Thursday, September 1, 2011

Home care vs. hospital vs. LTC

The media blitz continues.
Here is a Metroland article...

Read more here

Ontario’s long-term care system is paralysed, and failing its most vulnerable residents. More than 600 government-funded homes are supposed to provide high quality, around-the-clock care to the frail elderly. But a Metroland Special Report shows seniors stuck on record wait lists, entangled in bureaucracy and subject to pressure tactics that jeopardize their rights.  
By Mike Adler, Jillian Follert and Rob O’Flanagan
Record nursing home wait lists leave seniors with nowhere to go

Ontario facts and figures
  • Long-term care homes: 625 homes  with 75,829 long-stay residents
  • Number waiting for a bed: 25,206 
  • Average Ontario wait time: 109 days 
  • Per cent who get first choice of facility: 39.5
  • Only 900 more beds are expected to be available in nursing homes over the next 24 months.
  • The supply of new beds is static, with annual growth of less than 1 per cent. 

Macleans writes: The end of hospitals, by Julia Belluz
For the last several years, there’s been a lot of apocalyptic chatter about whether the aging population—or “gray tsunami”—will overwhelm the health system. That, coupled with the fact that there seems to be a shortage of hospital beds, has politicians offering up home-care services as an alternative to hospital and long-term care, and health-policy wonks pondering what a system without hospitals would look like.

This week, Ontario Health Minister Deb Matthews was the latest such politico to announce the Liberal plan to invest $60 million in home-care for seniors and the disabled. Though details about the program were not yet available, Matthews said it would offer services ranging from a health professional’s house visit, to phone and online consultations. (More politicking in this, and Ontario election year. But I have hopes.)

They surmise, falsely I am sure, that we can close hospitals. I think not. It is a puerile argument. As if we don't have people lining the halls looking for a diagnosis, surgery, treatment. What we need is Integrated Care. Some complain that doctors over-test. Quality care in hospitals can be improved. Seniors prefer staying in their own homes, but it is not always safe, nor adequate treatment. Some end up in retirement homes, where care can border on neglect. There are health issues that demand we have more nursing, retirement homes are not required to have a nurse on hand at all times. In these situations  (retirement, long-term care, and private homes) a nurse is often the only healthcare professional a patient will see. I know of a 90-something woman in a retirement home who only sees the doctor occasionally, and has been suffering sciatica for months, if not years. This is less than adequate treatment.

The UK is working on this: June 2011 report Getting out of Hospital. We continue to face barriers to home care, however, especially in rural healthcare, with travel distances for staff, and transportation issues for seniors. 

Barriers to health care

We know what works in health care: prevention, early identification, efficient treatment.
We know how to prevent chronic diseases: stop smoking, eat well: a balance of food groups, exercise (FITT- flexibility, endurance, strength), relax, socialize, monitor your blood pressure, live well, and listen to your body.

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