CAQ wants to revamp Quebec's network of seniors' homes. Is the plan realistic?

The Coalition Avenir Québec is pledging to overhaul the province's system of long-term care centres, replacing government-run care facilities (CHSLDs) with a new network of smaller, more "humane" homes for seniors.

The CAQ's proposal represents the most significant — and costly — proposal early in the campaign for the party leading in the polls. 

Dubbed "les maisons des aînés," new homes would host between 70 and 130 people each.​ CAQ Leader François Legault said his government would build 30 in its first mandate at a cost of $1 billion.

The service would cost $245 million annually, he said. 

"The creation of places in seniors' homes will help relieve emergency room and hospital beds," Legault said Friday, on the second day of the election campaign.

The CAQ also plans to replace all the existing CHSLDs with "maisons des aînés" between now and 2038.

But just how realistic is the party's proposal?

The CAQ will face two major challenges in getting its project off the ground: funds, and a lack of personnel.

Currently, there are 37,500 people living in CHSLDs in Quebec — and that number is expected to grow exponentially as the population ages.

Quebec has about 100,000 more seniors each year. By 2031, more than a quarter of the population will turn 65 or older.

The Conference Board of Canada, a non-profit research centre, estimates that nationwide, the demand for beds in long-term care facilities will double by 2035.

Using that projection, that would mean that in order to come up with 75,000 places, the CAQ would need to build 35 "maisons des aînés" per year between 2022 and 2038. That would cost $20 billion in today's dollars.

Marc Rochefort, the interim director of a group that represents the users of Quebec's health and social service network (RPCU), said the CAQ's plan to invest money in new facilities raises a question about what it intends to do with existing buildings in need of repair.

"It's nice to invest on the margin to build new things, but … we have people in old buildings, so what do we do while we wait? That's one of our big concerns," Rochefort told CBC News.

Lack of staff

CHSLDs have been the subject of complaints and controversy in recent years, as Quebec's population continues to age.

Nearly a quarter of CHSLDs across the province are in poor or very poor condition, according to data obtained by Radio-Canada in June.

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Earlier this year, five associations representing more than 700,000 seniors in Quebec issued an open letter calling for political parties to improve the care provided in CHSLDs.

A patients' rights group, as well, filed an application for a class-action lawsuit in July that targets all the government-run care facilities in the province.

To offer more services, the CAQ would need to invest heavily to hire new employees — especially since there will be more facilities, each housing fewer residents.

Of the 12,000 workers currently employed at CHSLDs across the province, another 1,000 are needed to offer an adequate level of services, according to a study by the CSN, the labour union federation.

Rochefort said the facilities are dealing with a lack of attendants and nurses who offer day-to-day services.

"If we continue to have a lack of manpower, what does [this proposal by the CAQ] do?" he asked.

"Facing a multitude of needs, I think we need a multitude of different tactics because the needs vary from one region to the other."

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