caring for our seniors

8/6/2019 Caring for Our Seniors

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SENIORS

Liberal Policy Platform

Aging at Home:

The Best Place to Be


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CARING FOR OUR SENIOCARING FOR OUR SENIOCARING FOR OUR SENIOCARING FOR OUR SENIORSRSRSRS

Aging at Home: The Best Place to Be

4 areas of care: 14 Initiatives

1. Valuing Our SeniorsMinister of Aging and Seniors

Aging and Seniors Strategy, including aLong Term Care Strategy

Office of the Seniors Advocate

2. Geriatric Focus: Acute Care

3. Community CareCare in the CommunityLong Term Care FacilitiesHome CareFamily CaregiversPaying Family Caregivers

Personal Care HomesHome Oxygen ProgramPalliative Care

4. Prevention and Management

Chronic Disease Management andPrevention

Appropriate Use of Medications


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AGING IN

NEWFOUNDLAND AND LABRADOR

AGING IN NEWFOUNDLAND AND LABRADOR

Newfoundland and Labrador has a changing population that willchallenge our ability to provide health care for decades to come.Currently, Newfoundland and Labrador has the fastest agingpopulation in Canada. People are living longer, the birthratecontinues to decline and young people still continue to leave ourprovince.

In 1990, 1 in 10 people were over the age of sixty-five (65). By2025, more than 1 in 4, or twenty-six (26)%, of our population willbe seniors (Source: Government of Newfoundland and Labradorhttp://www.economics.gov.nl.ca).

The cost of providing care for seniors in their homes andcommunities is less expensive than in an institution. The costs, as

of May 2011, are summarized below:

Hospital - $1,500.00/day, $45,625/month or $547,500 year(Source: Minister of Health and Community Services, Healthestimates meeting: May 17, 2011); Long Term Care Institution - $7,000- $8,000/month or $84,000-$96,000/year (Source: Minister of Health and CommunityServices, Health estimates meeting: May 17, 2011); Home care Cost depends on the level of service required.Government pays $17.63/hour to agencies; the self managedhome care rate is $12.00/hour (Source: Department of Healthand Community Services Memorandum, May 26, 2011); and Personal Care Home - While the personal care homesubsidy is $1,800.00/month, this is not the actual cost togovernment Source: Minister of Health and CommunityServices, Health estimates meeting: May 17, 2011). The actualcost to government is approximately $670.00/month or $8,040/year.

Hospitals and long term care homes are the more expensivemodels of care. As our population of seniors increases we canexpect that government resource requirements will grow unlesspublic policy is changed.


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AGING IN

NEWFOUNDLAND AND LABRADOR

Approximately 1 in 6 hospital beds are occupied by patients whoshould be receiving care somewhere else. This is known as bedblockage. The high number of hospital patients waiting foralternative levels of care such as rehabilitative or long term care islikely the single biggest cause of wait times, according to the WaitTime Alliances (WTA) July 12, 2011 report.

In many communities seniors make up more than half thepopulation. Attachment is very strong to communities, especially inrural and remote areas. Seniors want to be home and in theircommunities for as long as possible. They want to be independentand socially involved.

Our seniors prefer to live in a supportive family environment in theirown homes or community-based, home-like settings for as long as

possible. They want alternatives to enable them to stay in theircommunities.

Long term care in a nursing home, while an important serviceoption for most dependent, fragile and ill seniors, is seldom a firstchoice of seniors and their families.

Aging at Homeallows our seniors to have a better quality of life, tolive in dignity and preserve their independence.

Our policy platform is intended to offer more choices toour aging and seniors and allow them to live withdignity and independence for as long as possible, insupportive communities close to their families andfriends.


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MINISTER OF AGING AND SENIORS

AGING AND SENIORS STRATEGY

MINISTER OF AGING AND SENIORSCurrently the Minister responsible for aging and seniors is the Ministerof Health and Community Services. In just nine years time, more than 1in 4, or twenty-six (26)%, of our population will be seniors. Theopportunities and challenges facing an aging population are not onlyrelated to their health and well-being. There are a host of issues that

need to be addressed including age friendly communities, diversity,income and finances, secure housing, active living, life long learning,safety, and violence prevention. The concerns and issues of todaysaging citizens, as well as coming generations, must be given priority.

A new Liberal government will form a new department dedicated todealing with opportunities and challenges related to aging and seniors.

AGING AND SENIORS STRATEGYMore than a framework for action, the strategy will be a guide for

helping all sectors create senior-friendly communities to support ourcitizens as they age at home. A key component of this will be a long-term care strategy.

