The Inside Agenda Blog

Getting Long Term Care Right in Ontario - Part II

by Steve Paikin Thursday April 12, 2012

Last time, we outlined some of the issues facing the long-term care sector in Ontario.

Don Drummond, who headed the task force recommending how to get to a balanced budget, predicted the strain on our long-term care sector "is going to be incredible."

Guests at a conference mounted by the Ontario Long Term Care Association insist we need a more mature discussion about the end of life.

Something that other countries have begun to do, that critics say we're way behind on, is having the so-called "adult conversation about the end of life." A recent conference held by the Ontario Long Term Care Association didn't shy away from the issue.

"We need to have a broader dialogue about ageing," says Shirley Sharkey of St. Elizabeth Health Care, a non-profit organization. "The key is to feel more empowered about the end of your life. Your treatment. Your experience. Deciding on the kind of death you want should be a normal conversation. Right now, it's horrible."

Tom Closson, former head of the Ontario Hospital Association, and Shirley Sharkey, president and CEO of St. Elizabeth Health Care

Here's the math: 1% of our population uses 50% of our health care resources, according to Tom Closson, former head of the Ontario Hospital Association.

"And most of that happens close to the end of life," Closson says. "We have to do a better job making it a more pleasant experience."

And then Closson added the kicker: "The majority of the population agrees with euthanasia. It's the politicians that don't."

Closson recalled one case from Sunnybrook Hospital that ended up in the Supreme Court of Canada. A patient was in the final stages of life, suffering from Alzheimer's Disease, curled up in a ball, completely non-responsive. 

Sharkey with Don Drummond, former chief economist at the TD Bank and head of the special task force to balance Ontario's budget.

"The family insisted on keeping the patient hooked up to all sorts of stuff," Closson recalled. "It's a total misuse of resources."

"We got here because of the power of technology," adds Ron Sapsford, Ontario's former deputy minister of health, now the head of the Ontario Medical Association.

"It seems that death is not an option. Well, the health care system needs to lead a debate about this. Polticians can't."

Closson points out the obvious obstacle to any discussion about changing the way we treat patients at the end of their lives.

The recently retired head of the OHA, Tom Closson

"Twenty-five per cent of all hospital funding goes to Roman Catholic hospitals," he says. "They'd be totally opposed."

And so, the math continues to scream at us: Ontario has an aging population, doesn't spend enough of its health care resources keeping people well (as opposed to treating them after they're sick), and the last Ontario budget insists it'll hold health care spending increases to 2.1%, after typically increasing funding by anywhere from 5 to 10% per year for decades.

Without significantly changing the way we do business, it's hard to see how we avoid the looming crisis of trying to appropriately treat our parents and grandparents towards the end of their lives.

(PS: Our Sandra Gionas, who produces most of our health care programs, is pulling something together on this subject. Watch for it in the weeks ahead).