Long-term care: re-sparking the debate

Staff at Joseph Brant Hospital in Burlington are asking their elderly patients to go home in order to free up hospital beds for those needing acute/emergency care. Critics of this action suggest that the hospital is really removing, rather than freeing up, these beds in order to reduce their $5.5-million deficit. What strikes me as surprising is that staff are wearing "Home First" buttons to promote this initiative. What impression does this give to patients who absolutely need hospital care? Unfortunately, in order to balance the reality of taking on more patients, especially those with acute care needs, others are left to draw the short end of the stick. This time its seniors, re-sparking debate about the need for extended home care coverage and investment in long-term care facilities. 

A few issues are at play.

There are both advantages and disadvantages to receiving care at home. At home, patients are most comfortable in a familiar setting, can move around more to improve rehabilitation, and are away from any threat posed by superbugs at hospitals. However, the sicker the patient, the more supervision they need. Supervision by health care professionals costs money and currently the province only covers 1-hour worth of services - the rest of the costs have to be shouldered by the patient and their family. Admittedly, the hospital is trying to get churches and community organizations to help out, but the absence of any suitable long-term care facilities makes alternatives difficult to consider. 

One hopes that the hospital is only releasing elderly patients when they are deemed fit to leave. This cannot be guaranteed in constrained circumstances where new patient arrivals dictate the frequency of freeing up hospital beds. Acute care needs trump chronic care needs, but a chronic care patient left unsupervised in their home can easily wind up with an acute care problem. Are they ways in which adequate home care services can prevent this from happening?

My housemate Gabe believes that technology offers a solution. Specialized monitoring systems could be set up at home to provide 24/7 visual access on the patient's whereabouts. In addition, gadgets could be attached to their bodies to provide feedback on vitals and any unusual physical movements. All this information could then be fed into a data processor where people would work around the clock to monitor the health and safety conditions of hundreds, if not thousands, of patients living at home. Could this work as a short-term solution? 

WC