A recently released report performed by the Institute for Clinical Evaluative Sciences (ICES) and published in the Journal of the American Medical Directors Association has brought the quality of care provided at Ontario’s long-term care facilities into question. In particular, the report found that residents of privately run nursing homes, which account for about 60 per cent of Ontario’s long-term care facilities, had a significantly higher death rate than the residents of non-profit facilities.
Credit: Thomas Bjorkan/Wikimedia Commons
The study followed the experiences of nearly 54,000 residents of 640 long-term care facilities in Ontario between early 2010 and early 2012. Specifically, it found that residents of for-profit homes were 16 per cent more likely to die within the first six months of their stay, and were 33 per cent more likely to be hospitalized.
“Those are not trivial numbers,” said Dr. Peter Tanuseputro, one of the researchers involved in the study, in an interview with CTV News. “If there’s a way that we can get to the bottom of this and correct it, we could potentially be preventing many, many hospitalizations and potentially many deaths.”
While the report’s statistics are illuminating, the reasons behind the troubling numbers are unclear. One possible reason for private facilities’ high mortality numbers could be insufficient staffing.
“A lot of the research finds that for-profit facilities actually hire fewer staff,” said Dr. Margaret McGregor, a family physician and researcher at the University of British Columbia, also to CTV. “One can’t help but ask [if that is] because more staff affects the bottom line.”
This sentiment was echoed by Donna Rubin, CEO of the Ontario Association of Non-Profit Homes and Services for Seniors, when she spoke with the Toronto Star.
“Ownership matters,” she said. “(Non-profit homes) are not in it for the business of profit, so all surplus, if there is any, goes back into the home.”
While the standard of care gap between non-profit and for-profit homes is certainly cause for concern, resident-on-resident violence has also been receiving attention of late.
A new report from Ontario’s chief coroner has recently shed light on some of the violence occurring inside long-term care facilities. Of the 45 nursing home deaths the coroner investigated during 2013 and 2014, 13 were considered homicides, some of them fairly disturbing. In one instance, a 75-year-old man attacked an 86-year-old woman, leaving her with a broken pelvis and wrist, and a gash on her forehead. She later died in hospital; both residents suffered from dementia.
The coroner’s report calls the violence “an urgent and persistent issue,” while Candace Chartier, CEO of the Ontario Long Term Care Association told the Globe and Mail that “this is probably our biggest issue.”
According to Chartier, residents of Ontario’s long term care facilities are arriving sicker than they have in the past. She also notes that more than half of the 77,000 residents suffer some level of dementia.
While neither the ICES report on the state of for-profit nursing homes nor the coroner’s report on resident-on-resident violence provide substantial answers, one thing is certain: Ontario’s – and indeed Canada’s – population is aging rapidly, and solutions to sub-standard care at long-term care facilities must become a focus for all levels of government.
