Hospital hit by Rainycrest woes

While families in Fort Frances and the surrounding area wait for the suspension on admissions at Rainycrest Home for the Aged here to be lifted, almost half of the beds at La Verendrye General Hospital are occupied by patients waiting for placement in a long-term care facility.
Twenty-six of the hospital’s 60 beds are occupied by patients who would be better served in a long-term care facility like Rainycrest, said Liz Clark, the hospital’s assistant executive director for patient services.
“Hospitals exist to provide care for people who are sick. A hospital is not a home,” Clark said, adding some of these patients have been waiting in the hospital for nearly a year.
Of the 26 patients waiting for long-term care, 18 are in the hospital’s Continuing Care Unit (CCU), which is generally reserved for patients requiring chronic care.
Clark said the difference between chronic care and long-term care is an important one.
In chronic care, “there is an emphasis on rehabilitation, like physiotherapy, occupational therapy, or speech therapy,” she noted. “A person with a chronic illness, such as a stroke, can be rehabilitated to return to their home in the community.”
The duration of the rehabilitation for chronic care patients can last weeks or even months, but the goal is to get them home as soon as they are healthy enough to do so.
“Typically, many more patients from CCU are returned home than are transferred to long-term care,” Clark said.
Long-term care patients, on the other hand, need care on a 24-hour basis.
“They are no longer able to function independently in their own home environment,” she explained, adding that while they may require some nursing and medical care, they also require psycho-social care.
When these patients are placed in a hospital, as opposed to a long-term care facility, these psycho-social needs are not always met.
“There may not be time to sit down and write a letter with them, or read the paper,” said Bonnee Kielczewski, the hospital’s utilization co-ordinator.
This is particularly true for patients in the acute ward, where eight of the hospital’s 26 long-term care patients are located.
The turnover in an acute bed is usually three or four days, Kielczewski said, meaning an elderly patient in a room with two or three beds in the acute ward will share their room with many people over the course of time.
“It’s very upsetting to them,” Kielczewski said, adding many of these patients simply want to be settled in a home-like environment.
In addition, acute care patients often need constant monitoring.
“Someone’s in there every hour with the lights on,” Kielczewski said, adding that can be very disturbing to seniors sharing these rooms.
Regular patients in acute care who are stable often are moved to CCU for rehabilitation, but with most beds there taken up by long-term care patients, they can’t be.
“Everything’s backed up,” Clark said.
Long-term care facilities like Rainycrest also provide social events like dances or birthday parties, and residents often bring in personal belongings to make them feel at home.
Hospitals generally cannot provide these services.
Then there’s the price difference. The cost to keep a resident in a basic room at Rainycrest is roughly $48/day while the cost to keep an insured Canadian citizen in acute care in hospital is more than $700/day.
Chronic care is less expensive, at just over $100/day, but patients in CCU also pay a fee based on their income (these figures do not apply to uninsured or out-of-country patients).
Meanwhile, with no new patients being admitted to Rainycrest for now while it works to comply with ministry standards, the waiting list is growing steadily. There are 52 names on the list for Rainycrest, but administrator Jill Colquhoun said there are only four vacancies.
And the pressure on the hospital is not letting up.
“I get calls on an average of three times a week, asking what our bed availability is,” Kielczewski said. “You feel so horrible saying you can’t take another person.”
Patients who need long-term care who are not in hospital often live with families, who must provide round-the-clock care. This, in turn, can result in overburdened family members.
“Families have come with suitcases to Emergency and said, ‘I can’t do it any more’ and leave,” Kielczewski noted.
“Elderly people who take care of their spouses get burned out, and they both end up in hospital,” added Mary Boucher-Polz, the hospital’s nurse manager.
Boucher-Polz is familiar with the problem on both a professional and personal level. In addition to her work at the hospital, she also cares for her elderly mother at home.
Her family’s summer vacation plans had to be changed this year because Rainycrest no longer was offering respite services, which give caregivers a break from the demands of looking after a loved one.
Before the suspension on admissions, people requiring 24-hour care could stay at Rainycrest for a nominal daily fee, providing a much-needed rest for the caregiver.
“It was the only overnight respite offered in our community,” Kielczewski said.
“There are lots of caregivers who are suffering from burn-out now,” Boucher-Polz said.
Many of the long-term care patients in the hospital now came in as patients with pneumonia or other illness, and ended up staying because there was nowhere else to go.
“A lot of these people have been here over a year,” Kielczewski said. “What’s going to happen when the hospital fills up to where we can’t take any more?”
Meanwhile, 26 elderly people sit in hospital waiting for a place to call home. “The one word I use is ‘heart-breaking,’” Kielczewski lamented.
(Fort Frances Times)