Long-term care, the other side of the story

Anyone who has gone through or dealt with Nova Scotia’s placement process for getting an elderly resident into long-term care knows what a horrific, frustrating experience it is.

Anonymous people make decisions which seem to conflict with or ignore medical advice. One specialist described the process as “arbitrary”.

And some of the people responsible for placement either have no say, lack knowledge about levels of care local facilities are licensed to offer, and/or don’t know about available beds.

While we are way behind in the number of beds we need in this province (1800 when the previous government fell), little has been said about the staffing shortages. During the election campaign unions and political opponents tried to frighten nurses and other care givers with the idea that jobs would be threatened if the then-government wasn’t returned to office.

The reality is that long-term care facilities, hospitals, clinics and services like the VON are all in competition for RNs, LPNs and other care givers. So even if we were to find the physical accommodation, which under the previous government had suffered, we still have potential staff shortages. Current staffing pressures can mean too few caregivers are responsible for too many patients/residents. This can lead to mistakes or staff burn out. It is as serious a safety issue as the fire code.

I understand a new class of care givers just graduated in November. I also understand that the province, seven months into the current fiscal year, is $12 million over-budget in long-term care.

There are misconceptions about the elderly in care. Yes, we are an aging population, but many of the pressures on the system seem to have been created by the system for its own purposes.

A few months ago a senior member of the provincial medical community dismissed concerns about seniors waiting in hospital for long-term care beds. This doctor said seniors in hospital weren’t the drain on resources that health authorities let on. They are, in fact, just the opposite; they are profit centres. This is because the authorities are paid the same for holding the senior as they are for for a medical patient. Given that most of these seniors only require basic personal care and not the extensive level of care a medical patient does, the authority collects a fee at a higher rate than the level of service delivered. Plus this doctor said these seniors help a hospital look busier than it is.

In 2010 when two new long-term care facilities with 115 beds opened in Kings County, the financial statements for Annapolis Valley Regional Health Authority show the authority took in $265,000 more for providing long term care than the previous year.

One fast move to address the long-term bed shortfall would be to look at whatever buildings we can rehab quickly, like the former hospital in Truro and even the school for boys in Shelburne. Maybe there are other buildings already owned by the taxpayer that could also be recycled. Tearing things down costs money and delays the addition of beds needed now by real people. In 2010 the waiting list for a long-term care bed in Nova Scotia was eight months. As we approach 2014 has this gotten any shorter, stayed the same or become worse?

[According to Marilla Stephenson’s column in the November 16th issue of The Chronicle Herald there are now 2,500 people waiting for a long-term care bed in Nova Scotia: 

http://thechronicleherald.ca/opinion/1167716-stephenson-that-looming-seniors-crisis-it-s-here-now

According to an article, He’s hale, hearty with nowhere to call home, by Mary Ellen MacIntyre, the wait list for a long-term care bed is now two years!

http://thechronicleherald.ca/careincrisis/1166596-hale-and-hearty-with-nowhere-to-call-home

This is another glaring example of the failures of the status quo in Nova Scotian health care. Perhaps the new minister can consult with families about the failings in dealing with long-term care placement. And maybe we need to test the placement people to see if they’re actually fully aware of the facilities and levels of care available and bed supply in their areas.]

Waiting to find a safe home for our elderly is an unacceptable drain on everyone and an unfair burden on those needing care. Hopefully a new government will work for faster change than the plodding process of the past.

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