Missing the forest for the trees – bricks and mortar versus services

When we focus on building more nursing homes, we miss the forest for the trees.

On March 18, the Ford government approved funding for 80 projects to create 7,510 new nursing home beds and upgrade 4,197 older ones. It will provide nearly $80,000 in public subsidies to build each bed. Some of these new spaces will be for Indigenous, Francophone, and other cultural communities. It’s welcome news that these communities will have residential services that are culturally appropriate and supportive.  

What’s still missing is meaningful thought about the people who work in long-term care. With the exception of $121 million to accelerate training of 9,000 personal support workers for nursing and retirement homes, the March 24 Provincial Budget continues to focus on bricks and mortar responses to the needs of seniors. We do need safer residential facilities, but if we really want safe spaces for ageing Ontarians, we need to improve working conditions in those facilities. This is the only way to attract new staff and keep the ones we already have.

Also, new beds aren’t the only way to reduce nursing home wait lists and ease pressures on hospitals. When home and community care services are available and strong, more people can remain in their homes. For many, this means delaying, or even preventing, the need to move into a group setting. It also relieves the pressure on their unpaid caregivers. We need to expand our home and community services, beyond temporarily boosting the Meals-on-Wheels program and offering a home safety tax credit. We also need to improve working conditions for the people who provide home care services. Just as much as those who work in long-term care homes, these workers need stability, a living wage, and benefits.

Many residents of long-term care homes and those on waiting lists could live in the community with some support. If we use the figures from the Canadian Institutes of Health Information (CIHI), “…1 in 12 (8%) individuals being admitted to Ontario’s LTC homes could likely have remained in the community with existing home and community supports.” Eight per cent of the 30,000 people currently on wait lists for nursing homes is 2,400 people. That’s 2,400 people who could have stayed in their homes. Ontario plans to spend $933 million for 11,707 new and upgraded spaces. If we reallocated 8% of that amount, we would have nearly $75 million for more home and community care. We could also improve pay and benefits for community-based workers. Within months, nursing home wait lists would shrink by thousands. Hospitals could have some breathing room.  The Budget misses these opportunities!

Recent research confirms that most Ontarians 65 years and older want to live safely and independently in their own homes as long as they can. Premier, please listen to the people.

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