The policy of sending ALC patients out of hospital has been piloted in Sudbury. It didn’t go well

Horizon Santé-Nord dropped the policy after an outcry. Now, however, a similar plan is being pursued across the province

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This isn’t the first time local long-term care advocates have faced a strategy to ship hospitalized elderly patients to nursing homes in other communities, though it may be more difficult to stop or stop this time.

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“About seven years ago, several people contacted us to say that their loved one was being sent out of town and couldn’t visit us every day,” said Terry Martyn, co-chair of Ontario North Family Councils Network. “And of course we are not in favor of that.”

Pressure from the ONFCN and other groups forced Health Sciences North to reconsider its policy of placing so-called ALC (alternate level of care) patients in facilities outside of Sudbury at the time.

Now, however, the plan is being continued province-wide, thanks to a new bill tabled at Queen’s Park that would allow hospitals to transfer patients to a “temporary” home until they find a place in their preferred location.

“It’s a bit late and it doesn’t make much sense,” Martyn said of the proposal. “They have a majority government, so it’s a law they can just push through – but that doesn’t mean we’ve given up. We always represent the interests of family councils and residents of long-term care homes and we will continue to do so, even if it is a very small step forward.

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The province said it was seeking to ease pressure on hospitals, many of which are overcrowded and understaffed, as burnt-out nurses flee the profession and new ones cannot be recruited quickly enough to fill the void.

The new legislation, if passed, would allow placement coordinators to select a home for an ALC patient – even if it’s not a destination they’re hosting – although they must first make reasonable efforts to obtain patient consent,” according to the bill. .

Long-Term Care Minister Paul Calandra said Thursday the changes “allow us to continue that conversation to explain to someone who is in a hospital why their needs can be met in a long-term care home.” .

Martyn agrees that a long-term care facility is preferable to a hospital, as well as a floor in a hotel – one of the interim measures that has been used in Sudbury, among others, to deal with the constraints of space. But a home in another community is not a scenario he wants for the patient or his family members.

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“If you have an elderly spouse who has to travel out of town, whether it’s North Bay or Espanola or wherever, that’s not very fair, and what if they can’t travel?” he said. “They can’t do that. They must transfer these patients to long-term care homes in their own communities so that spouses and families can visit them.

At the same time, however, the province needs to make sure long-term care homes have the resources they need, Martyn said.

“They want to transfer people from hospitals that are currently in crisis, but they are transferring them to long-term care homes that are still in crisis,” he said. “There is still a severe shortage of PSW (personal support staff), so how can you provide the necessary care for these people?

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Martyn, whose late wife resided at Pioneer Manor, said the city’s seven long-term care facilities are currently full, with waiting lists for each, and all are struggling with staffing issues.

“I know the government is trying to do something to alleviate the shortage of nurses in hospitals, but these issues were raised by our family councils in Sudbury as far back as 2015,” he said. “We have also provided some of the solutions they are currently looking for in terms of increasing the number of nurses, but the government has still not been involved in promoting and trying to recruit support workers. to the person.”

Nancy Johnson, a former Ontario Nurses Association health and safety specialist and former ONFCN president, said the province’s latest push to empty hospitals of ALC patients will only be not much of a shock to residents of Sudbury and the greater region.

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“Settlement choice has been an illusion in Northern Ontario for many years,” she said. “It’s always been a problem to know if you can get the place you want, and even when someone has been promised a bed in another place, you have to go through hurdles to get there. So I’m very sensitive to the challenges that people are about to face, but it just seems to codify, in my mind, a practice that pretty much already existed for a lot of people, at least in the North.

Johnson said HSN was built too small to begin with – as current HSN chief Dominic Giroux also acknowledges, making it something of a mantra in recent years – meaning that “people who needed care and could not stay at home have long been moved to Sudbury.”

Now that kind of experience “has migrated to the rest of Ontario,” she says. “So people understand what we’ve been going through here for over a decade.”

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Johnson is skeptical, however, that there will be enough space in long-term care homes to accommodate discharges from hospitals, and fears what might await those unwilling to accept the recommended placement.

“I don’t know where they’re going to find these beds other than opening more hotel rooms or moving these people back to four-person rooms with poor ventilation,” she said. “And what is the consequence, now that they are changing the law, of saying no? Is it just to come home and take care of yourself?

Johnson said there are innovative and healthy ways to house older people, as author Moira Welsh points out in her book Happily Ever Older, including smaller facilities with better outdoor access, but his feeling is that the province is married to more of the multi-storey complexes that have become so problematic during the pandemic.

“Skyscrapers with closed windows are not the solution,” she said. “I think they’re building another nursing home down south where there will just be people huddled together in closed areas, where they get up at a certain time and eat at a certain time and bathe for a certain number of minutes. . It’s not progress and it doesn’t help anyone.

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