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    This document summarizes a symposium on age-friendly communities in Ontario that discussed governance issues in assisted living and long-term care. It notes that Ontario spends $3.5 billion annually on long-term care facilities, which face challenges upgrading aging infrastructure and a shortage of beds. Retirement homes have surplus space but primarily serve less intensive needs. The document calls for a task force to develop continuum of care models integrating long-term care, assisted living, retirement homes and other services to improve patient-centered care flows and system efficiencies.

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    Scott PDF

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    This document summarizes a symposium on age-friendly communities in Ontario that discussed governance issues in assisted living and long-term care. It notes that Ontario spends $3.5 billion annually on long-term care facilities, which face challenges upgrading aging infrastructure and a shortage of beds. Retirement homes have surplus space but primarily serve less intensive needs. The document calls for a task force to develop continuum of care models integrating long-term care, assisted living, retirement homes and other services to improve patient-centered care flows and system efficiencies.

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    This document summarizes a symposium on age-friendly communities in Ontario that discussed governance issues in assisted living and long-term care. It notes that Ontario spends $3.5 billion annually on long-term care facilities, which face challenges upgrading aging infrastructure and a shortage of beds. Retirement homes have surplus space but primarily serve less intensive needs. The document calls for a task force to develop continuum of care models integrating long-term care, assisted living, retirement homes and other services to improve patient-centered care flows and system efficiencies.

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    © All Rights Reserved
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    17 views10 pages

    Scott PDF

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    Institute for Research on Public Policy (IRPP)
    This document summarizes a symposium on age-friendly communities in Ontario that discussed governance issues in assisted living and long-term care. It notes that Ontario spends $3.5 billion annually on long-term care facilities, which face challenges upgrading aging infrastructure and a shortage of beds. Retirement homes have surplus space but primarily serve less intensive needs. The document calls for a task force to develop continuum of care models integrating long-term care, assisted living, retirement homes and other services to improve patient-centered care flows and system efficiencies.

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    IRPP

    Symposium
    Age-Friendly Communities in Ontario: MultiLevel Governance, Coordination Challenges
    and Policy Implications
    Governance Issues Session: Assisted living and Long-Term
    Care

    Chestnut conference Centre,


    University of Toronto
    89 Chestnut Street, Toronto
    November 4-5, 2013
    Graham W. S. Scott, C.M., Q.C.

    Key Reference Materials


    Why Not Now? 2012
    Elements of an Effective Innovation Strategy For LTC in
    Ontario Conference Board of Canada
    Dr. Sinhas Living Longer, Living Well
    Dr. Walkers Caring for Our Aging Population and
    Addressing Alternate Level of Care Act, 2011
    Excellent Care for All Act
    Retirement Homes Act 2010
    Long Care Homes Act
    Report of the Long-Term Care Task Force on Resident
    Care and Safety, 2012
    Long-Term Care in Ontario Sector overview 2012

    LTC/Retirement Resident Snapshot


    Ontario spends $3.5 Billion or 7.8% of the health
    budget on LTC
    Over 630 homes regulated under the Long Term Care
    Homes Act
    Mix of non-profit (270) and For-profit (359)
    ELDCAP operated by acute care hospitals in small
    northern communities
    680 licensed Residences regulated under the
    Retirement Homes Act
    78,000 LTC beds of which 97% are long stay beds with
    99% occupied
    51,000 in Retirement Residences

    LTC/Retirement Resident Snapshot


    Most RR facilities provide assisted living programs
    which must comply with the Care and Safety Sections
    of the Retirement Homes Act
    Most RR facilities have a substantially higher vacancy
    rate the LTC.
    2.2% for Interim (1.9) Respite (0.5%) and convalescent
    (0.6%) in LTC
    Average age 83 with females at 71% in LTC
    Average age over 85 (and climbing) and roughly 70 %
    female
    Average wait time 76 days varies considerably

    LTC/Retirement Resident Snapshot


    Roughly 20% of residents require lighter care less than MAPLe 4-5
    Overwhelming reason for choosing a retirement residence is when
    a major health issue arises
    27% of LTC admissions come from private homes with no home
    care
    35,000 beds require capital investment to upgrade them before
    2025
    Stalemate between the Ministry and the providers on the amount
    of incentive required to proceed with the capital upgrades
    Less than 2000 refurbished beds completed or underway
    Last province with 3-4 bed wards still in existence
    Continuing demand for new LTC Beds forecast of additional 10,000
    for 2016

    Observations on LTC and Retirement


    LTC has 35,000 beds requiring upgrade with
    progress at an impasse;
    20% of the LTC beds have residents that require
    lighter care than mandated for LTC
    The current model will require the development
    of thousands of new LTC beds
    Most Retirement Residents have surplus living
    facilities
    LTC has few beds available for respite, rehab and
    interim care (2.2%)
    The Age profile of LTC and Retirement have
    residents in the mid 80s

    Observations on LTC and Retirement


    Both LTC and Retirement Homes are serving
    seniors with health support needs
    For the most part LTC have heavy care/high risk in
    the MAPLe 4-5 category
    In Retirement the vast majority would be in their
    Assisted Living programs would be in the MAPLe
    1-2 category.
    In Retirement given the higher ages it is clear that
    as residents age many will often move up to
    MAPLe 3-5
    Assisted living for High risk seniors does not cover
    seniors in Retirement Residences

    ALC Beds
    2012 the OHA ALC Survey 14% hospital beds were
    occupied with ALC patients over half of which are
    awaiting Long-Term care roughly 2000 patients.
    Residents in LTC not requiring the level of care
    provided in LTC facilities could amount to as many as
    14,000 residents
    There is no provision for hospitals to permit discharge
    to Retirement Residences with approved Assisted
    Living programs so that potential relief opportunity is
    lost.
    A senior in an ALC bed health deteriorates very rapidly
    because of lack at activation but if sent home or to a
    retirement home would help maintain their abilities.

    How to Get there Task Force


    Terms of Reference

    A review of the recommendations contained in Why Not


    Now? 2012,
    Dr. Sinhas Living Longer, Living Well, Dr. Walkers Caring for
    Our Aging Population and Addressing Alternate Levels of Care
    and other relevant reports;
    Drafting at least two models for the development of a
    continuum of care addressing LTCs, Assisted Living,
    Retirement Homes, Rehabilitation, Home/residential care,
    ALCs, Primary care and emergency and palliative care;
    The models should first ensure that the process starts with
    the patient and is patient centered and secondly is assists
    the providers in enhancing their experience in the system
    which will result in system savings and efficiency;

    How to Get there Task Force


    Terms of Reference
    Focused on flow and appropriate flexibility on
    addressing changes in patient requirements as
    dictated by the outcome of various
    events/treatments
    Identify the barriers created by the
    organizational, regulatory and legislative barriers
    to the success of the continuum model and
    recommend a legislative regime supportive of the
    continuum;
    Coordinate with Health Links Process; and
    Report within one year.

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