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Long term care beds coming too late, say health policy experts

Posted: November 10, 2017

Published: November 10, 2017

Hamilton Spectator, by Joanna Frketich

Beds are needed now, as Hamilton and Burlington alone have about 1,900 people waiting for long-term care. – Getty Images/iStockphoto

The Liberal government’s promise of thousands of long-term care beds over the next decade is too little and far too late, say health advocates and policy experts.

“It’s good they are talking about the issues that we’ve been raising for so long as a crisis,” said Natalie Mehra, executive director of the Ontario Health Coalition. “On the other hand, this is years from now and may or may not happen.”

The province plans to open 5,000 new long-term care beds within four years with a total of more than 30,000 beds over the next decade as part of its action plan for seniors announced in Hamilton by Premier Kathleen Wynne on Tuesday.

“That’s a huge increase,” said Michel Grignon, director of the Centre for Health Economics and Policy Analysis at McMaster University. “One bed in a long-term care home costs approximately $50,000, so we are talking about $1.5 billion.”

But the beds are needed now considering Hamilton and Burlington alone have about 1,900 people waiting for long-term care.

“The wait list for long-term care beds (in Ontario) is approximately 30,000, so to solve the problem of the wait lists we would need to build those 30,000 beds now,” said Grignon. “If you ask hospitals, they would like to see more beds in the near future.”

With an election scheduled for June, the Liberals are facing gridlocked hospitals that have more patients than beds before the busy flu season even starts. A big part of the problem is long delays in discharging patients who need other types of care — most often long-term care.

Right now, 80 Hamilton hospital beds and 23 in Burlington are taken up by patients waiting for long-term care, says the Hamilton Niagara Haldimand Brant Local Health Integration Network.

“If all those beds were not occupied and were used as acute care hospital beds the problem would be solved,” said François Béland, co-director of Solidage, a McGill University and Université de Montréal research group on frailty and aging.

So is opening beds the best way to cope with hospital overcrowding and an aging population?

“How much does it cost to have one person in one bed in long-term care?” said Béland. “Now ask yourself, how many home care hours can you deliver (with that) — a lot. But it’s only if you’re willing to organize that level of home care and all of the stuff that goes around it that you can say, ‘We don’t need the beds.’ But if you are not willing to invest in home care then you need those beds.”

A transformation of the home care system is what some health policy experts say is missing from the action plan.

“The solution of last resort should be to build a nursing home,” said Steven Lewis, research consultant and adjunct professor of health policy at Simon Fraser University. “I’m not sure that this plan is essentially saying, ‘We have done everything we possibly can with home care to keep people out of nursing homes.'”

It’s not just about adding more home care hours or money to the budget.

“There are a large number of people who are on nursing home waiting lists because there is no existing alternative,” said Lewis. “Imagine if you pooled the long-term care and home care budgets. My strong suspicion is there would be a lot fewer incentives to put people in nursing homes and a lot more creative thinking about how to keep them out of nursing homes.”

Without a doubt some new long-term care beds are needed and fast.

“There is certainly a growing, legitimate, unavoidable need for nursing home beds,” said Lewis. “The question is how do you minimize the need?”

Béland sums it up by saying: “Do we want to stick to a system where long-term care facilities are the kingpin?”

Waiting for long-term care

Patients can be on the wait list for more than one home

Hamilton

City-wide

3,819 beds

1160 waiting for a bed

962 waiting to move from one long term care home to another

St. Peter’s Residence at Chedoke

West Mountain

210 beds

618 waiting

The Village of Wentworth Heights

Central Mountain

120 beds

597 waiting

Idlewyld Manor

West Mountain

192 beds

495 waiting

Macassa Lodge

East Mountain

270 beds

441 waiting

Chartwell Willowgrove

West Mountain

169 beds

376 waiting

Ridgeview

Stoney Creek

120 beds

352 waiting

The Meadows

Ancaster

128 beds

315 waiting

Regina Gardens

West Mountain

128 beds

287 waiting

St. Joseph’s Villa

Dundas

390 beds

287 waiting

Extendicare Hamilton

West Mountain

159 beds

270 waiting

Queen’s Garden

Central Hamilton

128 beds

245 waiting

Arbour Creek

East Hamilton

128 beds

240 waiting

Alexander Place

Waterdown

126 Beds

188 Waiting

Shalom Village

West Hamilton

109 beds

166 waiting

Clarion

Stoney Creek

100 beds

132 waiting

Heritage Green

Stoney Creek

166 Beds

123 waiting

The Wellington

Central Mountain

102 beds

94 waiting

Victoria Gardens

East Hamilton

76 beds

72 waiting

Grace Villa

East Mountain

184 beds

70 waiting

Pine Villa

Stoney Creek

38 beds

49 waiting

Orchard Terrace Care

Stoney Creek

45 beds

31 waiting

Baywoods Place

East Hamilton

128 beds

29 waiting

Blackadar

Dundas

80 beds

20 waiting

Parkview

Central Hamilton

126 beds

19 waiting

Hamilton Continuing Care

East Hamilton

64 beds

14 waiting

Dundurn Place

Central Hamilton

173 beds

13 waiting

Burlington

City-wide

1,279 beds

739 waiting for a bed

480 waiting to move from one long-term care home to another

The Village of Tansley Woods

4100 Upper Middle Rd.

144 beds

667 waiting

Burloak

5959 New St.

144 beds

487 waiting

Creekway Village

5200 Corporate Dr.

144 beds

437 waiting

Chartwell Brant Centre

1182 North Shore Blvd. E.

175 beds

305 waiting

Billings Court Manor

3700 Billings Ct.

160 beds

270 waiting

Hampton Terrace

75 Plains Rd. W.

101 beds

214 waiting

Cama Woodlands

159 Panin Rd.

128 beds

175 waiting

Mount Nemo Christian

4486 Guelph Line

60 beds

47 waiting

Wellington Park

802 Hager Ave.

130 beds

31 waiting

Maple Villa

441 Maple Ave.

93 beds

7 waiting

Source: Hamilton Niagara Haldimand Brant Local Health Integration Network

jfrketich@thespec.com

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