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SUBMISSION TO
Health Committee site
CANADIAN PENSIONERS CONCERNED INCORPORATED
POSITION STATEMENT ON LONG TERM CARE
MARCH 6, 2001. Prepared by: MAE HARMAN
"The Ministry's goal is a first-class health system that provides better and more
accessible health services for all Ontarians when and where they need them, at every stage of their lives. ... This plan makes people the first priority."
- Health Minister Elizabeth Witmer's Health Business Plan for 1999-2000.
What kind of health care do seniors want?
Services that are...
- effective, sufficient, available, accessible and affordable
- delivered with continuity and predictability
- consistent with values and cultural preferences
- flexible and adaptable as needs change, with options to make decisions and choices
- offered at the right time and delivered at the right speed
- amily centred, with family caregivers included in care planning and instruction
Service providers that are...
- clear and honest communicators
- caring, competent and well trained
- willing to go the extra mile, anticipate needs, solicit opinions, and make time for
questions and
concerns
A health care system that offers...
- adequate staff and well co-ordinated gap-free services
- transportation if and when needed
- expanded roles for volunteer seniors to help others and use their knowledge
- care in the appropriate setting and more flexibility in new care options, such as group
homes
- opportunities for self-managed care
- ways to meet concerns about the availability, cost and use of medications
NACA, How are health reforms affecting seniors? (from a survey of Canadian seniors)
From Expression, Bulletin of the National Advisory Council on Aging, Winter 2000.
Canadian Pensioners Concerned
Canadian Pensioners Concerned Inc. (CPC), founded in 1969, is a national, voluntary,
membership-based, non-partisan organization of mature Canadians committed to
preserving and enhancing a humanitarian vision of life for all citizens of all ages.
CPC began with a special concern about whether retirement income would allow for a
good quality of life for seniors. We have expanded our interests over the years to include all
age groups and especially those who by virtue of illness, physical or psychological
impairments, age and/or economic need are especially vulnerable in a society driven by the market place and economically determined values, often to the exclusion of other social values that sustain and enhance a fair, just and inclusive social order.
Health Care - An Overview
Adequate health care means the right service at the right time and place by the right
caregiver. Health care is not a commodity to be marketed but a service that should be
accessible to everyone who needs it. The health care system must be integrated and coordinated so
that services flow from one level to another. Patients should be able to tap into the system
at whatever stage is appropriate to their needs and re-enter as their needs change.
CPC strongly supports the Canada Health Act and stresses the need to include within it
such services as Home Care and Pharmacare. We are totally opposed to privatization of
health services and equally opposed to a two-tier system, where those who can pay can go
to the head of the line for services and those who cannot pay can wait for whatever service
may be left over.
Seniors remember the days before Medicare and many of us bear the scars of
inadequate care in those days, when families hesitated to go to the doctor because they were ashamed that they couldn't pay. Some families were wiped out financially because of the expense of hospitalization or long term illness or injury.
There are many stresses and strains in our health care system at present but these
could be removed with careful coordination and long term planning. In the long run, this would
cost less than letting people's health deteriorate.
THE BASIC ELEMENTS NEEDED
IN A NEW LONG TERM CARE ACT
Overarching Principles
1. That Long Term Care be recognized as an integral part of a continuum of health
care ranging from Primary Care to Hospital Care to Home and Community Care to Institutional and
Palliative Care.
2. That provincial standards for all levels of Long Term Care be developed and that it
be the responsibility of government to see that these are maintained.
3. That where continuous care and observation is required as
post-hospitalization care, transitional arrangements such as a convalescent centre or a sub-acute wing be available.
Home Care
1. That no person be sent home from hospital without adequate arrangements for
whatever followup for care and safety has been designated by knowledgeable and well
trained discharge planners. It should not be assumed that there are family members and
friends available to take care of patients once they reach home.
2. That Home Care services not be dependent on or restricted to a need for medical
assistance. Help with the daily chores of housekeeping, cleaning, meal preparation, shopping and
respite while caring for another, should be available on an equal basis with nursing care.
Providing supportive service to the frail (elderly or disabled) helps them maintain some
sense of independence and the ability to remain in their own homes rather than being forced to
move to an institution.
3. Prescribed drug treatments which were provided free of charge in hospitals
and which are to be carried over into home care, should be provided and not charged to the
patient but to OHIP, whether they are or are not on the formula.
4. The Request for Proposal process should be ended and replaced by the
implementation of a publicly-funded, publicly-administered and publicly-delivered community care
system, with meaningful control and adequate provincial standards that ensure quality care.
(Recommended by Ontario Health Coalition)
5. There should be a standard and adequate rate of pay and benefits for staff,
equivalent to that paid by hospitals and nursing homes for equivalent types of services.
6. Full time employment should be available with appropriate remuneration for travel
time.
7. There should, in so far as possible, be continuity of staffing instead of a stream of
strangers entering the home, unfamiliar with the client's need. Time available should be based
on need, not arbitrarily restricted hours.
8. All caregivers should be appropriately trained for their roles, as well as in
understanding the special needs of seniors and the disabled and recognizing their right to be treated with respect and dignity.
9. In so far as possible, ethno-cultural preferences should be given consideration.
10. No one should be urged to employ extra assistance because CCAC services are
rationed.
11. The rights of persons to appeal decisions made about their care and to make
complaints about treatment received must be protected and remedies pursued and recorded.
12. The CCACs must have open membership for everyone living in their catchment
area.
Nursing Homes
1. Nursing Homes must have regular and unscheduled inspections and provincial
standards of care and service must be enforced.
2. The supply of beds must be speeded up in order to meet waiting lists and projected
future needs.
3. All health related services must be provided to the resident free of charge.
4. There must be adequate staffing to meet the need for a caring environment of
hospitable living, where residents can feel that the facility is their home.
5. There must be special care units with trained staff for the care of persons
suffering from Alzheimer's and other dementia.
6. There must be a registered nurse on duty 24 hours a day.
7. Provision must be made for Patients' Councils and Family Councils to monitor the
operation of a facility, advise residents of their rights and generally act as the
residents' advocate.
8. The Health Ministry should be required to investigate every complaint reported to
it about a facility.
Chronic Care Facilities
Chronic Care facilities must be restored and expanded with full service and staffing and
with full OHIP coverage.
Health Promotion and Disease Prevention
Local community agencies must be encouraged by government grants to provide
programs for all age groups which promote healthy living and help prevent both mental and physical
illness.
Retirement Homes
1. Standards should be developed by the province and homes should be certified
by the province.
2. There should be regular inspections by government trained inspectors and
compliance must be required.
Overall
Our government must commit to providing adequate funding to fulfil the right of every
citizen and every community to a good quality of health care, delivered with respect and dignity for
the recipient. Without such funding, the goals set forth by the Minister's Business Plan
cannot be met.
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