Without money, without hope. Ontario seniors pushed into long-term care for lack of better options

Lucy DeFilippis is a light sleeper, so when her phone rings in the middle of the night, she wakes up quickly, ready for the next crisis.

There have been many calls over the years, mostly from her mother Maria DeFilippis’ emergency department. When she was still living alone in her own home, Maria wore a bracelet that detected her fall and called an operator to see if she was okay. If she did not answer, an ambulance was sent to the house.

Lucy put Maria on the surveillance system when she could no longer afford to pay for her mother’s private home care and found that government home care allowances were insufficient to offset the costs. Lucy struggled with caring for her mother, but often felt torn between her obligations as an only child and those of wife and mother. Eventually, she left her mother to fend for herself and hoped for the best. This uncomfortable choice resulted in frequent calls in the middle of the night.

Home care in Ontario is strained and faces increasing pressure as the population ages. Representing 5% of the overall health care budget, home and community care should help those who need help to stay at home. This help can include personal support, whether it’s nursing, toileting and bathing, helping with daily house cleaning or shopping.

Laura Tamblyn Watts, Founder, President and CEO of CanAge, Canada’s national seniors advocacy organization, says senior care must be a priority. “We should prioritize significant government investment in this area, as more than 30 reports in as many years have been found in Canada,” she says. “In addition, there must be more accessible and affordable options for people to modify their homes, obtain accessibility technologies such as wheelchairs, walkers, ramps, elevators and assistive devices – including most are not covered by government programs at all.”

With over 20 years of experience advocating for the rights and dignity of older people as a lawyer and advocate, Laura Tamblyn Watts is urging the government to make policy changes. Photo courtesy of CanAge

According to the 2021 Canadian census, the number of people over the age of 85 has doubled in the past 20 years. Statistics Canada predicts that over the next 25 years, this age group could triple to nearly 2.5 million.

The vast majority of people over 65 want to stay at home. A 2020 Home Care Ontario survey found that 93% of people over the age of 55 said they want to stay in their homes where they feel safest, especially with COVID-19 still circulating.

Lucy DeFilippis is a light sleeper, so when her phone rings in the middle of the night, she wakes up quickly, ready for the next crisis. #Ontario #Seniors #Elderly Care #LTC #Home Care

Tamblyn Watts acknowledges that many families have no choice but to turn to long-term care (LTC) centers to help care for their aging loved ones. “The cost of getting real, solid home care for someone like Lucy’s mom can be $10,000 to $20,000 a month, which is totally unaffordable for most people,” she says. “Our publicly funded home care ― if you can get it ― is not adequate…”

“It’s a story we hear almost daily at CanAge. With 40,000 people on the waiting list in Ontario for LTC and 6,000 people on the waiting list for home care (they have been approved but there are no staff available), this situation s ‘worse more than ever,’ says Tamblyn Watts.

The “grey economy” puts seniors at risk

According to Tamblyn Watts, the need is driving a dangerous new trend – a “grey economy” of untrained caregivers offering “elder care” on sites like Kijiji or Craigslist. While sometimes these arrangements work, she fears they are dangerous for both the recipient and the caregiver, who risks being exploited, working without a contract, employment insurance or job security.

But families have few options when a loved one’s condition deteriorates, and waiting lists for long-term care seem insurmountable. And older people who don’t necessarily need to live in a care home, but need help to stay where they are, often fall through the cracks.

The most desperate families abandon their loved ones in the emergency room, hoping that hospitals will keep them indefinitely or quickly direct them to permanent care. This is colloquially known as “granny dumping”. Medical staff are required to address any physical health issues, but as soon as the patient is functional, they are discharged. Tamblyn Watts says that “some form of social services is called in, but there’s really nowhere to put people. And they often end up in hospital or on the streets, which is not a solution. “.

In desperation, people sometimes take loved ones to hospital, hoping that staff will step in and ensure they are taken care of. Stock photo via Envato Elements

Senior lawyers and the National Institute on Aging (NIA) are calling for a national seniors strategy. The plan would help ensure that health care, social services and economic systems meet the needs of Canadians as they age. Additionally, the NIA says it should include providing care closer to home. This would benefit all Canadians and help ease some of the pressure on middle-aged children struggling with affordability in the face of inflation and a lack of seniors’ residences.

A lack of affordable home care

The crisis that forced Maria into long-term care happened one night in July 2020. Lucy received an emergency alert notification, and when she called her mother’s number, no one picked up. . “Why isn’t my mother answering? she wondered. Her mother always had her phone with her. Lucy called several times.

A few minutes later, the alert service informed her that they had sent an ambulance to the house. Lucy put on some clothes and rushed out the door. Tears streamed down her face as she walked towards her mother’s house. She imagined the worst.

She stiffened before getting out of the car. Inside the ambulance was Maria on a stretcher, bruised and scared. Lucy hugged and hugged her mother as Maria apologized for calling her ‘paranoid’. She never thought she would fall down the stairs of a house she had lived in for years.

When Lucy closed the house, she saw her mother’s walker lying at the bottom of the stairs. At that point, she decided that this was to be her mother’s last fall in that house. It was time to move on to long-term care.

Maria had been on the LTC waiting list for four years. The fall propelled her to the top.

Lucy knew her mother wanted to age at home and felt bad about having to move her. “It hurt a lot to put her in there. And to this day, that guilt is killing me – killing me,” she says. “I wish to God my mother didn’t have to be there.”

Lucy DeFilippis’ mother, Maria, knew the cost of adequate home care was out of reach and consented to move to long-term care. Photo provided by Lucy DeFilippis

It turns out that in most cases it is cost effective to provide home care rather than long-term care. For example, according to a study by the Institute for Health Services and Policy Research at Queen’s University, the Ontario government spends $73,000 a year to care for a single person long-term, but provides adequate financial support to those caring for this elderly person at home. would cost half that amount.

In an email to Canadian National Observer, the Ontario Ministry of Health is committed to ensuring Ontarians have access to the home care services they need. They say the provincial government will invest an additional $1 billion over the next three years to expand community care, such as adult day programs, meal services, transportation, caregiver support and health services. assisted living.

According to the Ontario Long Term Care Association, in 2020 Ontario spent nearly $5.76 billion on long-term care. Still, Tamblyn Watts says the government needs to do more.

“If we don’t help people stay in their homes longer and with proper health services and social supports, these seniors will definitely end up in our acute care hospital beds, our long-term care facilities or , tragically, morgues,” she said.

About Timothy Cheatham

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