Why are hundreds of seniors stuck in New Brunswick hospitals?

Too many New Brunswick seniors are spending extended periods in hospital when they should be elsewhere, according to a seniors advocate in the province, who has been following the issue closely.

"When I received the October stats, it was quite alarming," Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents' Rights, told Information Morning Moncton.

According to the province, 751 people were waiting for placement in nursing homes as of Oct. 31. The majority of them, 484, were waiting in hospital.

"Hospitals are for sick people," said Cassista. "The longer you languish in hospital, the weaker you're going to get."

The waiting list has increased from from an average of 595 from month to month in 2017. It's up 35 per cent since January 2018.

The province announced a plan last February to create 1,000 new nursing home beds and memory care beds over the next several years.

But for now, Cassista said, many of the people on the waiting list would be better off in special care homes — if fees were regulated and medical staff were on hand.

Special care home residents receive a maximum subsidy of $77 a day, but their fees can be as high as $5,000 a month, plus incidentals.

"Some, up north, will accept the subsidy rate that the government provides, but still, that's still very high. We have, like, more than 50,000 seniors on low income. They can't afford that."

After fees are paid, she said residents are left with $135 to $108 a month for all of their other expenses. 

You know, that's unacceptable.- Cecile Cassista,  Coalition for Seniors and Nursing Home Residents' Rights.

In the past, the association representing special care homes has said its members would be happy to take in people waiting for nursing homes, but some doctors felt special care homes wouldn't have the resources to meet the needs of patients.

The homes are not required to have medical staff on duty.

There are even more seniors in hospital beds than those waiting for nursing homes.

Cassista said there's also a growing backlog of people waiting for home-care assessments.

One woman who called her had been in hospital for months after breaking her ankle, she said. 

"She wanted to get out. She called me and she said, 'Look, I'm just languishing here. I'm watching TV. I could be at home.'"

A neighbour helping to look after the woman's home and her dog could have provided some home support.

Cassista had a similar call last week from a man who wanted to get his loved one out of the hospital.

"All he wanted was home care. He said, 'I can cook the meals. I can do that, but I can't get her assessed to have home care.'

"You know, that's unacceptable. That needs to happen quicker than what we're thinking."

On the other hand, Cassista said, she also knows of people who are released from hospital while they wait for a home-care assessment in unsafe conditions.

"It's just not a fair practice," she said. 

Cassista suggested too many parties are involved, which is part of the reason why she wants the seniors portfolio moved out of the Social Development Department and back to Health. 

The New Brunswick Association of Nursing Homes says home care is part of the solution to the shortage of nursing home spots.

Executive director Jodi Hall said more work must be "done to further develop home care options, which we envision nursing homes can play a supporting role in."

But she said that's only one part of the solution in addition to increasing the number of nursing home beds and "ensuring factors such as demographics, bed locations and an available workforce are aligned."