For years, every health-care expert in Alberta has said that one of the main solutions for better emergency room access is more long-term care beds. The government has said it, Alberta Health Services has said it, doctors and advocacy groups have pushed for it, but the situation never improves. In fact, it has gotten worse.
The province currently has 14,574 nursing home beds — at least 50 fewer than in early 2008 and an inconsequential increase from the 14,500 that existed in 1992. The paralysis on this critical issue is one of the great failings of the ruling Tories. Former premier Ed Stelmach vowed to build 1,000 long-term beds per year. But facility operators say new spaces frequently replace aging capacity that's being closed down. Of the 511 beds announced by the Redford government in December, only 30 are 24-hour nursing home spaces, with the remainder being supported living beds for residents without complex medical needs.
The government's failure to deliver more long-term care beds is a key reason behind the excessive waits in the province's emergency rooms, according to Dr. Paul Parks, past president of the Alberta Medical Association's emergency medical section. The recent Alberta Health Quality Council report on the province's health-care system said that six to eight per cent of hospital beds are occupied by patients waiting for access to supportive living and long-term care facilities, calling it "an inefficient use of a critically limited resource that further contributes to high in-patient occupancy bed rates."
Chloe Atkins, an associate professor at the University of Calgary who specializes in medical ethics, recently wrote on these pages that she is one of the "bed blockers." With a chronic illness that occasionally keeps her hospitalized for long periods, she blocks the move of patients from the emergency ward, causing a backup in the system. Atkins says she does not require a long-term care bed, simply better federal tax breaks that would allow her to make her house more accessible. It is another simple solution that governments at two levels fail to grasp, let alone resolve.
In its 2012 budget, the provincial government announced $25 million for three home-care initiatives for seniors. Among them is a new program, Destination Home, designed to help seniors return home as quickly as possible after a hospital stay and avoid unnecessary hospital visits. Specifics were thin, with the government saying it was developing the program for gradual implementation over the next three years. Also announced were new adult day program spaces for 440 home care and better access to 24-hour on-call registered nurses for home care.
Considering the inability of the province to resolve this issue over the years, we won't be holding our breath.
Calgary Herald, Mon Mar 12 2012