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A tiny response to growing elder needs

The Ontario government’s 26 page Action Plan for Seniors came out yesterday.  There’s not much to it.  About half of the report simply rehashes what is already in place.

To the good, they at least formally recognize that the elderly population is expanding rapidly and that this is going to require an  “overarching plan” that (absent their reforms) is going to cost a lot of cash. (For more information on the tsunami we are facing in long-term care, and how far short we are falling, click here, here, and here.)

To the bad, their reforms are pipsqueak-sized compared to the problem at hand.

Perhaps the biggest proposal here is their plan to designate 250 beds in long-term care as ‘assess and restore’ beds.   Essentially this means opening hospital beds in long term care facilities.  Instead of using long-term care to provide long-term residential care, they want to use long-term care to provide short-term care (providing curative treatment, as in the hospitals).   

The for-profit long term care providers have advocated this for a little while (apparently starting about the time when it became clear the government was averse to expanding long-term care).  

The government promises only to “designate” 250 beds – they do not promise to create 250 beds.  If LTC beds are turned in to short-term beds, this will worsen the backlog for LTC (which is already very bad).   Despite the recognition that the elderly population is rapidly expanding, they make no commitment to expand either LTC or hospital services.  They do make some reference to expanding asses and restore beds in LTC, the community, and hospitals, but there is no specific promise.

Other LTC plans mentioned are: 
  •  “We will propose to amend the Long-Term Care Homes Act to ensure that these homes are reporting to the Ministry of Health and Long-Term Care all critical incidents involving injuries where a resident is admitted to hospital, and all environmental hazards that affect the care, safety or well-being of residents for a period greater than six hours. 
  • “Also to be included in this proposed amendment will be other improvements, such as staff training and developmental opportunities that focus on improving resident safety, preventing abuse and neglect, and advancing quality of care for residents with responsive behaviours or other specialized care needs, including residents with palliative or end-of-life care needs. In addition, we will provide an additional $20 million in funding, over the next two years, for safety improvements in long-term care homes, specifically fire safety and equipment to improve resident care and safety.” 
  • For seniors who live in retirement homes and long-term care homes, the government is considering the advice of an expert technical advisory committee on how to make fire safety improvements, such as automatic sprinklers and improved staff training, in residences housing seniors, people with disabilities and other vulnerable Ontarians.

On home care, the report  raises the question of who should deliver the service: 
  • “The question, then, is how best to deliver those additional hours. At present in Ontario, only community care access centres provide personal support services, and access to these services could be enhanced if other organizations were allowed to do so as well.”

They have flagged better primary care as a big area for better senior care.  And they have proposed an impressive sounding 13% increase in physician house calls hours for senior.  But as house calls were at a very low level (228,000 hours) before this announcement, this is a pretty puny absolute increase (30,000 extra hours).

Following earlier suggestions, the document plans the establishment of “hospital in the home”.

  • “As part of Ontario’s Action Plan for Seniors, we will provide more care at home across the province through innovative models such as the Hospital at Home program and help our hospitals and Emergency Departments become more senior friendly.”

But it is left unclear who will deliver these services, or how much will be provided. 

Other plans: 
  • They will increase the number of Active Living Fairs around the province and explore ways of expanding the network of Elderly Persons Centres.   Reportedly, Ontario currently has more than 270 Elderly Persons Centres that serve approximately 250,000 older adults. 
  • Expand life leasing.  In life lease housing, you do not own a property; you hold an “interest” in that property. The life lease interest gives you the right to occupy, or live in a unit, rather than owning the unit itself. 
  • They will provide a “one-stop” information source for seniors that will be accessible online and by phone. 
  • They will partner with the National Initiative for the Care of the Elderly to gather new data on the prevalence of elder abuse in Ontario 
  • The Ontario Provincial Police (OPP) Seniors Assistance Team provides strategic crime analysis and research with respect to the impact of seniors’ abuse, and develops solutions and operational strategies to lessen the impact of this abuse. 
  • As part of Ontario’s Action Plan for Seniors, the OPP will develop provincial e-learning training on elder abuse for other police services and community agencies. For the OPP uniform members, this training will be mandatory through annual required training. 
  • They will work with the Office of the Fire Marshal to develop information and resources to enable home support workers to address basic fire safety issues in their clients’ homes, such as smoke alarms and home escape planning. 
  • They will distribute information brochures about powers of attorney to elderly persons centres, retirement homes and long-term care homes across the province.

Bottom line – what they have promised here is a rounding error in the overall health care budget. We will see if there is much more to come. 

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