Outreach teams are not the answer for long-term care

A letter to the Editor of the Belleville Intelligencer, by Candace Chartier, CEO, Ontario Long Term Care Association

The Ontario government is funding more nurse practitioners in long-term care homes to provide additional support for residents with increasingly complex health care needs. The plan is to place the nurse practitioners in long-term care homes. However, in your recent story (Nurse practitioner jobs debated, Aug 31), a number of Local Health Integration Networks (LHINs) said they would prefer to see these nurse practitioners in outreach teams that provide services to long-term care homes as needed.

Mobile outreach teams are not the answer for long-term care. More than 62% of our residents have Alzheimer’s or other dementias in addition to conditions such as heart disease and diabetes, and as such their health care requires much more than traditional diagnosis and treatment. Each resident needs an individualized plan that takes into account the unique challenges of their dementia and how that affects their care. If someone needs intravenous medication but is confused and regularly rips out the IV line, what can be done to help her confusion and keep the IV in place? If someone has lost interest in food and isn’t getting the nutrients needed to heal a diabetic ulcer, how can he be encouraged to eat or drink?

This type of specialized care requires sensitivity, teamwork, and significant knowledge of each resident. The nurse practitioner needs to have ongoing relationships with residents, families, and nursing and medical staff. These require investments of time and consistency that are not possible with a drop-in health care professional.  

We have recommended that each nurse practitioner be assigned to one long-term care home as a home base and also assigned a small number of other homes to support.

Getting this right – by placing nurse practitioners and other providers into long-term care homes – will help to ensure that the 100,000 annual residents of Ontario’s long-term care homes receive the support and care they deserve.