More than a year after his scathing report called for an overhaul of New Brunswick’s long-term care sector, Child, Youth and Seniors Advocate Kelly Lamrock said he remains concerned about a lack of standards for what is — and isn’t — acceptable.Lamrock released a monitoring report at an event in Fredericton on Wednesday, which was National Seniors Day, to outline how the provincial government has applied recommendations from his 2024 report.That document was titled “What We All Want — A Review and an Urgent Proposal for Change in New Brunswick’s Long-Term Care System.”He said there have been positive strides when it comes to accountability, the use of data, and an openness to protect whistleblowers. He also welcomed a reduction in paperwork for families, and a commitment to a new Long-Term Care Act. WATCH | Dornan likes ‘challenge’ of accountability:Dornan responds to advocate’s push for more flexibility on ALC placementsSeniors’ advocate Kelly Lamrock wants other options explored before an alternative-level-of-care patient gets a hospital bed, and he says a senior official should be the one signing off on admissions.But he said there are still areas of disagreement where he invites the departments involved to come back to the table. One example is people living in alternative level of care situations, usually in hospitals, who are often referred to as ALC patients.”I’m a little concerned by the lack of standards of care for people who are in hospital who should be in long-term care,” he said. “Even though they’re waiting, there hasn’t been enough to ensure that there are practice standards…”If this is going to be something that we accept we’re going to live with for a while, and the government’s goal is to simply freeze it where it’s at, at best, then there needs to be things to improve some of the quality-of-life issues that we identified in the first report.”Community-based supports urgedLamrock said the province needs to create capacity in community–based ways, with the least restrictive level of care possible. That ensures privacy, autonomy and dignity for everyone in need of support, he said. According to the National Institute on Aging, 85 per cent of Canadians want to remain in their home as they age, with only five per cent wanting to move into long-term care. Keeping people in their homes is also the more affordable option, which is part of the reason Lamrock finds it frustrating to see governments resist those up-front investments. “We always seem to say: ‘We don’t have the money to fix the problem now, but when it all blows up in 20 years, we’ll find 20 times as much money,'” he said.”Think of all the choices … that we are now making desperately,” he said, pointing to the millions of dollars spent on travel nurses at a time when the urgent-care system is overloaded with long-term care patients. We always seem to have money to do the stupid thing out of desperation late, but we never seem to find the money to do the smart thing early…— Kelly Lamrock”We always seem to have money to do the stupid thing out of desperation late, but we never seem to find the money to do the smart thing early — and to find a way to analyze that.” The monitoring report says the document is not about fault-finding, but rather an opportunity to question whether recommendations have moved “from acknowledgement to action, and from crisis management to prevention.”A panel of experts discussed the challenges facing long-term care in New Brunswick at an event in Fredericton Wednesday. (Allyson McCormack/CBC)Lamrock said in his report that it was reassuring to see the Department of Social Development has dedicated resources to address the recommendations, including a tracker to itemize each point and assign the responsible team, follow progress and identify any remaining gaps.He said he acknowledges a new Long-Term Care Act will take time, but he hopes the government will find ways to address some of the administrative and common-sense recommendations now. “When we’re very young and when we’re very old, we are heavily reliant upon others to meet some of the most basic questions of how we live day to day,” he said.”It can be disconcerting when government doesn’t have its act together. And I think there’s anxiety because people don’t see that yet. And hopefully we can get there.”Need to age with dignity recognizedHealth Minister Dr. John Dornan was at Wednesday’s event. He said he recognizes the need for New Brunswickers to be able to age with dignity, noting that a hospital room is not the best way to provide long-term care. Health Minister Dr. John Dornan describes what he sees as the ideal way to age: ‘I imagine being treated at home for as long as I can, then having other support in the home, then eventually a special-care home or a nursing home.’ (Allyson McCormack/CBC)”I am embarrassed that we don’t give people a respectful level of care, but it takes groups working together to do that,” he said. “I don’t imagine my future sharing a room with two other people,” he added. “I imagine being treated at home for as long as I can, then having other support in the home, then eventually a special-care home or a nursing home.” When you get to a point where the percentage of alternate level of care patients is so high that we can’t do surgeries, we can’t treat people in emergency departments, that becomes an acute-care problem.— Dr. John Dornan, N.B. health ministerDornan said he would like to see the number of people in acute-care beds at somewhere between 20 and 30 per cent.”When you get to a point where the percentage of alternate level of care patients is so high that we can’t do surgeries, we can’t treat people in emergency departments, that becomes an acute-care problem,” he said. Dornan said his department is committed to coming up with a plan to reduce the amount of time seniors are spending in hospital as acute-care patients, with a focus on getting them back into the community.”I think as a government, we need to recognize this,” he said. “We will need to spend money on giving respectful, appropriate care at the right place at the right time.”Institutionalized care a last resortInclusion N.B.’s Danny Soucy was a panellist at the event, and said institutionalized care is not the answer for everyone. Instead, it should be used as a last resort, he said. “Creating big, monstrous buildings is not the answer,” he said. “We’re not going to be able to afford all the beds that are needed. We need community to be part of the solution.”Danny Soucy said a person-centered approach will be especially important for aging individuals with intellectual developmental disabilities. (Allyson McCormack/CBC)Soucy said the province needs to look at engaging everyone in the community — friends, family and neighbours — to support people living where they want to be, which is in their own homes.”We see communities that do that on a regular basis. Why can’t we do it here in New Brunswick? And I think it’s making sure that we talk about it and that we test things out — like, maybe we pilot things — but we need to think totally differently than what we’ve been thinking before.” Among other things, the report recommended that someone at the senior level have to sign off when someone is admitted into a facility.Soucy said that person-centred planning will be especially important for individuals who are aging with intellectual developmental disabilities, guaranteeing real choice for people. “One of the things that I’m looking forward to in the next year is that we stop placing individuals who have intellectual developmental disabilities in nursing homes and in special-care homes just because there’s an empty bed,” he said.”We need to look at what their desires are, how they want to live their life, who they want to live their life with, and make sure that that’s happening.”
No standards for what’s acceptable in New Brunswick long-term care, advocate says
