Long-term care requires ‘more boots on the ground’

Feb 17, 2015

CAMBRIDGE – Long-term care for Ontario’s ailing seniors isn’t what it used to be or could be, says Donna Rubin, chief executive officer of the Ontario Association of Non-Profit Homes and Services for Seniors (OAPNSS).

Speaking at Fairview Mennonite Home this past Thursday (Feb. 12) morning, Rubin told a packed room that long-term care facilities throughout the province are facing a crisis in meeting the growing needs of seniors, and more help is needed.

In 2008, the Ontario government’s Sharkey Report identified the need to increase the level of care in long-term care facilities to four hours per person, per day, from current levels.

“It was right then and it is right now,” Rubin told Fairview’s staff members and seniors. “We need more boots on the ground.”

Jim Williams, Fairview’s administrator, said his staff now spends 3.4 hours per day caring for each long-term care resident. To come up to the recommended four hours of care per person, per day, Williams said Fairview would need to hire eight personal service workers and another registered nurse.

Province-wide, the Ontario government would need to spend $385 million to bridge that gap, Rubin said.

With more than 78,000 seniors living in Ontario’s 630 long-term care facilities and 20,000 more on the waiting list, the OAPNSS is urging the provincial government to bridge the gap over the next three years.

“It will take a considerable commitment to close the gap,” Rubin said, noting that people now entering into long-term care are frailer than in previous years.

They also have more complex medical issues and require more staff time and resources on a daily basis.

“There is a growth in the numbers of impaired seniors and their care needs are going up,” she said. “In long-term care, people are coming in with pretty complex needs.”

In some cases, seniors entering long-term care may have as many as six serious conditions that need to be monitored and addressed. Those conditions could include such things as heart or respiratory ailments, or diseases like diabetes.

Fairview’s administrator said times have changed during the past 20 years.

“In 1995, some long-term care people could still drive their cars,” he said. “People today entering long-term care are older and need more care.”

Williams said the level of care needed by the 84 long-term care residents at Fairview is also increasing. He explained that last year, 47 residents needed help getting to the bathroom. This year, 55 residents now require that same help.

“That’s eight more residents we have to get to the bathroom,” he said. “We have to get them up at 6 a.m. in order to finish before 8 a.m. when they get their breakfast.”

Williams said his staff not only has to get the long-term care residents to the bathroom, but may have to assist them in washing, getting dressed and getting them to the dining room for breakfast. Some also require assistance with eating.

With the increase in workload, Williams said staff has had to become more task focused and personal attention suffers as a result.

“We want to be a home to the residents in more than name only,” he said.

Marlene Goerz, director of nursing care at Fairview, said it can be very frustrating for her staff.

“When staff get into replacing a dressing requiring 45 minutes, they aren’t helping anyone else,” she said.

Long-term care staff is also being hamstrung by government regulation, Goerz said, explaining a nurse might spend an eight-hour shift filling out forms instead of dealing with residents, while a personal care worker might spend several hours of their day on paperwork.

Much of that paperwork is to document the work each staff member has performed. That paperwork is then reviewed by provincial inspectors to ensure Ontario’s Long Term Care Homes Act and its regulations are enforced.

“A lot of it is designed to cover your butt,” Goerz said.

“We are not micro-managed, we are micro-regulated,” Williams said. “The government has gone too far with its regulations. Everything has to be written down.”

Williams said Fairview has a good working relationship with the London area office regulating long-term care, calling its inspectors “professional and cordial”.

Rubin said some homes across the province have opted to focus on resident care over doing all the government paperwork required of them.

“The homes for the most part and trying to do the best they can,” Rubin said.

One resident, whose wife is in Fairview’s long-term care, agrees.

“You are doing a good job and I have to commend you for it,” he said.

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