Vanessa Leslie is working to launch her own business after retiring from a lifelong career with the Ontario Provincial Police. But those plans are on hold after her mother suffered a health setback several weeks back.
“My life now revolves around making sure she gets the care she needs.”
Her mom, 91, suffered a stroke in late November and was taken to hospital where she was released on December 16.
“Our plan was never to put mom in a long term care home, so that is a family choice,” she told us. “But the government has said, ‘keep your elderly at home as long as possible, we’ll provide you supports in the community’ but it has been much harder to navigate than you would think.”
Leslie says when her mother was discharged from hospital, she was given a promise.
“They said everything will be in place when you go home but I kept asking, are the PSWs in place? Do we have the therapy that you say she’s supposed to get, the physiotherapy? Is that in place yet?” she said. “Patient transfer came. I brought her home, and then it was just constant, no-show cancelations, hour-and-a-half late, two hours late, it’s been so frustrating.”
Leslie is not alone according to Kathleen Finlay with the Center for Patient Protection, an organization which advocates for patient and family caregiver rights.
“I hear about this issue from a lot of families,” she said. “What we are seeing all too often is that patients are being sent home too early, without proper planning and without ensuring that the services are in place. Early discharge is a problem for any patient, but for elderly patients there are particularly serious risks.”
Risks which add stress to loved ones, like Leslie, who says she’s under immense pressure to take on health care responsibilities when service workers can’t show up.
“She has a catheter. I had no clue what to do with that. I didn’t even know how to empty the bag, nothing, no instructions and no supplies. I didn’t see a nurse until seven days after discharge, so it’s really been a challenge.”
While advocates like Finlay say early discharge is a concern, others point out the issues of home health care for patients like Leslie’s mom have more to do with an overburdened system, a longstanding issue in Ontario with an aging population.
“Getting a home care assignment after discharge is only half the battle,” said Graham Webb with the Advocacy Centre for the Elderly. “Once people do have home care, they find the service can be very inconsistent because there are simply not enough home care workers.”
It’s a shortage which has been ongoing for years in Ontario and one the provincial government says it’s working to address. The 2024 Ontario budget will inject $2 billion over three years to expand home and community care services. The funding is intended to increase compensation for front-line workers and stabilize expanded service.
“This is in addition to the $1 billion our government invested through budget 2022 and has doubled our investment in the delivery of home and community care,” said Ema Popovic with the Ministry of Health.
“This funding has not only added thousands of PSWs, in fact, we have added nearly 25,000 since 2021, but it has also increased compensation for PSWs, nurses, and other frontline care providers, to further stabilize the workforce and has increased service volumes by 10 per cent this year alone, connecting more people to the care they need than ever before.”
While the additional funding is applauded by many patient advocacy groups they still have concerns.
“Home health care is largely run by for profit service providers,” Graham said.
Which he argues leads to challenges when families have service complaints, like no-shows.
“The system needs more public oversight and more accountability. The people who are handling the complaints are the people who also provide the service, and there’s no independent review mechanism. We would like home care to be administered by the Ministry, or a direct agency of the Ministry, not by for profit service providers.”
The provincial government established the Patient Ombudsman to help resolve concerns from patients, residents and caregivers about Ontario’s home care services, public hospitals, long-term care homes, and community surgical and diagnostic clinics.
“We receive more than 4,000 complaints annually and can review complaints after a patient or caregiver has first tried to resolve their complaint directly through the health care organization’s internal complaints process,” a spokesperson with the independent organization tells CityNews.
Leslie says she has reached out to the organization but tells CityNews she has yet to receive a response.
The Canadian Union of Public Employees (CUPE) has long fought what they call the move to privatize home health care.
“Ontario is now on our fifth home care restructuring since the last PC government privatized home care. None of these efforts have ended the basic problems that come with compulsory contracting out: low wages, bad working conditions, high staff turnover, and staffing shortages,” CUPE spokesperson Stella Yeadon said.
Union members say the latest restructuring by the province fails to address these concerns and threatens to deepen care privatization even more.
“The result? Chaos, supply chain problems, terrible staff morale, widespread uncertainty, and job security concerns.”
But the Ministry insists its plan will improve the home health care industry both for patients and the workforce.
“We’re making the PSW wage enhancement for PSWs permanent and investing $300 million, or up to $25,000 per student, to help thousands of people launch their careers as PSWs.”
For Leslie, the promise does little to address her concerns. While she says her mom’s situation is improving — with PSW’s now showing up on a more consistent basis, she calls the first few weeks after hospital discharge a nightmare.
“It shouldn’t have been that challenging,” she said.
“I’ve called Ontario health. I went to the Patient Relations. They haven’t even called back. If you’re going to have these services, you say it’s available in the field, you need to make sure of that before you release someone.”
“Sadly, the way things stand now, the onus is really on families to get things done,” Finlay added about anyone with a loved one in hospital who needs at home care.
“If you’re planning on taking your loved one home you have to start early. Find out who the discharge planner is at the hospital. Find out who the coordinator is at Ontario Health at home. Make those contacts, get the hospital bed, get all the equipment in place. You may not have a date yet, but it’s coming, and it could come faster than you think.”
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