Crisis in Long Term Care

Originally posted


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.


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!



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