Quality gap found in long-term care facilities
January 24, 2011
Susan Pigg
LIVING REPORTER
Fewer nurses, higher staff turnover, more bedsores, pneumonia, anemia and dehydration.
Those are the issues facing Canada’s aging population as more provinces — especially Ontario — allow the for-profit sector to drive the creation of much-needed long-term care facilities, a new study says.
A mounting body of research points to a significant “quality gap” between homes built by the private sector and those built by non-profit or public organizations, says a report being released Monday by the public policy think-tank the Institute for Research on Public Policy.
Lower staffing levels, for instance, in for-profit homes have been blamed for higher hospitalization rates among senior residents for issues such as pressure sores, pneumonia and dehydration, the report notes.
Yet almost two-thirds of new residential care beds built in Ontario since 1998 have been in for-profit homes. That’s a much higher rate than in other provinces which are also increasingly turning to the private sector to cope with Canada’s greying population, says co-author of the IRPP study, Margaret McGregor, a professor and research associate at the University of British Columbia.
But Christina Bisanz, chief executive of the Ontario Long Term Care Association, the umbrella group for some 625 homes in Ontario, questioned the report’s findings, noting that much of the research comes from the U.S.
In fact, Ontario is leading most provinces in improving the quality of long-term care thanks to new legislation aimed at making care uniform in all homes — whether for-profit or not — by boosting inspections, legislating minimum staffing levels and giving residents more of a voice, she said.
The bigger issue facing homes, says Bisanz, is the shortage of funding and adequately trained doctors, nurses and personal care workers to handle the growing number of elderly with dementia and more complex health issues.
In the next 30 years, about 120,000 new long-term care beds will be needed to handle the estimated 1.6 million residents who will be 85 and older, the report estimates. The 41-page report is a meta study of research (data from a number of independent studies) done in the U.S. and Canada.
Currently, just one in five Canadian seniors requires long-term care, the report says. While that may seem relatively small, Canada actually has one of the highest rates of institutionalization in the world, especially compared to countries such as Denmark which have created a host of programs to keep seniors in their homes as long as possible, McGregor says.
While the report doesn’t go so far as to ask for an all-out moratorium on new for-profit homes, it calls for a number of measures to improve quality, from mandatory minimum staffing levels — at least 3.5 hours of care per day per resident — to regular, surprise inspections and anonymous surveys of residents, family and staff.
Many homes, McGregor says, currently provide less than three hours of care per resident.
The report also calls for uniform standards in facilities, which now vary greatly from province to province.
Susan Pigg focuses on issues about aging and baby boomers.spigg@thestar.ca
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