The province plans to reduce the number of nursing-home spaces this year, despite new figures that show a rising number of Albertans are still stuck in hospital or at home waiting for a bed to become vacant.
Doctors are worried delays in the province’s emergency rooms could worsen and facility operators are concerned ailing seniors will suffer poor care if Alberta Health Services cuts 150 spaces with round-the-clock nursing.
“I’m baffled as to how we’re going to eliminate the bottlenecks in our hospitals at the same time as we’re cutting long-term care beds,” said Paul Parks, past-president of the Alberta Medical Association’s emergency medicine section. “I’m very afraid we’re on the cusp of another crisis in our ERs.”
Bruce West, executive director of the Alberta Continuing Care Association, said AHS seems determined to push seniors with complex medical needs into less-expensive supported-living spaces, which may not provide adequate care.
“My concern is these patients will end up back in acute-care hospitals because they won’t get the care they need,” West said.
“There appears to be a disconnect between the government’s philosophy and the front-line reality that we have a lot of very sick seniors.”
The provincial health authority released figures this week that show the number of seniors waiting for a nursing-home bed increased 14 per cent to 215 patients during the first 10 months of the current fiscal year.
More than 25 per cent of the 473 patients clogging the province’s hospitals in January were waiting for a long-term care bed.
Just over nine per cent of the 1,021 seniors struggling to manage on their own around Alberta were also in the lineup to be ad-mitted to a nursing home.
The situation is dire in Calgary, where 55 hospital beds are occupied by seniors waiting for a nursing home space and another 40 seniors are coping on their own waiting for a vacancy to come open.
An AHS official said long-term care beds are being closed so they can be refurbished.
David O’Brien, the authority’s vice-president of seniors’ care, said normal turnover in nursing homes means space will be found for patients on the waiting list.
O’Brien said that, over the next 12 months, AHS is adding 1,000 supporting-living spaces – beds not equipped or staffed to handle residents with unpredictable behaviour, intensive rehabilitation needs or who require 24/7 nursing care – because that level of care is adequate for the vast majority of seniors in the queue.
“We’re building supportive living as fast as we can,” O’Brien said, “because that’s the level of care Albertans want and need.”
But a study published last year suggests more than a quarter of the patients the province is placing in supportive living beds may be unsafe because there is insufficient staffing and care for their complex medical needs. As a result, they were twice as likely as nursing home patients to end up in hospital or visit an ER.
O’Brien says changes have been made since the study was done to improve care at supportive living facilities by providing on call nurses who can deal with ill patients and nurse practitioners who regularly review a client’s condition.
A recent report from the Health Quality Council of Alberta fingered the long list of seniors being warehoused in overcrowded hospitals for average stays of six weeks as one of the key causes of chronic, excessive waits of seriously ill patients in Alberta’s ERs.
Dr. John Cowell, the council’s top executive, said the province needs to reduce occupancy in its major hospitals to 85 per cent and develop accurate predictions of its growing need for both nursing home and supportive living beds to clear the backlog.
“It’s critical that AHS match its resources to its needs,” Cowell said, “and the numbers of people on the waiting list for long term care have me concerned that’s not happening.”
AHS documents show the health authority plans to hold the number of nursing home beds fairly constant through 2015 at just under 14,500 and add another 3,000 supportive living spaces to the system, but neither the health authority nor the government could provide figures this week to show whether the new capacity will match the needs of an aging population.
Health Minister Fred Horne said he hopes to have a new fore-casting model up and running later this year that will allow his staff to plan up to two decades into the future.
In the meantime, Horne said the level of care available in many of the new spaces being opened can be adjusted upwards, if that’s what is required to match patient needs and to empty acute care beds.
“We have the flexibility,” he said.
Calgary Herald, Thurs Mar 22 2012
Byline: Matt McClure