A fail­ing grade on long-term care

The Hamilton Spectator - - OPINION - Howard El­liott

In the past decade or so, this space has had more than its share of editorials about long-term care in On­tario. They typ­i­cally dif­fer in some ways, but the themes are the same. We don’t have enough long-term care beds or com­mu­nity ca­pac­ity. Peo­ple need­ing Al­ter­nate Lev­els of Care beds are stuck in acute care beds due to the short­age, mean­ing the acute care beds are not avail­able for peo­ple who need them for their in­tended pur­pose. And the prob­lem is only go­ing to get worse due to an ag­ing pop­u­la­tion.

Back in 2009, the lo­cal health in­te­gra­tion net­work (LHIN) in­tro­duced the provin­cially-man­dated “home first” strat­egy, which in­tended to pro­vide pa­tients with enough sup­port to re­cover or wait for other types of care at home rather than hospi­tal. The strat­egy seemed to be work­ing, with the per­cent­age of blocked beds in the LHIN drop­ping from 25 per cent in 2009 to about 12 per cent after Home First rolled out.

But due to re­source short­ages the strat­egy stalled, the blocked beds num­bers shot up again and the LTC bed short­age re­mained acute.

Fast for­ward to 2017. More than 3,200 se­niors are wait­ing for long-term care in Burling­ton and Hamil­ton. One-in-four beds at St. Joseph’s Health Care is blocked by some­one wait­ing for al­ter­nate care.

Hamil­ton alone has 2,061 se­niors wait­ing. On av­er­age, they will wait be­tween 148 and 708 days for a ba­sic long-term care home room. Wait times for pri­vate rooms were about three years for some homes. It’s even worse in Burling­ton, with 1,157 wait­ing be­tween 196 days to 843 days.

This is not progress. It’s not that Home First is a fail­ure, but it is in­ad­e­quate without other ini­tia­tives. There are many ben­e­fits to se­niors spend­ing more time in rel­a­tive in­de­pen­dence at home be­fore tran­si­tion­ing to long-term care, pro­vided ad­e­quate home­care re­sources are avail­able. But too of­ten, those re­sources are not ad­e­quate, putting un­man­age­able strain on fam­ily and other care­givers. And in many cases, a move to long-term care is es­sen­tial. But it’s not hap­pen­ing fast enough, leav­ing frail se­niors and their fam­i­lies in a bu­reau­cratic limbo wait­ing for care and se­cu­rity they should be able to count on.

When­ever the gov­ern­ment is asked about this, when it deigns to re­spond, the an­swer is the same. We know it’s a prob­lem, we know more needs to be done, we are mak­ing progress. There al­ways seem to be seem­ingly end­less rounds of con­sul­ta­tion.

But there are only a cer­tain num­ber of per­mu­ta­tions that end up as an­swers here. To one de­gree or another, Hamil­ton, Burling­ton and the rest of On­tario do not have an ad­e­quate num­ber of de­cent-qual­ity long-term care beds and fa­cil­i­ties.

And so, to Health Min­is­ter Eric Hoskins and his gov­ern­ment col­leagues, we say: Not good enough.

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