Is it safe? 5 questions when looking for long term care

As it wraps up its fourth week of hearings, the Wettlaufer inquiry in St. Thomas is causing many people to question the safety of Ontario's long term care homes. 

"What the Wettlaufer inquiry is doing is putting the face of a serial killer on an issue that's already terrifying to people," said Laura Tamblyn Watts, national director of law, policy and research with Carp, an organization that bills itself as the country's largest advocacy association for older Canadians. 

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While she said she has always received periodic calls from people concerned about the quality of long term care, in the past four weeks she's been fielding calls every day from people who are both concerned and referring to the inquiry. 

"Some of that is really quite legitimate and some of it is just a lack of information," she told CBC News. 

"Many Canadians are getting excellent quality of care, but what we know is the long term care system by its nature right now has a long way to go in terms of getting better."

Devastating, but unpredictable

Due to the high profile of the Wettlaufer case and now the inquiry, Tamblyn Watts said some people are concerned that something similar might happen to their own loved one in long term care. 

To quell these fears, she recommends taking a deep breath. 

"Recognize that the Wettlaufer inquiry is a unique situation of a serial killer and it's certainly not the norm in terms of long term care homes," she said.

Andrew Costa, Schlegel chair in Epidemiology and Aging at McMaster University, referred to the Wettlaufer case as a natural disaster: devastating, but unpredictable.

"There's no mechanism to be able to know that in advance," he told CBC News. "It's not something you can control against."

Website a starting point

But Tamblyn Watts and Costa agree that there are many other things a family can learn before making a choice about long term care. 

One helpful tool is the website yourhealthsystem.ca (external link) developed by the Canadian Institute for Health Information. 

I don't think very many people know that it's there. And, yes, it's limited, but it's not bad, and it's fairly useful. With a little bit of experience you can start figuring it out.- George Heckman, Research Institute for Aging

The online database allows Canadians to search for any long term care home in Canada, and see how that home compares with regional, provincial and national averages on a range quality of care indicators — everything from inappropriate use of anti-psychotic drugs to the mental health of residents.

Data on the site are mathematically adjusted so homes that take in patients with simple needs don't skew to look better than homes that take in patients with more complicated needs. 

"I don't know that people know this [site]," said Dr. George Heckman, Kitchener geriatrician and the Schlegel research chair in geriatric medicine at the University of Waterloo's Research Institute for Aging.

"I tell everyone that I know and everyone thinks that it's really cool," he said, "but I don't think very many people know that it's there. And yes, it's limited, but it's not bad, and it's fairly useful. With a little bit of experience you can start figuring it out." 

While he does stand behind the site, Heckman admits it's only a good first step. It doesn't replace visiting the home and asking questions. 

What to ask when you visit

When visiting a long term care home, here is a short list of expert-suggested questions to ask:

• How many staff will be available to care for my loved one? You will also want to ask about staffing on evenings, weekends and holidays.
• How long have you worked here? This is a question to try on a few different staff. If the home is retaining staff, that could be a good thing.
• When do you use anti-psychotic drugs? You want to be cautious about homes that say they need to put many older adults on these drugs to keep them calm.
• Do you have behavioural supports for people with dementia? These are important supports for reducing violence in long term care homes, and keeping people with dementia and cognitive impairments safe.
• Who is your house doctor and how often does he or she visit? When your loved one moves into long term care, he or she will likely have to give up his or her family doctor, so you want to know who the new doctor will be.

After asking questions of the staff, experts suggest finding a few residents and asking them what life is really like at the home. 

This is not only the best way to find out if the home is a good and safe place to live, but also whether it will be a good fit for you or your loved one.