The strategy will supersede the boundaries that exist between eachlevel of government, community, business, not for profit and volunteerorganizations. It will view the province as a whole and determine howall parts can work together in a shared vision for our aging and seniors.It will be built around the vision of Aging at Home. It will include a wide

range of programs and housing options needed to ensure seniorsmaintain personal dignity and functional independence in their homesand communities for as long as possible.

A new Liberal government will launch a healthy aging and seniorsstrategy that will include, but not be limited to: health and wellness promotion; respecting and celebrating seniors; supportive communities; seniors financial security; employment and life transitioning; secure housing options; and caregiver assistance and support.


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OFFICE OF THE SENIORS ADVOCATE

GERIATRIC FOCUS: ACUTE CARE

OFFICE OF THE SENIORS ADVOCATE (OSA)A new Liberal government will establish an independent office of theHouse of Assembly called the Office of the Seniors Advocate (OSA).Much like the Office of the Child and Youth Advocate and itsrepresentation of children and youth, the Seniors Advocate will

represent the rights and interests of aging and seniors in our province inorder to preserve and enhance their quality of life.

The Advocate will carry out a number of functions including: ensuring that the rights and interests of aging and seniors areprotected;

ensuring that the views of seniors are heard and considered inappropriate forums where those views might not otherwise beadvanced;

ensuring that seniors have access to services and thatcomplaints that seniors might have about those servicesreceive appropriate attention;

providing information, advice and guidance to thegovernment, agencies and communities about the availability,responsiveness and effectiveness of services to seniors; and

acting as an advocate for the rights and interests of seniorsgenerally.


A new Liberal government will shift spending into rehabilitative andcommunity-based support services for hospitalized seniors. This willpromote inclusiveness, health promotion and localized care. Evidenceshows that delivering rehabilitative and community-based supportservices can reduce the number of seniors requiring costly institutionalbased care and improve the quality of their lives by allowing them toreturn to their homes and communities.

We will add a geriatric focus to our health care system that is nowsolely focused on acute care. Our priority will be getting our seniors

back in their homes and communities. This focus will be implementedinitially as a pilot project in one of our provincial hospitals. This will allowlead officials to determine its feasibility and fine tune it to suit ourmedical system and customize it to meet our provinces needs.Subsequently it can be rolled out to all provincial hospitals.


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The new model of care will: establish a geriatric assessment and rehabilitation program. This

program will assess seniors entering acute care and subsequentlycontinue to provide care after patients have been discharged.Different components of the program will include:

Evaluation for in-patients, utilizing new assessment tools Management of the seniors as inpatients, including:

dedicated geriatric units; and multi-disciplinary teams with focus on geriatric care.

Post discharge, including continuum of services/programs inthe community, restorative and rehabilitative in nature andemergency response services.

implement geriatric interdisciplinary teams and mobilize resourcesthat recognize seniors issues and allow for better flow through the

health care system. This focus will be enhanced in a number ofareas including the emergency room, internal medicine andorthopedic services;

improve access to information technology to allow the health careprofessionals and teams to share appropriate information andcommunicate efficiently and effectively;

provide enhanced home and community support teams to allowseniors to receive a continuum of services in their own homes upondischarge. The multidisciplinary teams would include communitynurses, nurse practitioners, licensed practical nurses,physiotherapists, occupational therapists, social workers andphysicians;

establish home support services such as pharmacy care andrespite care for caregivers;

implement seniors care navigators in the health system, the sameconcept as the patient navigators recommendation from theCameron Inquiry;

collect appropriate data to provide critical feedback regarding thenew model of care; and

establish an advisory team, at both the department and regionalhealth authority level to oversee and provide advice to integratechanges in the health care system.


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CARE IN THE COMMUNITY

CARE IN THE COMMUNITYThe profound demographic shift underway in parts of ruralNewfoundland and Labrador will require a shift in the types of servicesthat will be needed by residents in rural communities. Lower population

densities will further complicate the situation. Yet, innovative solutionsto these challenges are available. We must strengthen our community-based programs and promote the dignity and independence of ouraging population.

