Let's talk the future of seniors' care

Did you know that according to Statistics Canada (2020) 17.6% of Ontario’s population is over 65 years of age? Or that for every 100, 000 people that 26.4 of them are centenarians (Statistics Canada, 2020)? Have you ever thought about what aging in your home may look like? What do you do when you require support to complete your activities of daily living? I think societies goal for our aging population should be supporting them to aging in their own home which will help support growing waitlists for the long-term care (LTC) homes, and costs of congregate living and create a more sustainable system for LTC homes in Ontario (Sinha, Nolan, McDonald, Nicin & Wong, 2020). Did you know the waitlist for a LTC bed has grown from over 19, 000 individuals waiting in 2011-2012 to having over 38, 000 individuals on the wait list in 2019-2020 (Sinha, Nolan, McDonald, Nicin & Wong, 2020)? By exploring ways to support individuals in their home longer and with the correct supports, we could help this crippling health care system be more efficient at providing person centered care.

By modeling the National Seniors Strategy pillar for care closer to home, this would allow person-centered care to occur by care providers who have the knowledge and skills to care for them (Sinha, Nolan, McDonald, Nicin & Wong, 2020). By supporting these individuals in their home, we can be more cost efficient and respect their wishes. As Sinha et al (2020) states this population have “an increased need for improved care coordination, primary care, and social support, as well as in-home episodic care needs associated with chronic disease during the waiting period for placement in a LTC home”. It has been noted that 8% or 1 in 12 recent admissions to Ontario’s LTC home could likely be support in their own home environment with correct home supports (Sinha, Nolan, McDonald, Nicin & Wong, 2020). Of note, 78% of senior’s preference is to stay in own home over move to a LTC setting (Sinha, Nolan, McDonald, Nicin & Wong, 2020). In 2016-2017, approximately 124,000 home care patients had care need that would be equivalent to LTC level with this level of need on the climb since then (Sinha, Nolan, McDonald, Nicin & Wong, 2020). The cost associated with this style of care is something to be considered when supporting this patient population.

Did you know it costs approximately $201 a day for care in a LTC home bed (Sinha, Nolan, McDonald, Nicin & Wong, 2020)? This is even higher for a patient in an alternative level of care bed in a hospital with a cost of approximately $730 per a day (Sinha, Nolan, McDonald, Nicin & Wong, 2020). By exploring ways to bring care to the patient at home costs could be as low as $103 per a day (Sinha, Nolan, McDonald, Nicin & Wong, 2020). This is something that we need to be considering with the future of health care and the growing aging population. If patients have access to personal care support, meals and household chore supports, and health care this population can live in their own home. The two program ideas below explore options on how the healthcare system can be supporting the senior population in their own homes.

1. Victoria’s new pilot program hospital at home developed to assist in managing pandemic, allows eligible patients to receive care in their own home (Harnett, 2020). This program allows eligible patients access to “hospital-based doctors, acute-care registered nurses, and special equipment and technology” (Harnett, 2020). This program is beneficial for the elderly as they do better in their own environment Harnett, 2020). This pilot program has the patients’ admitted to a hospital but care is received in the home (Harnett, 2020).

2. Another option is described by Sinha et al (2020) as the virtual long-term care @ home program which fosters partnerships amongst community organizations to allow individuals on the waitlist for LTC to receive care at home. The ideal partnerships would include community support service agencies, home care, community paramedics, and primary care providers (Sinha, Nolan, McDonald, Nicin & Wong, 2020). The Ontario Health Teams are a great opportunity to foster these relationships and support individuals in the community (Sinha, Nolan, McDonald, Nicin & Wong, 2020). By the partnerships supporting the patient’s in their own home, the high level of care needed for these individuals is met at a cost-effective option. With this purposed partnership, care cost per a day could be $122.78 (Sinha, Nolan, McDonald, Nicin & Wong, 2020).

Both of these programs support the patient in a home setting but connecting them to person centered care they require. Addressing the patient as a whole allows all needs to be met and has many benefits of Improved quality of life, prevent decline, encourage independence, reduces risk of illness, reduces stress as in own familiar environment and can expedite healing (Bayshore, 2017). With the advancements in technology development health care is going to be reshaped (Canadian Medical Association, 2018). I feel the use of these advancements such as virtual care that we are seeing being implemented during the global pandemic is the perfect time to move forward and think outside the box for seniors’ care in the future.

References

Bayshore. (2017, February 17). Benefits of Aging at Home [web log]. https://www.bayshore.ca/2017/02/17/benefits-of-aging-at-home/#:~:text=Aging%20at%20home%2C%20or%20%E2%80%9Caging%20in%20place%E2%809D%20as,health%20resulting%20in%20the% 20loss%20of%20complete%20independence.

Canadian Medical Association. (2018, August 15). The future of technology in health and health care: a primer. https://www.cma.ca/sites/default/files/pdf/health-advocacy/activity/2018-08-15-future-technology-health-care-e.pdf.

Harnett, C. E. (2020, November 15). Creating hospital beds 'out of thin air': Hospital at Home program launches in Victoria. Times Colonist. https://www.timescolonist.com/news/ local/creating-hospital-beds-out-of-thin-air-hospital-at-home-program-launches-in-victoria-1.24239644.

Sinha, S., Nolan, M., McDonald, L., Nicin, M., & Wong, I. (2020, November). Bringing Long-Term Care Home. https://static1.squarespace.com/static/5c2fa7b03917eed9b5a436d8 /t/5fb57afdbb4dec698ea3b7d2/1605729021992/BringLTCHome_V2.11.17(4)pdf.pdf.

Statistics Canada. (2020, September 29). Demographic estimates by age and sex, provinces and territories . Interactive dashboard. https://www150.statcan.gc.ca/n1/pub/71-607-x/71-607-x2020018-eng.htm.