The right care, time and place

The Niagara Falls Review - - NEWS - SEAN KEAYS

It is very im­por­tant for the provin­cial­go­v­ern­ment and its pol­icy mak­ers to rec­og­nize the im­pact that lin­guis­tic, eth­nic, cul­tural and re­li­gious ser­vices have on health-care out­comes for res­i­dents liv­ing in long-term care. Hav­ing worked and stud­ied in longterm care for more than 20 years I have no­ticed that meal­time, mu­sic and faith-based ser­vices are the three most reg­u­larly at­tended and im­pact­ful so­cial events within long-term care homes.

In ad­di­tion, the Cana­dian In­sti­tute of Health In­for­ma­tion re­ports that 60 to 70 per cent of res­i­dents liv­ing in long-term care have some form of de­men­tia, and there is plenty of ev­i­dence that sup­ports the fol­low­ing: peo­ple who suf­fer from de­men­tia often re­vert back to their mother tongue.

Fur­ther­more, the French Health So­ci­ety of Canada re­ports that lin­guis­tic bar­ri­ers are an im­por­tant ob­sta­cle for fran­co­phones’ health when they live in mi­nor­ity sit­u­a­tions. Mis­com­mu­ni­ca­tion can cause di­ag­nos­tic er­rors in treat­ment, medicine er­rors and in­crease pre­ventable health risks. Lin­guis­tic bar­ri­ers pose se­ri­ous con­cerns in eq­ui­table de­liv­ery of health care that can re­sult in in­fe­rior qual­ity of life.

The prov­ince has an­nounced that by 2025, 30,000 long-term care beds will be re­de­vel­oped to up­grade build­ing stan­dards equal to the Long Term Care Act and reg­u­la­tions.

Al­though this news is very pos­i­tive, there is clearly an ur­gent need for new beds to the sys­tem. The Min­istry of Health and Long-Term Care re­ported that it cur­rently has 78,500 places for long-term care and, un­for­tu­nately, the 27,000 in­di­vid­u­als who are on the wait­list wait for an aver­age of 2.9 years to se­cure care be­cause oc­cu­pancy rates hover around 99 per cent — a ma­jor ca­pac­ity is­sue.

The On­tario As­so­ci­a­tionof Non Profit Homes and Ser­vices for Se­niors sug­gests that if noth­ing is done, the wait­list for long-term care could climb to nearly 48,000 by 2021.

In Ni­a­gara, we have a unique chal­lenge due to the fact that we have one of the high­est per­cent­ages of se­niors per capita in Canada and we lack the avail­able geri­atric re­sources com­pared to other com­mu­ni­ties.

For ex­am­ple, cur­rently there are 515 unique peo­ple wait­ing for place­ment in long-term care in Wel­land, which is a 1:1 ra­tio (beds avail­able to peo­ple wait­ing) com­pared to three beds for ev­ery one per­son wait­ing provin­cially. This will have neg­a­tive con­se­quences across the en­tire sys­tem.

Se­niors who must wait for place­ment in long-term care homes de­te­ri­o­rate more quickly, use more healthcare ser­vices and end up in hos­pi­tal emer­gency de­part­ments more fre­quently cost­ing our health-care sys­tem more money. We should strive to al­low for peo­ple to get ‘the right care, in the right lan­guage, at the right time and at the right place.’

Some may con­sider Ni­a­gara’s de­mo­graph­ics to be a ‘se­nior tsunami’ with very low ca­pac­ity where we heav­ily rely on in­for­mal care­givers.

Ac­cord­ing to the Cana­dian As­so­ci­a­tion of Re­tired Per­sons, more than eight mil­lion Cana­di­ans pro­vided in­for­mal care to a fam­ily mem­ber or friend last year. It re­ported that the eco­nomic value of care­givers is as­tound­ing, be­tween $24 bil­lion to $30 bil­lion per year. These are some of the un­sung he­roes; with­out them, where would our health care sys­tem be?

I would like to urge our friends at the Min­istry of Health to con­sider adding 2,500 to 5,000 new long-term care beds over the next two years as a start­ing point to meet de­mand.

Pri­or­ity should be given to not-for­profit French des­ig­nated long-term care homes that have been slated for re­de­vel­op­ment and are lo­cated in emer­gency ar­eas for short­ages of long-term care li­cences.

Foyer Riche­lieu in Wel­land is a lead­ing em­ployer for franco phones want­ing to work in healthcare and in their na­tive tongue, which re­tains and at­tracts many tal­ented bilin­gual em­ploy­ees and fam­i­lies to Ni­a­gara. Other such or­ga­ni­za­tions is the Cen­tre de Santé Com­mu­nau­taire Hamil­ton-Ni­a­gara, which has been rec­og­nized as an early adopter for new pro­grams by the Lo­cal Health In­te­grated Net­work and has de­vel­oped many part­ner­ships with Foyer Riche­lieu over the years so that the res­i­dents can re­ceive more high-qual­ity ser­vices in French.

Pol­icy mak­ers, ser­vice providers, res­i­dents/pa­tients and in­for­mal care­givers have a sig­nif­i­cant chal­lenge ahead in en­sur­ing that Cana­di­ans con­tinue to re­ceive ef­fi­cient, high-qual­ity health-care ser­vices. Some have even re­ferred to it as “apoc­a­lyp­tic de­mo­graph­ics” (Gee and Gut­man, 2000) or “Ag­ing Tsunami” (Sinha, 2014).

How­ever, by in­vest­ing in our high qual­ity not-for-profit ser­vice providers, en­sur­ing that lin­guis­tic and cul­tur­ally based or­ga­ni­za­tions are given the op­por­tu­nity to be vi­able and hav­ing Cana­di­ans con­tinue to in­vest in their el­ders we will con­tinue to strive and meet in­creas­ing de­mo­graphic de­mands for longterm care ser­vices.

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