Hamilton hospitals stave off forcing seniors into homes against their will
Hamilton homes have enough open spots to take in all seniors waiting for long-term care in hospitals.
But despite being more strained than ever with COVID, Hamilton's hospitals say they aren't using unprecedented powers given to them by the province to move patients to LTC without their consent.
The amended provincial order can only be used during major surge events where the demand for critical care threatens to overwhelm a hospital and compromise care," St. Joseph's Healthcare said in a statement. Although hospitals are working very hard with record high levels of COVID-19 in ICUs, we are using other strategies and resources to maintain capacity."
Hamilton Health Sciences (HHS) said even if hospitals reach a point where they have to enact the emergency order, It will be used sparingly."
In April, the province announced a new emergency order to allow hospitals to transfer certain patients waiting for a long-term care bed to any nursing home without their consent, in an effort to free up hospital capacity for COVID-19 patients in need of urgent care.
The Ministry of Health says patient choice and circumstance will be given consideration.
The implementation guidelines ... reflect key ethical considerations, including making all efforts to place individuals as close as possible to their existing choices, transparent communications with families and patients and ensuring the needs of the patient can be adequately met at the receiving home," the ministry said in a statement.
A doctor would have to determine the hospital patient can go to a seniors' home and the ministry says it will ensure patients or their substitute decision maker will have the opportunity to be actively involved."
The NDP has opposed forcing seniors to live in LTC or retirement homes against their will to free up hospital beds.
It's heartbreaking to think of seniors being sent far from their families, to live in LTC homes they didn't choose, without their consent," NDP Deputy Leader Sara Singh, said in a statement.
Moving patients to LTC would make a massive difference for Hamilton's hospitals considering 111 seniors were ready to be discharged as of May 7 but couldn't leave because they're waiting for the homes of their choice. The exact number fluctuates each day.
At the same time, Hamilton LTC homes had 159 empty beds - more than enough to take them all.
It's not clear if the homes have enough staff - that question couldn't be answered by the Ministry of Health, the Ministry of Long-Term Care, Ontario Health or Home and Community Care Support Services Hamilton Niagara Haldimand Brant, which is the former Local Health Integration Network (LHIN).
We continue to use our standardized placement policies, regulations, and legislation to place patients in appropriate long-term care beds when they become available," the former LHIN said in a statement. When placing patients, hospital care co-ordinators consider a person's condition or circumstance and preferences."
Another barrier to hospital patients taking up all of the open spots is that there are hundreds of Hamilton seniors waiting at home for LTC - roughly 1,036 as of May 7.
It means in total, there are 1,147 Hamiltonians on the wait list - more than seven times the number of open beds.
It can take months, or even years, to get into the most desirable homes which cost the same as the least popular as the price is set by the province.
We understand the stress and concern on patients and their families when selecting a congregate care setting," St. Joseph's said. We are grateful to those who are being flexible and choose to go to other places while they wait for space at their preferred location."
The government temporarily waived the co-payment starting April 23 for those who voluntarily go to a home that isn't their preference. They wouldn't start paying until they either got into a home of their choice or decided to stay where they are permanently.
This same rule applies if seniors have to be forced into homes against their will.
Normally, seniors are reluctant to go where they don't want to live because it can be hard to transfer out with long wait lists and their priority being lower than those in more urgent situations.
But the ministry says right now it will retain their priority on the long-term care wait-list for their first choice."
To take some of the pressure off, Hamilton's hospitals have opened up a satellite health facility in Effort Square at 150 King St. E. to care for these patients known as alternative level of care or ALC.
But the hotel doesn't have enough space to take in all of the ALC patients who could also be waiting for retirement homes or other community care. St. Joseph's had 113 as of May 3 while HHS had 143 - together it's enough patients to fill a medium-sized hospital.
Joanna Frketich is a Hamilton-based reporter covering health for The Spectator. Reach her via email: jfrketich@thespec.com