SENIOR CARE WILL CONTINUE TO DOMINATE

By KEN MCGEORGE
For The Daily Gleaner
Published Friday January 4th, 2008

Care for our seniors and elders has come on the political agenda in North America in recent years and, in 2008, we will hear more of this.
Population statisticians tell us we are seeing the beginning of the baby boomers' move into elder care.
Since baby boomers represent such a critical and large segment of the population, the implications for health care and social services are immense.
Last January, the waiting list for admission to nursing homes in the greater Fredericton area was 20 names long; by November it had climbed to 71, an increase of 355 per cent.
The numbers may not be great, but nursing home beds don't turn over as they do in acute care, so the numbers are profound.
If we are at the early stages of the baby boom generation needing such services, and if the waiting lists have increased that rapidly in one year, what will it be in five years?
Yet, there are no official plans at this point for providing significantly more beds in nursing homes.
Another crisis in the making?
The crisis is probably already here, since the Dr. Everett Chalmers Regional Hospital has, on any given day, 40 patients waiting for admission to nursing homes. And when the average citizen needs to get into hospital for urgent surgery, heaven help him or her.
It has been the pattern of decision-making in health and social services in our country that we have to come up to a crisis period to spur us into action.
The reason for our hesitancy to act on what we know?
The health agenda is dominated by the forces of large drug companies and powerful professional associations and unions, the net effect of which makes it nearly impossible for governments to make good and timely decisions.
The impending crisis has been known and predicted accurately for well over a decade, yet year over year inaction at the public policy level has failed to create a realistic strategy.
The current government of New Brunswick, having had the foresight to include a commitment to excellence in seniors' care in its election platform, is positioning itself to respond to the crisis.
Already the government has authorized more beds in advance of the release of its long-term care strategy.
In response to expressions of need by the New Brunswick Association of Nursing Homes, the government has dramatically improved staffing for nursing homes.
Institutionalizing the elderly, however, is not the sole answer to our society's problems. The economic impact of providing institutionalization for the frail, elderly and baby boomers, who are feeding that age group, would be unaffordable.
There are many ways in which our society can provide wonderful and appropriate care for the elderly and for those with physical or mental challenges, other than simply institutionalizing them.
Hospital accommodation is brutally expensive.
Nursing homes can provide the same service for the elderly, and some would say more appropriate service, at 20 per cent of the cost.
Yet we need better strategies to help people remain at home or in lesser-care facilities longer.
The province's minister of family and community services has spoken of the Australian model which, we are told, resembles the nursing home in the home model.
Others have advanced the idea of using the smart home as another model for assisting seniors to maintain independence.
When we get beyond the normal resistance to change, the following are things that must happen in New Brunswick in 2008, if we are to effectively deal with the rapidly growing seniors population:
* seriously conserve spending in acute care by reducing infrastructure and competitiveness;
* create more nursing-home beds, which are a less expensive way to provide institutional care for seniors;
* provide regional infrastructure to let nursing homes and regional health authorities work together better;
* create a series of seniors' health centres where seniors can receive emergent care without visiting an emergency department and where they can get information on the vast number of services available to them;
* overhaul the single entry point system to reflect the electronic way of doing business;
* create a series of services that will be an alternative to institutionalization such as foster care, nursing home in the home, supportive housing and such;
* move the control of the education and training of health professionals back from professional interest groups and training facilities to the service providers.
This is the model that was in place years ago and did, in fact, serve the public very well.
Some of these strategies and many more will, I expect, be included in government's long-term care strategy. The public should look for it to emerge early in 2008.
Once released, we need to encourage government to be strategic in the implementation of its elements.
The issues are so profound that dealing selectively with them will not lead to resolution of the long-term care issues in the province.

Ken McGeorge is the executive director of York Manor.