Association calls for full-scale review of care
Province must examine all forms of treatment of seniors, OHA says
The mandate of the province’s commission into long-term care should be expanded to look at how frail seniors are treated in the entire health system, the president of the Ontario Hospital Association says. The pandemic has overwhelmed all parts of the health system, not just long-term care, and seniors have paid the highest price, Anthony Dale said, adding that the federal government should be involved in the commission’s work.
“The pandemic has reminded us what can be done when there is a sense of true crisis and urgency. This is the biggest mobilization of health-care resources since veterans returned home from the Second World War,” he said.
Health-system sectors — including long-term care, hospitals, home care and community care — are interconnected. What happens in one can affect the others, Dale explained.
“Long-term care is linked to wider questions about accessibility of appropriate services for seniors,” he said.
The way forward should involve expanding home care, he argued. Home care allows seniors to stay in their own homes. They receive assistance from visiting nurses, personal support workers and others.
Ontario Long-term Care Minister Merrilee Fullerton announced Tuesday the creation of an independent commission to examine the impact of the pandemic on nursing homes.
Dale said the federal government should be involved in any kind of examination because the system of transfer payments from Ottawa to the provinces needs to be overhauled to better support the provision of health and social services.
Frail seniors have been bouncing around the health system since the pandemic started.
They were among the patients cleared out of hospitals in mid-March to make way for an expected surge of COVID-19 patients. Then, when the pandemic slammed long-termcare homes, frail seniors were transferred back to hospitals.
Hospitals have long struggled with a high level of “alternative-level-of-care” (ALC) patients. These are typically frail seniors who have received acute care and are ready for discharge. But they are stuck in hospital beds because other parts of the health system — including long-term care and home care — are at capacity.
This causes a shortage of beds in hospitals. There aren’t enough in-patient beds for patients initially admitted through ERs. The result is hallway health care.
Dale said hallway health care isn’t appropriate at the best of times.
The pandemic has laid bare society’s reliance on chronically congested hospitals, he said.
While all parts of the health system are overburdened, hospitals are the “safety net,” he said, explaining that people end up going to emergency departments when they can’t get their health care anywhere else.
Hospitals are once again experiencing capacity pressures, Dale warned, noting the number of ALC patients is rising.
According to the Ontario Hospital Association, there were 5,200 ALC patients in hospitals on March 1. The number fell to 4,000 by April 9 due to efforts to make space in hospitals for COVID-19 patients. But by May 13, the number had gone up again to 4,900.
Hospitals are now faced with the “extremely difficult challenge” of dealing with competing demands, Dale said. In addition to caring for the growing number of ALC patients, they have been ordered by the province to reserve 15 per cent of their acute-care capacity for COVID-patients.
At the same time, they have begun to ramp up elective surgeries and some scheduled cancer surgeries, which were cancelled in mid-March.
“This (resulting) risky situation means that this is not a moment for half measures. This is a moment for powerful change in Ontario’s health-care system,” Dale said.