With dozens of Londoners waiting for home care and not enough personal support workers and nurses to meet the demand, there are fears the situation will only get worse as flu season gets underway.
Home-care advocates are bracing for even more pressure on the strained sector as the mega-agency that allocates health-care dollars in much of Southwestern Ontario grapples with chronic home-care capacity issues in London and beyond.
“Last year we had a very bad flu season and our hospitals were left very vulnerable because home care is a protective factor to our hospitals,” said Sue VanderBent, chief executive of Home Care Ontario, the umbrella group for Ontario’s home-care providers. “It means that people who are in hospitals have a hard time coming out because they need PSWs (personal support workers) and home care and it also means people outside hospital (who need home care) . . . may have difficulties and the need to go to hospital.”
In the last two months, the South West Local Health Integration Network, which oversees health-care funding and administration in the region from Lake Erie to Tobermory, including London, has had an average of 50 patients in London waiting for home care by PSWs. Of those, about half already get some in-home care by PSWs and are awaiting additional hours.
Over the same time frame, fewer than 10 patients have been waiting for in-home care by nurses, the South West LHIN said in a statement.
The agency said “significant capacity challenges” across the region are to blame for the wait lists. Recruiting and retaining PSWs — who report important details about patients to other health care providers and assist with bathing, dressing and feeding clients — is a major issue not just in the South West LHIN, but across the province too.
“We are competing with other parts of the health sector for the same scarce human resources but are at a disadvantage because PSWs and nurses in the hospital sector are paid more than they are in our sector,” VON Canada vice-president of marketing and communications Beth Green said in an email.
“We do what we can to address the shortage, working with the colleges, associations and others to promote the impact of the personal support worker role and its importance.”
VON Middlesex-Elgin is one of the South West LHIN’s contracted home care service providers.
In October, the South West LHIN launched a new referral system to better handle high-needs patients and mitigate staffing shortages, South West LHIN interim vice-president of home and community care Daryl Nancekivell said in a statement.
The policy prioritizes patients with complex care needs and ones being discharged from the hospital. For patients who are put on the wait list, the average wait time for PSW home care is 12 days and about five days for nursing services.
The regional health-care organization is also working with educational institutions to promote careers in community health care and is investing in assisted living and supportive housing to address the ongoing home-care issue, Nancekivell said.
Across Ontario in 2016-17, the latest year for which data are available, new clients in the community applying for in-home care by PSWs had a median wait time of 11 days until their first appointment.
In its 2018 annual report, Health Quality Ontario — the province’s health-care watchdog — said nearly 667,000 people received publicly funded home care from the province in 2016-17. The total has grown by nearly 96,000 people since 2011-12.
“We have a lot more elderly people and that is only going to grow,” VanderBent said.
Provincial funding in the home-care sector and increased caseload and scheduling demands for individual PSWs are core reasons behind the labour shortage in the sector, VanderBent said.
Ontario Health Coalition executive director Natalie Mehra said home care and supporting PSWs are key parts of the system that can’t be ignored.
“When your physician orders home care for you because you require home care, that care should be available to you,” she said. “This PSW crisis has made things much, much worse.”