Wang: Dire long-term care problems call for urgent solutions

What’s more, the Ontario Long-Term Care Association estimates that the current workforce needs to double in order to meet a predicted 38 per cent increase in demand for care in 2029.

Published Apr 20, 2024 • Last updated 4 hours ago • 3 minute read

Files: Long-term care facility Photo by Heiko119 /GETTY IMAGES / ISTOCKPHOTO

What could you do in 201 days?

You could definitely train for a marathon — anywhere from 112 to 140 days. You could start learning a new language — the average English speaker needs 189 days to pick up a working proficiency in French. If you really put your mind to it, you could even pick up the basics of a basic computer programming language in around 180 days.

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Yet, for the average Ontarian looking for a long-term care home (LTCH) for themselves or their loved ones, all 201 of those days are spent waiting.

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This isn’t a new issue. The wait time has actually grown by 47 days compared to 154 in 2013, when the Canadian Medical Association (CMA) urged the federal government to develop a “national strategy for seniors’ health care” due to concerns about the future of long-term care in Canada.

Nor is it a cheap one. While wait time for LTCH placement for a hospital patient is a relatively short 72 days, the average hospital bed cost Ontario taxpayers $919.44 per day in 2021.

In the context of hospital systems across the province suffering from full wards and empty staff rosters, a solution to current long-term care issues would create much-needed breathing room to deliver vital care.

Such solutions are unfortunately not readily forthcoming. The average new admission into long-term care is more medically complex, more likely to have dementia, and requires more assistance with daily living compared to 10 years ago.

Being pushed to do more with less, job vacancies in healthcare and social assistance sectors have increased 210 per cent in the last three years. In fact, the Ontario Long-Term Care Association (OLTCA) estimates that the current workforce would need to be doubled in order to meet the predicted 38 per cent increase in demand for care in 2029.

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This problem goes beyond quantity. A report summarizing the observations of Canadian Armed Forces personnel deployed to five homes in Ontario during the COVID-19 pandemic revealed a shocking state of dysfunction ranging from impossible staffing ratios of up to 30-40 residents per support worker to outright resident neglect with deprivation of basic necessities such as toileting and wound care.

Oversight is minimal and often deliberately so. One such home had incident reporting channels that were “locked” with the exception of medication errors.

That said, some significant recent efforts have been made to improve the situation. The passing of the Fixing Long-Term Care Act in 2021 has raised the bar for care alongside a $4.9-billion commitment to hire and retain more than 27,000 nurses and support workers.

With this came a renewed commitment to both announced and unannounced inspections, something that was all but suspended during the pandemic. Though a step in the right direction, only time will tell if these changes will make the difference for Ontario’s elderly and their families.

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In all, Ontario’s long-term care system must rapidly adapt to address the challenges posed by an aging and medically complex population, short-staffing, and other systemic problems that have no easy or fast answer.

Frank acknowledgement of this increasingly dire situation and longitudinal commitment to finding and implementing solutions must remain the top priority of policymakers, politicians, and the public in order to uphold our collective duty to provide excellent care for some of our most vulnerable individuals.

James Wang (he/him) is a medical student at the University of Ottawa

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