10/13/11

Radical changes in Ontario home care service

The Community Care Access Centre (CCAC) annual reports are beginning to roll out for 2010-11. While the reports are not exactly filled with informative facts, the Central CCAC report does contain at least one useful chart (p. 5) which provides a partial update on home care trends.

Personal Support
The chart notes that the number of hours of personal support work declined by 100,000 hours in 2010-11 compared with 2009-10.  In terms of total hours, that is a modest decline, but the number of clients assigned personal support declined much more sharply, from 22,049 to 16,884 -- a 23.4% decline.

This breaks with recent provincial trends.  Province-wide data to 2009-10 indicates a 19.3% increase in the hours of personal support over 2007-8. Is this a new trend for the province? We'll see.

Out of this data, the Central CCAC highlights the increase in the number of hours of personal support per patient. (This, I might add, is only a result of the large decrease in the number of patients who got personal support.)  The annual report connects this to the growing role of the CCAC "in quickly and safely transitioning people from hospital to their home and community, after acute care has been provided by a hospital."

The focus for personal support is clearly on getting people out of the hospital -- with the result that fewer patients get personal support.

Paramedical Services
The trend at the Central CCAC for paramedical services is, unfortunately, consistent with recent province- wide trends.

Occupational therapy, physiotherapy, social work, and nutritional counselling visits declined sharply at the Central CCAC in 2010-11: e.g. occupational therapy was down by almost 20%, physiotherapy by about 25%, social work by 44%.  Similarly, province-wide, occupational therapy lost 31% for the two year period ended 2009-10 and speech language therapy was down 45%.

Nursing
Nursing is more of  mixed bag.  Nursing visits have increased modestly province-wide moving from 5.89 million visits in 2007-8 to 5.96 million visits in 2009-10.  This is not so far off the trend at the Central CCAC, which saw a small decline in the number of nursing visits in the last year.  But the details supplied by the Central CCAC reveal that visits by nurses to patients in their houses shrank, while visits by patients to "home care" nursing clinics grew.



1 comment:

  1. This is shocking and verifys what we have been thinking right along. The emphasis is on getting the patient out of the hospital and sending him hom. They fondly call it Aging At Home. It sounds good, but the problem is they send them home without proper support and by your figures it looks like it is getting worse instead of better.

    We had a case in our area of Niagara whereby an elderly patient with multiple health problems fractured her shoulder in a fall at home, where she lived alone. She was taken to Welland Hospital. A doctor eventually saw her and put a sling on her shoulder, gave her a shot of morphine and released her. Her sisters, who had gone to the hospital were very upset and insisted her sister could not manage at home and they did not feel capable of looking after her in her condition. CCAC arrived on the scene and insisted she go home or they would charge her anywhere from $50 to $90 per day. A fight ensued. Since the patient was due for a dialysis treatment she was taken for that and the nurse in charge of dialysis said the woman was not in shape to go home and to readmit her, which they relunctantly did. The next day the patient died. Not a pleasant way for that poor lady to go.

    This is how heartless our system has become. We call the Provincial Policy Dying At Home.

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