Fall 2010

h e a l t h   p r o m o t i o n
Advice for politicians on improving long-term care


Jonathan Carpenter Photo

 

Dr. Patrick O'Shea

On September 9, NLMA President Dr. Patrick O’Shea was among the presenters who spoke about improving the delivery of long-term care during the government consultation session in St. John’s.

by Jonanthan Carpenter

Throughout the summer, the provincial government has held a series of consultation sessions seeking the public’s input on the guiding principles that will form the basis of a new provincial long-term care and community support services strategy. On September 9, NLMA President Dr. Patrick O’Shea was among the presenters who spoke about improving the delivery of long-term care during the final consultation session in St. John’s.

He explained to Keith Hutchings, parliamentary secretary for health, and MHAs Ed Buckingham and Paul Davis that physicians would like to see seniors living in their own homes for as long as they are comfortable; however, many are forced to enter long-term care facilities prematurely when home support is unavailable.

“The first source of support for any senior is family. However, lack of training and inadequate support often leaves family caregivers exhausted, in poor health, and unable to care for themselves or others. They need a community-based model of support that provides education and assistance. They also need more community-based “day care” programs, as well as more respite beds to prevent caregiver burnout,” said Dr. O’Shea.

Dr. O’Shea explained that the option of staying at home longer needs to be supported with increased home-based professional care services, which starts with recruiting more well-trained and better-paid home care workers, community health nurses, family physicians and geriatricians. He also called for an increase in the number of physiotherapists, occupational therapists, and other rehabilitation specialists.

He said that greater emphasis on rehabilitation upon admission to hospital will help prevent premature entry to nursing homes and will reduce prolonged hospital stays. Many elderly patients experience extended stays in expensive acute care beds when they require ongoing care, and there are no beds available in long-term care homes. To reduce this unnecessary use of acute care services, Dr. O’Shea said a plan is needed for determining the correct number of beds that will accommodate the projected number of seniors who will need long-term care in the coming decade.

In addition to increasing the number of beds, Dr. O’Shea said there should be a seamless transition between various care settings. In the current system, care can be variable, fragmented, and financed through different mechanisms. A better coordinated and comprehensive system would allow people to move more easily from acute care to home care, assisted living or long-term care, according to their needs.

Additionally, Dr. O’Shea called for a government-subsidized universal prescription program to ensure that medications covered in hospitals are available once the patient is discharged. He also encouraged government to explore the use of a standard assessment tool to determine the best plan and the required funding based on the individual patient and their family’s needs.

“Because each person has varying physical and psychological needs, any government subsidies should be defined and allocated according to the needs of that senior, and not arbitrarily attached to the institution or bed. By aligning government subsidies with individuals’ needs, more choices for seniors will develop. We also need to consider private delivery of publicly funded care. We should not be afraid of competition in providing services and settings for our seniors,” he said.

During the NLMA AGM in June, Dr. O’Shea announced the Association’s plan to hold its own summit on care for the elderly, which is currently in the planning stages. He explained that the summit is not a duplication of government’s consultations, but rather an opportunity to assess and debate the medical model for elder care.

“Seniors are vulnerable members of our society, who deserve to be treated with dignity and the highest level of care that we can provide. As a society, we will be judged by how well we care for them. We must provide the same level of care to seniors that we will expect to receive ourselves, as all of us will need these services in the future.”

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