A new Liberal government will increase investments to reflect the shiftto community based care for our seniors. As a result, some seniors willbe able to live longer in their own homes or in supportive living. We will:

prepare our communities for the increased number of seniors andassist community leaders in adapting services such as housing,transportation, health care, shopping, and recreation to better meetthe needs of our aging citizens;

work with communities and municipalities to ensure our seniors areable to remain in and move safely in their communities;

enhance the resources provided to our communities to provideincreased community supports;

provide a seniors support network to give friends, family,caregivers and other members the information, support and trainingthey need to be effective in their roles;

find new, collaborative and innovative ways to support aging athome through smart planning and creative approaches;

support innovative product design and technologies that support

and sustain the independence of seniors and assisting caregivers,care providers and volunteers;

encourage innovative service delivery approaches, create newprograms, observe best practices and improved delivery models;


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CARE IN THE COMMUNITY

LONG TERM CARE FACILITIES

create a human resources strategy and invest in recruitment,retention and training of primary health care providers such aslicensed practical nurses, community nurses, registered nurses,

nurse practitioners, pharmacists, social workers and occupationaltherapists;

implement a housing strategy and home adaptation fund thatenables seniors to live independently and with security in theirhomes and communities; and

provide incentives for people to volunteer with seniors.

LONG TERM CARE FACILITIESThese facilities provide living accommodation for people who have highcare needs and require on-site delivery of 24 hour, 7 day a weeksupervised care. These homes play a critical role in supporting ouraging and seniors. They are increasingly dealing with patients withmore complex needs and we must work with these facilities to meetthose demands.

A new Liberal government will:

complete and implement a long term care strategy for our province;

review the supply of long term care beds and address the currentshortfall;

complete a human resource strategy that ensures that the staffingnumbers and skill mix meet the needs of todays patients. All staffingwould be reviewed including nurses and front line staff such as socialworkers, dieticians, activity co-ordinators and therapists; and

commit funds to improve the aging infrastructure.


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HOME CARE

FAMILY CAREGIVERS

HOME CAREEnsuring a high standard of care and support for our aging and seniorsis very important to allowing them to remain in their homes andcommunities. Home care is a critical component of this care. A newLiberal government will:

develop and deliver a new provincial home care strategy; develop and implement a human resources strategy to deal with,

among other health care professions, the shortages of home careworkers;

implement a new model for home care service assessment anddelivery to improve access, efficiency and effectiveness;

promote the contributions and value of our home care workers; improve training to home care workers regarding patients with more

complex needs;

increase opportunities for home care workers to attend conferencesand professional development seminars; and

increase education to help workers deal with difficult situations.

FAMILY CAREGIVERSFamily caregivers are the backbone of the long-term care system andvital to meeting the needs of our aging population. They provideassistance for parents, children, spouses and other family and friends inneed of support. Caregivers are the cornerstone of home and

community care and their role needs to be acknowledged. If caregiversdid not provide this care, the health system as we know it would not beable to function.

A new Liberal government will: introduce legislation to recognize and support caregivers and their

contributions. This legislation will: recognize the value of caregivers to the people of our

province; establish a provincial care giving advisory committee to

provide government with advice and recommendations; and work with the private, not for profit, volunteer and public

sector to engage in initiatives to provide recognition,education, support and assistance to caregivers providingcare for their family members and loved ones.


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FAMILY CAREGIVERS

PAYING FAMILY CAREGIVERS

investigate and implement financial and social support to formaland informal caregivers; and

strengthen the volunteer sector to help support seniors intheir homes and communities.

PAYING FAMILY CAREGIVERSThere are many families who find it difficult to recruit a caregiver fortheir loved ones. Many have to cut back on their employment or evenquit their jobs in order to take care of a family member. Lack of humanresources in rural and remote areas as well as the level of care requiredto look after some people are just a few reasons why recruitment andretention are an issue. Current government policies prevent familymembers from working as home support workers except in extremecircumstances.

A new Liberal government will implement a policy that will make iteasier for family members to be paid caregivers when there is difficultyin recruitment and retention of a homecare worker. We will: create and implement a new assessment measure that will be

completed in the home to determine the clients homecare needs.The assessment will include interviews with individuals caring forthe client as well as the clients medical care team, such asphysicians and community nurses. The number of monthlyhomecare hours required will be determined. Payments will go to aspouse or family member who is providing them with the requiredcare;

Implement an assessment process that will be designed to preventpublicly paid homecare from substituting for informal (family andfriends) care. An essential part of the assessment will be thedetermination of how much informal care is available to theindividual who needs the assistance;

implement proxy decision makers to help the client with theselection of homecare worker. The proxy decision maker and theindividual being paid for care giving will not be the same person, so

as to avoid conflict of interest; and collect appropriate quantitative and qualitative date in order to

monitor and evaluate effectiveness of the program.


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PERSONAL CARE HOMES

PERSONAL CARE HOMESWe recognize that not every senior can or will want to live in their ownhomes as they age. This is why we need to provide our seniors withoptions, with a choice as to where they wish to live. Personal carehomes take care of clients that are in need of Level I and/or II care. Atpresent government pays $670.00/month for each senior living in a

personal care home. A modest increase in funding would still seepersonal care homes as one of the most cost effective options for thecare of our seniors.

