Long-term care complaints soar in London region

Click here to read ‘Long-term care complaints soar in London region‘ by Jane Sims – The London Free Press, December 2, 2015

“That’s (violent dementia) a phenomenon that the long-term sector knows about, but they haven’t had adequate responses, neither in resources nor in the training

In a province where seniors already outnumber kids, it’s enough to make you shudder at getting old.

Need home care to help an elderly or disabled loved one stay in their home, like 713,000 Ontarians get?

You could wait a year just to get them assessed.

And if they’re not at home, but in long-term care centres like nearly 78,000 Ontarians?

Backlogged complaints and inspection delays for critical incidents are putting those people at risk.

Those are among the findings in the annual report released Wednesday by the province’s spending watchdog, Auditor General Bonnie Lysyk, whose review ranged from the billions in extra costs consumers have paid

for electricity under the Liberal government, to a botched computer system that erroneously teed up $20 million in welfare and disability overpayments and will cost more than double that to fix, to some child-welfare agencies taking too long to investigate suspected abuse.

But what raised eyebrows for many about the annual spending audit were Lysyk’s findings about health care for the elderly, a large and growing demographic whose needs will only grow with Canada now a nation where people age 65 and older exceed those 14 and younger for the first time.

“What this report sadly shows is that we can’t rely on the government of Ontario to ensure our most vulnerable citizens are being treated appropriately in long term care and home care,” said Ontario NDP Leader Andrea Horwath, who pulled no punches in her advice to those with elderly loved ones.

“If you want to feel confident, then you have to stay on top of the (nursing) home yourself because the government’s not doing it,” she said.

Two years after the Liberal government was found breaking its own nursing-home inspection law, Lysyk found the ministry in charge — it responded by hiring an extra 100 inspectors — did complete comprehensive inspections of the about 630 long-term care facilities.

But the backlog of home inspections for complaints and so-called “critical incidents” — things that must immediately be reported, like fire, neglect or abuse of residents, improper care or unexpected deaths — doubled between December 2013 and March 2015, from 1,300 to 2,800, Lysyk reported.

With a rising workload for inspectors, including a 13-per-cent jump in overall complaints in 2014 and the highest spike in numbers in the London region, at 47 per cent, better oversight is needed, she found.

“Depending on the location of the home, residents’ concerns might be inspected or followed up sooner, later or not at all,” Lysyk reported.

Two years ago, The London Free Press found the government was violating the spirit of its own nursing home inspection law, with some homes going as long as three years without annual inspections.

The issued raged in the legislature, with the province ultimately hiring the extra inspectors.

Wednesday, advocates for the elderly were not assured.

“What did they find out, is the question,” said Susan Eng of the Canadian Association of Retired People. “Are things going to change after they had the inspections? What systemic issues have they discovered that they’re going to fix?”

Eng said she’s especially concerned about violent dementia in nursing homes, a growing problem flagged by a recent report for Ontario’s Chief Coroner’s office that dealt with 12 homicides in long-term care homes in 2012 and 2013, cases of residents dying at the hands of one another but not necessarily criminally.

“That’s (violent dementia) a phenomenon that the long-term sector knows about, but they haven’t had adequate responses, neither in resources nor in the training,” to deal with the fallout, Eng said.

Lysyk also found many elderly and disabled aren’t getting much-needed home-care services on time, with some waiting more than a year to be assessed. The level of home-care that Community Care Access Centres (CCACs) provide varies widely, as each develops its own criteria as a result of funding inequities,

Auditing three CCACs, her office found 65 per cent of initial assessments weren’t done within required time frames. “Although the (Health) ministry has recognized the importance of strengthening the home and community care sector, clients still face long wait times for personal support services,” Lysyk said.

She found delays in assessments of a year or more.

Lysyk highlighted the case of a client in her 90s living alone in a retirement home who waited 52 days for a phone assessment for physiotherapy and personal support services — “well beyond the three-day timeline for initial contact assessments.” The client was only approved for 16 hours of personal support per month and not physiotherapy, but when the family asked for more services after the woman fell and sustained a fracture, they were told those services were wait-listed, Lysyk said.

Though by law, home-care clients can receive up to 90 hours of personal support services a month, care co-ordinators at the CCACs usually allow a maximum of 60 hours, Lysyk said.

The CCACs — Ontario spends $2.5 billion a year on home care — are also not consistently conducting site visits to ensure home-care providers comply with their contract requirements, Lysyk found.

Health Minister Eric Hoskins said that more and better funding is needed. The government is increasing that by $500 million over the next two years, but more can be done to ensure consistent service, he said.

“That variability concerns me a great deal, both in terms of the nature of the service that’s provided, the variability of that across the province, but also making sure that the funding goes to where it’s needed the most,” he said.

In long-term care, the biggest spike in complaints came in the London region, which Lysyk’s report noted the ministry chalked up to better public awareness but which it could not explain compared to other regions. Her report noted homes in the London region scored lower than the Ontario average in eight out

of nine quality-of-care indicators in the same period in 2013 and 2014.

The Health Ministry committed to addressing all of Lysyk’s recommendations.