New Chatham care home likely to play larger health-care role: minister

A new, state-of-the-art Chatham long-term care home likely will play a larger role in local health care, an Ontario cabinet minister says.

Long-Term Care Minister Paul Calandra’s comments came at a July 24 groundbreaking for St. Angela’s Care Centre, a 160-bed long-term care facility that will replace the 99-bed Meadow Park Nursing Home.

“Long-term care can be so much more than it is,” Calandra said.

He envisions a time when care homes and home care work together, with people coming to these facilities for such things as blood work or scans, as opposed to going to a hospital.

“It’ll be an important part of rebuilding not only long-term care, but working with home care and transitioning to that Ontario team concept we have been talking about for a very, very long time,” Calandra said.

Dr. Dax Biondi, a Chatham doctor who treats long-term care patients, said, “One of the things we need to do in our health-care system is to provide the right care in the right place.”

Bringing medical resources to patients in long-term care has benefits, he said.

It can be a challenge to transfer some nursing home residents to hospital, because some have mobility problems or cognitive impairments, Biondi said. “It’s tough on them physically and mentally and emotionally to go through the process of being transported to the emergency room by ambulance.”

These patients then often face a long wait in the emergency department, where those with dementia can become agitated and anxious in an unfamiliar setting, he added.

“If you can provide care-in-place with personal support workers and nurses who know them, that’s very, very helpful for them,” Biondi said.

Dr. Doris Grinspun, chief executive of the Registered Nurses’ Association of Ontario (RNAO), said the organization has been pushing for these changes dating back to a 2016 report calling for allowing registered nurses to prescribe some drugs.

“Instead of sending (care home) residents for what we call ‘avoidable transfers’ to emergency departments, we should do all we can to treat them in-place, meaning in their home,” she said.

Registered nursing prescribing, which has been in place in the UK for 20 years, exists in many jurisdictions in Canada.

She noted nurses are trained to deal with common ailments, such as urinary tract infections, that routinely occur among long-term care patients.

The RNAO has begun an initiative to have a nurse practitioner available for every 120 long-term care patients, Grinspun said.

During the COVID-19 pandemic, nurse practitioners were allowed to serve as medical directors in nursing homes where the post was vacant, she said. “That should continue.”

She added the RNAO is thrilled Calandra is pushing for these kinds of changes in health care

Calandra said he’s heard from nurses in long-term care homes he’s visited across the province that they want to do the full-scope of their practice, including retraining.

“We’re going to look at that,” Calandra said. “We’re going to look at what our nurses do and what they can do and we’re going to ensure that they can practice the full scope of what they’re trained to do in our long-term care homes.”

Not only is Ontario spending $10 billion to build more state-of-the-art long-term care homes, but it’s also putting $5 billion into ensuring “we have the highest level of care in North America,” with four hours a day of care per resident.

That will mean bringing on 27,000 more health-care workers across the long-term care system, he said.

When it comes to the full scope of practice, Biondi said a value resource for him as a doctor is nurses’ skills in assessing such things as patients’ cognition or pain level.

Nurses will call him about patients and he trusts their assessment skills to be able to start things with a phone call, he said.

“Their ability to provide these assessments to make these recommendations, to initiate these treatments. . . allows me to do my job very well.”