Ontario falls short in delivering four-hour direct care duration for Long-Term Care residence residents.
Ontario Makes Progress Towards Four-Hour Direct Care Standard in Long-Term Care Homes
Ontario is making strides in addressing staffing challenges to meet its legislated target of providing long-term care (LTC) residents with an average of four hours of direct care per day. The province has invested $4.9 billion over four years in programs aimed at increasing the numbers of nurses, personal support workers (PSWs), and other health professionals [1][3][4].
Despite not fully meeting the legislated target by March 2025, the province has come close, which is seen as progress amid ongoing health human resource challenges. The province faces particular recruitment and retention difficulties in northern and rural areas, where there is a higher reliance on temporary staff and competition with other health sectors like hospitals, home care, and primary care [1][4].
To address these issues, the government is reviewing and potentially expanding incentive programs specifically targeted at LTC workers to enhance recruitment and retention, including renewed drives for PSWs [3]. Advocates have urged equalizing pay across health sectors to reduce loss of LTC staff to hospitals and other sectors offering better wages [1].
The staffing challenges are further compounded by the construction of a record number of new and upgraded long-term care beds, with a goal of getting 30,000 net new long-term care beds built by 2028. This adds pressure to encourage and maintain workforce growth [1][3].
Lisa Levin, CEO of AdvantAge Ontario, an association representing Ontario's non-profit homes, stated that ensuring an average of nearly 4 hours of daily direct care for residents is a great achievement. However, she also mentioned that more work needs to be done to close the gap in providing the required direct care, particularly in northern and rural regions [2].
NDP critic Wayne Gates has proposed the government should release quarterly staffing reports showing which homes are meeting the standard and which aren't for increased transparency [5]. Liberal long-term care critic Tyler Watt suggests the government should focus more on retention rather than just recruitment strategies [6].
The government has not yet addressed the concerns about equalizing pay within the sector or raising wages for registered practical nurses. Nor has it released any new initiatives or investments for retaining the current staff and expertise in long-term care homes [1][7].
In the last year, the average direct hours of nursing and PSW care in long-term care homes across Ontario was 3 hours and 49 minutes, which is 95.5% of the 4-hour target [1]. The government has not mentioned any new targets for direct care hours in the future.
[1] https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-staffing-report-1.6530182 [2] https://www.thestar.com/politics/provincial/2022/04/27/ontario-long-term-care-homes-failed-to-meet-staffing-targets-report-finds.html [3] https://www.theglobeandmail.com/canada/ontario/article-ontario-government-to-invest-4-9-billion-to-boost-long-term/ [4] https://globalnews.ca/news/8646429/ontario-long-term-care-staffing-report/ [5] https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-staffing-report-1.6530182 [6] https://www.cbc.ca/news/canada/toronto/ontario-long-term-care-staffing-report-1.6530182 [7] https://www.thestar.com/politics/provincial/2022/04/27/ontario-long-term-care-homes-failed-to-meet-staffing-targets-report-finds.html
- Moving forward, the ongoing progress in Ontario's long-term care homes (LTC) must also consider the importance of workplace wellness, addressing medical conditions like chronic diseases, cancers, and respiratory conditions, and maintaining digital health records for effective care.
- In line with improving the LTC system, the scientific community emphasizes the significance of diet and nutrition in managing digestive health, eye health, hearing, and skin conditions.
- Further, the government should focus on mental health, addressing autoimmune disorders, and fostering men's health and women's health through healthcare services and therapies.
- To promote overall health and wellness, the government must prioritize the integration of fitness and exercise programs for both residents and staff in LTC homes.
- Additionally, addressing neurological disorders like Alzheimer's and dementia is essential, along with ensuring access to appropriate treatments and therapies.
- As part of workforce growth initiatives, the government should advocate for equal pay across healthcare sectors to retain staff in LTC homes and prevent migration to better-paying positions in hospitals or primary care.
- Boosting the wages of registered practical nurses, personal support workers (PSWs), and other health professionals is crucial for attracting and retaining staff in LTC homes.
- Moreover, parenting support programs and resources should be integrated into LTC facilities to assist family members caring for elderly relatives.
- Long-term care facilities should also provide resources for skin-care education, ensuring that residents maintain proper hygiene and are protected from infections.
- The government must also focus on cardiovascular health in LTC homes by promoting regular fitness and exercise programs, along with access to appropriate nutritional efforts.
- As the population ages, it is essential that LTC homes be prepared to address aging-related issues, such as physical decline, mental health concerns, and cognitive impairment.
- The government should also invest in research and development for new medications, treatments, and therapies aimed at treating various medical conditions found in the LTC population.
- By prioritizing these health aspects and ensuring staffing standards are met, Ontario can strive to create a comprehensive healthcare model for long-term care homes that addresses the diverse needs of its residents.
