'Dire' home-care gap stranding discharge-ready patients in hospital
Without personal support workers to care for them, some patients can't return home
Christine Benoit has been told four times she's medically fit to be discharged from Ottawa's Saint-Vincent Hospital, but each time has been forced to stay because of a shortage of personal support workers (PSWs).
Benoit, 43, was diagnosed with multiple sclerosis 15 years ago and has used a wheelchair for the last decade. Before being admitted to hospital in June 2017, two PSWs came to her home three times a day to help with life's necessities, from getting out of bed and dressed in the morning to cooking dinner and getting back into bed at night.
Without their help, Benoit can't return to her apartment for more than a couple hours at a time.
"I feel guilty because I know there is a person who really needs my [hospital] bed, and I know I'm taking it from them," she said.
Benoit underwent surgery to ease leg spasms in October 2017, and after five weeks' recovery was transferred to Saint-Vincent Hospital.
In August, she was told she was well enough to go home.
"I was ecstatic," Benoit recalled.
The celebration was short-lived, however: she was soon told she couldn't return home after all because there weren't enough PSWs to continue caring for her.
The news was "disheartening," Benoit said. "I felt like a third-class patient."
Each Thursday, Benoit takes ParaTranspo from the hospital back to her ground floor apartment in a Kanata co-op, where she has just enough time to check her email and have tea with a neighbour before she has to go back. It's a moment of necessary respite.
"In the hospital there are people screaming and banging, and you can't get away from it," she said.
Benoit is also concerned she'll lose the subsidized apartment if she doesn't make the regular appearances.
Dire shortage of PSWs
According to the Champlain Local Health Integration Network (LHIN), which oversees home-care services in eastern Ontario, the daily cost of Benoit's hospital bed is $563. For an acute care bed, that cost rises to about $1,000.
The average daily cost of home care is just $28 a day, although the level of care Benoit requires would likely cost more.
But without available PSWs to provide the care, the cost is academic. LHIN CEO Chantale LeClerc described the shortage of PSWs, which has intensified over the past few months, as dire.
"I can only imagine her frustration," LeClerc said of Benoit's predicament. "It's depriving them of the need to be home with loved ones, pets, and getting on with their lives."
There's nothing to gain anywhere in the system from keeping them in hospital.- Chantale LeClerc, CEO, Champlain LHIN
Those prolonged hospital stays aren't just frustrating — they're also costly, and they're keeping needed beds tied up unnecessarily.
"There's nothing to gain anywhere in the system from keeping them in hospital," LeClerc said.
LeClerc said there are at least six other patients in the same situation as Benoit.
Amy Porteous, vice-president of communications, planning and family medicine at Élisabeth Bruyère hospital, which oversees Saint-Vincent Hospital, agrees the situation is untenable.
"It is in our vested interest that we work with our partners because of the dire situation we're in. No one should be put through this," she said.
A working group struck by the LHIN is looking at potential solutions such as improving working hours for PSWs who work split shifts.
Two of the larger agencies that provide the home-care workers are trying to attract new recruits by offering signing bonuses.
In the meantime, after 18 months Benoit said she's growing tired of hospital food and longing for a good steak cooked medium-rare.
"I feel very hopeless," she said. "They know I am determined and I will do everything I can to go home, but I'm not sure how much fight I have left in me."