Ontario pilot project to address cultural mismatches in long-term care admissions

Ontario is proposing a pilot project to tweak long-term care priority rules in order to address a problem of declining and mismatched admissions to the province's cultural homes.

The issue was created by the Progressive Conservative government's own 2022 law known as Bill 7, which has been criticized for allowing people to be placed in a long term-care home not of their choosing.

It gives admission priority to people in hospital, as a way to free up beds for acute care once people can be discharged. Thousands of people across the province are waiting in hospital beds at any given time for a spot to open up in long-term care.

But advocates and operators in the sector say the new admission rules have proven to be a bit too blunt of an instrument when it comes to the several dozen cultural long-term care homes across the province, which cater to seniors from Korean, Jewish and francophone communities, for example.

Seniors are being admitted to cultural homes when they are not part of that culture.

For example, some are being moved into an Italian home without speaking that language, operators say, while people who are looking for a placement in that Italian home end up elsewhere.

If a spot opens in a Ukrainian home, it goes to the person at the top of the list, even if the person in the No. 2 spot wants a Ukrainian placement.

The previous long-term care minister, Stan Cho, said in the spring he was actively working on a solution, and now the current minister has posted a proposed regulatory amendment that would enable placement co-ordinators to prioritize cultural admissions within the "crisis" category, which largely consists of people waiting in hospital.

More than 6,000 people on crisis waitlist, minister says

There are more than 6,000 people on the crisis waitlist, Long-Term Care Minister Natalia Kusendova-Bashta wrote in a notice attached to the regulatory proposal.

"Given that the majority of admissions are from the 'crisis' waiting list in comparison to other waiting lists, this pilot is necessary to better support culturally appropriate placements of LTC applicants in the crisis waiting list to LTC homes that are engaged in serving the applicants' particular religious, ethnic, and/or linguistic origin," she wrote.

Lisa Levin, the CEO of AdvantAge Ontario, representing the province's non-profit long-term-care homes, said the proposed new rules will definitely help make life better for long-term care residents, many of whom have dementia.

"Often those individuals, if English isn't their first language, would revert back to their mother tongue and that's why it's just so important that they be able to be in the homes where the language is familiar, the food is familiar, the traditions are familiar," she said.

"It also is challenging for the homes when they have individuals come in who are not of the culture — especially when you have so many — because the people might want different diets and they don't understand the language, and it's just very difficult for everyone."

Levin said she hopes the government expands the new rules beyond a time-limited pilot project, because the issue has continued to worsen.

"We know anecdotally it's gotten worse, because culture admissions haven't really been occurring since the new Long Term Care Act came in, in Bill 7," she said. "We need to stop that and reverse the trend."

A spokesperson for the minister said that the pilot project will span a set amount of time and be limited to a certain number of participating homes, which will allow the government to evaluate the changes.

The minister's office didn't specify which homes are on the list, or how long the project would run.