Supportive living complexes may be unsafe, officials say

Over a quarter of residents in Alberta’s supported living facilities may be unsafe because there is insufficient staffing and care for their complex medical needs, according to a recent study.

And the report – co-written by epidemiologists at the University of Calgary and University of Alberta – found seniors in these facilities were more than twice as likely to be rushed to an emergency ward or end up staying overnight in a hospital compared with nursing home patients who have round-the-clock nursing care.

“We have put some people in supported living when we should have known their condition could quickly deteriorate and there was a lack of medical oversight,” author Colleen Maxwell said. “We do worry whether people with diabetes, heart conditions and dementia are slipping through the cracks.”

Maxwell, a former U of C researcher who is now a professor at the University of Waterloo’s school of public health, said she was surprised to find that over half the residents in sup-ported living facilities were medically unstable and nearly 60 per cent had been diagnosed with dementia.

But the facilities were much less likely to have the medical expertise to handle these conditions than nursing homes. Only 34 per cent had doctors who were formally affiliated with the facility. Less than half had a licensed practical nurse on duty at all times.

“Everybody wants a more home-like environment and likes the idea of aging in place,” Maxwell said, “but as with the experience in the United States, there are questions about whether a supported living facility can respond to prevent ad-verse events.”

The survey of over 2,000 residents – half in supported living facilities and half in nursing homes – showed marked differences in how residents accessed medical care and what it cost the system.

In the previous 90 days, patients in a long-term care setting were 50 per cent more likely to have seen a doctor, but they were less than half as likely to have been hospitalized or to have visited an ER.

“Once someone has a hip fracture, they have to go the ER,” Maxwell said. “The question is, was everything was done at the facility to prevent that fall.”

She said the survey also found residents in supported living paid higher fees, faced additional costs for health-related supplies and services and that family caregivers were expected to bear more of the burden of care.

“There is this off-loading of costs and care on to family members,” she said.

“Many told us they enjoyed getting involved, but there is a limit beyond which we can expect caregiver burn-out or the exhaustion of financial resources.”

Liberal health critic Dr. David Swann said the findings raise serious questions about the province’s continuing care strategy and its focus on adding more supported living beds instead of nursing home spaces.

“If the government wants people to age in place, they need to ensure they are getting adequate medical attention,” Swann said.

“When patients end up in ERs and hospitals, it’s neither the best care nor is it the most cost-effective for the system.”

In the wake of conflicting numbers from the seniors ministry about the number of nursing home beds, Health Minister Fred Horne released figures this week that show Alberta has 50 fewer spaces today than it did four years ago, when the province promised it would add hundreds of new beds to eliminate hospital gridlock and shorten ER waits.

Wildrose health critic Heather Forsyth said she was troubled by the decline in the number of nursing home beds and the government’s difficulty in pinning down an exact number.

Calgary Herald, Tues Mar 13 2012
Byline: Matt McClure