Lily Wong was admitted to the Yi Hong Aged Care Center in Toronto at the age of 88, several years after she suffered a stroke that severely affected her short-term memory, ability to follow conversations and her balance.
The waiting period for admission to the long-term care home was nine to 10 years, but Wong was admitted at just under seven years.
“It was really fast,” said her son, Tony Wong.
Her son said it’s been two years since she was accepted, and Lily Wong lives well in a home that meets her cultural needs. It’s a relief to her kids, too.
“If you can go to a nursing home that speaks your language, has specific cultural activities, and has food that you remember, that’s just heavyweight,” said Tony Wong.
“It’s incredible to be able to experience it.”
Part of the reason for the long waiting time is that Yee Hong Aged Care Center is one of the few culturally specific homes that cater to the Chinese Canadian community in Toronto and surrounding areas.
Experts say culturally private care homes have some of the longest waiting times for long-term care. A study by the Wellesley Institute, a nonprofit organization engaged in health research and policy, found that more than half of the top 20 homes in the Greater Toronto Area with the longest waiting times are culturally private nursing homes, reflecting the need for more of these facilities.
Its demographic changes [driven] Seung Jie-um, a researcher at the Wellesley Institute, said there is a growing demand for such care.
“It’s really important that the system adapt, evolve, and reflect the diversity of its current and future population.”
Moreover, in 2017/2018, those who want to live in specific cultural care homes They had to wait an average of 246 days longer than those who would wait for a normal home, even when they have the same level of needs.
Long waiting times can have health effects on older people waiting for long-term care.
“We know it over there [are] Ashley Flanagan, a research fellow whose work focuses on gender identity and aging at the National Institute on Aging, a think tank on aging in Canada, said differential health outcomes for people from diverse societies.
“Whether the queues for access to a culturally appropriate home, [that] It tends to take longer to be accepted. So you see the deterioration of health and not [being] able to access care.”
Stella Lang, chief administrator at Moon Xiong Long Term Care Center, which has four locations throughout the Greater Toronto Area, said something as simple as the language spoken by those caring for the residents matters.
Having health care providers and staff who can serve patients in Mandarin or Cantonese is important for residents who may have lost the ability to speak English in old age, Lang said, a common scenario for patients with dementia.
Staff can even assist with translation for residents whose first language is Chinese and family members who may be second-generation Canadians and thus better understand English.
“That’s why they don’t feel isolated, and they don’t get very depressed,” Lang said.
While the appreciation for culturally themed homes is clear, there isn’t enough to meet the level of demand across the county, according to Final report of the Ontario Long-Term Care Commission for COVID-19, which required more culturally specific homes to meet the needs of Ontario’s diverse population.
Developed by societies
Culturally defined homes generally offer a high level of care, in part due to their funding structure and community support, according to AdvantAge Ontario, an advocacy group dedicated to advancing senior care.
“It was developed by communities, for community,” said Lisa Levine, group CEO.
Community integration is an integral part of their structure because this is how most of them are established. Furthermore, the boards that run a culturally specific role represent the community to which they are being cared.
“This means that the caring philosophy, the caring approach, the caring language… the food, the traditions, the festivities, the volunteers are all culturally appropriate,” Levine said.
Culture-specific care homes also tend to be not-for-profit, which advocates for older adults believe plays a large role in the health and well-being of residents because of how they are managed.
All Ontario long-term care homes get the same funding formula from the province, which provides enough of them 2.75 hours of direct care per resident per day.
Dr. Samir Sinha, director of geriatrics at Sinai Health, an academic center for health sciences in Toronto, said culture-specific nursing homes and municipally-funded homes tend to support care more.
“They often raise money, they’ll have parties, they do bake sales, and they do a whole bunch of fundraising efforts where the community invests extra dollars to set up better facilities than the government would fund,” Sinha said.
In addition to government funding, AdvantAge Ontario reports that municipal and non-profit nursing homes annually contribute more than $300 million in additional funding in Ontario alone. That extra money goes to better pay to employees and to the facilities themselves, which contributes to a higher standard of care, according to AdvantAge.
High demand but low supply
While there is little data that specifically addresses the health of older adults placed in culturally appropriate care, both staff and children of residents at Moon Xiong Long-Term Care Center and Yi Hong Elderly Care Center support the idea that older adults improve when they receive ho-he .
For example, at Mon Sheong Long-Term Care Center, dishes as familiar to residents as breakfast are served. Because they enjoy food, Lang said, they are more likely to eat it, allowing for better nutrition, and improved overall health.
Despite the overall psychological and physical benefits, significant disparities exist in terms of arrival and waiting times.
according to Wellesley Institute StudyWait times can vary depending on factors such as an individual’s health status or the urgency of accepting long-term care. However, waiting times are particularly long for those seeking placement in a religious, ethnic or cultural home.
The same study found that homes serving Chinese Canadians had longer average wait times than other groups, from two to seven years.
Some family caregivers may delay placing loved ones in long-term care due to a lack of culturally appropriate options.
study in Journal of the American Medical Directors Association showed that older people from diverse backgrounds are underrepresented in the long-term care resident population in Canada. The study said that immigrants who arrived in Canada after 1985 make up only 4.4 percent of Ontario’s long-term care residents even though they make up 13.9 percent of the total population.
While specific cultural care homes have proven popular, there are some cultural groups that are too small or not mobilized enough to start their own homes.
In general, these societies are newer in Canada or lack critical mass or fundraising power.
“When you have an Ismaili person, a Somali person, an Afghan who needs safe and culturally appropriate care, there is no specific home that meets the needs of those communities,” Sinha said.
A solution to remove barriers to safe and culturally appropriate care can be found in the data.
A recent study looked at Strengthening data collection in long-term care settings in Canada He called for the government to collect a standardized set of socio-demographic information, including age, gender defined at birth, gender identity, sexual orientation, race, ethnicity, language and Aboriginal identity – something that many other countries, including the UK, Australia and the US, have already done.
“I think if we’re going to kind of take that mandate and advocate better sociodemographic data collection, we get a better understanding of who has access and who doesn’t, and that will give us an idea of where to start guiding and implementing policy,” Flanagan said.