A new Liberal government will strengthen our community-basedpersonal care homes by providing:

an increase in the resident allowance from $150.00 to$300.00 per month;

a monthly rental increase to assist owners to pay appropriatewages and meet all government requirements; night security subsidy to older homes; a wage guarantee for personal home care workers, similar to

the Home Care program; and a new assessment tool that will allow some seniors with Level

II plus care to be cared for in certain personal care homes.

A new Liberal government will strengthen the personal care homeindustry by investing in programs that will allow access to: funding for modernization of Personal Care Homes under the

current Newfoundland and Labrador Housing program foraffordable housing;

a fixed bed subsidy buy-out program; and a loan insurance program for homes with fewer than 50 beds,

similar to Canadian Mortgage and Housing Corporations 50 plusbed offering.


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HOME OXYGEN PROGRAM

PALLIATIVE CARE

HOME OXYGEN PROGRAMOxygen therapy services are vital in supporting people with breathingdifficulties such as chronic obstructive pulmonary disease (COPD),emphysema and cystic fibrosis. Oxygen is considered a drug in that itrequires a prescription from a doctor in order to be administered to apatient. Most people requiring oxygen therapy are seniors. Oxygentherapy is vital to improving their health and quality of life.

We are one of only two provinces that does not have a provinciallyregulated home oxygen industry. Home oxygen is a prescription drugyet no provincial standards exist to ensure the safety and qualityassurance to the people of the province.

A new Liberal government will implement a provincial home oxygenprogram including standards and quality assurance.

PALLIATIVE CAREPalliative care can be provided in any number of settings ranging fromhomes and hospitals to long term care institutions. It should berecognized as an integral component of care across acute care, longterm care and the community.

A 2009 report, funded by the Cancer Care Program, found that fewpeople who die in Newfoundland and Labrador have access toappropriate palliative care. In this province we have a rudimentarypalliative care service which is not available to all residents. Currentlythe care is fragmentary and discontinuous at best and is not fulfilling thenecessary requirements for our people. This province needs acomprehensive palliative care service.

A new Liberal government will fund a Provincial Palliative Care Programincluding core components of: clinical services available to all areas of the province, delivered

through four specialized regional palliative medicine/care teams; dedicated funding for the program including resources for

governance, clinical, educational and research components; and a palliative care education strategy including making palliative care

a core component for all medical students, nurses, allied healthprofessionals and other professional schools developing provincialpublic education programs.


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CHRONIC DISEASE MANAGEMENT &

PREVENTION

APPROPRIATE USE OF MEDICATIONS

CHRONIC DISEASE MANAGEMENT & PREVENTIONChronic disease is the leading cause of death in Newfoundland andLabrador. Diseases of the circulatory system, cancer and respiratorydisease account for approximately 75 percent of all deaths in thisprovince. Our population is aging, rates of chronic disease are risingand the health care system needs to respond to these changingcircumstances. Risk factors associated with chronic disease include:

physical inactivity, unhealthy eating, tobacco, alcohol, hypertension,high cholesterol and being overweight or obese. The province does nothave a chronic disease management and prevention plan.

A new Liberal government will develop and implement a chronicdisease management and prevention plan.

APPROPRIATE USE OF MEDICATIONSExcessive or unnecessary use of medication is the leading cause of

drug related issues in seniors. It can result in adverse drug effects thatcomplicate therapy, increased costs associated with medication andoften presents challenges for the individual, families and friends as wellas the healthcare system.

Eighty-five (85) percent of seniors, sixty-five (65) and older, inNewfoundland and Labrador have one or more chronic conditions, thehighest rate in the country. Many of their conditions are managed withmedication. Some conditions include: high blood pressure, diabetes,arthritis and heart disease.

About fifty (50) percent of seniors do not take their prescribedmedications in the proper amounts either because of cost, side effectsor because they feel the medications do not really help them. There is adirect correlation between taking medications properly and increasedhealth. It is also a fact that not taking prescribed medications on time orat all is one of the leading causes of seniors having to be readmitted tohospitals and nursing homes. We must help seniors manage theirmedications.

A new Liberal government will develop and implement a strategy for theappropriate use of medications.


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Liberal Party of Newfoundland and LabradorSuite 205

20 Crosbie PlaceSt Johns, NL

A1B 3Y8

Tel: (709) 754-1813 or 1-866-726-7116Fax: (709) 726-7164

Website: www.nlliberals.caEmail: [email protected]

Twitter: @nlliberals

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