As the Ford government hurries the passage of its bill to quicken the transfer of patients from hospitals to long-term care homes, some families are afraid of what will come of it.
The aim of the bill is to help hospitals free up beds by making it easier to move patients out of them and into long-term care homes once they no longer require hospital-level support. The legislation would do this by removing the requirement of the patient's consent from the process of admitting them into an LTC home.
The bill states patients can't be physically transferred from a hospital to a long-term care home without their consent. However, the province has not ruled out allowing hospitals to charge patients the same rates uninsured patients pay, which can be as high as $1,800 a day, if they refuse to move into an LTC home that has been chosen for them.
The Ford government has skipped the committee stage of the bill, where Ontarians could have provided their input to parliamentarians.
QP Briefing spoke to two families who said they had stories to share.
Lucie Laplante, a 77-year-old Sudbury, Ont., resident, shared her family's conundrum on Monday.
Gabriel Laplante, 82, is Lucie's husband. He's been in and out of the Health Sciences North hospital in Sudbury a few times already this year. He's in poor health and suffers from chronic obstructive pulmonary disease (COPD) and dementia.
Lucie can't take care of Gabriel at home anymore, she said. Her health isn't great either and she simply can't provide the level of round-the-clock care and monitoring that Gabriel needs. He needs assistance with feeding and dressing and was injured twice when he fell in their home.
Gabriel is on a waiting list for a semi-private bed at the nearby 128-bed St. Gabriel Villa long-term care home, where Gabriel's and Lucie's son, Joel, is cared for. Joel Laplante stays there to be treated for cerebral palsy, Lucie said.
"It's wonderful. (Joel's) never complained," Lucie said.
Lucie said she was informed within the last year that Gabriel got as high as second on the waiting list for St. Gabriel, but admissions aren't strictly first come, first served, and now he's back down to 10th.
While Gabriel stays at Health Sciences North, the couple pays daily the co-pay rate for the long-term care spot they're waiting for, which amounts to a cost of around $2,000 a month, Lucie said. Gabriel's getting around 60 to 70 per cent of the care he actually requires at Health Sciences North, Lucie said. In her almost-daily visits while he's there, she said she finds herself effectively being his caregiver. It's obvious the hospital is understaffed, Lucie said.
There have been other instances that have bothered Lucie about Gabriel staying in the hospital. Once, because of pandemic restrictions, she couldn't visit him for a month. She's also arrived for a visit to find her husband in need of changing, she said.
Lucie also thinks Gabriel's condition is deteriorating more quickly because he's receiving inadequate care and is barely active. Sometimes all he does in a day is make a trip to the bathroom and return to his hospital bed.
The care her son gets at St. Gabriel's is much better and how active he is during the day would be "much better" for her husband, Lucie said.
Currently, Lucie can visit her husband and son separately. Gabriel can't make the trip to visit Joel, and it's extremely difficult for Joel to visit Gabriel, so it's been a month since the two of them have seen each other.
Lucie said Gabriel is often offered spots in different long-term care homes, but she and her husband won't accept anywhere that isn't St. Gabriel's, where father and son can be together.
“I’m not going to change my mind. I don’t know why they keep asking,” Lucie said.
Bill 7 worries Lucie because she thinks she's going to lose what choice she has left over where her husband lives.
If it comes to choosing between moving him to a long-term care home that isn't St. Gabriel's and returning Gabriel to their home, Lucie said he'll be coming home "to die at home" but that struggling to care for her husband and visit her son may be too much for her to bear.
"And maybe I'll die, too," Lucie said. "I don't care at that point."
In Bruce County, Kevin Daniels is also uneasy about Bill 7's expected passage because of how it could affect his mother, Carol Daniels. He recently wrote to Long-Term Care Minister Paul Calandra expressing his concern that the legislation will force his mother to go to a different long-term care home than the one she used to live in, Gateway Haven.
"We don't want Carol to stay in hospital longer than she has to, but we certainly don't want Carol to face any arbitrary transfers to any other LTC institution by virtue of the government's announcement last week," he wrote.
Like so many Alzheimer's patients, Carol has responsive behaviours that require management and care.
The Daniels family has been fighting a legal battle with Bruce County, which runs the home, over the administration's refusal to readmit Carol as a resident since she was taken to hospital last July.
The provincial government has sided with the family so far, even issuing a director's order — the highest level of rebuke the ministry can issue — telling the home it must take her back, rejecting the administration's argument that she requires too much staff time to care for.
The county is appealing that decision and, until it is resolved, Carol remains in hospital.
Daniels said he's often asked why the family is fighting so hard to have his mother readmitted to a long-term care home that doesn't want to take her. He said it comes down to the fact that it was her home, that it's the only one close enough to her family that they can provide additional care for her, and that it is supposed to offer behavioural support for dementia patients like Carol.
"We recognize there's system shortages and challenges and whatnot, and the government can only do so much," he said. "But my mother still requires the care. And if she requires the hands-on full-time care from family, in her long-term care home environment, we're prepared to do that."
Daniels recalled the night the long-term care home sent Carol to the overcrowded hospital.
"There was nowhere for her to go," he said, his voice breaking. "The doctor said, 'I don't have any other safe place to go other than to admit her here — except I don't have a bed to admit her to here.'
"So, my mother and father stayed together in a six-by-ten ER examination room with no bed overnight. For 30 hours, they stayed there, in that tiny room."
For its part, the home denied, through legal counsel, wrongly excluding Carol from Gateway Haven.
"In making decisions, the LTC home has an obligation to protect the safety and well-being of all of its residents," said lawyer Valerie Wise in an emailed statement.
Daniels said Carol was eventually admitted to the hospital and later moved to the psychogeriatric ward, but her medical team says she is ready to live in long-term care again.
That is exactly what the family wants, as long as it's the long-term care home that can meet her needs.
"We have this societal tendency to discard our elderly, to consider them a burden, after society has milked them for all their (perceived) worth," wrote Daniels in an email to QP Briefing with his thoughts on Bill 7. "We need to change this point of view. The elderly are owed a rich quality of remaining life with dignity and choice, and accordingly, require support and advocacy."
Bill 7 will be voted on at its second-reading stage late on Tuesday morning, bypass the typical committee study and head to the third-reading debate soon after.
NDP, Liberal and Green MPPs have called the government's move to rush the bill through the house anti-democratic.
On Monday, the NDP hosted its own version of a public hearing, giving advocates a platform to speak out against the bill.
A spokesperson for Calandra couldn't provide a response to QP Briefing's request by deadline, but the premier and long-term minister gave a full-throated defence of the bill in question period on Monday.
"The opposition want people who should be in long-term care in hospital beds," Ford claimed, in response to a question on the bill from the NDP. "Hospital beds weren’t made for long-term care patients. And what’s happening is it’s clogging up the emergency departments, delaying surgeries. These problems are decades in the making, created by years of refusal to act under the Liberals and NDP."
Calandra's office released a statement saying opposition MPPs are "hypocrites that say no for the sake of saying no."
"For years, NDP MPPs have complained about the problem of discharged patients waiting in hospital beds for long-term care," it said. "But now that the government is taking the necessary action to address this long-standing issue, the NDP is opposing it. Why? Because they will always find a reason to say no, even when it comes to improving our health-care system."
With files from Jessica Smith Cross