Hot! Retirement homes should receive government subsidies: top geriatrician

OttawaCitizen.com – Health – Move could help ease hospital gridlock
September 20, 2010.   By Pauline Tam, The Ottawa Citizen

Governments should consider subsidizing the cost of privately run retirement homes as an antidote to overcrowded hospitals and a backlog in nursing-home admissions, says the outgoing head of Eastern Ontario’s geriatrics program.

Such a move would effectively expand the stock of supportive housing for seniors and, possibly, be a step toward regulating retirement homes more like nursing homes.

“If you’re a senior with dementia who has no caregiver and no bucks, we use a very expensive solution, which is long-term care. Why wouldn’t we subsidize retirement homes much more? Much less cost,” said Dr. William Dalziel, a geriatrician at The Ottawa Hospital.

A basic bed in a retirement home costs between $50 and $250 a day — but usually toward the low end of that range — while a nursing-home bed costs up to $220 a day.

The Ontario government spends $3 billion a year on provincially licensed nursing homes, and co-payments are estimated to cost families another $1 billion.

The tab does not include the millions that are spent on building new nursing homes.

A recent study commissioned by eastern Ontario’s health authority found that many seniors are on the waiting list for nursing-home beds not because they need round-the-clock nursing care, but because they can’t afford retirement homes.

Dalziel argued more also needs to be done, through tax breaks and caregiver allowances, to support families struggling with the financial toll of elder care. Last fall, Nova Scotia became the first province to introduce a caregiver allowance that provides up to $400 a month to family members who look after someone with a disability or chronic illness.

Dalziel, 59, made his remarks in an interview to mark his imminent retirement from the top job of a program he founded 25 years ago.

The Regional Geriatric Program of Eastern Ontario was the first of its kind in the province and became a model for others across Ontario.

As one of the first geriatricians to be recruited to Ontario, Dalziel pioneered a number of elder-care services at The Ottawa Hospital, many of which have gone on to be adopted province-wide.

They include:

– Specialized teams of outreach nurses, therapists and social workers to assess the in-home and medical needs of seniors living on their own or with their families.

– Dedicated nurses in hospital emergency rooms to attend to the elderly.

– The province’s first in-patient unit devoted to frail elderly patients who no longer need hospital care, but are awaiting nursing-home placements.

But repeated service cuts, as eastern Ontario hospitals have struggled to balance their budgets, have erased any progress on elder care, said Dalziel. “We squandered the head start that we had.”

In the process, Dalziel has become highly critical of how hospitals, including his own, fail seniors, even though they are the health-care industry’s biggest customers. Once hospitalized, frail elderly patients are too quickly labelled as candidates for nursing homes and left to languish without proper care, Dalziel said.

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