Long wait times in nursing homes in the Toronto area targeting cultural groups reflect the need for more of them, the report says

Lily Wong was admitted to the Yee Hong Center for Geriatric Care in Toronto at the age of 88, several years after she suffered a stroke that severely affected her short-term memory, ability to follow conversations and her balance.

The waiting time to enter the long-term nursing home was nine to ten years, but Wong was hospitalized at just under seven.

“Which was super fast,” said her son, Tony Wong.

It’s been two years since she was admitted, and Lily Wong is happy to live in a home that meets her cultural needs, her son said. It is also a relief for her children.

“If you can walk into a nursing home environment that speaks your language, that has culture-specific activities that have food that you remember, it’s just a massive weight,” Tony Wong said.

“It’s just an incredible thing to be able to experience.”

A portrait of Lily and Tony Wong was part of an exhibition of residents and their children at the Yee Hong Center for Geriatric Care in Toronto. (Onnig Cavoukian)

Part of the reason for the long wait is that the Yee Hong Center for Geriatric Care is one of the few culture-specific homes that caters to the Sino-Canadian community in Toronto and the surrounding areas.

Experts say that culture-specific nursing homes have some of the longest waiting times for long-term care. A study by the Wellesley Institute, a nonprofit working in health research and policy, found that more than half of the top 20 homes in the Greater Toronto area with the longest waits are culture-specific nursing homes, reflecting the need for such facilities.

“Demographic change has [driven] the growing demand for such care, “said Seong-gee Um, a researcher at the Wellesley Institute.

“It is really crucial for the system to adapt and evolve and reflect the diversity of its current and future residents.”

Longer waiting time

What’s more, in 2017/2018, those who want to live in culture-specific nursing homes had to wait an average of 246 days longer than those waiting for an ordinary home, even when they had the same needs.

These longer waiting times can have health consequences for older adults awaiting long-term care.

“We know that [are] different health outcomes for people coming from different communities, “said Ashley Flanagan, a fellow whose work focuses on gender identity and aging at the National Institute on Aging, a think tank about getting older in Canada.

“Whether it’s waiting lists to access a culturally appropriate home, [that] tend to take longer to be recorded. Therefore, you see declining health and not [being] able to access care. “

A resident shows off a Chinese New Year’s craft at the Mon Sheong Private Care Center in Markham. (Posted by Mon Sheong Foundation)

Stella Lang, senior administrator at the Mon Sheong Long-Care Center, which has four locations throughout the Greater Toronto area, said something as simple as the language spoken by those caring for residents is important.

Having healthcare providers and staff who can serve patients in Mandarin or Cantonese is important for residents who may have lost the ability to speak English in their old age, a common scenario for residents with dementia, Lang said.

The staff can even help translate to residents whose first language is Chinese and family members who may be second generation Canadian and therefore understand English better.

“That’s why they do not feel so isolated and they do not get too much depression,” Lang said.

While the appreciation of culture-specific homes is obvious, there is not enough to meet the level of demand throughout the province according to Ontario’s final report on long-term care COVID-19 Commission, which calls for more culture-specific homes to meet the needs of Ontario’s diverse population.

‘Developed by the communities’

Culturally specific homes generally offer a high standard of care, in part because of their funding structure and community support, according to AdvantAge Ontario, a law firm dedicated to promoting senior care.

“They are developed by the communities for the community,” said Lisa Levin, the group’s CEO.

Community integration is integrated into their structure because that is how most of them were founded. What’s more, the boards that run the culture-specific homes are representative of the community they care for.

“So that means the philosophy of care, the approach to care, the language of care … the food, the traditions, the festivities, the volunteers, they are all culturally appropriate,” Levin said.

A community group visits Mon Sheong Home for The Aged in Toronto to celebrate the Chinese New Year in February 2021. (Posted by Mon Sheong Foundation)

Culturally specific nursing homes also tend not to be for profit, which advocates for the elderly believe play a major role in residents’ health and well-being due to how they are run.

All long-term care homes in Ontario receive the same funding formula from the province, which provides enough 2.75 hours of direct care per. Beboer pr. Day.

Culture-specific nursing homes and municipally funded homes tend to subsidize care further, says Dr. Samir Sinha, Director of Geriatrics at Sinai Health, an academic health science center in Toronto.

“Often they will fundraise, they will have galas, make back sales, they will make a whole lot of fundraising efforts where the community invests extra dollars to create nicer facilities beyond what the government will fund,” Sinha said.

In addition to government funding, AdvantAge Ontario reports that nonprofits and municipal nursing homes annually contribute more than $ 300 million in additional funding in Ontario alone. This extra money goes to pay staff better salaries and to the facilities themselves, which contributes to a higher standard of care, according to AdvantAge.

Great demand, but lack of supply

While there is little data specifically looking at the health of elderly people in culturally appropriate care, both staff and children of residents at Mon Sheong Long-Term Care Center and Yee Hong Center for Geriatric Care support the notion that the elderly do better when they get it.

For example, residents at Mon Sheong Long-Term Care Center serve well-known dishes such as congee for breakfast. As they enjoy the food, they are more likely to eat it, providing better nutrition and improving overall health, Lang said.

Despite the overall psychosocial and physical benefits, there are major differences in terms of access and waiting times.

A resident is performing a calligraphy activity at the Mon Sheong Private Care Center in Markham. (Posted by Mon Sheong Foundation)

According to one Wellesley Institute study, waiting times can vary depending on factors such as a person’s health condition or urgency with prolonged hospitalization. However, the waiting times are particularly long for those seeking placement in a religious, ethnic or cultural home.

The same study found that homes serving Chinese-Canadians had longer average waiting times than other groups of two to seven years.

Some family caregivers may endure placing loved ones in long-term care due to the lack of culturally appropriate options.

A study in Journal of the American Medical Directors Association showed that older adults with different backgrounds are underrepresented in Canadian populations with long-term care. The study said that immigrants who arrived in Canada after 1985 make up only 4.4 percent of long-term caregivers in Ontario, even though they make up 13.9 percent of the total population.

While culture-specific nursing homes have proven to be popular, there are some cultural groups that are too small or not mobilized enough to start their own home.

In general, these communities are newer in Canada or lack the critical mass or collection power.

“When you have an Ismaili person, a Somali person, an Afghan person who needs culturally secure and appropriate care, there is no specific home that meets the needs of these communities,” Sinha said.

The way forward

The solution to removing barriers to culturally safe and appropriate care can be found in data.

A recent study that looked at improving data collection in long-term care settings in Canada called on the government to collect a standardized set of socio-demographic information, including age, gender at birth, gender identity, sexual orientation, race, ethnicity, language and original identity – something that many other countries, including the UK, Australia and the US, already do .

“I think that if we take up this mandate in a way and speak for better socio-demographic data collection, we will have a better sense of who has access and who does not, and that will give us a sense of, where we need to start managing policy and implementing metrics, “Flanagan said.

Give a Comment