Originally published @allaboutestates.ca

The sad story of our Long Term Care crisis continues and this blog will focus on what’s available and the seniors who apply for them.  As we know, Long Term Care homes provide Ontario residents with access to 24 hour nursing and personal care and are available to those 18 years or older whose care needs cannot be safely met in the community.  As the Ministry website states: “you can expect much more nursing or personal care here than you would typically receive in a retirement home or supportive housing[1]”.   In 2017 there were 627 long term care facilities operating 78,120 beds in Ontario[2].  From these, approximately 550 beds are convalescent care beds are allocated to provide short term care and 400 beds are allocated to provide respite care.

In terms of who lives there, in their report, Building Better Long-Term Care: Priorities to keep Ontario from failing seniors.   the Ontario Long Term Care Association provides the following resident profile:

  • Average age is 85 year old female
  • 9/10 residents exhibit some form of cognitive impairment with one in 3 being severely impaired.
  • Over 40% exhibit aggressive behaviours stemming from their cognitive condition
  • 1 in 3 are completely dependent on staff and all others require frequent support with their activities of daily living
  • 2/3 of residents use a wheelchair
  • Almost every resident exhibits multiple chronic conditions.

The bolded points above are, in my opinion, a major contributing factor to the worst of the problems- assaults between residents and between staff and residents. “In many cases, the lack of privacy afforded in older homes, particularly those with three- and four-bed wards, results in more seniors displaying responsive behaviours[3].”

These homes are funded, licensed and regulated  by the Ministry of Health and Long Term Care under the Long Term Care Homes Act, 2007 and Ontario Regulation 709/10. This spells out residents’ rights, care and services available however most amazingly does not spell out a required staffing patient ratio.

Eligible applicants can apply for either a private room (private room and private bathroom) or a semi private room (2 beds per room with shared bathroom in an older building or a private bedroom with a shared bathroom in a newer building) or a ward or basic bed, which can be up to four beds in a room. The applicant can select up to 5 different facilities. Then the wait begins…. The average placement wait time as of June 2017 was 137 days, with a wait list of 32,046 people.  Not every one is equal on the wait list.  There is a priority wait list which is determined by the placement coordinator  from the LHIN and is based on the Inter RAI assessment[4].   The waitlist priority breakdown[5] is determined in a number of different ways based on:

1) Crisis: People who need immediate admission or in crisis

2) Spouse/partner Reunification: People who need to be reunified with their spouses/partners, who are currently residing in LTCH.

3A) Religious, Ethnic or Linguistic Origin: People waiting for LTCH serving those of a religion, ethnic origin, or culture. People with high care needs but can be supported a home.

3B) Religious, Ethnic or Linguistic Origin: People waiting for LTCH serving those of a religion, ethnic origin, or culture. People with care needs currently managed at home with supports.

4A) People who have high care needs, but can still be supported at home until be become available.

4B) People with care needs who are currently managing at home with support

Once your name gets to the top of the list and a bed is offered, you have 24 hours to either accept or reject the offer. If it is your 5th choice and you are not interested and decline the bed, your name is taken off all of the lists and you must wait 3 months before reapplying, unless there is a significant change in your condition or circumstances.  If you accept, you then have 5 days to move in.

Each resident must pay a monthly co payment; regardless of where one lives in the Province the rates are the same. As of July 1, 2017 they were:

Type of Accommodation Daily Co-PaymentMonthly Rate
 Basic Long Stay $59.82$1,819.53
 Semi-Private Long Stay* $68.02-$72.12$2,193.65
 Private Long Stay* $78.27-$85.45$2,599.11
 Short Stay (Respite) $38.72

*Varies depending a home’s structural class and date of move-in.

Source: Ministry of Health and Long-Term Care, Senior’s Care: Long-Term Care Homes.

Government subsidies or a rate reduction is available for those who can’t afford to pay the full amount, however it is only available for Basic room accommodation.

Lessons Learnt:

Apply early, ask questions of the placement person,  research your options, visit and tour each facility, check the Ministry wait lists and the licensing and annual inspection reports of the selected residences.

