Written by Ryan MacKellar, Communications Assistant, Alzheimer Society of Ontario
With a potential provincial election on the horizon, the ramifications of our aging population need to be put on the agenda. Two hundred thousand Ontarians are living with Alzheimer’s disease or another form of dementia. And as more Baby Boomers enter their later years, this number will continue to increase, with 90,000 new cases expected in the next decade.
Most people with dementia wish to remain at home as long as possible. It decreases health-care costs and home helps people with dementia maintain a sense of self. The Ontario government has increased funding to home and community care in the 2013 by 5 percent over the next three years in an attempt to achieve this goal. But as the disease progresses, so do care needs. Eventually, they will all require some kind of long-term care placement.
The government’s efforts are being undermined by the ‘dementia domino effect.’ Ninety percent of community-dwelling Ontarians with dementia are living with two or more chronic health conditions, and dementia, because it affects cognitive capabilities, limits these people’s ability to self-manage their own health.
The result is that people with dementia are prone to cycles of emergency department use and hospitalization, which speeds up their deterioration and ultimately means the transition to long-term care happens sooner than it needs to. Currently, the Government of Ontario has no policy that recognises this ‘dementia domino effect.’
Often it is after a crisis that the transition to long-term care occurs. People with dementia are not able to return home and are forced to wait in an ‘alternate level of care’ bed, that is, a hospital bed designed for acute rather than long-term care. This uses up hospital resources and is difficult for people with dementia and their families. Cognitive abilities decline faster in such a setting.
The long-term care system in Ontario is already stretched to the limit. Today, Ontarians wait an average of four months to access a long-term care bed. Waits vary immensely by region, with some regions boasting wait time of 45 days and others as high as 269. Half of provincial Local Integrated Health Networks have wait times above the regional average.
When someone with dementia finally receives a long-term care placement, the care they receive is often inadequate. Sixty percent of residents have dementia, with 45 percent of these showing significant behavioural symptoms that are difficult for staff to manage. The result is residents are more likely to be physically restrained or put on anti-psychotic medication to control these behaviours, even though these measures are not clinically recommended due to increased risk of death.
Research shows that with adequately trained staff, lower drug and restraint use is possible, greatly improving quality of life for residents. Behavioural Supports Ontario was an innovative approach to creating effective responses for difficult behaviours as well as addressing the problems of wait times and alternate levels of care days. But funding was only able to reach roughly 30 percent of long-term care homes and even fewer community-dwelling people, greatly limiting its impact.
The Alzheimer Society of Ontario is launching an ambitious public advocacy campaign to address these problems and help people with dementia and their families living in both the community and long-term care. It is asking the government to:
1. Make people with dementia and their families the priority in the next round of community funding by creating policies targeting dementia care in the community.
2. Provide for more staff in long-term care with specific skills to support people with dementia, using Behavioural Supports Ontario as the model.
3. Establish a fair and standard wait time for long-term care so that people with dementia have equal access and Ontarians do not wait longer in some parts of the province
These Alzheimer Society solutions will go a long way to alleviating the difficulties people with dementia and their families face and lessen the disease’s impact on our health-care system.
Please sign and share our petition to make people with dementia and their families the priority by creating policies targeted to dementia care through a comprehensive dementia plan.
The Alzheimer Society of Ontario is the province‘s leading health charity for people with Alzheimer‘s disease and other dementias. We provide programs and services for people living with the disease and fund research for a cure.
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