Not enough being done in Ontario for those waiting for nursing homes

Posted on December 14, 2012 in Child & Family Delivery System – news/canada/politics
December 14, 2012.   By Thomas Walkom, National Affairs Columnist

Politicians talk endlessly about the problems of an aging society. It’s a standard line in any stump speech.

But as Ontario’s auditor general pointed out this week in a low-key but shocking report, for old people themselves far too little is being done.

In some areas, matters are getting worse

For example:

• Between 2005 and 2012, the median wait time for people trying to get into an Ontario nursing home almost tripled — from 36 to 98 days.

•  Those with more money now have a better chance of getting in faster;

•  In some cases, such as those where non-English-speakers seek facilities in which the staff can understand what they are saying, the average wait time is 14 years.

•  Not surprisingly, given all of the above, about 15 per cent of people on nursing home wait lists die before they can be placed. Those who do make it manage to stay alive, on average, just three more years.

The nursing home section of Wednesday’s wide-ranging auditor’s reportdidn’t get much attention. I’m not quite sure why. Governments — and Ontario’s Liberal government in particular — have been promising to fix thelong-term care system for years.

The Star routinely runs exposés detailing the problems of the system. Ministers routinely respond by breaking into tears and promising to better.

But what Auditor General Jim McCarter details, in his own dry way is how inadequate this response has been.

More money has been put into long-term care. But nursing home capacity has barely budged.

While the number of people on nursing home wait lists increased by 85 per cent between 2005 and 2012, the number of long-term beds went up by only 3 per cent.

Why? In part, it’s because nursing home operators (private and public) are gaming the system.

Instead of simply expanding bed capacity, many new facilities have chosen to construct more private and semi-private rooms — what the auditor calls “preferred accommodation.”

The reason? They can charge patients up to $2,200 a month for deluxe rooms, which is $500 more than the fee for accommodation in a basic four-bed room.

As a result, only 40 per cent of beds in the province are now considered standard accommodation. But about 60 per cent of those on nursing home waiting lists want this cheaper option.

What that means in practice, says the auditor, is that those able to pay the higher fees get in faster.

Little to do with long-term care is simple. The auditor says that many of those on the waiting lists are already placed in one nursing home but would prefer another that, for instance, is closer to home.

Are these people just picky? I’m not sure they are. Think of someone whose elderly spouse lives in Toronto and doesn’t drive. For such a person, being moved to a nursing home in Barrie 100 kilometres away would be like going to the moon.

Then there is home care. Studies show that some people on nursing home wait lists would be better off if offered care that enabled them to stay in their own homes.

The government understands this and, indeed, talks a good line on home care. But here also it has as delivered too little, treating home care largely as a cost-saving measure that, in effect, transfers the burden back to the elderly themselves and (if they are lucky) their families.

Even if Ontario’s home-care system were adequate, it would be only a partial answer. Some older people simply cannot stay in their own homes.

For them, a nursing home is the only plausible option. Wednesday’s report is a reminder of how badly flawed that option remains.

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