Elder care model must be changed

With a rapidly aging population never has the need been more critical to transform elder care. We need a more modern, comprehensive, non-profit, community based and co-ordinated system of care for elders. The pandemic’s horrific toll on seniors’ lives in long-term-care facilities the past two years supports the urgent need for a transformative approach. Simply “fixing” a fundamentally flawed model of institutional care will not work.

It is important to note other socially devalued groups (orphans, Indigenous youth, people with mental illness, people who have developmental disabilities, troubled youth) forced to use the institutional model of care have abandoned it amid harm, lawsuits and scandal.

All of the recently announced political party platforms acknowledge home care needs to be strengthened to enable seniors to stay in their homes as long as possible. However, while making a commitment to expand home care is good, the elder care system is heavily weighted toward long-term institutional care. The province’s Financial Accountability Office confirms more than $10.6 billion (up from a base of $4.4 billion) is needed to increase direct care for residents and to expand and redevelop 30,000 beds. Home care, in contrast, spends about 60 per cent of its $3.3-billion budget (about $2 billion) to assist 440,000 seniors living in the community.

The central issue that distinguishes the different party platforms is the extent to which they seek to correct the imbalance in public investment between institutional care and home and community support.

The PCs have committed to “bed expansion,” 30,000 new and 28,000 redeveloped beds. The NDP’s platform almost matches that projecting 50,000 new “modern beds.” The NDP’s major “overhaul” of the system is to get profit out of care beginning in 2022.

In contrast, the Ontario Liberal Party plan strikes at the heart of the transformation needed. We must have a policy priority shift away from the institutional care and toward a more robust home, health and community-based model of care. Party leader Steven Del Duca stated, “institutionalizing seniors through long-term care has been one of the greatest mistakes of the 20th century.” This statement reflects the bold, transformative action that is needed, and the reasoning could not be clearer.

First, recent polls and surveys from the National Institute on Aging and from the Canadian

Association of Retired Persons (CARP) find that more than 95 per cent of seniors want to avoid long-term institutional care.

Secondly, we simply can’t afford to build our way out of the need for elder care. The institutional model costs over $200 per day per person of public investment given recent commitments to improve it plus copayments from residents. In addition, property developers are provided construction subsidies of up to $200,000 per bed. The 2021 Queen’s University Report, Aging Well, concludes the institutional model of care is unaffordable.

Thirdly, alternatives to the institutional model of care are proven, preferred and cost effective. Recent media coverage about the Danish model helps us understand what is possible. Older Danes who need double or triple the amount of home and health care that Ontario provides can access this assistance.

Ontario must change its model of care. The Liberal plan for elder care recognizes we need to begin a transformational process toward a home and community model. Only then will seniors have the choice that they want; to remain in their homes and communities to the end of life.

DOUGLAS CARTAN IS A DISABILITY CONSULTANT AND CO-FOUNDER SENIORS FOR SOCIAL ACTION ONTARIO. JUDITH SANDYS, DISABILITY ADVOCATE AND DEAN OF COMMUNITY SERVICES (RETIRED) TORONTO METROPOLITAN UNIVERSITY. PETER CLUTTERBUCKIS A RETIRED SOCIAL DEVELOPMENT AND PLANNING CONSULTANT.