BY NORM TOLLINSKY

A North East LHIN study on housing needs for seniors points to an urgent requirement for alternatives to long-term care homes. The Seniors Residential Housing Options Report conducted by SHS Consulting projects an alarming increase in the number of seniors over the next 25 years.

Seniors aged 65 and over currently account for 16.9 per cent of the population in the northeast, compared with the provincial average of 13 per cent, but in the next 25 years, seniors are projected to account for 29.1 per cent of the population. The study found that the total population in the region is expected to remain virtually unchanged at just over 550,000 by 2031, while the number of seniors jumps from 90,985 to 162,260, an increase of 78.3 per cent.

The number of seniors in the 75 and over age group during the same period is expected to increase at a rate of 84.7 per cent – from 39,905 to 73,710.

The study demonstrates that current waiting lists for long-term care homes and the alternate level of care crisis in the northeast’s four major hospitals are just the tip of the iceberg.

“The traditional solution is to supply more long-term care beds,” said Rémy Beaudoin, CEO of the North East LHIN. “With the high level of ALC patients in hospitals, everyone wants more long-term care beds. That’s why we commissioned the study. We thought it’s OK to invest in homecare and long-term care, but there should also be a continuum of care in-between.”

As part of the study, Professor Paul Williams of the University of Toronto’s Health Policy, Management and Evaluation group conducted an analysis of 1,600 people currently on the Community Care Access Centre’s (CCAC) wait list for long-term care beds.

“He divided the seniors into categories of needs based on a template he developed at the University o Toronto,” said Ed Starr, the study’s project director and a principal of SHS Consulting. “There are 36 different categories of needs – from people with very intensive needs, who require long-term care, all the way to people who have very minimal needs like housekeeping, maintenance or meals on wheels. What he found was that anywhere from one-third to two-thirds of all of the applicants did not need the kind of services provided in long-term care.”

They applied, said Starr, because long-term care is subsidized and therefore more affordable, despite the fact that it’s the priciest option for taxpayers.

Win-win solution
“I met with seniors in each of the North East LHIN’s planning districts and, one after another, they all said they would prefer remaining in their own homes or living in a seniors apartment where they could get support services,” said Star.

Struggling to make ends meet at home on a meager income and problems arranging for transportation to medical appointments often lead seniors to apply for long-term care, especially in view of the fact that it’s often the only game in town.

“Supportive housing would provide a better quality living environment for seniors and cost savings for the taxpayer, so it would be a win-win solution all the way around,” said Starr. “It would save the government a fortune.”

There are a few supportive housing facilities in the northeast, including Finlandia in Sudbury, Cassellholme Home for the Aged in North Bay and Au Chateau in Sturgeon Falls, but more facilities need to be built to accommodate the growing population of seniors, and they need to be affordable, said Starr.

“The ones who really need it are largely on fixed incomes – widows, for example, who can’t afford private nursing homes, so there needs to be a capital subsidy program so these people can afford it.”

This, in turn, requires co-ordination between the Ministry of Municipal Affairs and Housing and the LHINs. It’s also necessary to have a sponsoring organization that will step up and manage a supportive housing operation.

“In the early 90s, there were big cut backs in funding for affordable housing, especially for seniors, “ said Starr. “Throughout the North East LHIN, there wasn’t a single unit built from the mid-90s to the early 2000s because all of the programs were cancelled. Federal dollars were cut, too, in the name of deficit reduction.”

The gap grew larger and larger, and only now are we starting to realize the extent of the problem.

Long-term care homes, by contrast, underwent an expansion during this period with licenses for some 20,000 beds issued during the Harris regime between 1995 and 2002. However, relying excessively on long-term care homes is an expensive proposition because of the strict regulations governing their design and the services they are required to provide. Starr also points out that long-term care homes are evolving more and more toward a complex continuing care model with Alzheimer’s wings and the transfer of patients from mental health institutions.

Supportive housing, or assisted living facilities, on the other hand, are much less expensive to build and operate.

Abbeyfield
In his report, Starr also urges government and other stakeholders to look at the Abbeyfield model, a U.K.-inspired housing alternative based on the conversion of single family homes into group homes for seniors. There are currently 1,100 Abbeyfield homes providing family-style accommodations for 9,000 seniors in 17 countries. In Canada, there are 40 Abbeyfied Societies, 29 homes and 10 more planned or under construction.
“The society purchases a home and renovates it to create five or six bedrooms with shared living and dining room space, and a live-in caregiver who makes meals, does the housekeeping and drives residents to appointments,” said Starr.

The North East LHIN’s focus on seniors housing may not be directly related to its health-care mandate, but it’s necessary, according to Beaudoin, in light of the ALC pressures on the hospitals and the waiting lists for long-term care.

An integrated health-care system with a vision for health and wellness for all requires more than just a focus on delivering care, he said. “You need to engage your stakeholders. You need to get them on board, have common objectives and unity of vision. The municipal, provincial and federal governments need to align their policies to complement what providers, professionals and the education system can do. Now, when we engage with our partners, we can put the evidence on the table.”