Most importantly choose wisely so whichever facility has a vacancy and when a spot is offered, you are ready to make the move.  My next blog will discuss some of the challenges I have experienced first hand with my clients.

[1] https://www.ontario.ca/page/find-long-term-care-home

[2] City of Toronto 2017 Long Term Care Homes  & Services https://www1.toronto.ca/wps/portal/contentonly?vgnextoid=63fedefa5c528510VgnVCM10000071d60f89RCRD&vgnextchannel=8a87116288528510VgnVCM10000071d60f89RCRD

[3] https://s3-us-west-2.amazonaws.com/oltca/bsc2017/OLTCA_Budget_Submission_Request.pdf

[4] http://www.interrai.org/long-term-care-facilities.html

[5] https://www.oltca.com/OLTCA/Documents/SectorDashboards/TC.pdf

 

Originally posted @allaboutestates.ca

THE WHAT:

Recently on most days newspaper articles are highlighting some injustice or abuse regarding seniors living in Ontario’s Long Term Care facilities, commonly known as ‘nursing homes’ or ‘old people’s home’. This is a major problem facing society and one that we must get under control.  Last week’s Marketplace Crying Out for Care exposé highlighted abuse amongst residents in many facilities within Ontario. Frankly, it likely caused nightmares for many families as they worry about their family members who reside in some of these facilities.

The yearlong investigation found that in Ontario, “the reported rates of abuse have doubled in 6 years and every day, 9 residents are harmed by another resident and 6 are harmed by staff who are supposed to care for them. The investigation revealed that staff-to-resident abuse increased 148 % from 2011 to 2016.”

I thought I would spend the next few blogs discussing this important issue. This first blog will help set the stage.

I have found that almost all of the seniors I have met would like to remain living in their own homes. I am no different and am sure you feel the same way. The 2011 census data supports this as over 90% of seniors aged 65 plus live in their own private households[1].

In helping families to decide whether ‘to stay or to go’ which means either remain living at home with available care and modifications that might be needed or to explore alternate accommodation, I review the the 3 C’s  which include: Care, Cost and Choice. Included in the discussion is explaining the difference between Long Term Care, which is publicly funded by the Ministry of Health and retirement living, which is privately paid.

THE WHY:

However, many seniors don’t have a choice as they cannot afford to either stay at home as their care needs exceed what is possible at home or cannot afford to pay for a private retirement setting. As such, the demand for publicly funded facilities that provide 24/7 nursing care continues to increase.  Stats Can tells us that from our current demographics that older seniors, those 85+ are the 2nd fastest growing demographic  with centenarians (those aged 100 and older) leading the way as the fastest growing age group[2]. The demand on our health care and home care sectors is ballooning and cannot keep up with the current demand for care.

As well, we know now that there are more seniors over age 65 than children under 15,  resulting in less workers contributing tax dollars as well as fewer individuals, whether paid or by size of family, who are interested or able to assume a caretaking role.

The demand on employed carers (35% of working Canadians provide unpaid care to a family member or friend) is high, with the average employee spending 9 hours per week on caregiving. Families are juggling to keep up.

Income for many seniors prohibit them from hiring private care  (averaging in the GTA at approximately $28 +) and without family to assist, they often do with the little that is available from the LHIN’s (Local Health Integration Network, formerly the Community Care Access Centres or CCAC). The services provided by the LHIN will be discussed in a subsequent blog.

The Conference Board of Canada in their report, Future Care for Canadian Seniors, A Status quo Forecast”  shared: “The status quo forecast indicates that by 2026, over 2.4 million Canadians age 65+ will require paid and unpaid continuing care supports—up 71 per cent from 2011. By 2046, this number will reach nearly 3.3 million.”   Older seniors (85+) tend to have greater care needs which greatly impact their ability to live on their own. Functionally they are limited, whether it be from a cognitive or physical impairment. Falls are the number 1 reason that senior have to leave their homes.

In sum, this introductory blog highlights our demographics and sets the stage of the who and the why of those individuals who require Long Term Care. Our Long Term Care options are in a crisis and unless there are some major changes, the future does not look bright.

