Woman loses her care bed while in hospital
by Darrell Bellaart, The Nanaimo Daily News
The fatigue shows on Jane Clarkson's face as she puts an arm around her 91-year-old mother, Violet Ferguson.
Violet has spent more than a month in a 90-square-foot room on the third floor of Nanaimo Regional General Hospital. A large window facing the west hospital grounds is the only visual relief in a stark room occupied by Violet's small bed, dresser, a commode and an eating tray. For Violet, the hospital room feels like prison.
"It's rotten," she says. "There's not enough room."
Ferguson is waiting to be assessed and placed in an affordable, appropriate nursing home space. But the wheels of the health-care system can turn slowly, and it could be months before she is moved from the hospital into her new home.
Her situation illustrates a growing reality for many nursing-home residents who get ill and need to move from one level of care to another.
Ferguson's family is discovering that the process of caring for their aging loved one is far from simple, as they and health staff try to balance the ever-changing needs of Ferguson and hundreds of other Island seniors, most who also must worry to some degree about the growing cost of care.
Ferguson was hospitalized on July 1. Against the predictions of doctors, her condition stabilized in August. But by then her subsidized bed in a Qualicum Beach assisted-living facility was no longer available. On Sept. 19 she was moved to the tiny hospital room, where she gets quality care but not the quality of life she could have in a nursing home.
Ferguson, who has early-stage dementia, is growing more confused in the cramped room. She can't understand why she can't go back to her Qualicum Beach nursing home.
Unable to walk more than two or three steps at a time, Violet no longer gets the socialization she needed to stay stimulated in a nursing home environment.
"Her delusions are getting worse, because she has no one to deal with," Jane Clarkson said.
Ferguson has been assessed for a higher level of care, but no subsidized rooms are vacant in the region. There are currently 283 people awaiting publicly funded beds in the Central Island region, and caregivers have told her daughter it could be another month before a bed is found.
Violet could move into a private facility, but her daughter worries it will drain her mother's life savings.
It will soon get more complicated. Last week Health Minister Kevin Falcon unveiled a new, stepped, care rate structure that would mean 75% of clients will pay more for care.
It's yet another worry for Clarkson, as she awaits a bed opening for her aging mother. Her mother's subsidized room at Gardens at Qualicum Beach cost $1,100 a month.
"You could pay a lot more and put her in a nursing home room. At $5,000 a month, my mother's money would last less than two years," Clarkson said.
After more than a month of frustration, the family took its concerns to the public.
"We've talked to everyone we can think of," said John Clarkson, Jane's husband. "Finally it was suggested by people in the health system to go to the media."
Meeting the constantly changing needs of aging seniors is a growing challenge for the Vancouver Island Health Authority.
In Nanaimo Lois Cosgrave is director of Home and Community Care, a VIHA agency that works to connect patients with resources. The Clarksons' situation isn't that unusual.
"There is a growing population of people in this age group with complex and numerous problems that make them frail, all over Vancouver Island," Cosgrave said.
"They get ill and they go to hospital."
An assessment includes both their physical health and financial capability.
"If someone is currently in hospital they are typically contacted by a social worker in the hospital, who starts to have discussions with them about options, then they are referred to home care. If they are in the community, we have central intake services."
The waiting is taking a toll on Ferguson and her family, who are growing increasingly frustrated.
"The issue also is we know for a fact there are empty beds in Stanford Place in Parksville and there are empty beds at Gardens at Qualicum Beach," said Jane Clarkson. "I understand there are also empty beds at Trillium Lodge in Parksville."
Of 180 complex care beds at Stanford Place, 140 are government subsidized. All are fully occupied. Thirty of the 40 unfunded beds are empty. The Gardens at Qualicum Beach has 85 funded beds, which are all occupied. That facility has "two or three" unfunded beds available, a staff member said.
The daily rate at both facilities is $180. VIHA currently pays 85% at Stanford; at the Gardens the patient's portion of the daily fee is between $30.90 and $74.30. Trillium Lodge would not confirm whether the facility had any openings.
The daily cost of care-home beds is considerably less than the cost of an acute-care bed, estimated at $985 a day. Nanaimo MLA Leonard Krog said the difference in cost could be put to better use in a health-care system suffering with budget shortfalls.
"It becomes crazy, then you back up the hospital with people who don't need that level of care and you can't get people in the hospital for the care they need," said Krog.
In January most nursing-home patients will start paying more for their care. Patients with the lowest income will get a 5% cut, but everyone else's rates rise. The cut affects only those earning less than $14,034 a year, a $46 reduction. But those earning up to $22,000 a year will pay 13% more, up to $1,392. Higher income earners face a 9% rate increase, to $1,815 a month.
Announcing the new formula, Health Minister Kevin Falcon said it is more equitable, and protects those who need care the most. Meanwhile Clarkson grows increasingly frustrated watching her mother's condition worsen in what she now calls the "broom closet" at NRGH.
"If my mother could afford $5,000 a month, she could have a bed tomorrow... I just want her out of that room."
