A ‘ journey losses’ of
Wait- lists for long- term care beds across Ottawa are the second- longest in Ontario, further stressing families already burdened with the challenges of caring for their loved ones
Anita Lee says she doesn’t have a lot of patience, and never has had much. Don’t believe her. She has stores of patience and a wonderful sense of humour, too. These qualities have helped her endure a range of emotions — anxiety, sadness, loss, ambivalence — as she plans and prepares for her mother’s inevitable move into a long- term care facility.
Mrs. Lee is primary caregiver for her 86- year- old mother, May Vallière, who was diagnosed with Alzheimer’s disease about four years ago. Mrs. Vallière, who also has some Parkinson’s- type symptoms, lives with her daughter and sonin- law, Bob, in their west Ottawa home.
Although Mrs. Vallière has been “ really doing well” of late — sleeping less, eating better than before, walking without her cane, improving her crossword puzzle skills — Mrs. Lee has already placed her mother on a waiting list, even though she may not need to make the move for another year or two.
Planning ahead is essential because wait- lists have become a fact of life for those in search of a long- term care home for a relative with Alzheimer’s disease.
“ At the beginning of the year, there were perhaps five homes that did not have a wait- list,” says Sheila Bauer, director of client services at Ottawa’s Community Care Access Centre, which co- ordinates placement of clients into the city’s 28 longterm care homes. “ Now each home has a wait- list.” The wait- lists are a sign of the times. About 10,000 people in Ottawa currently have Alzheimer’s disease or a related dementia, and that number is expected to grow by 2,000 new cases annually for the foreseeable future. ( Of the more than 12,000 CCAC clients, about 2,000 have Alzheimer’s or a related dementia.) The lists are also groaning under the weight of an aging and expanding population: there are currently about 100,000 people 65 and older in Ottawa, out of about 840,000 residents. By 2025, one of every six residents will be a senior.
As of the end of August, Ottawa’s 28 homes had 1,621 people on wait- lists, queueing up for as long as five years for the city’s approximately 4,730 beds. The region’s health- planning council reported this month that Ottawa’s long- term care homes have the second- longest median waittime in the province.
“ I don’t think there’s a crisis per se — right now,” says Marg Eisner, director of programs and services for the family support and education wing of the Alzheimer Society of Ottawa.
“ But I think what we need to do right now is plan. How do we do appropriate placements and what do we need to put in place to let family members cope better at home? I think it’s time now to get a strategy where we’re all working together to plan better. If we don’t do that part, then I don’t think were doing a service for people.”
Wait- times vary from home to home, depending on the level of care required and other factors, including the home’s reputation and location.
“ People are waiting, but sometimes people choose to wait,” says Ms. Bauer. “ Geography is important. If you have lived in one area for a large portion of your life, you may want to find a home there so you can stay in that area.” Transportation also comes into play: relatives may want to be close to their loved ones to make visiting easier.
Preference is also part of the equation in choosing a home, Ms. Bauer says. “ If you like the environment and feel a connection, then the family will feel that’s where they would like their mom or dad to be. And some homes in the city have always had a wait- list because they have an excellent reputation.”
The City of Ottawa operates four long- term care homes: Carleton Lodge in Nepean, Centre d'accueil Champlain in Vanier, the Garry J. Armstrong Home in central Ottawa, and the Peter D. Clark Centre in Nepean. The queue at the city’s four homes ranges from a few months to two years; private rooms, because they cost more, generally have shorter wait- times than shared rooms. One of the longest wait- times is at the Clark Centre, according to CCAC statistics from June: three years for a ward bed for a woman with dementia ( men usually have shorter wait- times).
Ministry of Health and Long- Term Care statistics show that, between 1999 and 2004, 1,327 new beds opened at long- term care homes in Ottawa. About 90 additional beds are scheduled to open by June 2007, a ministry spokesman said. Under provincial benchmarks, these additions will bring the city up to the number of long- term care beds deemed appropriate for the percentage of population aged 75 and older.
The wait- lists in Ottawa have created serious problems for hospitals. A report released this month found that one of every five of the city’s acute- care hospital beds were being used by people who did not need to be in hospital — many of them seniors with Alzheimer’s waiting for a bed in long- term care.
As a result, because hospitals often do not have enough room to accommodate new admissions, surgeries are being cancelled and emergency wards are, at times, lined with patients on stretchers as they wait for ward beds.
As the problem grows, the region’s health planning body, the Champlain Local Health Integration Network, has joined advocates calling for change: more long- term care beds, enhanced home care and supportive- housing projects to allow people with mild dementia or other infirmities to live in a group- home setting with staff able to manage their daily needs. Health officials have also asked the province to expand housing options for seniors by subsidizing the cost of personal care at private retirement homes.
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