A program pioneered by community paramedics in Renfrew County is being adapted province-wide to help people waiting for long-term care to stay safely in their homes.
Ottawa and Renfrew County are among five communities across the province that will be part of the first phase of the new Community Paramedicine for Long-Term Care program announced by Long-term Care Minister Dr. Merrilee Fullerton Friday.
In addition to Ottawa and Renfrew County, programs will be set up in Brant County, Cochrane District and York Region, all of which have significant waiting lists for long-term care beds.
The new program will build on existing community paramedic programs, offering 24/7 access to health services and ongoing monitoring for those at highest risk, among other things.
In Ottawa, where 27 community paramedics have been working in long-term care homes and with the elderly, it will allow up to 200 people waiting for long-term care to be monitored 24/7. That is just a fraction of the 2,288 people waiting to get in to long-term care beds, though.
Mayor Jim Watson said the program will allow people in the community to receive the same level of care in their homes as they would receive in long-term care.
Ottawa is one of the communities in the province with the longest waits for long-term care, a chronic issue that has been compounded by the pandemic. Ottawa’s hospitals are also dealing with high occupancy rates, crowded emergency departments and high numbers of patients waiting for long-term or alternative care.
Long wait lists for long-term care beds are a problem in Ontario that has worsened significantly during the pandemic as homes closed down multi-bed wards and stopped admitting residents in an effort to control outbreaks.
That has resulted in an explosion of patients in hospitals who need a bed in long-term care or extra support to return home. In Ottawa, many of those so-called ALC (alternate level of care) patients have been or are about to be moved to temporary hospital wards in a hotel and a retirement home.
There are also growing numbers of people waiting in their own homes until a space comes up in a long-term care home. They are often frail and have complex health issue, which means they frequently end up in hospital emergency departments. Province-wide, more than 38,000 people are on wait lists, although the true number is likely higher.
The $5 million pilot program will initially target five communities across Ontario that have long wait lists and community paramedic programs in place. It will allow monitoring of around 200 patients per community, said Fullerton. It is expected to be expanded to other communities.
The long-term care-focused provincial program is modelled, in part, on a program that has been in place in Renfrew for more than a decade. Other communities, including Ottawa, have community paramedics programs in place.
The Renfrew program has reduced 911 calls among high-needs and vulnerable residents living in their own homes by 60 per cent. The program provides those residents 24/7 access to a designated community paramedic who can provide everything from flu shots to remote patient monitoring, intravenous fluids and ultrasound in the patient’s home. The paramedics work with family doctors and home care nurses.
Renfrew Paramedic Chief Mike Nolan said although the program is targeting people who are waiting for long-term care, it aims to help them remain in their own homes.
“We don’t have enough long-term care beds in the province. We are never going to have enough long-term care beds in the province. How do we actually do better by using that money and keeping people where they want to be instead of putting all of the investment into building buildings and almost encouraging people to end up in institutional care, when really what they want is to be able to stay home safely as long as they can.”
In Renfrew County, palliative care is part of the job of community paramedics. The new funding will allow it to more than double the number of community paramedics — from the current five to 11.
Many communities around Ontario, including Ottawa, have increasingly relied on community paramedics in recent years. In Ottawa, community paramedics have assisted in long-term care homes and done short-medical management of vulnerable patients, in some cases. The new program will expand the numbers and scope of what they do, specifically targeted to those on a long-term care waiting list.
Renfrew’s community paramedic program has been watched and studied by people throughout the province and around the world as a means of helping people stay in the community and out of hospital or long-term care.