Subsequent blogs in this series will address eligibility, costs, alternate level of care beds, challenges for younger differently abled adults and the LGBT community, those with dementia and behaviorial challenges and hopefully concluding with some suggestions for improving the system and some options. Stay tuned!

 

 

Originally posted @allaboutestates.ca

Let’s take a moment to consider one of the biggest health crises that we will be facing over the next several years. A health diagnosis that not only robs people of their memories but a health crisis that can destroy families. Without planning, I fear it may also bankrupt our health care system.

Alzheimers disease is the most common form of dementia and is only one of many diseases that can cause dementia.  Dementia is a progressive disease of brain cells that includes symptoms of memory loss, confusion, difficulty with problem solving and thinking and can impact, at end stages even the most basic of functioning levels. It affects one’s ability to live independently and perform everyday tasks, including both instrumental activities of daily living (ie shopping, cooking, banking, using the telephone) and activities of daily living including bathing, eating and toileting. Here’s what we know[1]:

  • 1 in 3 seniors over age 85 will develop a dementia
  • 65% of those diagnosed over age 65 are women
  • 16,000 Canadians under age 65 live with dementia (2016)
  • 25,000 new cases are diagnosed every year
  • 1 million Canadians are affected directly or indirectly by the disease
  • $10.4 billion annual cost to Canadians to care for those living with dementia
  • 24 hour care is required at some point along the journey
  • The greatest risk of developing dementia is aging
  • Dementia is not a normal part of aging
  • Many living with dementia can continue to have meaningful relationships and productive lives for many years
  • There is no cure

Over the last many years I have blogged   extensively on this subject.

I am glad to say that finally the message is being heard.  Bill C-233, an Act respecting a national strategy for Alzheimers disease and other dementias received Royal Asset on June 22, 2017. Canada is the 30th Country (out of 194 World Health Organization members) to now have a Dementia Strategy.

The Alzheimers Society has been doing great work in helping to destigmatize the diagnosis and encourage those affected to seek help and speak out.

Much work is still to be done. It is a long journey and  there are many individuals and families who are struggling to cope with  a difficult and nasty disease that impacts the entire family unit.

Please consider getting  involved with your local Alzheimers Society  by advocating, donating and participating in awareness and educational campaigns.

[1] http://www.alzheimer.ca/en/Home/About-dementia/What-is-dementia/Dementia-numbers

A New Caregiving Benefit

by Audrey Miller on January 15, 2018

in Articles & Blogs by Audrey, Caregiving

Originally posted @allaboutestates.ca

While employed family caregivers (over age 60) in Hawaii are now eligible to receive a $70 per day stipend to pay for additional care support for  a family member, we have something different.

As of December 3, 2017  there was a new EI Family Caregiver Benefit which provides for “eligible caregivers to receive up to 15 weeks of financial assistance to provide care or support to a critically ill or injured adult”.  Eligible caregivers depending on their wages could earn up to $574 a week and the 15 weeks of benefit may be shared by eligible caregivers over the 52 week period either at the same time or one after another.

Care is defined as “participating in the care of” and  Support is defined as “providing psychological or emotional support”.

There is a broad definition of family which includes “immediate family as well as other relatives and individuals considered to be like family, whether or related by marriage, common-law partnership or any legal parent-child relationship.”

The definition of critically ill or injured adult is defined as “anyone 18 or over whose baseline state of health has changed significantly and whose life is at risk as a result of illness or injury. They must also need the care or support of at least one caregiver.

If the person is already living with a chronic medical condition, caregivers are not eligible for the Benefit unless the person’s health changes significantly because of a new and acute life-threatening event.”  A medical certificate must be completed by a medical doctor or nurse practitioner.

The terms seem to me to be broad and open to interpretation.  I would think that an older person who gets the flu or pneumonia meets the requisite criteria and family who  stay with them to provide care and support would qualify for a paid leave of absence. I can only hope that the government approval process will be relatively uncomplicated and in keeping with the spirit of the legislation.

Should the person’s situation further deteriorate, the Compassionate Care Benefit is also available, providing up to an additional 26 weeks of employment insurance benefits.

