Step up scrutiny, funding for nursing homes

Posted on September 19, 2015 in Health Delivery System

TheStar.com – Opiniojn/Editorials – Ontario’s nursing homes need more scrutiny than they are getting, including speedier and more transparent inspections when complaints are lodged.
Sep 17 2015.   Editorial

When Fatemeh Hajimoradi developed gaping, infected bedsores at a Mississauga nursing home in May, her family did the right thing. They demanded that the home call 911 and send the 88-year-old to hospital. She was treated and released. But the family rushed her back to hospital with more ulcers a month later, where she is still being treated.

Yet while her granddaughter, Fariza Trinos, emailed a complaint to the Ontario ministry of health and long-term care last spring, plus photos of the wounds, the family got little satisfaction. A ministry inspector visited the nursing home in August, two months later, but didn’t interview the family. Instead the inspector interviewed staff at the home and discounted the complaint.

All this left Trinos feeling “like I’m helpless,” she told the Star’s Moira Welsh and Andrew Bailey. “They aren’t going to send anyone else in there. They just go in, close the book and that’s it.”

The families aren’t alone in feeling helpless. Many residents do, too.

Moreover, as the tragic case of Dorothy Benson illustrates, nursing homes rarely face serious consequences for neglect. A ministry inspector found that an Oakville nursing home’s “neglect” and “inaction” in 2013 when the 93-year-old came down with bedsores put her well-being at risk. She died of problems related to sepsis and dehydration. But no police charges were laid and no inquest was called. The family is now suing the home.

The 112,000 Ontarians with advanced illnesses who are living in some 630 long-term care homes deserve better than this. The ministry’s own guidelines say that in cases of “harm, neglect or danger” an inspector will get back to the complainant, usually within two days to “decide the next best step to take.” That’s the sort of response a vigilant and caring family might have hoped to get. But in the case of Fatemeh Hajimoradi at least, it wasn’t to be.

Dipika Damerla, Ontario’s new associate minister of long-term care, says she was “saddened and troubled” by photos of the gaping wounds these women suffered, and promises to “do more” to prevent similar incidents.

But as Ontario Health Minister Eric Hoskins should know, sadness isn’t enough. Nursing homes clearly need more scrutiny than they are getting, including speedier and more transparent inspections when complaints are lodged. Residents need timely protection, and homes must be held to account.

In the past few years alone, the Star has reported that Ontario nursing home residents are among the most depressed in the country. That antipsychotic drugs are over-prescribed, increasing the risk of falls, strokes, pneumonia and death. That nursing home staff are ill-trained to cope with violent residents. And that some homes use restraints because they are understaffed.

Indeed the system is generally underfunded, understaffed and overworked. The Ontario Association of Non-Profit Homes and Services for Seniors has called for a $385-million injection of public funds, phased in over three years, to close the current staffing gap.

There is no easy remedy. Ontario’s nursing homes are struggling to accommodate an influx of elderly residents with dementia, complex ailments, limited mobility and other needs. That challenge is building as the general population ages, as modern medicine prolongs life and as fewer families are willing or able to take care of the elderly at home. The demand for institutional care can only grow.

Still, none of this excuses neglect of seniors. In recent years the health ministry has strengthened its regulations, beefed up its inspection services and put more information on the Internet about nursing homes.

But as the cases of Hajimoradi and Benson illustrate, the system still isn’t working as well at it should. Ontario needs to address that funding gap, and provide residents with the protection they deserve.

< http://www.thestar.com/opinion/editorials/2015/09/17/step-up-scrutiny-funding-for-nursing-homes-editorial.html >

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