Ontario's Bill 7 makes seniors living at home a lower priority for long-term care, says caregiver

A Sudbury, Ont., caregiver says Ontario's Bill 7 will make it more difficult for her elderly mother to get into a long-term care home as a result of how the legislation prioritizes older adults already receiving in-hospital care.

Linda Toner has been the primary caregiver for her 89-year-old mother Joyce since April 2019. Joyce has limited mobility, chronic heart conditions and moderate Alzheimer's disease.

"So her short term memory is pretty much shot," Toner said.

She would possibly just die before she'd ever get into a long term care home.-Linda Toner, caregiver for her mother

Joyce has been on a wait list to get into long-term care since June 2021 because her daughter only receives around 90 minutes of respite care per week – where a personal support worker comes on Tuesday and Friday mornings to help with showering.

Toner said she was told to expect a two to four-year wait to get her mother into a long-term care home, but with Bill 7, she expects it could take even longer.

"I don't have a crystal ball, but it's quite reasonable in my view that my mother would – I mean, she'll be 90 next year – that she would possibly just die before she'd ever get into a long term care home," Toner said.

Bill 7, the More Beds, Better Care Act, allows Ontario hospitals to transfer their elderly alternate level of care patients – who don't necessarily need full hospital care – to a long-term care home not necessarily of their choosing. 

Patients who refuse to leave a hospital also face a mandatory fine of $400 per day.

Unintended consequences

Dr. Samir Sinha, the director of geriatrics at Toronto's Sinai Health System, said the bill will have some unintended consequences for elderly people in home and community care.

"Right now we have over 40,000 people who are currently waiting for long-term care," Sinha said. 

"Most of those folks, the vast majority, are those who are living in the community but have been waiting, you know, in some cases for many years to get into a home."

Sinha said the fastest way for someone receiving home care to get into a long-term care home is if they are placed on a community crisis list, which means their situation, and health, has worsened. Otherwise, elderly people in hospitals get priority.

But Sinha added that with more support for home and community care, the province could reduce the need for long-term care homes in the first place, and cut back on the growing waitlist.

"We know that anybody receiving government funded home care, about 90 per cent of their home care is being provided by family caregivers," he said.

"Very little is usually being provided by the government itself."

Sinha said money the province has invested to add more long-term care beds to the system, would be better spent improving home and community care. It costs around $750 per day to care for an alternate level of care (ALC) patient in the hospital, while long-term care costs around $200 per day, and home care is only $103 per day.

In April, the province announced it would invest $3.7 billion, beginning in 2024-25, on top of the $2.68 billion already invested, to build 10,000 new long-term care beds and upgrade another 12,000 beds.

New Democrat health critic France Gélinas agreed home and community care needs more funding.

"A lot of those patients who are ALC, they want to go back home," she said.

"They could go back home, they should go back home, if only our home care system hadn't been privatized and wouldn't fail more people than it helps every single day."

In an email to CBC News, Ministry of Long-Term Care spokesperson Jake Roseman said the province has helped more than 2,420 ALC patients find placement in a long-term care home, which he said is a 28 per cent increase over the same period last year.

Roseman said Bill 7 has also helped reduce long-term care waitlists in hospitals by more than 20 per cent. But he did not address the bill's impact on home and community care.

Support to stay at home

Toner said if she received more financial support, her mother would not be on a waitlist to get into a long-term care home.

She said it would be helpful if she received some funds to hire more respite care when she needs it, so she can spend more time with her husband and adult children.

"Under no circumstances would I ever think of leaving my mother for more than a couple of hours on her own," Toner said.

"Definitely never ever leave her overnight on her own. She's had some falls in the middle of the night."

While she said she loves her mother, Toner said she also feels trapped at times.

"I don't in any way want to imply that I'm kind of disliking my mother, or whatever, but it is a trapped feeling when you know that you can basically never go anywhere because I'm the caregiver," she said.