Awaiting long-term care, patients find support on a special unit of a Dartmouth hotel

A temporary care facility in a Dartmouth, N.S., hotel that's meant to transition patients from hospital to long-term care is being called a success, with some health-care workers suggesting the model could be expanded.

That's even though the community transition unit at the Holiday Inn has seen only 12 patients so far.

Kitty Connell, the director and site lead for the Halifax Infirmary, said the hotel is a "great place" for people who need a certain level of care. "As they work with the recreation therapists and people at the hotel, they may gain some of that strength back and have more options of long-term care facilities," she said. 

The hotel offers patients single rooms with their own bathroom, television, telephone and mini-fridge. 

In early December, Nova Scotia's health authority announced a partnership with the Northwood continuing-care organization and the province to set up a 50-bed unit on two floors of the hotel. The estimated project cost is $2.5 million, according to the Health Department. 

The unit is staffed by workers from Northwood, and accepts patients who are waiting in hospital for placement in a long-term care facility. The patients, who the hospital system labels "alternate level of care" or ALC, do not need acute care but have needs that are too high for them to be discharged.

Connell said since December, 12 patients moved to the transition unit, and four of them have moved on to long-term care homes. Eight people were being cared for in the hotel as of Wednesday, with one more to arrive on Thursday.

Connell said the unit was originally set up for 50, because at the time there were about 160 to 170 ALC patients in hospital.

"But at the same point in time as we opened the hotel, the long-term care facilities were able to open their intake more," she said. 

Forty-two people have been placed directly from hospital into long-term care facilities, skipping the hotel altogether. This has left about 100 ALC patients in hospital, and some are being assessed to determine whether they can go to the hotel.

"That's pretty amazing. We weren't expecting that to happen at such a rapid pace," she said. "So if that hadn't happened we probably would have had more people at the hotel."

During the first wave of the pandemic, nursing homes were permitted to keep some beds empty while retaining their per-day funding rate. That was meant to give homes more space to deal with COVID-19. 

However in September, the Department of Health sent a letter to nursing homes telling them they could only keep up to three per cent of beds empty, and the rest had to be filled. 

At that time, the Health Department said there were 447 vacant long-term care beds across the province.

Call for more units 

Janet Hazelton, the president of the Nova Scotia Nurses' Union, represents some of the Northwood staff who are working at the unit. 

"They're accustomed to looking after seniors, so it's a really nice fit," she said, adding that she's hearing "really good things" about the hotel unit.

"I'm hearing that the families are really enjoying it. I know that the nurses that we represent are liking it and feel that the care that's being provided is very good."

The transition unit at the Holiday Inn was designed to be a temporary measure and is only leased until the end of June. 

Hazelton said she believes transition units should be set up more permanently around the province. She said hotels might be a good place right now, although they could be inappropriate in the long run. 

"I think they should be in every region, because regardless of how many beds we get over time, we're still always going to have that person who has to transition from hospital to long-term care," she said. 

Connell does not know whether the Holiday Inn unit would be extended beyond June but she said it could be worthwhile. 

"I believe that if we could get this working with more clients going through the hotel, then I do believe it's a worthwhile project," she said, adding health officials have been looking at using the model in northern Nova Scotia.

Ellen Rudderham-Gaudet, a member of a citizens group called Nova Scotians for Long-term Care Reform, said she thinks the transition unit makes sense, but is only part of broader changes needed in long-term care. 

"I think temporarily this is a good idea, but at the Holiday Inn they don't have the equipment, they can't do specialized care. Baths, for instance. So that has to be temporary," she said. 

Rudderham-Gaudet said her group hopes to meet with incoming premier Iain Rankin to offer him a perspective on the long-term care system.

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