1 in 3 Manitoba seniors in care could stay at home with right supports, study suggests

Out of six provinces, Manitoba has the highest proportion of seniors in long-term care facilities who could potentially live at home with the right supports, a study released Tuesday by the Canadian Institute for Health Information suggests.

The CIHI report Seniors in Transition: Exploring Pathways Across the Care Continuum says 33 per cent of Manitoba seniors in the continuing care system showed low to moderate signs of round-the-clock care needs.

"I thought that was really high," said Verena Menec, professor in the University of Manitoba's department of community health sciences. 

The research suggests B.C. has the lowest proportion of seniors prematurely in care (15 per cent), while the average across six participating provinces was pegged at 22 per cent. There are currently about 5,700 seniors in Winnipeg care homes; only facilities that are part of the Winnipeg Regional Health Authority were studied.  

"The report validates what we're seeing — that a number of seniors are being prematurely placed into residential care when there could be better options for them," Gina Trinidad, Winnipeg Regional Health Authority chief operating officer of community health services and long-term care, said in a statement.

The study analyzed the priority levels of seniors in care in 35 health regions in Manitoba, Ontario, Saskatchewan, Alberta, B.C. and Yukon over three years, ending in 2015.

The report authors said early admission can be influenced by physical or cognitive impairments, living alone or a primary caregiver or family member becoming unable to continue looking after a senior.

"When we look at individuals and the care required by an individual, we need to also look at the caregivers and ensure there are appropriate supports for the caregiver as well," said Hannah Forbes, executive director of long-term care with the Winnipeg Regional Health Authority.

"We just need to ensure that we're allowing individuals to remain in communities as long as reasonably possible and safe to do so. It really is a partnership between family and the health system."

Trinidad said the research reinforces the need for the health authority's planned short-term intensive home care service. 

"Supporting seniors in the community helps them sustain a higher quality of life, avoid unnecessary hospital stays and perhaps even prevent long-term care placement entirely," Trinidad said in a statement.

"The approach also improves patient flow, ensuring hospital beds are available for individuals that are acutely ill. Matching patient need to the right patient care environment is critically important, and what we're seeing is that the right care environment for many seniors is the community."

Meanwhile Menec said she is in favour of more short-term supports for seniors, but details of the incoming program remain scant.

"I would want more information as to how short-term intensive home care will reduce [long-term] institutionalization," Menec said.

About 1,200 seniors who entered hospitals in 2016 transitioned into long-term care homes, according to the WRHA. Trinidad previously said the aim of the short-term intensive service — beyond saving money and improving patient flow — is to cut that number in half.

"I can't quite figure out how that [intensive short-term services] figures into the math of institutionalization reduction that they are hoping for," Menec said.  "I just can't picture this and what projections are behind these numbers?"

Menec said she is pleased something good may come from the cancellation of the Hospital Home Team initiative, which was axed a few months ago, but she still has questions about exactly what the short-term intensive program will hold.

About 2.6 million people in Canada — seven per cent of the population — are currently older than 75. That number is predicted to more than double over the next two decades.

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