LETTER: Long-term health care is short-sighted, says reader

SooToday received the following letter to the editor criticizing Ontario's long-term care strategies from concerned Saultite and nurse, Patty Greve:

Throughout my career, I have been an advocate for elderly patients. I respect and value their experiences, I love interacting and caring for each and every one of them like they were my own family.

Life is a journey of learning and a series of stories. The elderly are the culmination of these stories, putting in the groundwork for the society that we live in today. They were the frontline soldiers in WWII, the bricklayer that made your house, and the teacher who taught you to read. I go into this article with this bias. I highly respect this demographic and in my line of work I will always put my elders first.

I am a registered nurse with 30 years of experience in long-term healthcare. I specialize in working with geriatric (older) patients and I have worked in various streams such as long-term care nursing homes, community nursing, geriatric emergency management, hospital admission avoidance, retirement homes, geriatric clinic and medical floor nursing.

Throughout my career, I have directly worked with patients as a personal support worker and registered nurse, but I have also had the perspective of health care from a manager and director. I spent seven years as administrator and director of 90+ long-term care interim beds.

Throughout my experience, I have noticed and weathered the failed attempts to fix our long-term healthcare (LTC) problems. You could ask a person 20 years ago what they would foresee as our greatest challenge in elderly healthcare and they would reply – the increased strain of the baby boomers as they age. I go into policy meetings hearing the familiar ring of “silver tsunami” yet our preparations for this demographic shift have been repeatedly deferred. We have been procrastinating and we have been fooled into thinking the problem is solved by intermittent press releases.

Recently, 68 additional beds were announced for the Ontario Finnish Rest Home (OFRA). These beds are part of a newly built facility that could take up to three years to come into play. In one of my previous roles, we implemented our 90-bed capacity to the public in two years. This is a great accomplishment for our community as it is desperately needed.

I applaud the staff and management at the OFRA for all of their efforts. I know it’s not easy and involves many hours of paperwork and meetings to get to this point, but I would urge our community to continue to press for more beds as the current state of affairs is not nearly addressed by 68 beds. Sixty-eight beds are a drop in a bucket. A ministry report up to date as of December 2019 more than supports my stance that we are behind the metaphorical eightball when it comes to our long-term health care.

There are currently 871 beds for all of our elderly loved ones who are at a high health risk and in need of 24-hour care. All 871 are occupied. You may think, great we are actually using the resources we have allocated. Yes, yet there are 421 people currently on the waitlist that are at a high health risk, that require care but are unable to get the care that they need.

Further, spots in LTC aren’t exactly opening up like they do in other sectors of health care. Even compared to places like the intensive care unit or the emergency unit. You can recover from a burn that sent you to the emergency unit of the hospital and even leave the intensive care unit after recovering from two broken femurs and internal organ damage you sustained in a car accident.

You cannot recover from old age. It is a natural process that is always working against all of us. There is no fountain of youth or way to reverse aging. However, in the past century, we have immensely increased our ability to prolong life. Our ability to deliver care and extend life expectancies means that LTC beds do not open up quickly. Out of 871 beds, 108 will open up in the next year. Never mind waiting five hours in an emergency room, some of our elderly will wait over five years to move from the waitlist to a place where they can be adequately cared for. That is around 6 per cent of the average person’s life. Waiting.

At the time where we should be celebrating the end of life, we are instead telling our seniors to wait and to suffer. This goes against my morality and exacts an emotional toll on families and communities. Most importantly to policymakers, this is an ineffective model of care that looks financially cheaper, but has cost us too much. Delaying our care of the elderly has vastly and broadly drained our healthcare resources.

With a lack of resources allocated, a shortage of beds, and long waitlists we are placing more strain on healthcare, families, finances, and services. For example, Sault Area Hospital is reporting 14 alternate levels of care beds (ALC) being occupied by patients waiting for LTC beds in the community. These patients are constantly overflowing a reserve set of beds and many patients are unable to be discharged because they require 24-hour care.

Imagine living in a hospital for weeks or months because there wasn’t anywhere else for you to go? This is a trend we have seen in the past and it is continuing at a harmful pace. Other arms of the hospital like the emergency department are being drained by a service that the hospital isn’t even properly equipped for.

Elderly patients that are not getting the services they need are more frequently arriving at the emergency department after experiencing falls, trying to navigate complicated medication regimens, and suffering from comorbidities. Along with more emergency visits is an increased strain on ambulance services. Many elderly calls are simply because they cannot get back up after falling and have no one to call to help them. It is enough of an emergency for EMS to be called but is not necessarily the best way to concentrate EMS resources. This isn’t just a Sault Ste. Marie problem or northern Ontario problem. Emergency services around the province are having to create policies for falls because they represent a large proportion of their calls.

Most seniors are on a fixed income and waiting at home with limited services. Adult children and grandchildren are working to fill in these gaps by providing care for their loved ones as well as provide financial support. Our way of life is changing. We have carved out an extra 15 years of life for people today compared to those in the 1950s, yet we have not properly accounted for this stage of life in our health care policies. We are spending more money on this segment of the population, but we need to spend the dollars where they will have the most effect.

As I move closer and closer to retirement and my golden years, I am more frequently reflecting on what the future holds for me, my family, my friends, and my community. Will I be able to advocate for my friends as they need 24-hour care? Will I feel like a burden to my family? Is our long-term health care destined to be stressed in the future or will we be able to make the adjustments to our efforts necessary to adequately address an aging population? For now, I will continue working towards and advocating for a better future. I will, stay informed on the topic, and share my knowledge with my community and our members of parliament.

Patty Greve
Sault Ste. Marie, Ont.