The provincial government is forecasting the Fredericton area will need an additional 111 nursing home beds by 2016. It’s part of a prediction that the province will require 684 new nursing home beds by the middle of the next decade.
Some observers say that won’t be enough, while others say the emphasis should be on keeping seniors out of institutional beds and in their homes for as long as possible.
Eugene McGinley, the minister of state for seniors, said he’s confident the province’s new formula is a good way to look at future needs.
The formula was created by the Department of Social Development during work to develop the Liberals’ long-term care strategy that was released in March.
According to the government, the formula took into account the number of seniors aged 75 or older by 2016, the frailty of seniors as measured by hospital admissions, seniors living at home, and the percentage of seniors living in special care homes, receiving home support and waiting in hospitals for a nursing home bed.
It also looked at regional demand.
The department said Fredericton needs 111 more beds because its senior population is growing, unlike other regions. The Fredericton area, which includes communities such as Woodstock, Fredericton Junction and Coles Island, has 736 nursing home beds.
The city is home to two nursing homes: York Manor with 204 beds and Pine Grove with 70 beds.
According to the formula, Moncton is projected to need 117 new beds and Saint John requires 89.
The total of 684 new beds required in New Brunswick is close to the target of 700 new beds over the next 10 years identified in the Liberals’ long-term care strategy.
But Jody Carr, the Opposition’s Social Development critic, said the shortage of nursing home beds is already a crisis.
"A 10-year formula does not do much good when we have a waiting list for nursing home beds that has doubled in the last two years," he said. "There could be more relief-care beds provided to help families today."
He also said he wants to hear more about tax incentives to allow families to take care of elderly relatives in their home.
"They are very short on details in the long-term care plan," said Carr. "We have been waiting two years for action and we have seen very little."
According to the province, as of June, there are 591 seniors waiting in hospitals for a nursing home bed, including 73 in the Fredericton region.
That’s up from 537 in February.
Ralph Smith, president of the New Brunswick Seniors Federation, said he’s pleased the province has developed a forecast model.
But he questions if the target number of beds is high enough.
"I would not think that would be sufficient," he said. "The numbers are going to increase as we go down the road."
There are 62 not-for-profit nursing homes in New Brunswick with 3,930 beds.
But the total number of seniors over the age of 65 in New Brunswick is expected to double to 188,000 in the next 20 years.
Work has started on increasing the number of nursing home beds in Fredericton.
York Manor has an expansion and renovation project underway that will add 10 more beds by 2010.
The capital is also getting a new nursing home through a public-private partnership with the provincial government and Nova Scotia-based Shannex Inc.
Jason Shannon, chief operating officer of Shannex Inc., said the company is on track to complete the 72-bed nursing home project in Fredericton by 2010.
But Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents’ Rights, said she thinks the province should be focusing on improving ways to help seniors stay in their homes rather than building more nursing home beds.
"That is the piece that needs to be fixed," she said. "I don’t think we should be advocating for seniors to go into nursing homes. Seniors don’t want to go into nursing homes."
The province spends $44 million a year to provide home support for 4,530 seniors.
"Addressing the (nursing home) beds are not going to keep people in their homes as long as they can," Cassista said. "I don’t think they (the governing Liberals) have a direction, quite frankly."
She said the biggest problem in the home-support sector is the issue of recruitment and retention of workers.
But Smith said providing home-support workers only delays when a senior goes into a nursing home.
Charles Cirtwill, president of the Atlantic Institute for Market Studies, said forecasting needs for nursing home beds is prudent.
"It makes a lot of sense to plan for it now, rather than wait until we have seniors waiting on stretchers in hospital hallways," he said. "The challenge for government is how do they respond to these projections?"
Cirtwill said if the public sector builds and owns nearly 700 new nursing home beds by 2016, maybe that many won’t be needed 10 years later, in 2026. But the public sector will still have to operate those unneeded beds, he said.
"The private sector would be far more capable to respond to shifts in demand than the public sector is," he said.
Bringing in Shannex is a good move if the government has the right, flexible contract, said Cirtwill.
"If you have given Shannex a blank cheque and say ‘Build this and we will pick up the tab for it,’ it may not be a good deal," he said. "If you have an inflexible contract with a private supplier, you might as well have an inflexible contract with yourself."
He also said any contract should have a clause for auditing the services provided.
Prof. Gary Irwin-Kenyon, chairman of gerontology at St. Thomas University, said there’s no question New Brunswick will need the extra beds.
"We tend to have roughly five per cent of seniors who require residential care," he said. "But the five per cent is increasing because we have an older population."
As for bringing in the private sector, Irwin-Kenyon warned the province must not allow standards of care to slip.