Tuesday, April 19, 2011

Spousal reunification: Long-term care in Ontario

Couples won't have to pay extra to stay together at care facilities

Elderly couples will no longer have to pay extra to live together in Ontario's long-term care facilities.Health Minister Deb Matthews said Monday she will change the rules after learning of the glitch in the system through the media.Couples in older long-term care facilities are currently forced to...

Spousal reunification - for couples in long-term care (LTC) homes. There was a good news story yesterday, as the Liberal provincial health minister moved to make an arrangement for a couple who needed a LTC placement.  

Ontario residents pay $1614 a month to stay in a four-bed ward in LTC. These wards are being phased out and changed, with renovations to old buildings. The standard now is a two-bed ward. This is considered sem-private these days. If a senior wants a semi-private room in LTC they pay $1857.

Money may be tight, though. Especially if a spouse remains at home, while the other must live in LTC. This is heart-breaking for many. 

Seniors give up their pensions when they enter long-term care, with the money going to the (mostly) for-profit long-term care homes. In Ontario most of the LTC homes are for-profit, and most are headquartered in the USA. 

If they have savings, spouses can afford to pay for the semi-private arrangement. In fact, anyone with money can pay for a private room. Sometimes they are indicated. My late father, for example, was up in the night. He was agitated, angry, anxious and apathetic at times. (The four A's of dementia)
In a fight with another resident, they knocked into each other's wheelchairs. Got into a fist fight.

Yet, residents such as these end up in 4-bed wards, with people who may be loud, angry, up in the night, and have insomnia, as well. Some people have seizures, they may have mental illness. Being in a LTC is not the easy solution, but it may be the only one for many without the money to get enough support for *ADLs at home. For incontinent adults, adults with stroke, and other disabilities, it is one solution. The Aging at Home strategy has not worked, due to a lack of caregivers. *PSWs hired by CCAC, through agencies such as Red Cross, and provide a few hours a day, free, to clients in their homes. For those, again, with money, extra support can be arranged through private agencies, which abound in Ontario. 

The complication is, of course, a senior shares a room with another person, and they have to learn to get along with a stranger. If a couple wants to enter a LTC, they must find two single residents prepared to move in with each other. The seniors must prepare for change, as they no longer have control over their living arrangements.

Of course, Alternate level of care (ALC) hospital patients take priority. The wait lists seem to be longest in the big cities. This article quotes a list of 600 waiting for care. 
Linda Chaplin, executive director of St. Patrick's Home, said she has 398 people on the wait list and the reality is that a large number will never make it there.

Ms. Chaplin said that 98% of admissions are people from hospitals, because many assessments done by CCAC show that seniors living in the community are medically stable enough to continue living in their home. However, this becomes a large strain on many caretakers and family members.

For how many of us can say they have changed adult incontinence products for their failing spouse or parent? It is not an easy thing to do. I have done it.

*ADLs: activities of daily living: toileting, food preparation,
PSWs: Personal Support Workers

“Finding the Right Long-Term Care" (PDF)

6 Oct 2010 ... Admission requirements are the same in every Ontario Long-Term CareHome. .... SPOUSAL REUNIFICATION. There is a special provision that allows your spouse or ... you in the Long-Term Care Home. Once the first spouse is

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