COVID-19: Crowds of Ontario Homecare Workers Go to Hospitals and Nursing Homes | The Canadian News

TORONTO – Donna Marcaccio had been caring for her sister Marcia for years.

But when Marcia’s condition deteriorated and she needed palliative care about a year ago, Marcaccio sought help from the Ontario home care system.

After waiting a month, he found himself in front of a revolving door of personal support workers, many of whom were hours late or had no idea what to do. Then the last minute cancellations began.

“I stopped it, it was so stressful,” Marcaccio said.

Nurses, personal support workers and therapists have left home care in droves during the COVID-19 pandemic.

“We literally lost more than 3,000 skilled nurses and therapists and personal support workers to other parts of the health care system,” said Sue VanderBent, executive director of Home Care Ontario, which represents home care providers in the province.

“And that’s very bad news for Ontarians who are getting home care because now our capacity is so depleted that people are just waiting at home for a home care nurse or therapist or PSW who isn’t coming.”

The organization achieved a 95 percent referral acceptance rate before the pandemic, meaning it could satisfy the vast majority of home care requests. The current rate is 60 percent.

“This is a crisis for home care,” VanderBent said.

Home care workers left their jobs for better pay in hospitals and long-term care homes, he said.

About 900,000 Ontarians receive home care each year, he said, with 730,000 in the publicly funded system. That means several hundred thousand people in Ontario receive reduced or no home care services, VanderBent said.

Dr. Samir Sinha, director of health policy research at the National Institute on Aging, said the home care situation is dire. Pay parity can solve some of the problems, he said.

“A nurse who works in an acute care hospital earns much more than a nurse who works in a long-term care home and who earns much more than a nurse who works in home care,” Sinha said.

“What we’ve really seen right now is a huge cannibalization of our home care workforce, especially when it comes to nursing.”

COVID-19 has wreaked havoc on the home care system, he said.

Nurses left the industry at the start of the pandemic when testing and assessment centers appeared across the province. Drainage continued when nurses were needed for mass vaccination clinics and later for contact tracing, he said.

And they all got paid a premium for those jobs.

“All of a sudden you have all these nursing jobs on the market to deal with the COVID response that pay much better than what a nurse working in a home care system was doing,” Sinha said.

Both Sinha and VanderBent agree that the problem is expected to worsen due to the looming and massive backlog of surgeries created by the pandemic.

Patients can often leave the hospital before surgery if they have scheduled home care, they said.

“When home care is not available, it means that people end up waiting longer in the hospital to go home and a whole system is created that becomes dysfunctional,” said Sinha. “That’s why we ended up taking medicine for the hallway.”

The former liberal Ontario government had increased funding for home care so that older people could stay in their homes longer.

Sinha worked with the Liberals on the senior strategy. He said the money, a five percent year-on-year increase from 2012 to 2018 when the Progressive Conservatives formed the government, helped create 30,000 more “long-term care virtual beds” where people received care at home rather than at home. nursing homes.

He said it costs more than $ 700 a day to treat a patient in the hospital versus $ 200 a day for someone in long-term care and $ 103 for home care.

Sinha pointed to Denmark, a country that invested heavily in home care in the late 1980s, as a role model.

Of the money allocated to long-term care, Denmark spends 64 percent on home and community care, Sinha said. The rest go to nursing homes.

The results have been impressive, Sinha said. The country was able to avoid building new nursing homes for nearly 20 years, closing several thousand nursing home beds because they weren’t needed, and saving 12 percent on long-term care overhead for people 80 and older. .

There is a growing demand for home care in Ontario.

In a recent survey of more than 1,000 people 55 and older commissioned by Home Care Ontario, 91 percent said they would prefer to stay home if additional supports were available. Those numbers resemble previous National Institute on Aging surveys, where the vast majority of respondents 65 and older preferred home to long-term care.

“This is a rare opportunity when what people want you to do is actually the cheapest thing for your government,” said Sinha. “Why wouldn’t the government do that? I keep scratching my head. “

Health Minister spokeswoman Alexandra Hilkene said the department pays more than $ 3 billion a year for home care and has invested more than $ 100 million this year to support home care for patients with “high needs and complex “.

He said the province is also working toward a “modernization strategy” of home care that includes legislation that will allow for better “patient-centered” care.

Despite the extreme stress, Marcaccio said she is happy that her sister lived with her until she died in the spring.

“I knew that in her declining well-being, she had the peace of mind and emotional security of being in a familiar place surrounded by people she knew,” she said.

“But there has to be a better way.”

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