I was privy to an interesting conversation the other day. A family member in a small Ontario town was talking about an elder's recent hospitalization. Apparently, after being discharged home with community supports in place, the senior ended up requiring Long-Term Care with immediacy.
Because there had been no pre hospitalization planning (should there be a future need for care), there was no Long-Term Care wait list formulated. The individual would be entering into the first available LTC home as a crisis admission, and so the thought prevailed that their fate was permanently sealed.
This is not the case however.
So what just happened? The individual was deemed to be in “crisis" by their Case Manager at the Community Care Access Centre (CCAC). This status provided them with priority access to the first Long-Term Care home bed in the geographical region served by this CCAC. This location may be a considerable distance from their current home, it is basically the luck of the draw where the first opening surfaces.
Are you forced to stay in this home? The individual continues to have the right to make alternate home choices after admission. Wait lists for more preferred locations can be opened. In essence, the client is then awaiting a lateral move when a different bed becomes available. Due to the disproportionate number of people waiting for some locations vs. the number of beds, this move is not going to happen overnight. If there is an existing wait list created prior to the crisis, the individual still retains their wait list as before.
Tip: If you can afford basic, semi and private rooms as options to place on your application, you will expedite your movement up the wait lists. Not everyone is flexible because of the higher costs incurred for differing room configurations.
What might have circumvented this lengthy wait to access a Long-Term Care home of choice?
Here are some great strategies to potentially preempt a long interim wait should the unexpected occur:
· Call the CCAC and discuss your current health status to ascertain if you are eligible for LTC wait list application. The call will be triaged to a case manager as required. Generally potential applicants have difficulties with self care and/or safety. Gone are the days when people applied years in advance of need.
· Tour LTC homes before the need and leisurely determine which choices best suit your unique needs. Use the Elderpilot LTC home app for iPhones and Androids to help with the tour navigation and report creation. Leisurely formulate a prioritized list of desired locations long before the need arises. The app has the ability to cross reference numerous homes in all 9 categories.
Tip: Read the Resource Manual built into the app. There is an abundance of tips and insights.
· In determining whether application to a Long-Term care home may be in the near future, consider your current health status. Do you have a debilitating illness that will inevitably require 24/7 care? Are there resources in place to meet your needs aside from the Long-Term Care option?
· During the meeting with CCAC, often an applicant will be asked if they are prepared to accept a LTC bed within 3 months if one of the choices has an open room. If the response is no, the general outcome is that a wait list will not be opened.
Tip: I strongly encourage you to review: http://oaccac.com/Quality-And-Transparency/Provincial-Wait-Times/long-term-care-wait-times to gain insight into average wait times. (The CCAC prioritizes applicants based on legislation) What average timelines are represented by your home choices?
What if I refuse a bed when offered? Before a bed is refused, think about the consequences and potential wait for this opportunity to arise again in a chosen home. Take a breath before refusing.
If a bed is refused, the applicant will be removed from all wait lists for 3 months and will need to restart the application process thereafter.
What if a crisis situation arises and a bed was refused only days earlier? If the CCAC deems an individual to be in crisis they retain their rights to accept the first available bed in the served geographical area. This right is not negated due to a past refusal. The wait lists for a lateral move to a more preferred location will have to be reinitiated however.
What if there is an impasse between the assigned CCAC Case manager and the applicant/POA?
First and foremost, ask to speak with an alternate team member of the CCAC who is operating in a supervisory role.
Should there be questions relating to advocacy, an excellent resource is the Advocacy Centre for the Elderly “ACE" http://www.advocacycentreelderly.org/
The Public Guardian and Trustee also has a variety of information accessible. Of particular interest may be the information regarding consent and capacity: http://www.attorneygeneral.jus.gov.on.ca/english/family/pgt/overview.asp
Although opening a wait list for Long-Term Care is a huge decision, there are merits to being prepared. You can look before you leap and be as prepared as possible, or you can accept fate as it finds you.
It is the set of the sails, not the direction of the wind that determines which way we will go.
Tomorrow's Blog: What if a Long-Term Care Home refuses me, what next?