Since the end of November, patients waiting for long-term care homes in Ontario hospitals have been forced to choose: go to the first long-term care home that opens up, or pay a daily fee of $400.
The Ford government passed Bill 7 in an attempt to create more beds in hospitals to address the backlog of surgeries and long ER wait times. Under the legislation, LTC homes could be up to 70 KM away from the patient’s preferred choice.
But Guelph General Hospital hasn’t had to charge anyone yet, and hopes they won’t have to, said vice-president of patient services and chief nursing executive Melissa Skinner.
Skinner said their goal is to work with patients from the time they’re admitted to “explore all the different options available,” and try to keep them from waiting in the hospital in the first place.
“Because hospitals are not the best places to wait. We really want to get people back to the closest destination where they were hoping to be.”
But still, she said along with other hospitals in the province, the legislation deems they must be prepared to do so.
Currently, there are eight patients waiting in hospital for a bed in an LTC home. They aren't being charged the $400 fee though, because no beds within the radius have become available. But once they do, if they refuse to leave, they will be charged.
However, Skinner said the 70 km distance is “a last case scenario,” and that “99 per cent of families have a plan, and we follow through on it, and things go well. Families might find their loved one a bed at a location that’s not the one they want, but they’re there to wait until the bed comes open.”
In hospital, patients waiting for an LTC bed start at the top of the waitlist. When they move to a home not of their choosing, they’re moved to a lower priority category while they wait for their preferred home, according to Jake Roseman, a spokesperson for the Minister of Long-Term care.
And when it comes to a patient at GGH getting into a home of their choice in the Guelph area, Skinner said “it’s probably going to be pretty rare.”
There just aren’t enough beds.
The Ontario Health Coalition lists the top 10 LTC homes with the longest and shortest wait times.
In Waterloo-Wellington, one home has a wait list as long as 433, with only 85 beds. According to the OHC, between one to eight beds becomes available each month. The average wait time in the area is 112 days.
In terms of the shortest in Waterloo-Wellington, there is only one in Guelph, and it’s on the bottom of the list, with 92 beds and a wait list of 66 people as of April.
All but one of the 10 LTC homes listed are private, for-profit homes, with the exception of one not-for-profit in New Hamburg.
But some of these homes are “vacant for a reason,” according to Brit Hancock, co-chair of the Guelph District Health Coalition.
“They have the worst records, some of them. And the ones with the worst records are private, for-profit. And a lot of them are currently in COVID outbreaks. So people are being sent to long-term care homes that are in the middle of criss as well. So saying that’s better care… it’s absolutely not better care,” she said.
Skinner said at GGH, they give people an idea of how long wait times are when they first come into the hospital, so they can exercise autonomy when it comes to choosing alternate locations.
However, it remains “up to the family to make those decisions. We just give them the information,” she said.
Hancock said the legislation is "not helping," and that she’s heard from countless people upset by the choices they're faced with.
“Oftentimes, they’re bursting into tears because they are in total crisis. And I don’t blame them.There’s a lot of stigma and shame and guilt that they’ve put their parents or grandparents in this situation.”
“Bill 7 gives (the government) the power to threaten the frail and elderly to consent, otherwise they will be charged that $400 a day or $2,800 a week. And if someone’s only consenting because they’re worried about the financial repercussions, that’s not actually consent.”
She said it’s comical the bill is called the More Beds, Better Care Act, because “they’re not increasing more beds. The beds are just furniture at this point.”
The problem, she said, is resources: “A lot of people aren’t getting the treatment they need in the hospitals, because the hospitals are dealing with such a shortage of workers and finances.”
So if hospitals had the beds and staff available to take care of the patients there, they would be able to wait for the homes they wanted.
Yet Roseman said the legislation has had a “positive impact on freeing up capacity in the health system, having reduced (Alternate Level Care) to long-term care waitlists in hospitals by over 20 per cent since the Act came into effect.”
He said more than 2,420 ALC patients have been placed in a home since Sept. 21, and that they have “observed excellent on-the-ground results.”
Skinner, though, said she doesn’t anticipate this legislation being “the driver of fixing the surgical backlog,” but rather is just one small step to a multifaceted issue that needs to be handled as such.
In fact, GGH has 39 ALC patients, but only eight of them are waiting for long-term care beds. The remainder are waiting for hospice, rehab and retirement homes.
However, she does think it’s great that “the media and people are talking about long-term care, and they’re talking about wait lists.”
“And I think it’s encouraging families and loved ones to have those conversations,” earlier than they normally might. It’s not always the best time to be making important decisions when your loved one is ill.”
At the end of November, the OHC and the Advocacy Centre for the Elderly announced they would be enacting a charter challenge for the legislation, and are aiming to have it repealed by the end of the year.
They claim the policies the legislation enforces bypass and coerce consent, violating Charter rights.
However, for their part, Skinner said they are “focused on what’s best for the patients.”
Is your loved one waiting in the hospital for a long-term care home? Have you sent a loved one from hospital to long-term care since Bill 7 passed? If you'd like to share your experience, contact [email protected].
