12/14/12

Long-term care beds falling well short of need

The Auditor General reports that the stock of long-term care beds in Ontario has grown only 3% since 2004-5.  Over seven years (until 2011-12) that means an annual average growth rate of  0.42% (or about 319 beds per year).


Photo: Derek Tyson
That falls well short of population growth.  But much more important, it falls far short of the growth of the relevant population - the elderly.  Or as the Auditor General demurely states:  "An increase in the number of LTC home beds of 3% during that period has not kept pace with the rising demand from an aging population."

Ontario Ministry of Finance figures indicate that in the five years between 2006 and 2011 the number of people 85 and over increased 34%.  By 2016 the plus 85 set will have increased by 67% over 2006 -- and the ratio of those 90 and over compared to those between 85 and 90 will have increased from about 50% to 70%.

With a 1.5% annual increase in the number of LTC beds, the Conference Board estimates Ontario would be 127,000 beds short of need by 2035.  

But to fall "only" 127,000 beds short of need, we would have to increase the number of new LTC beds by more than three times the current rate!

The Liberal government constantly talks of dealing with these sort of problems by moving resources from "institutions" to home and community care -- and unfortunately the media has too often innocently bought this line as a panacea.  But the sorts of demographic changes we are facing swamp any such wishful thinking.  Home care can and should be  expanded -- but it can't completely offset  the increasing need for long-term care and hospital services.   

What makes this all the more vexing is that the 'increased' home care funding the government brags about hardly offsets the impact on existing home care services for population growth, inflation, and aging -- never mind making up for the real squeeze on hospital and long-term care services. 

Notably, we are beginning to see sharper measures to curtail the use of long-term care by the government.  The Auditor General notes that the government reduced the wait list for LTC in 2010 by redefining who is eligible for it. There are also reports of hospitals refusing to discuss LTC options with patients or fill in application forms.  

As public home care services are inadequate, the squeeze on LTC will force more elderly people to pay for their own private care, through private retirement homes or private home care.  Paying for private long-term care in the home or in facilities is an unaffordable business for individuals (that's why we have a public insurance system). Some won't be able to afford any such care and many others will be challenged to make do with inadequate care.  

Increased need for more volunteer assistance from family members (especially women) is going to happen too.  

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