From the General Manager
A Nursing Home Story
Our elderly relative’s experience is common to thousands of Ontario families
Our family has recently gone through an experience that thousands of Ontario families share: obtaining appropriate long-term care for a loved one. In our case, it was finding a nursing home for our beloved 89-year-old aunt. It was a frustrating and eye-opening exercise that left me deeply concerned about the state of our care system. It had been a decade since my mother-in-law entered similar care. Since then, the process has become deeply bureaucratized, with
institutions trying to download as many costs as possible onto families and other institutions.
In February, Aunt Helen fell in her seniors’ apartment, breaking her elbow. This led to an eight-week stay at Scarborough General Hospital, during which she experienced a range of setbacks. It was clear to us that several doctors and some nurses essentially wrote her off because of her advanced age. Fortunately we were there to advocate for her, and some of the medical staff were willing to listen. She improved enough to be released, but only to long-term care, for which there are long waiting lists. At that point, the hospital placed her on an ALC list (alternate level of care), charging her $56 per day to remain in hospital (this is allowed under provincial law).
We discovered her situation was unfortunately common: an estimated 18,000 other Ontarians are waiting at any given time for a long-term care bed, and thousands of them are waiting in hospital (referred to as “bed-blockers”). We went into emergency mode, visiting ten facilities, interviewing friends about their nursing home experiences, and checking online provincial inspection reports for infractions. We learned that all LTC homes are under-funded and under-staffed, many prescribe mind-dulling, potentially deadly medications, and some are filthy and shabby. That’s the bad news.
On the positive side, we were able to find half a dozen homes that met our criteria. We put our aunt on the waiting list for five of them and prepared to wait it out for months, if necessary. To our great relief, the wait was a short one: Auntie was admitted to the nursing home section of the same building in which she had resided in independent living. The staff there is hardworking and caring, and the setting is a safe and familiar one. We are very grateful.
That said, I know that many other families are struggling in the same system. You could see the panicked, frightened, weary looks on the faces of many of those on the nursing home tours. Hospitals pressure families to take the first-available LTC facility so they can clear out the bed-blocking relative. They go so far as to insist that selection lists include at least two homes with short waiting lists. Of course, these are often the least desirable facilities—old, poorly maintained, and often with a history of violations. The thing is, under provincial law, hospitals are not actually allowed to force you to choose any home; admissions procedures are solely administered by the province’s Community Care Access Centres (C.C.A.C.), but no one tells you that.
It was clear to us that a hospital bed was not a good place for our aging aunt to remain longer than necessary. Besides the expense incurred by Scarborough General, there was the issue of her welfare. Hospitals are for acutely ill people, and they are rife with opportunities for infection. Nursing and other hospital staff are terribly overworked, and too few of them are available to lift weak patients into wheelchairs, meaning those patients spend endless hours in bed with no mental stimulation. Those already dealing with minor dementia usually suffer most, often sinking into states of delirium.
We spent Easter weekend moving our aunt’s belongings out of her old apartment. Some went to her nursing room, most went to charity. It’s sad to see her declining and becoming less mobile, but I can happily report that her mental state is vastly improved and her spirits are generally better.
So what did I learn from this? Politicians talk constantly about a non-existent gravy train, about debt, deficit, and waste. The truth is that operating government is expensive. While plenty of fat has been cut over the years, we’ve now gone beyond that, spending years hacking into the meat of our healthcare and social welfare systems. People who have worked hard and paid taxes all their lives are now suffering because the system they paid into is not supporting their needs. The richest Canadians can afford private nursing and expensive retirement homes, but most of us are facing a bleak future as we age. We should always ask our prospective leaders to clarify their priorities when it comes to these fundamental services.