Bermuda does not have the infrastructure to support people requiring long-term care in a community setting, according to Claudette Fleming.

The executive director of charity Age Concern was responding to the announcement in the Throne Speech that the Bermuda Hospitals Board’s Long Term Care pilot programme will likely entail a shift towards community care and home care to reduce the cost of long-term care.

“We don’t have sufficient community care resources to support people requiring long-term care in a home setting,” Ms Fleming told The Royal Gazette. “The idea is to have seniors living in the community and at home. But there are those instances where seniors will need assistance with care whether through an institution or structure of care that supports them in their home.”

According to the Bermuda Government, the number of elderly in Bermuda is set to double over the next two decades and the Island will require system-wide changes to meet the needs of those requiring long-term care.

Governor George Fergusson, who delivered the speech on behalf of the Government, said the Long Term Care pilot programme focuses on incremental changes in the hospital’s Long Term Care wards, where a mix of residents require complex to intermediate skilled nursing care.

He said the wards will be reorganised to develop a more efficient staffing model and improved service delivery, with the objective being the creation of a model of care that improves the value for money spent on long-term care. “To this end, the BHB is taking initial steps to decrease the cost of care without compromising quality,” Mr Fergusson said. “BHB’s progress on a model of care will help advance work on a system-wide solution that can accommodate the anticipated need for long-term care for this growing segment of the population.

“It is expected the solution will entail a shift towards community care and home care where quality of life is highest and the costs of care are lower.”

He added: “To achieve this shift, it will be necessary to integrate service delivery among primary, hospital and community caregivers.”

In response to this, Ms Fleming called for a more in-depth discussion on the hospital’s role in assisting the community in creating community-based care options.

She said there was no sense transferring patients requiring long-term care into the community when the infrastructure to support them does not exist.

“The shift is going to happen because it is forced,” she said. “The hospital has to cut costs, whether that will translate into the ideal environment for seniors remains to be seen.

“That’s why the discussion needs to be expanded to the hospital’s role in assisting the community in creating community-based care options.

“The question is, is the community prepared for this shift and the hospital should be leading this discussion, otherwise we are creating a revolving door scenario for the hospital.”

The BHB was approached for comment but no response was forthcoming by press time.

According to Tawanna Wedderburn, the acting CEO of the Bermuda Health Council, the organisation recently completed voluntary registration for all health businesses and the public will be able to see more details about the available services on its website within the next month.

She said the registration was undertaken to determine the available services and where there are gaps between service demand and service delivery.

“It also allows us to better plan for health system needs based upon Bermuda’s disease profile,” she added. “The Health Council continues to support quality care in the most appropriate setting.”