Date Added: 5/1/2009
Posted by:
 birdie
 supporthitug.org

Author/Source:
 OANHSS

Viewed: 366 times

Long-term homes provide the necessary medical, social, and personal care to individuals who are unable to provide for themselves. Apart from the older individuals who require assistance due to old age; there is a growing trend of younger people who are entering long term care homes unable to meet the basic living needs. Due to accidents, illness or old age an individual maybe unable to dress, bathe, eat or even use the toilet.

There are three different types of long-term care homes

• Nursing homes, which may be for-profit or not-for-profit; most are for profit;

• Municipal homes are owned and operated by municipal councils;

• and Charitable homes are usually owned by non-profit corporations.

The need for not-for-profit long term care homes

• Not-for-profit homes have over 100 years of experience in serving their communities and delivering added value.

• Not-for-profit homes re-invest their surplus dollars to enhance and expand the level of service provided to residents. They typically contribute additional resource beyond what the province provides, topping up provincial funding with charitable donations and municipal transfers.

• Not-for-profits are deeply rooted in the cultural, religious and geographic communities they serve and these communities financially support the homes.

• Not-for-profit homes are actively supported by local volunteers and are responsive to local needs.

• Not-for-profit homes often providing a seamless continuum of other housing and community services and programs.

Not-for profit providers have a long history of bringing added value to long term care and community services in Ontario. Government support for not-for-profit delivery is embedded in both the legislation governing Local Health Integration Networks (LHINs) and more specifically in the new Long Term Care Homes Act. Despite this, there has been a noticeable erosion of the not-for-profit sector over the last few years.

Funding of long-term care beds

Long-term care facilities receive their operating funds on a per diem basis. The per diem rate is divided into three separate parts: nursing and personal care; program and support service; and accommodation. MOHLTC determines the total per diem funding that the long-term care facilities will receive.

Critical Issues faced by Long-Term Care homes

Ontario has the second worst long term care staffing levels in Canada, followed on by British Columbia, according to statistics Canada. Nurses and care providers within a long term care home work very hard, every day to provide the highest quality of care possible to the residents. Apart from staffing the other major issues are:

• Care needs of the residents in long term care homes have dramatically increased in the last few years. According to the Statistics Canada website, 74% of Ontario's long term care residents were classified as the second highest level of acuity, a substantial increase over the last decade. Hospitals expect long term care homes to accept new admissions at a much faster pace but long term care homes cannot fulfill this need due to their staffing and space issues.

• Individuals with Dementia move into long-term care homes when their illness is at the most debilitating stage; some other residents suffer from chronic health condition which puts additional stress on long-term care homes to provide the personalized care and attention to these residents.

• Today, the older residents require more complex care; violence and abuse of personal care workers (PSW) are on the rise. Unfortunately due to the lack of funding and staffing long-term care homes find it increasingly difficult to cope especially with volatile and aggressive behavior for which they are not adequately trained or resourced.

• There is a growing need for specialized units within long-term care homes. Presently there are very few alternate locations where residents with violent and aggressive behavior can be transferred. This poses a threat not only to the personal care workers (PSW) but also to other residents.

• With current funding levels with long-term care homes find it very difficult to address residents with developmental disabilities and those with acquired brain injury (ABI), Huntington's disease and substance abuse issues.

Due to inadequate staffing levels in Ontario, it is a reality that, residents in long-term care homes may be required to wait long hours for a bath or a dress change. On an average about 8 - 10 residents have one personal support care worker (PSW). PSW's often have to make personal choices on whose needs are more urgent for instance, there have been occasions where PSW's would be taking residents for their meals and one of the residents would soil his/her clothes and would require attention immediately. The other residents in the meantime would have to wait to be fed their meals. In a province like Ontario, it is inhumane that an elderly resident would have to wait in a soiled incontinence product or wait to be fed for a long time before being attended. Some families are choosing to pay privately for attendant care to augment the services the home can provide, which can be very expensive.

When a resident suffers from major ailments like dementia, stroke or Parkinson's, these residents require more personal care which puts a strain on long term care homes that are already understaffed due to lack of funding.

Long-term care homes have been functioning on low budgets for a long time; they depend heavily on volunteers to help with the daily care of their residents. In spite of this, long-term care homes have placed strong emphasis on their resident's safety. Policies are in place that mandates the disclosure of adverse incidents. All adverse incidents have to be reported in a timely manner to the management.

In 2007 municipalities' provided over 16,500 beds in 103 homes across the province. Municipal homes range in size from 32 to 456 beds, with an average of 161 beds. Many municipalities provide their own voluntary contribution to the operation of their homes often raising both the quality of care and the home as a workplace. Current estimates suggest that in 2007, OANHSS member municipalities' contributed at least $140M to home operations over and above provincial LTC funding.

In 2007, OANHSS delivered a mandate letter to the Minister of Health and Long-Term care identifying major issues that should be priority long term care objectives to be achieved. OANHSS has in their letter stated that the level of care needs to be increased to an average of three hours per resident per day, whether or not a specific care standard is mandated in legislation. By achieving such a benchmark, Ontario will be catching up to other progressive jurisdictions in the level of care provided to those living in long-term care homes.

ONAHSS has also estimated the operating funding to be increased by $586 million in 2008-2009 in order to support an average of three hours of care per resident per day.

About Ontario Association of Non-Profit Homes and Services for Seniors (OANHSS)

OANHSS is the provincial association representing not-for-profit providers of long term care, services and housing for seniors. Members include municipal and charitable long term care homes, non-profit nursing homes, seniors' housing projects and community service agencies. Member organizations operate over 27,000 long term care beds and over 5,000 seniors' housing units across the province.

References

http://www.opseu.org/bps/health/longterm/ohcmay082008.htm

http://www.health.gov.on.ca/english/public/program/ltc/15_facilities.html

http://www.oanhss.org/