The Question: My mother is an elderly woman with Alzheimer’s admitted to Sunnybrook a few weeks ago and she is now ready to leave. None of the retirement homes I have visited so far seem to be suitable for her but I’m actively looking for one. What will happen to my mom in the meantime?
The Answer: Each day, there are 70 to 75 patients at Sunnybrook like your mother: with her acute problem treated in hospital, she is now awaiting placement elsewhere – be it a rehabilitation facility, long-term care home, complex continuing care, palliative care – or her own home with extra help. In your mother’s case, it’s a retirement home equipped to care for patients with dementia.
Her circumstance is faced by thousands of patients every day. An estimated 7,500 hospital beds, representing 14 per cent of all acute care beds in Canada, have patients in them, awaiting care elsewhere, according to a Canadian Health Services Research Foundation report.
When patients are in beds, waiting for alternate care, it has a domino effect on the system. Operations are postponed, there are long delays in emergency and some patients can’t even get into Sunnybrook – and are sent to other hospitals in the province or even to the United States – because the hospital is literally full and beyond. There are days in this hospital when it is operating at 110 per cent occupancy.
“We need to have a system when the person needs rehabilitation, long term care or home with all the supports, they immediately have access to the right type of care at the right time in the right place. The system is presently being improved upon, but it isn’t 100 per cent yet,” said Lois Fillion, operations director of Sunnybrook Health Sciences Centre. “There are still delays in the system which results in all being caught in a juggernaut.”
When an alternate level of care [ALC] patient, such as your mother, is identified, Ms. Fillion is able to track her in real time, including the health care facilities she has applied to and whether those institutions have accepted the referral or not, and whether that has been done within five days of the patient’s request.
Patients, in particular, are caught in a terrible spot: knowing the hospital is not the ideal place to convalesce, they stay, waiting for placement. On a late August day, one patient had been waiting 268 days at one of our other sites, the Holland Orthopaedic & Arthritic Centre; two others had been waiting 274 and 262 days respectively at the Sunnybrook site.
While there is no one fix, the Home First program has been able to help patients such as your mother through a specialized team led by a community care access coordinator, who supports and assesses care needs of the patient and family within one to two days of discharge from hospital. That coordinator has access to health care professionals and community support services to support your mother, while you search for acceptable accommodation. Since its inception in fall 2009, it has helped reduce emergency room visits and numbers of those on long-term care wait lists.
For more information on HomeFirst, please visit:
