WRHA trying to avoid hospital stays for patients about to enter long-term care

Winnipeg health officials are trying to reduce the number of seniors in hospitals by keeping them home longer — but critics question if there's enough home care staff to accommodate more clients. 

The Winnipeg Regional Health Authority has embarked on a new initiative to ensure 60 per cent of new residents arriving at personal care homes come directly from home, as opposed to hospital.

Right now, the majority of care-home residents are transferred from a hospital bed. 

"The goal is to have clients supported in the community for as long as safely possible prior to admission to [personal care homes]," Gina Trinidad, community and continuing care regional lead, wrote in a July 25 memo obtained by CBC News. 

Trinidad said keeping patients at home longer will prevent "avoidable hospitalization" before people are admitted into a personal care home.

She also said the move will stop the "premature placement" of some residents into care homes. 

Most PCH admissions come from hospital

The WRHA calls the initiative "the 60/40 Project" to account for the 60 per cent of admissions they want coming from the community, versus the remaining 40 per cent from hospital.

Winnipeg's hospitals have a long way to go. On average, from 2019 to 2021, eight to 10 people were moved every week from their home to a personal care home, compared to 22 to 25 being transferred from a hospital.

Since the implementation of the 60/40 Project in June, 32 per cent of clients have been transitioned from home to a care-home bed. That's a comparable percentage to previous years.

"A system-wide commitment to the 'home is best philosophy' will result in better care for clients and improved system access and flow," the memo reads.

An advocate for retirees worries the province is offloading the problem of overburdened hospitals to the community, rather than eliminating it.

"It's not just a matter of keeping [seniors] at home because they want to be," said Carmen Nedohin, vice-president of the Winnipeg branch of the Canadian Association of Retired Persons.

"They have to be safe. They have to be comfortable. Their health and well-being has to be tantamount."

The leaked memo acknowledges a "reinvigorated commitment to the home is best philosophy may bring concern with respect to existing workload challenges" for community health services staff, particularly home care workers.

Trinidad does not explain how the WRHA will address this challenge. She says management is listening to concerns from staff.

Nedohin said she expects elderly Manitobans to suffer because a greater burden has been placed on a home care sector that's already dealing with high vacancies and five years of frozen pay.

"Why is it on the back of seniors?" Nedohin asked.

"A senior who maybe does need hospital care in the interim, but they're going to be dependent on home care that may or may not be adequate for them."

CUPE 204 president Debbie Boissonneault was a health-care aide before becoming president of the union representing home-care workers and other health-care support workers. 

She said in her former role, she often saw families bring their elderly loved ones to hospital after exhausting all other home-based options for care. 

Home stays not ideal if care insufficient: CUPE

"Any time we can keep someone at home that's well looked after and cared for, then that is an ideal thing," she said. "But if you don't have the proper care provided to them, I think we need to achieve better home care so that these people can stay in their homes."

She questioned how families would find enough home care staff, since workers are so scarce.

The memo also states hospitals would reinforce the practice of assigning patients to the first available personal care home on an interim basis, before their preferred choice of care home becomes available.

NDP health critic Uzoma  Asagwara worried this could result in more Manitobans being sent hundreds of kilometres away from home.

"My initial reaction when reading the memo actually was that it sounded a lot like they're treating their seniors like a set of targets."

The WRHA's Trinidad was unavailable for comment Friday and Monday.