I continue to applaud employers who support their caregiving employees and while not all employers are like Microsoft, who  this summer announced they are providing their caregiving employees with a 4 week paid leave of absence, this  federal announcement is  welcome news.

A Directed Death

by Audrey Miller on January 8, 2018

in Articles & Blogs by Audrey, End of Life

Originally published @allaboutestates.ca

My first blog of the New Year  may be about death. But it is about having as good a death as possible- (in your own bed while asleep) and of your choosing…..A recent  blog was about  a fellow who wanted to ensure his dying wishes would be followed which involved tattooing ‘Do Not  Resuscitate’ on his chest.  DNR wishes, for me, apply when our health deteriorates or something unexpected occurs.

On the other end of the spectrum is planning for an exact death towards the end of the journey, with place and timing determined in advance, I am specifically referring to  Medical Assistance In Dying (MAID) which came into effect in June 2016.

Bill C-14   provides the ability for terminally ill and suffering patients to choose how to end their lives.

The following description and explanation is taken directly from the Dying With Dignity  website:

What types of MAID are permitted in Canada?

In Canada, two types of MAID are allowed:

  1. A physician or nurse practitioner can directly administer a substance that causes the death of the person who has requested it, and
    2. A physician or nurse practitioner can give or prescribe to a patient a substance that they can self-administer to cause their own death.

Who is eligible for MAID in Canada under the new law?

Under Bill C-14, two independent health care professionals need to evaluate an individual in order to determine whether he/she qualifies for MAID. To qualify, an individual must be 18 years or older and meet the following four eligibility criteria:

  1. Have a serious and incurable illness, disease, or disability;
    2. Be in an advanced state of irreversible decline in capability; 
    3. Endure physical and psychological suffering that is intolerable to them; and
    4. Their natural death has become reasonably foreseeable.

Patients must also be capable of providing informed consent at the time that MAID is provided.

How does the new law differ from the Supreme Court’s Carter decision?

Bill C-14 is much more restrictive than the Carter decision. The Carter decision made assisted dying available to any consenting, competent adult suffering intolerably from a grievous and irremediable medical condition. However, the new law includes two provisions that are much narrower in scope. To qualify for assisted dying under Bill C-14, an individual must be in an advanced state of irreversible decline and their natural death must be “reasonably foreseeable.” The vague language of the eligibility criteria — specifically this “reasonably foreseeable” clause — makes the new law ambiguous at its best and unconstitutional at its worst.

Despite assurances from the federal government that individuals do not have to be terminal in order to qualify, medical practitioners will ultimately have to interpret the eligibility criteria for themselves. There is a strong chance that many providers will interpret the “reasonably foreseeable” clause to mean that only those individuals whose deaths are imminent will qualify for MAID. In fact, some Canadian doctors have already been advised by lawyers to err on the side of caution and to only provide MAID to those who are terminally ill.

This means individuals who were granted the right to a peaceful death by the Supreme Court may now found themselves barred from access. For example, patients with excruciating conditions like ALS, Multiple Sclerosis, and Parkinson’s disease are at risk of being denied a dignified death because their deaths may not be imminent. Other individuals, like those who have endured a serious stroke or a series of strokes, may also be trapped in intolerable suffering with no natural end in sight. For many of these individuals, this intolerable suffering can persist for years, and to force them to continue languishing in agony is exactly the kind of fate the Supreme Court ruled against.

What procedural safeguards are required in Bill C-14?

If the individual meets all the eligibility requirements and has clearly consented to an assisted death without any external coercion, they must submit a written request in the presence of two independent witnesses. Once the patient’s doctor (or nurse practitioner) determines that the patient is eligible for MAID, a second doctor or nurse practitioner — independent of both the first doctor and the patient — is required to give a second opinion on the patient’s eligibility. If both agree that the patient is eligible, MAID can be granted.

There is a mandatory reflection period of at least 10 days that needs to occur between the day the patient signed the written request and the day MAID is provided. However, if death or loss of capacity to provide informed consent is imminent, the reflection period may be reduced.

Could a person with dementia qualify for MAID?

