By Daniel Levac,
Ask any senior where they would prefer to live and the answer you will likely receive is—at home—with family and loved ones. Unfortunately, given the changes to our demographics, this will not be an option for some.
In this day and age, with the steadily increasing cost of health care and the limited new tax dollars being invested in our health care system, it is more crucial than ever for hospitals and health care organizations across Canada to treat patients at the right place, at the right time, with the right provider and at the right cost.
Hospitals continue to be overwhelmed with alternate level of care (ALC) patients. The average waiting list for long-term care (LTC) homes in Ontario is currently up to two years, which means that people are waiting in hospitals and have to find interim solutions until a LTC bed becomes available. To address the ALC crisis, the Ontario provincial strategy was mandated to promote aging at home through the Home First Philosophy as opposed to adding more LTC beds to the overall system.
At Bruyère, we believe that keeping seniors in the community for as long as possible and providing them with the required supports to remain healthy and well must be a priority. This is why we recently submitted a motion through The Great Canadian Healthcare Debate for the federal Ministry of Health and the Ministry of Infrastructure and Communities to develop a joint affordable and supportive housing strategy for seniors, focused on community living. It is a unique opportunity for us to address one of the most pressing issues facing our health care system. We have been advised that our motion has made the cut for the top ten. As the process continues, we hope to have the opportunity to debate and pass policy resolutions that will help improve the Canadian healthcare system for everyone.
Keeping and supporting seniors in their home for as long as possible before they rely on institutional care frees up acute care beds for those who need it and reduces wait times for admissions to LTC. It would save the system money while significantly impacting the quality of life of seniors, who would remain more active and involved in their community. Hospital patients waiting for LTC are not stimulated through social activities as they would in a proper assisted living setting or a LTC home.
We feel there is an urgent need for national and provincial leadership to create community-based living models for seniors to address the ALC crisis and the excessive wait times for LTC beds. The largest impediment to address this is housing affordability. The World Health Organization states that there are many determinants that impact health, one of them being housing. In fact, “evidence of health impacts focus on improvements in housing and improved mental health and general health”.[i]
Furthermore, providing affordable and supportive housing is highly cost effective. Acute care costs $1,000 per day whereas home care only costs a fraction of that amount, at $50 to $70 per day—a 93 per cent saving.
This approach also supports dignity, autonomy, as well as mental and physical health. By providing support with activities of daily living, many people would happily be able to remain in their home and maintain a healthy lifestyle.
Another important health determinant is socialization and the avoidance of loneliness. A successful national affordable and supportive housing strategy must be embedded in a philosophy of community living.
There are thriving communities across Canada that are wonderful examples of this innovative approach, both in the for profit and not-for-profit sectors. Seniors are living within a care continuum where they can get varying levels of care and services depending on their needs. Many of these communities allow people to maintain their independence and remain involved in decision making about their care for as long as possible. They also allow couples requiring different levels of support to continue living in the same setting, where one person lives in independent living and the other, in a LTC home on the same site.
Our own Bruyère Village and The Perley and Rideau Veterans Health Centre Village are excellent examples of this model in action in Ottawa. Both are not-for-profit organizations that provide different levels of housing (independent living, assisted living and LTC on one site), with affordable housing built within the model. There are also provisions to care for seniors with mild to moderate dementia in a community setting within a concept called cluster living.
As a leader in seniors’ health, Bruyère will be relentless in its advocacy efforts for a national affordable and supportive housing strategy for seniors. After all, our vision is to enhance lives and transform care.