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$400 fees, long-range patient transfers: What you need to know about Ontario's new long-term care rules:


https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-patients-transfer-1.6583036


I'm interested to hear different perspectives on this, people here are losing their minds about it in the belief that the vulnerable elderly will be dumped far from family supports in horrible "for profit" (dirty words) nursing homes.


Can we discuss?

We also have a free home nursing service (I was on the Board of our State’s for 6 years) and a subsidised Domiciliary Care system which keeps a lot of people at home rather than in a facility. Plus a smaller population which is mostly city-based so probably easier to access. All the variables do make a difference.
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Interesting that you don't have any shortages in long term care beds Margaret, we just don't have the capacity to handle all the people who need a nursing home's high level of care. A push to accelerate eliminating ward style rooms (which were identified as drivers of pandemic deaths in LTC) haven't helped any.
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Here it’s quite straightforward – hospital beds are for people who need acute medical care. They are staggeringly expensive for government in round the clock nursing and medical staffing. Otherwise you go back to where you came from, then the normal processes are used to find other care. But we do have a relatively large subsidised aged care system.
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Yes, cwillie, good article about dutch model, realistically, just to try to divert attention from existing problem.
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"As pressures mount on home care in Canada, experts look abroad for solutions"

https://www.cbc.ca/radio/whitecoat/home-care-problems-solutions-wcba-1.6581490

.... an article outlining the Dutch model of focusing on home care rather than nursing homes.

That sounds good and it's what my previous government was pushing for the last decade or so. But even 20 years ago my mom's PSW mentioned that at staff meetings almost all the heads in the room had grey hair, younger people would need to be paid significantly more in order to attract enough workers (if there even are enough workers available). And we are entering the years when the overwhelming numbers of the boomer generation are beginning to need care. And I don't see any way around the fact the home care model relies on unpaid family to provide the vast majority of care, something that many families can't or won't provide, especially for those with very high needs.
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This probably happens in the US. Medicare won't pay for people to be in a hospital if there is an option. If a bed is not available where you want to go, you take the one available. You can always transfer.
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I've learned a lot of things from this forum, one of them is the reality that sometimes there are no good choices so you have to pick the least bad from what you've got.
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Cwillie,
I am sure you are right, just remembered reading and I could be wrong, immediately it would free 400 beds, but there is something close to 5,000 seniors with different level of care required.
Possibly not all will be transferred.
You are so right those problems required solving decades ago.
Although necessary to free beds this is such drastic measures, read again nobody will be forced to leave hospital, but possibly pay $1800 per day?
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The article does state that it would only be temporary until space opened up in the facility of the elder's/family's choice. I didn't see in the article if the person needing placement would lose their "spot on the list" if they were placed in an alternate facility.

I can understand the family wanting their LO nearby for many reasons, but I don't know that that justifies taking a bed from someone who needs acute hospital care. As we unfortunately learned during the epidemic, there is a limit on hospital space and resources.

I also think a hospital might not be the best place for someone waiting for NH care. Certainly, every time my mom was in the hospital. they actively encouraged her to remain in bed for as much of the day as possible, for fear of falling. It made her very weak; she lost quite a bit of leg strength every time she was admitted. And each time she came out, it was a tougher and tougher hill to climb to get back even part of her strength. Plus, she was bored out of her mind. If they had offered to treat her illness (CHF) in conjunction with her subsequent stays in the rehab center, she would have jumped on that opportunity like a kangaroo, if for nothing more that the activities that went along with the rehab center.

Of course, my mom did not suffer from cognitive issues, which I know puts an entirely different spin on this idea, including the opportunity to change facilities if allowed.

CWillie, do you think this might lead to, depending on the condition and health issues of the elderly in question, doctors "fibbing" about the stability of the patient in order to medically justify keeping that person in the hospital until such a time that they CAN get placement in the facility of their choice? (*NOT* trying to be argumentative, just honestly wondering...)
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Not sure where you get the 400 number Evamar, I'm seeing estimates of 2000 to over 5000 people that don't require that level of care occupying hospital beds across the province.
The overarching problem of course is that we just don't have enough long term care beds, including these priority patients there are some 30,000 people on wait lists. Even if we put shovels in the ground tomorrow we can't build spaces fast enough.... this has been a sh!t show decades in the making. And unfortunately the focus on community care has never been a viable solution for those with high needs.
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It is just quick fix for about 400 beds, which does not solve a bigger problem, which is obvious, the health system is not working. For years. For years there are discussions leading to no solutions.
But forcing seniors, who are the most impoverished group or paying $400 per day is just not acceptable. Which senior can pay $12,000 per month? More burden on families, paying or travelling for 100+ km to see them.
Caregivers and families are totally neglected, simple caregiving credit for tax purpose is next to nothing.
average pension remains at 25% of earnings, or $700 per month.
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I'm posting this here because any discussion at home inevitably degenerates into political name calling and I'd like some outside perspectives. My thought is that an acute care hospital is not able to give better care than a nursing home, even a poorly rated one, especially for those with any level of cognitive decline. How many times have we said on this forum that a hospital can be a dangerous place for the elderly - don't count on help with ADLs like feeding, no possibility of rehab or recreation, rules allowing physical restraints that are not allowed elsewhere...
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