Under the new law, advance requests for dying are not permitted. This means Canadians with diagnoses of competence-eroding conditions like Alzheimer’s and Huntington’s disease will not be granted the right to consent while they are still of sound mind to an assisted death that would be carried out at a later time.

Without advance requests, these individuals will most certainly be found ineligible for MAID because they will likely lose competence before they reach the required “advanced state of irreversible decline” outlined in the eligibility criteria.

The government has initiated an independent review to study advance requests, but there is no guarantee that access to MAID through advance requests will ever be allowed under the law. That means individuals with conditions like dementia may never qualify for MAID.

According to an October 6, 2017 Toronto Star article from June to Dec, 2016, there were 803 MAIDs  in Canada. From Jan to June 2017 this increased to 1,179 MAIDs.  Cancer was the most frequent medical condition and the patient average age was 73. I found this relatively young age surprizing.

There is still much to figure out.  I have written extensively about Advanced Directives and continue to stress the importance of discussing, deciding and writing down one’s wishes.

If you are looking for more information about MAID:

http://www.health.gov.on.ca/en/pro/programs/maid/

https://www.ontario.ca/page/medical-assistance-dying-and-end-life-decisions

 

 

T’was the fight before Christmas, when all families know,
It’s better to forgive than tell them to F. O.,
Mom probably liked you better, if memory serves,
So while I am a P.O.A., she will get what she deserves

Come on siblings and get off your butts,
I need alittle help, ‘cause I really am going nuts,
I am pulled in many directions, with no time for my own,
Let’s hire an expert who we can speak with by phone

This Plan will save time and money and help us agree,
We can all care for Mom, in addition to me!
A Plan of Care will outline Mom’s needs,
Working together, we all will succeed

All families are strange, of this I am sure,
Now where did we put Elder Caring’s brochure?
Some guidance is needed to keep mom from harm
‘Cause with caregiver burnout, I’ve nearly bought the farm

I won’t wait this time, I will call them right now
Professional counsellors will give me know- how
I found it along with various papers
Advanced directives, wills, now finally some answers!

Meeting a counsellor, has made it much easier
I now have perspective on how to proceed
Hiring a caregiver is just what I need!
Alittle respite will go a long way
Of keeping my sanity day after day

Why did I wait? I really don’t know
We are living to 100 and there’s a long way to go
Having knowledge and resources makes it much easier
And learning when to say Yes and how to say NO!

Our government tells us, we should be aware
For those less fortunate, it may not be fair
Our society is aging and we all will need care
Live with your children? A threat or a dare?

Dementia is scary, forgetting all we know
The best is to love but how can we let go?
I too am part of the boomers, still looking ahead
One needs to be positive, no point feeling dread

We’ve had the talk and filled out the Binder
Make sure your wishes are clear- just a reminder
What’s ahead for us all, we really don’t know
I hope to have the choice when it’s my time to go

Planning ahead – my message is clear
Keep talking to your family and loving them dear

Happy holidays to you. Thanks for reading and my very best for a healthy 2018.

Originally posted @allaboutestates.ca

I am sharing my good fortune in that I am proud to be a ‘puppy raiser’ for the Canadian National Institute for the Blind (CNIB).I am doing so in this blog because it relates directly to aging well and philanthropic opportunities.

By way of background, CNIB is a national charitable institution that is celebrating its 100th birthday this year. They work with people of all ages in their own homes and communities offering a wide range of services to people who have vision loss.

This year for the very first time, CNIB developed its own guide dog program to raise and train guide dogs exclusively for people with sight loss.  I am lucky and proud to have Ziggy, who is a beautiful Golden Retriever.   As a puppy raiser my job is to socialize him and provide some preliminary training on basic skills, obedience commands and feeding routines before he goes off to guide dog university at about 15 months. From there ‘he will partner with a blind or partially sighted person to guide the user around their environment, avoiding obstacles and indicating hazards’ and so much more. Like any other pet he is a friend and a very much trusted companion.

