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Report on long-term care highlights growing 'crisis' in Nova Scotia
Published Thursday, January 14, 2016 12:26PM AST Last Updated Thursday, January 14, 2016 4:36PM AST
HALIFAX -- Canada's health-care system is struggling to find the resources to provide adequate long-term care for people who can no longer live in their homes -- and the challenge has already reached the crisis stage in Nova Scotia, a new report says.
The report, prepared for the Nova Scotia Nurses Union and released Thursday, says the province's antiquated system is plagued by understaffing, excessive workloads, demoralized staff, unsafe working conditions and workplace violence.
These problems can be found in other provinces, but they are particularly acute in Nova Scotia, where an unusually large proportion of seniors is growing at a rapid rate.
Seniors already account for 18.9 per cent of the population -- one of the highest proportions in Canada -- and that number is expected grow to just over 30 per cent in the next 22 years.
As well, the 6,900 residents in Nova Scotia's 90 long-term care facilities are by far the oldest in Canada with an average age of 88.
"The patients coming in are sicker and older," Sheri Gallivan, a registered nurse with 23 years of experience in long-term care, told a news conference. "The resources we have do not meet their needs."
And even though about 1,600 seniors and vulnerable citizens are on waiting lists, the province has no plans to add extra beds, the report says.
"Long-term care is in desperate need of resuscitation ... to prepare for the imminent and expansive growth of our seniors population," Janet Hazelton, the union's president, says in the report. "Our system is dangerously out of step with the times."
Health and Wellness Minister Leo Glavine bristled when asked if the system was gripped by a crisis.
"Absolutely not," he said after a cabinet meeting.
"I've been in half the homes in the province ... From time to time, individual nursing homes will have staff issues ... I haven't had those calls to my office from nurses who work in nursing homes, nor management about any dire situations."
The report includes 15 recommendations for improvement, including a call to update legislation that hasn't been changed in 38 years, hiring more long-term care nurses and nurse practitioners, improving monitoring and launching an independent inquiry.
On the national level, the latest statistics show that those in long-term care facilities suffer from more complex ailments than they used to, creating heavier workloads for caregivers and licensed staff.
The Canadian Institute for Health Information says three quarters of residents now report some level of cognitive impairment and 95 per cent require assistance with day-to-day activities, including dressing bathing and eating.
A 2014 study showed 60 per cent of seniors in long-term care used 10 or more drug classes compared with 26 per cent in the community.
As well, each Canadian direct-care worker typically cares for an average of 19 residents, which is much higher than in Scandinavian countries. And almost half of Canadian workers reported working short-staffed almost every day.
"Given these trends, staffing ... levels would need to be upwardly adjusted so as to maintain the same level of care," the study says. "Instead, we have witnessed stagnant or declining levels of staff and qualification."
An online survey of 248 Nova Scotia nurses last year found 75 per cent reported staffing levels were a serious problem.
"Nurses spoke of residents being abandoned into LTC facilities where there is no time to provide adequate care or attention," the report says.
The report also makes it clear that working in a nursing home can be dangerous, especially when younger, stronger residents with brain injuries or drug-induced ailments are among those being cared for.
"There are no facilities anymore for (behavioural ) patients and we've become a dumping ground," one nurse is quoted as saying.
"We had a gentleman that gave a couple of staff concussions, broke their noses. He's in a place where he shouldn't be," said another.
The report cites Workers' Compensation Board figures that show there were 81 violence-related claims in Nova Scotia's hospital sector in 2014, compared with 115 in the much smaller long-term care sector. The 2015 online survey found 25 per cent of those who responded said they experienced physical violence a couple times every month or more.
"Unacceptably high levels of violence, illness and injury rates across Canadian facilities contribute to making LTC one of the most dangerous workplaces overall," the report says.