Corbella: Improving the quality of life of our seniors in care is at the centre of new strategy

Corbella: Improving the quality of life of our seniors in care is at the centre of new strategy


One of the key recommendations is for the province to bolster home care services and keep our elderly out of long-term care facilities as long as possible

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Quality of life. What is it?

It’s tough to define exactly what it is, but most of us know when it’s not there. And it’s safe to say that during the last 16 months of the COVID-19 pandemic — despite the heroic efforts and compassion of our long-term care workers — most Canadians would agree that in many nursing homes it was lacking.

On Monday, the Alberta government released a 217-page report based on a long review into the province’s continuing care system, with the stated aim of making the lives of those in care more fulfilling and dignified right until the end.

Improving Quality of Life for Residents in Facility-Based Continuing Care makes 42 recommendations to better prepare Alberta for the coming grey wave as baby boomers — those born between 1946 and 1964 — head into old age.

The report states that in 2019 — when the review was first ordered — 13 per cent of the population was over 65 years of age. That’s expected to increase to 20 per cent by 2046, but people “over 80 years of age are expected to experience the highest growth with an expected increase of around 225 per cent” over the same time frame, states the report.

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“Nowhere in Canada have I yet seen recommendations as bold and with such transformative potential as these,” said Carole Estabrooks, a professor in the faculty of nursing at the University of Alberta, who was on the 15-member review panel, which was led by Calgary-Fish Creek MLA Richard Gotfried.

“The recommendations will go a very long way to eliminating the fear that many Albertans have of one day needing to place their loved one in care and to eliminating our own individual fears of one day needing those individual services ourselves . . . by tackling the most important aspect of any supportive or long-term care home — a good quality of life for residents and good end of life.”

One of the key recommendations is for the province to bolster home care services and keep our elderly out of long-term care facilities as long as possible.

This is an approach long touted as a best practice by experts in aging.

Carole Estabrooks, professor, faculty of nursing at the University of Alberta on Monday, May 31, 2021.
Carole Estabrooks, professor, faculty of nursing at the University of Alberta on Monday, May 31, 2021. Photo by Chris Schwarz/Government of Alberta)

Dr. Samir Sinha — the director of geriatrics at Sinai Health System and an associate professor of medicine at the University of Toronto and Johns Hopkins University School of Medicine — says whenever he has a chance to speak to policy makers, he reminds them that helping the elderly live longer in their homes by providing home care is the only time government can give people what they want and spend less money.

Sinha, who is also the director of health policy research at the National Institute on Ageing (NIA), says home care is the least costly form of continuing care out there. Sinha says that at any given time, about 15 per cent of hospitalized Canadians are elderly people designated as “alternate level of care” or patients who should be in a nursing home or in their own home with more supports.

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“We have a recent study that shows that almost 100 per cent of seniors plan to live independently in their own homes; that’s up from pre-pandemic times,” said Sinha. “If we give them what they want, this will save the health-care system and the long-term care system a lot of money while enhancing their lives and keeping them connected to community.”

According to the NIA, an acute-care bed costs about $730 per day, a LTC bed costs about $182 per day and home care costs $103 per day.

The new report states that currently only 61 per cent of continuing care in Alberta is long-term home care (LTHC) and 39 per cent is facility-based continuing care (FBCC).

“The projected economic impact of shifting to a ratio of 70 per cent LTHC and 30 per cent FBCC by the year 2030 is: A reduction in annual operating costs of $452 million and cumulative capital cost savings of $1.7 billion,” it states.

That’s the beauty of giving people what they want — it saves money and keeps people more active and living in their communities.

Health Minister Tyler Shandro told a media conference Monday that some of the recommendations will be acted upon immediately.

“As of July 1, continuing care facilities will no longer admit new residents into shared rooms that already have two residents,” he said, referring to what are called ward rooms — of which 50 still exist in Alberta.

“This is based on one of the key learnings from COVID-19 . . . Multi-resident rooms are among the biggest risk factors for infection control in continuing care  — for COVID, for influenza and for any other communicable disease. We’re already building new facilities with 100 per cent private rooms.”

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Shandro also said keeping couples together in LTC homes will be a focus going forward.

Starting on July 1, the government will expand public reporting on the performance of continuing care facilities to include “site-specific results” of the many different monitoring, inspections and audits that occur.

Health Minister Tyler Shandro on Monday, May 31, 2021.
Health Minister Tyler Shandro on Monday, May 31, 2021. Photo by Chris Schwarz/Government of Alberta

The $497,500 report by consulting firm MNP heard from 7,000 Albertans and conducted more than 90 in-depth interviews with residents, family members, operators and health workers.

The report recommends increasing the quality and variety of the food provided and improving the design of LTC homes — which is already happening — to provide more space for activities and dementia-friendly features. Improved cultural sensitivity should also occur to ensure that FBCC programs and services are provided in a culturally safe environment.

“On average, future seniors are expected to be more educated, have higher incomes, desire increased choice and independence, and want to be active and engaged in the community. They are also characterized by more cultural diversity and a better knowledge of technology,” states the report.

While the report calls on improving the working conditions of staff to prevent burnout and turnover, it does not recommend ensuring that all staff — be they full or part time — have paid sick days, something Sinha says would have recently prevented sick workers from going to work and infecting LTC residents.

Estabrooks says because Alberta currently has the youngest population of all the provinces “we have a rare window in which to prepare and the recommendations in this report give us a roadmap to do just that.

“These recommendations,” added Estabrooks, “will position us as a national leader in transforming facility-based care for older adults.”

Licia Corbella is a Postmedia columnist in Calgary.

lcorbella@postmedia.com

Twitter: @LiciaCorbella

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