We're Worried about the Lack of Planning for Long-Term-Care Patients,

say the MUHC's own Patient Committees

The following statement by these committees was first published in The Suburban newspaper,

Wednesday, July 25, 2001, page A-13

Long-term care solutions for MUHC

What will become of long-term care patients at the McGill University Health Centre (MUHC) once the planned acute-care facility is built on the Glen Yards site? Will they continue to receive the therapeutic treatment from which they now benefit? Based on current available information, we fear that they may not.

The patients' committees of the five hospitals that currently make up the MUHC are united in their concern that almost no accommodation has been made for long-term care patients in the planned hospital on the dangerous assumption that the government will provide for such beds in the community.

This assumption is in direct contradiction with both the 2000 public health report of the Régie régionale de la santé et des services sociaux de Montréal-Centre - which found that a majority of extended care institutions were inadequate and substantially underfunded - and with past government action. Even the administrators of Montreal's public long-term care centres claim that current residents are shamefully stripped of their dignity while being regularly denied required services.

The numbers just don't add up. The total number of beds in the new acute-care hospital is projected to be approximately 900, which is 300 fewer than the more than 1,200 beds that now exist in the MUHC. Presently, between 120 and 170 of these are occupied by long-term care residents awaiting permanent placement.

Advanced Alzheimer's disease sufferers and non-autonomous geriatric or post-trauma patients are examples of patients who are unable to return home to their previous level of functioning. They must rely on others for such basic needs as hygiene, feeding and mobility; and are often disoriented, requiring physical and/or cognitive stimulation. (While patients are seldom admitted to hospital for long-term care, acute-care hospitals like the MUHC are frequently obliged to provide long-term care for patients after treatment for an acute condition.)

Even today, some patients can wait over a year for the appropriate long-term care facility as a result of the government's ill-conceived 'virage ambulatoire' which cut long-term beds by eight per cent since 1993. Unless the need for long-term care is addressed, these delays, combined with a growing elderly population requiring medical attention, will further reduce the already limited number of acute-care beds in the planned hospital which would, in turn, critically worsen emergency room over-crowding, contribute to lengthier waiting lists, and place an impossible load on overburdened CLSCs.

Long-term facilities must also be available to patients with special needs. For example, chronic respiratory patients now living in the Montreal Chest Institute require the services of inhalation therapists and other specialized health professionals since their condition dictates constant access to supplemental oxygen and the regular use of respirators. Even today, the immediate life-saving equipment and expertise often required is unavailable in all other long-term care establishments.

Due to our concern, we have formally recommended that one or more of the existing hospitals of the MUHC be re-used as extended care facilities. Several lend themselves to such purposes. Existing facilities can be used to full advantage for long-term care patients and provide adequate access to public transportation, majestic views, access to Mount Royal Park, and space for various teaching programs and proximity to medical schools, recreational-therapy activities and support groups.

For example, the Montreal General Hospital could be adapted for long-term care by improving public access with the creation of an escalator from the Pine Avenue street level to the ground floor of the hospital. Other sites could equally be adapted.

Patients trust that their hospitals will afford them an efficient and effortless transition from intensive and acute-care to rehabilitation at home or to an extended-care facility as necessary. Our recommendation would require a contractual obligation as well as a collaborative relationship between the staff of the MUHC and that of these proposed facilities, which will ensure quality care and teaching.

By committing itself to this sensible, effective, and necessary long-term care strategy, the MUHC would preserve the architectural significance and legacy of its institutions. More importantly, it would fulfill its ethical obligation to ensure that physically and emotionally fragile patients receive the quality of care they deserve.

We urge all those responsible for the delivery of health care to recognize their duty to a vulnerable segment of our population who currently risk abandonment. They must never be allowed to fall through the cracks!

The MUHC Patients' Committees of the Montreal Chest Institute, Montreal Children's Hospital, Montreal General Hospital, Montreal Neurological Hospital and Royal Victoria Hospital