Inadequate care causes more trips to the ER, hospitalizations
The health system in Eastern Ontario is failing seniors with dementia, leaving many to languish without proper care, says a leading elder care specialist.
More than 16,000 Eastern Ontarians suffer from dementia, but a lack of preventive care means many land in hospitals unnecessarily, said Dr. Frank Molnar, a geriatrician at The Ottawa Hospital.
The situation creates long waits in emergency rooms and costs the region’s health-care system millions in avoidable expenses, he added.
“As a system, I don’t think we’re providing adequate dementia care. And, because of that, we have increased ER visits, increased hospitalizations,” Molnar told a public forum on dementia Friday. “My fear is that dementia care will remain a weak link.”
In Eastern Ontario, which has the fastest-growing seniors population in the province, gaps in dementia care have resulted in overcrowded hospitals and nursing homes as well as long waits to get into both.
Molnar said the gaps include a lack of home-care managers dedicated to monitoring the complex needs of dementia sufferers; access to respite care for spouses and children who look after seniors with dementia; and outpatient clinics to provide followup care for dementia patients who are discharged from hospital.
The Champlain Community Access Centre, the agency responsible for home care in Eastern Ontario, has hinted that it plans to look at creating more dedicated case managers for seniors with dementia, modelled after a team that currently serves the Glengarry-Prescott-Russell area.
But Molnar reserved his sharpest words for hospitals, including his own, which, he said, often fails seniors with dementia. Once hospitalized, such patients are too quickly labelled as candidates for nursing homes and left to languish without proper care.
And once discharged, dementia sufferers struggle to remain in their own homes, creating a burden on family and friends. As a result, these seniors often get caught in a revolving door of expensive and ineffective hospital visits.
“As a system, we let things deteriorate, escalate and then we end up spending 10 times as much caring for people in the hospital at a time when it’s less possible to reverse the problem,” said Molnar.
“We need to provide the services in the community so that they don’t get to the emergency room in the first place.”
Dementia is a degenerative disease that first attacks memory and then harms other brain functions, eventually robbing its victims of their personality and independence.
Seniors with dementia often suffer from other complex illnesses such as diabetes; when they lose their memory, they forget to take their medications and follow a proper diet, putting them at even higher risk of complications that result in unnecessary hospital admissions.
In Eastern Ontario, Molnar co-chairs a coalition of physicians and community support groups called the Champlain Dementia Network, which trains family doctors how to diagnosis and treat dementia patients early in the disease cycle.
The network also helps patients and their families find the necessary services to help seniors with dementia live in their own homes.
The Alzheimer Society of Ottawa and Renfrew County also offers a program called First Link, which connects dementia patients and their families with education, support services and counselling.
While all these services are aimed at preventing premature hospital and nursing-home admissions, they are largely volunteer-driven and underfunded, said Molnar.
In most cases, the services have more clients than they can handle, said Kathy Wright, executive director of the Alzheimer Society.
First Link, for example, receives $262,000 annually in provincial funding, which allows them to help about 2,000 Eastern Ontarians, or about one in eight seniors with dementia. “We know lots of people don’t get to us,” said Wright.
Molnar blamed the situation on the province, which, he said, has not made dementia care a priority.
The head of Eastern Ontario’s health authority acknowledged the pressures on existing dementia-care programs.
But Dr. Robert Cushman defended the Champlain Local Health Integration Network, saying the agency, which decides how provincial health dollars are spent in the region, has increased funding to some dementia-care programs. Among them is the Memory Disorder Clinic at Bruyère Continuing Care, which assesses seniors to determine whether they have dementia.
“We want to get as much money to the community to ensure that people stay out of the more expensive institutions,” said Cushman.
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