years to keep up with population growth. Clearly, this is not a feasible or appropriate option.”
There are still opportunities to improve the match between care needs and care settings for Canadian seniors, Atkinson said.
“Looking at those populations that enter residential care potentially before their needs necessarily require the services of residential care is certainly one place we can start to improve the long-term sustainability of continuing care in our country,” he said. “We also recognize that there is a preference among most seniors to remain as independent as possible in the community.”