A failing grade on long-term care
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.