Friday’s Globe and Mail ran an excellent article on the challenges faced by older adults in Ontario who wish to “age in place.” Many use this phrase to describe the aspirations of adults who wish to remain living independently at home for as long as they possibly can. The reality is that aging in place is often the unwanted outcome of the absence of adequate retirement homes or long-term care beds, as many older adults are discharged from hospital to home without the proper supports required to permit them to safely and comfortably “age in place.”

The following excerpt from the article by Kelly Grant and Elizabeth Church aptly summarizes the factors resulting in the increasingly difficult decisions families in Ontario must make in order to care for older family members:

More aggressively than any other province, Ontario is shifting health care out of hospitals and long-term-care facilities, and into people’s homes. It now has the fewest hospital beds per capita of any province in Canada – if Ontario were a country, only Chile and Mexico would rank lower in beds per capita among the 34 nations of the Organization for Economic Co-operation and Development.

In a cascade effect, the resulting spike in demand for home care is leading some cash-strapped community-care centres to change assessment standards, reduce services and cut clients off. In some cases, the CCACs are pressuring reluctant patients and their family caregivers to dress wounds, change intravenous medicine bags and perform other medical tasks in a bid to cut back on expensive in-home nursing visits. Meanwhile, more than 4,500 people across the province are languishing on waiting lists for publicly funded personal-support services in their homes – some of them high-needs patients.

The result is a perverse “postal-code lottery” in which Ontario patients win or lose for no reason other than their addresses and how generously their local agencies are funded – funding rates are different for agencies across the province – according to Samir Sinha, director of geriatrics at two of Toronto’s largest hospital networks. He was also a member of an expert panel that earlier this year excoriated the province for its approach to caring for people in their homes.

The haphazard system has left patients and their overburdened caregivers struggling to understand why they cannot get the care they need at home, especially when Premier Kathleen Wynne and Health Minister Eric Hoskins, himself a doctor, repeatedly trumpet their efforts to anchor Ontario’s health-care system in homes and communities, not institutions.

Kudos to the Globe for an excellent, in-depth discussion of an issue that every one of us will face over the next 20 – 30 years as the baby boom generation ages in the absence of adequately funded health care and social supports.