A group of leading care advocates and critics warn that the planned changes to the long-term care sector are a fundamental violation of patient rights.
On Thursday, Long-Term Care Minister Paul Calandra presented new legislation This, if passed, would allow hospitals to transfer patients waiting for a bed in their preferred LTC home to be placed in a “temporary” home after staff have made “reasonable efforts to obtain patient consent.”
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Bill 7, the More Family, Better Care Act, authorizes certain actions – such as moving a patient to an LTC home – without patients’ consent if the treating physician considers they require an “alternative level of care.”
Dr. Vivian Stamatopoulos, a long-term care advocate and professor at Ontario Tech, called the legislation “morally repugnant”.
“How can all this not send a direct message to the elderly that their lives do not matter?” Stamatopoulos said Friday at a news conference with the Advocacy Center for Older Persons and the Health Alliance Ontario.
“And frankly, does it matter what they want, what they need, and what’s in their best interests? Obviously what’s important is to make sure that all of this family is full.”
WATCH: Long-Term Care Minister Paul Calandra discusses proposed changes to LTC:
Before the bill was introduced, Calandra said Thursday that the legislation would not force anyone who didn’t want to leave the hospital to go and would not make “any changes to the priority waiting list,” but would allow entry long-term care homes to be part of the solution to improve Ontario hospitals — and many Some of them are under severe pressure due to staff shortages.
The Ontario Long-Term Care Association previously stated that the bill would not address employment issues.
“There is a challenge in acute care, and long-term care is in a position to make a difference for the first time in generations,” Calandra said.
Possible legal action
The Ontario Hospital Association said this week that there are about 5,800 patients now in hospital who could be sent to an alternative level of care if beds are available.
About 40 percent of these patients are on the waiting list for long-term care, the ministry said. She says legislative changes could mean 200 of those patients end up in nursing homes by the end of the fall and up to 1,300 patients within six months.
Rainer Bethke, who lives in the town of Berwick near Ottawa, says his heart sank when he heard about the bill.
Pethke is a caregiver for his son, who has an aggressive form of multiple sclerosis and is in long-term care, and for his 95-year-old mother, who has started to suffer from dementia in the groin.
“My fear is that they will take her somewhere, Lord knows where, since I can’t support my son, I can’t support her,” Bethke said.
“In the end, I won’t be able to support myself.”
He says he wonders if he would encourage his mother to go to MEED — Medicaid in the dying state — if she was sent to a long-term care home not of her choosing.
“No family should ever consider MAID because of their government’s decisions to forego choice,” Bethke said. “This is appalling.”
As it stands now, Jane Meadows, an attorney for staff at the Center for Advocacy for Older Persons, says the legislation removes the basic right to consent to health care and could have dire consequences for a patient, especially if they are sent home unable to provide the level of care they need. .
Meadus says while it’s hard to say what kind of legal action can be taken until more details are revealed, lawyers are already looking at legal options.
“I know many lawyers are looking at this very horrified by this violation of basic justice and basic rights of people, specifically older people and people with disabilities,” Meadows said.
“It’s definitely something we’ll look at, and actually discuss.”
Critic says bill could deter older people from seeking care
Dr. Sameer Sinha, director of health policy research at the National Institute on Aging, says this legislation will impact hospitals and their ability to provide high-quality care to elderly patients.
“I’m afraid this will make it even more difficult for people to access hospital care when they know that the risk is that they may actually be forced to go to a home they never wanted, or even end up in,” said Sinha, who is also the director of geriatrics. at Mount Sinai and the University Health Network in Toronto.
Sinha says that municipal and not-for-profit LTC homes generally have better records, and therefore have longer waiting lists, even though they only account for about a third of all homes in Ontario.
He says homes with vacancies are generally for-profit or older facilities, and are struggling to fill their family or meet their occupancy targets to get money from the county.
“This is a convenient way for homes to achieve their occupancy goals because they have a family, and now we have a mechanism to fill that, whether people want to go there or not,” Sinha said.
Sinha says this legislation mostly affects vulnerable populations, who often suffer from dementia, and cannot defend themselves.
Instead, he says the county could expand the number of preferred LTC homes for hospital patients and they can choose from one to five, and make collaboration a priority between hospitals and other organizations to get patient care within their communities instead.
“If we take those rights too far in these situations, it’s a slippery slope for a whole bunch of other things we can really do for people as well,” Sinha said.
Opposition takes aim
Talk to CBC’s power politicsCalandra said he hopes the legislation will pass no later than September 1, with regulations guided by the “overriding principle” of placing patients near the home of their favorite LTC and loved ones to follow about a week later.
Before that time, he says he will consult with the long-term care sector.
Wayne Gates, the Ontario National Democratic Party’s critic of long-term care, home care and retirement homes, says the legislation is terrifying for families.
“Consent is not required,” Gates said in a statement. “Families have no idea how far their loved ones may move in the last years of their lives.”
The party says it goes against allowing seniors to move without their consent and the lack of restrictions on the extent to which seniors can be separated from their loved ones included in the legislation.
A ministry spokesman said Friday that the government will not move people away from their communities.
“The government is working to ensure that patients whose doctors said they no longer need hospital treatment receive the right care in the right place, while ensuring they continue to be close to their family and friends,” said Mark Nisbet.
But the NDP also says the legislation paints a “bleak picture” of transferring seniors without their consent when the government should specifically rule out physically obligating an older person when carrying out bill procedures or transporting a patient.
“The regulations are not yet written and can be written and rewritten with the stroke of the prime minister’s pen behind closed doors,” Gates said.