Ziggy joins me when visiting my clients and I can tell you that he brings sunshine and a smile wherever he goes. I work with two sisters in their nineties who are frail and both use walkers. While he might be pulling me along in the apartment corridor leading to their unit, Ziggy knows that he must lie down and not get in their way nor make any sudden moves. When he is in their home he lies down at their feet and either puts his head in their lap or lies down for a belly rub. When he is wearing his yellow coat, he knows to leave his goofy puppyiness outside the door.

While Ziggy is specifically being trained to be a guide dog, there are several organizations that train therapy dogs. As well there are organizations that provide therapy cat and dog visitation programs. The benefits of pet therapy can be seen on an emotional and physical level, from those with mental health and cognitive challenges.

There is much time (love) and financial expense invested in breeding, raising and training guide dogs.  Many of the CNIB supporters have found that with a little planning, one does not need to be wealthy to make a profound difference.  Another wonderful charity to consider in your legacy planning work.

Like many of us reading today’s blog, I wear glasses. When I think about losing my eyesight and not being able to improve it, I find myself in a dark place, both figuratively and literally. A guide dog can make a huge difference.

Originally posted @allaboutestates.ca

While I was enjoying the Florida sunshine last week, a Washington Post article caught my eye ‘A Florida man collapsed with a ‘Do Not Resuscitate’ tattoo. Doctors didn’t know what to do’.

The full article in the New England Journal of Medicine  described doctors in Miami who found themselves caught in what they describe as an usual ethical dilemma.  Reportedly, an unconscious man was brought to the ER with a chest tattoo that read ‘DO NOT RESUSCITATE’; his signature was underneath. He did not have any identification or family with him. The doctors initially decided not to honor his wishes ‘invoking the principle of not choosing an irreversible path when faced with uncertainty.’ The ethics team advised them to honour his tattoo as “they suggested that it was most reasonable to infer that the tattoo expressed an authentic preference, that what might be seen as caution could also be seen as standing on ceremony, and that the law is sometimes not nimble enough to support patient-centered care and respect for patients’ best interests.”  The DNR order was signed. Subsequently the hospital was able to locate a copy of his Florida Department of Health, DNR order which was in keeping with the tattoo.  The gentleman passed away that evening.

The NEJM article concludes “this case report neither supports nor opposes the use of tattoos to express end-of-life wishes when the person is incapacitated.”

A professor of bioethics, Dr. Arthur Caplan opined that the DNR tattoo is not substitute for an advance health-care directive.  He recommends keeping the actual document in your pocket or wallet.

Most of us don’t want to think about this dying process and if we had, we do not carry this document around with us.  In Ontario we do not have a central registry.  I am not sure why it cannot be part of our OHIP record. Quebec is the only province that does have a central registry.  I have previously blogged about the Alberta ‘Green Sleeve’ program and gains they had made in having doctors spend time with their patients reviewing and discussing issues/concerns.

It does seems pretty clear to me having instructions tattooed on one’s chest should be a clear message. However until practice, policy and the law are consistent, we can all start with having the conversation with our loved ones.

Originally posted @allaboutestates.ca

My fellow bloggers and I write frequently about Powers of Attorney, however my concerns are often focused on the lack of planning when it comes to making Powers of Attorney for both Personal Care and Property. More specifically, although I do not have any statistical data, my subject matter experience tells me that people are more likely to have an attorney named solely for property than having both or only having appointed an attorney for personal care. People seem to care more about their finances than they do about they own care needs. Many times a trust or financial organization has been named as attorney for property yet there is no one named for care. Why do we continue to fool ourselves by thinking that we are going to live well and cognitively intact until we die in our sleep? Dr. Katherine Arnup highlighted the death experience in the Vanier Institute of the Family research paper called  Death, Dying and Canadian Families.  I summarized her findings in a previous blog and while it is from a few years ago, I don’t believe much has changed.

The top 3 Canadian desires are:
Desire 1: We want to live forever: We are living longer with more and more of us reaching our 100th birthday.
Desire 2: We want to be fully able and then to die suddenly in our sleep: Only 10% are lucky enough to experience ‘sudden death’. The rest of us will likely linger. For many seniors’ ‘old age’ is accompanied by a progressively increasing number of ailments and chronic conditions.
Desire 3: We want to die at home: Most Canadians die in hospital.

