What does ‘Alternative Level of Care’ mean?

Originally published @allaboutestates.ca

The Hospital News is a free monthly publication available in hospitals and related institutions across Canada. Their September 1, 2016 article titled “Hospital discharge: Reaching a breaking point” struck a chord with me and I wanted to share it with you. Readers of this blog are likely aware of the current crisis we are facing in terms of the lack of suitable accommodations for those ready to be discharged from hospital.  It is not just the elderly who are impacted. I have a client with ALS who has been living in a downtown hospital for close to 3 years. There is simply no place for him to go. Once someone no longer requires acute care and are waiting either to be discharged to home or to another facility such as Long Term Care, they are designated as “ALC” or alternate level of care.  It is a ‘system classification’ that applies to all patients waiting in all patient care beds in an acute or post-acute care hospital in Ontario who do not require the services and resources of the care setting. The designation is provided by a physician.

In the article, we are advised that as of ‘May 2016, 15% of all Ontario acute care beds were occupied by ALC patients.’ Furthermore as of ‘June 30, 2016, more than one-third (36%) were waiting for placement in long-term care. An additional 18% were waiting for discharge home, either with or without home care or community support’. The author, Jonathan Breslin PhD is an Ethicist and he provides the following figures: ‘ As of June 30, 2016, there were a total of 2765 ALC patients occupying acute care beds in Ontario at an average cost to the system of $800/day ($2.2 million dollars per day).’

Staggering, wouldn’t you agree? I don’t know who is addressing this issue but I do know that there needs to be some changes to this system.  We need more residences, we need more supports in the community. We all need to understand that ‘bed blockers’ do not want to be part of the problem;  we need to acknowledge the magnitude of our current situation and acknowledge that this problem will only get worse until we start working together and thinking outside of the box…..

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