Navigating nursing homes: Part 1 of 2
“Incidents of abuse and neglect in nursing homes, widely reported by the media, are relatively rare but highlight the need for publicly available information on the quality performance of this sector.”
— From the 2013 Canadian Institute for Health Information report, When a Nursing Home is Home: How do Canadian Nursing Homes Measure Up on Quality?
Ideally, long-term care homes are homes. It’s where many people will spend their final years of life. That’s why choosing the right place is crucial. — Photo by Thinkstock
If your family is trying to find a nursing home for a loved one, it’s not easy to make an informed choice.
Sure, some of the private facilities have sophisticated websites and photo galleries showing all the amenities, but finding detailed information on publicly funded homes is much more difficult.
Google “Agnes Pratt Nursing Home in St. John’s,” for example, and you’ll find a brief description of the facility on Eastern Health’s website, giving the number of beds and a rudimentary map, and advising that, “The Home is obligated to provide a safe, secure, homelike environment respecting the dignity, privacy and autonomy of each person while ensuring the involvement of family members in the care process.”
Ideally, long-term care homes are homes. It’s where many people will spend their final years of life. Helping a family member choose a nursing home is a challenge, with much to consider — that is, if they even have a choice, rather than having to take the first publicly subsidized space available that offers the level of care they need.
Getting the information you need can be a daunting process.
Christine Taylor’s family was in this situation when they began looking for a retirement home for her grandmother.
“Information was sparse …,” Taylor, who lives in Toronto, recalls. “I saw the revolving door (at some nursing homes). People move in. It’s not what they expect, then they leave. I could sense the exhaustion and the frustration. They don’t know where else to turn.”
Taylor has a master’s degree in gerontology and has worked as a nursing home administrator, so she decided to come up with a solution.
“With nursing homes, if you go in as a resident … this is their life now,” she said.
“If people go buy a TV, often they’re going on consumer reports … so why can’t we help them make the larger decisions in their lives?”
The biggest problem Taylor ran into was getting information from provincial governments, since different provinces post different amounts of information online, and some, nothing at all.
All and nothing
Ontario leads the way with detailed nursing home inspection reports.
A Dec. 18, 2012 check of the Avalon Retirement Centre nursing home in Orangeville, Ont., for example, found it in complete compliance with provincial standards.
Inspectors talked to staff and residents, and observed meal service, checked health records and reviewed policies and procedures.
British Columbia posts its inspection records online, but they only give information about the nature of infractions.
For example, on Feb. 27, 2013, a home in Abbotsford, B.C., was found to be non-compliant when it came to providing a “Menu (that) includes minimum 2 nutritious snacks with 2 food groups per snack.”
Alberta will tell you if nursing homes follow the rules, but there’s not much detail.
Manitoba committed to post nursing home inspection reports online in the wake of an investigative CBC report that found that one-quarter of nursing homes reviewed there in 2011-12 did not meet all the standards.
“We agree that there should be more information, it should be correct and useful to the public. And that’s exactly the direction we’re headed,” Manitoba Health Minister Theresa Oswald said in a May 2, 2013 CBC News online article.
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Other provinces are lagging behind as well. In Newfoundland and Labrador, detailed nursing home audits are not posted online.
When asked, Service NL promptly provided the most recent food and environmental health inspection reports for nursing homes in the metro area, but they aren’t meant to examine whether nursing homes meet provincial operating standards. Instead, they check for things like safe food preparation and potential safety hazards. All the homes fared well.
A Service NL spokeswoman said the provincial government would consider posting the reports online, but that no one had really asked for that before and their format posed a challenge.
As for detailed reviews of nursing homes to ensure they meet provincial standards, the Department of Health explained that each of the province’s four health authorities goes through a “rigorous accreditation process with Accreditation Canada every three years.”
The health authorities post these accreditation reports online, but they cover the whole of the health authorities’ activities and do not place particular focus on nursing homes.
Positives and negatives
Eastern Health’s most recent accreditation report, released on Thursday, devotes roughly three pages to “Long-Term Care Services.”
Only three homes were surveyed for the report — Agnes Pratt and
St. Patrick’s Mercy Home in St. John’s and the Interfaith Home in Carbonear.
Among the findings? Patient safety is emphasized; there’s a good mix of staff and solid medicine-management practices. The buildings are well maintained.
On the down side, some family members lamented the lack of physiotherapy support and said there’s too much staff turnover.
At the Interfaith Home there was a safety concern: “Four bedrooms, crowded narrow hallways on two levels with no storage options make it challenging for staff members to deliver care. The new (long-term care) home being built in Carbonear will resolve these issues, but in the meantime, it will be important to maximize programming, resources and equipment for this home. It is recommended that this facility conduct an evacuation exercise to assure that residents would be able to be safely removed in case of an emergency event.”
The bottom line is while there is some information on provincial nursing homes to be found if you have time and patience enough to ferret it out, it isn’t easy to come by.
There should be one central site where potential residents and their loved ones can read inspection reports and detailed audits, and the results of resident and family member surveys, so that people can make informed decisions about where to live.
As the Canadian Institute for Health Information noted in its 2013 report, “homes that use and share their quality indicators demonstrate to residents and families their continuing commitment to excellence.”
Seniors deserve easy access to all the information they need to make one of the most important decisions of their lives.
Don’t we owe it to them to provide it?
Next week: what we should do
Pam Frampton is a columnist and The Telegram’s associate managing editor. Email firstname.lastname@example.org.