Last week’s blog regarding the Aging With Confidence: Ontario’s Action Plan for Seniors reported that “Ontario will invest 1 million over three years in a public education campaign to raise awareness among seniors on how important- and easy- it is to set up Powers of Attorney and to encourage them to choose who can make personal care and financial decisions on their behalf, if necessary.” This is good news.

Part of our lack of planning, even by those who work in the health and legal fields is that of planning for when we become ill and are no longer able to make sound decisions. We ignore the inevitable and bury our heads in the sand. The message is timeless. Think about tomorrow and how you want to live UNTIL you die and choose someone who can speak for you when you can no longer speak for yourself.

Originally posted for @allaboutestates.ca

Last January 2017 the Ontario government recognized that Seniors in Ontario  are a growing force that needs to be better serviced and recognized and created its own stand alone Ministry, namely the Ministry of Senior Affairs. It has previously been housed within the Ministry of Infrastructure.  Yes I thought they were strange bedfellows too.  While Statistics Canada advises that there are more seniors over age 65 than children under 15 years of age, Ontario has recognized  that within the next 25 years, the number of seniors in Ontario will double to 4.6 million.

So, last week, the Wynn government released: Aging With Confidence:  Ontario’s Action Plan for Seniors:  which I hope is the start of something wonderful.

It is an exciting announcement  advising that the government will spend 550 Million$$ over 4 years for  the building of 5,000 new Long Term Care beds and another  $155 million over 3 years for community based services. In an attempt to support seniors at all ages, the Action Plan divides resource allocation into a few different areas.

Firstly, to all seniors, regardless of age and health status.  These initiatives included things such as:

  1. Free ‘high-does flu vaccines
  2. One Stop Website: www.ontario.ca/agingwell or call 211
  3. Better community transportation option
  4. More age friendly communities- accessibility (Community Planning Grant)
  5. Elder Abuse Prevention
  6. Expansion of consumer protection
  7. Strengthening elder abuse prevention (public education, service provider training, research and improved community response)
  8. Provide education about powers of attorney (Ontario.ca/agingwell)

The second area is directed towards supporting seniors living independently in the community.  These initiatives include funding for:

  1. More senior active living centres (community hub provide social, recreational program)
  2. More community engagement opportunities: funding more projects
  3. Staying physically strong (active for life recreation stream under Ontario Sport and Rec Communities Fund)
  4. Engaging seniors through arts programs
  5. Helping seniors with technology – linking youth volunteers with seniors
  6. Supporting seniors to become mentors- will fund 20-30 more projects

The third area is directed towards Supporting Seniors Requiring Enhanced Supports at Home.  This includes:

  1. Support for more naturally occurring retirement communities- providing more onsite support with focus on ethno-cultural services- OASIS model
  2. Increasing access to in home health care- access to house calls.
  3. Increased access to geriatric care- increasing training opportunities for health care providers and psw.
  4. Providing more home care hours (PSW , nursing and pt)
  5. Expanding seniors supportive housing new transitional care spaces (between hospital to home) and providing 200 new subsidies to access affordable housing
  6. Increase support for caregivers: will provide a single point of access for information?
  7. Making the quality of care more consistent: better consistency from region to region and better understand how need relates to hours provided.
  8. Helping people with dementia- expanding programs (investing $100 million over 3 years)
  9. Enhancing self-directed care- new- self directed care models –( new personal support services organization by 2018)

The last group is directed towards Supporting Seniors Requiring Intensive Supports.   These include:

  1. Modernizing long term care homes- eliminating 4 bed ward.
  2. Reduce the wait time for LTC – will create 5,000 new beds by 2022 and will create 30,000 more over next decade
  3. More staffing and support in LTC- increase in nursing hours, PSW hours and specialized behaviourial training and end of life care. Increase to 4 hours PSW care daily
  4. Promoting innovation- virtual consultation?
  5. Culturally appropriate LTC (meals and language)
  6. Strengthening safety in LTC
  7. Strengthen office of the OPGT
  8. Improved end of life care- more hospice beds closer to home

Some great initiatives ahead.  There are many that I am excited to learn more about.   Let’s see how things unfold….