Your Rights: Hospital first-available bed policies

How can patients access health care in a setting that can not only meet their ongoing-needs, but where they will want to live?

It happens suddenly. One day your mother is gardening. The next day she’s in the hospital, having suffered a stroke. After a few days, the hospital tells you that they need her bed and since she can’t go home, tells you that she can go to one or two long term care homes that have a bed for her. The discharge personnel might even tell you that if you don’t cooperate, it is hospital policy to charge you the uninsured rate for each day she stays in the hospital.

CARP regularly receives calls from people faced with this situation, sometimes right from the hospital, asking for advice. We often refer them to the Advocacy Centre for the Elderly, [ACE] the only government funded legal aid clinic dedicated to elder law in Canada although one is being established in BC.

Because of ER backups, limited beds in both acute and long term care, and limited public home care services, many hospitals tell older patients that they must accept transfer to the “first available bed” in any long-term care facility, regardless of their wishes or personal situation.

Recently, Ontario announced $109 million to deal with emergency room wait times by making sure people who need long term care or home care get it. The hope is that this will reduce the pressure on hospitals and that they will be more flexible and sensitive to their patients when they are most vulnerable. In any event, CARP recommends that hospitals discontinue their “first available bed” policies.

“While we recognize the pressure on hospitals and emergency rooms, we also believe that the way to solve this is not on the backs of seniors,” says Susan Eng, CARP’s Vice President of Advocacy.

Jane Meadus, of ACE, gives a tragic example of what can happen. In British Columbia in February, 2006. Fanny Albo, age 91, and her husband Al, age 96, were admitted to hospital. The hospital determined that Mrs. Albo required long-term care while her husband was much sicker and would remain in hospital. Against the wishes of the family, Mrs. Albo was required to accept the “first available bed” offered and was separated from her dying husband of 70 years, and admitted to a long-term care facility in a community 100 kms away. Mrs. Albo died alone 48 hours later. Her husband died two weeks later.

A furor arose over how this couple was treated. The furor, however, was short lived and did not result in system changes to prevent such an incident from reoccurring. So now, two years later, this could happen again in any province in Canada.

In Ontario, ACE has been successfully using the law for the last 10 years to advocate on behalf of seniors against such discriminatory hospital policies. “A senior has the right to live his/her life in a setting that is appropriate to his/her needs and to give or refuse consent to admission to a long term care facility. First available bed policies fail to reflect these fundamental rights,” says Meadus.