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Nursing facilities ‘woefully inadequate’

Age Concern yesterday called on the Bermuda Government to address “woefully inadequate” community care facilities for the frail elderly after it emerged the King Edward VII Memorial Hospital was buckling under the strain of a flu outbreak.

Hospital bosses admitted this week that the $247 million acute care wing had been unable to cope with a surge in demand from flu sufferers over the weekend, with some emergency patients having to wait more than 15 hours for a bed.

The shortage of beds, according to Bermuda Hospitals Board, is partly down to an “ageing and increasingly chronically ill community”, while a lack of community nursing home facilities makes it difficult to discharge people as they recover.

Reacting yesterday, Age Concern deputy chairman Charles Jeffers urged the Government to direct more funds towards caring for the elderly.

“Age Concern is well aware of the challenges being faced with the shortage of beds at the hospital and the need for those seniors who are well enough to be released,” Mr Jeffers told The Royal Gazette.

“This is not a new problem and is one that has the potential of becoming acute with the growth of the ageing population. We cannot overly emphasise the fact that a safety net infrastructure for seniors must be firmly in place along with all of the required support systems such as long-term care housing for the frail elderly which, at this time, is woefully inadequate.

“Government, families and the community need to work in concert to ensure that we get a handle on the issue of the protection, care and safety of vulnerable seniors and implement the right solutions in a timely manner.”

Mr Jeffers repeated Age Concern's call for a Public Guardian, to cover the needs of seniors and the disabled. “The government of the day should ensure that there are required funds available for adequate staffing and operations for Ageing and Disability Services, in particular,” he added.

A BHB statement said the maximum number of beds in the new wing was 90 and, with those full, other wings in the older part of the hospital were being used for acute care patients. Before the acute care wing opened in 2014, patients of varying degrees of sickness had been mixed together on three medical surgical wards, which had a combined 110 beds. There were 279 emergency department visits at KEMH between Saturday and Monday, and 38 admissions to beds, as Bermuda grapples with high levels of flu and respiratory illness. Of those admitted, 65 per cent were aged 65 or older. The wait to be admitted to an inpatient bed was 4.83 hours on Saturday, but on Sunday and Monday was more than 15 hours.

Yesterday, a BHB spokeswoman said: “If there were fewer non-acute patients in hospital beds, we could better cope with unexpected high surges of the kind we are currently experiencing.

“The issue is that a significant number of inpatients at BHB are non-acute at any one time, and this was identified in extensive research on hospital inpatients as the new hospital was planned. There are not enough community nursing homes to accept some people when they no longer need acute care, or families are unable or unwilling to accept them home.

“These individuals do not need acute care but may have some medical requirements. The hospital cares for them when there are no other options as we cannot in good conscience release people who could be hurt or get sick again if they are discharged to an inappropriate setting.

“The best solution, both clinically and financially, is for Bermuda to have more community nursing home placements and a more extensive home care service. Caring for people in hospital is very expensive; the longer they stay the higher the risk of hospital-acquired infections, and it means individuals are left in an institutional setting when they could have better quality of life in a home setting.

“Moving patients out of BHB when they are ready is better for them and for Bermuda. This would leave BHB with adequate capacity for surges such as this flu outbreak.”

One senior, who asked not to be named, told The Royal Gazette they had just spent three nights on the acute care wing. The senior said: “[I was] lucky to gain admittance, obviously, though perhaps discharged earlier than otherwise might have been.”

The senior described the nurses and cleaning staff as “excellent” but questioned why the acute care wing was built to cater for only 90 patients. “Who made that decision?” they asked.

This newspaper asked health minister Jeanne Atherden yesterday to comment on the bed capacity of the acute care wing, as well as the often-reported and ongoing lack of community nursing home beds for elderly people.

“I commiserate with those who have experienced longer than usual wait times,” Ms Atherden said.

“Waiting is difficult for many at the best of times, but becomes more stressful when one is also feeling ill. A small number of non-emergency elective surgeries were postponed and some patients had to wait for a bed in the acute or general wing. Difficult decisions had to be made in order to optimise available bed space. I must commend the hardworking medical professionals and support team at KEMH for, as always, putting patient safety first as they cope with the extra demand.

“The new acute care wing added 90 beds to those in the existing general wards. All are fully deployed.

“The ministry is conscious that demand for long-term care has outstripped capacity in the community. With an ageing population and changing demographics, Bermuda, like many countries, is being challenged by this. The ministry has put in place a long-term care action plan, which includes initiatives to address capacity. In addition, HIP and FutureCare offer the personal home care benefit to enable persons who qualify to be cared for at home.

“We recognise that families are struggling and we must call on the community to be part of the solution in caring for our seniors, as institutionalised care is not always necessary. Seniors who don't have acute medical needs are better cared for outside the hospital, and we urge families to step in and work together to get their loved ones into the appropriate care setting.”

Age Concern deputy chairman Charles Jeffers

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Published February 24, 2017 at 8:00 am (Updated February 24, 2017 at 6:15 am)

Nursing facilities ‘woefully inadequate’

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