Nova Scotia spends $11 million on health care every day — that’s $131 every second.
Chances are someone in your family is one of 6,900 people receiving care in a Nova Scotia nursing home right now. Or perhaps you know one of 1,463 people waiting to be admitted — a wait list that has dropped 40 per cent since this last time last year, according to figures obtained from the Department of Health.
The Health Department says part of that improvement is due to policy changes a year ago that forced people on the waitlist either to accept a nursing home bed no matter where it’s located in the province or to re-apply later. A further (and arguably overdue) change now being considered could reduce what is still a stubbornly long waitlist, if the government approves and implements it later this year.
Get ready for it. Instead of admitting people on a first-come, first-served basis, future nursing home admissions could be based on “a balance between how long a person has been waiting and the urgency of their needs,” says Ruby Knowles, executive director of Continuing Care for the Department of Health.
This is hardly revolutionary, considering these are the criteria already used by most other provinces. In Nova Scotia, only a relatively small number of cases get fast-tracked: those involving adults in need of protection because of neglect or abuse, and people who are married to each other. Everybody else gets processed chronologically.
Meanwhile, the province isn’t planning on building new nursing homes anytime soon. Instead, it will tackle the nursing home wait list by continuing to expand the amount of money spent on Home Care services to keep seniors in their homes longer and (perhaps) shorten the length of nursing home stays.
Nova Scotia not only has the highest percentage of seniors — 19 per cent of the population — but seniors in this province actually live longer in nursing homes than in other provinces – three years on average.
“If we could reduce that nursing home stay from three years to two years, it would free up an additional 1,100 beds and serve about 1,500 more people,” said Susan Stevens, senior director for continuing care with the NS Heath Authority.
If that sounds slightly ghoulish, think about trying to make that happen when nearly three-quarters of nursing home residents are now 85 years and older. Yet Stevens told a small audience at the Silver Economy Summit for Seniors in New Glasgow last week that when it comes to dealing with the challenge of rapidly aging population, “it’s not all doom and gloom.”
Department of Health & Wellness figures presented by Stevens link the recent decline in the number of people waiting for nursing homes primarily to putting millions more into Home Care. Keeping more people home longer is a trend she predicts will ensure only the frailest and most vulnerable will get admitted to nursing homes in the future — a cohort unlikely to live as long as the folks occupying the beds today.
Faster turnover could save the province millions of dollars each year.
The province now spends $567 million a year on nursing homes caring for 6,900 people. That cost continues to rise, but not as quickly as Home Care, whose budget has doubled in the past decade and now stands at $240 million.
Last year, 12,000 people received Home Care visits. According to figures from the Department of Health & Wellness, the cost to care for someone at home is at least $1,000 a month less than in a nursing home. And that saving is usually greater since most Home Care recipients don’t require the maximum support of 100 visits a month.
But guess what? There is also a steady and significant line-up for Home Care. Last month, 618 people were waiting for 3,824 hours of home support. That compares with 612 people lined up for 7,416 hours in July 2015.
The demand for home care is rising, according to Stevens, because the Department of Health & Wellness is increasingly directing hospitals to send people home instead of transferring patients to nursing homes.
That directive is to prevent someone who needs full-time nursing home care less urgently than someone else from “jumping the line” by checking into hospital first. (The number of people occupying hospital beds waiting for a nursing home admission remains constant at about 250 at any given time, according to the Nova Scotia Health Authority.)
The good news is that the wait list for a nursing home bed is much shorter than it was a year ago. The bad news is that 1,463 people are still on it.
And over the next decade, 34 more Nova Scotians will turn 65 every day.
See related article, “Nova Scotia still failing to meet nursing home standards.”