88-year-old Lily Wong was admitted to Toronto’s Yikang Elderly Care Center. A few years later, her stroke severely affected her short-term memory, speaking ability and balance ability.
The waiting time for entering a long-term care home was nine to ten years, but Huang was admitted in less than seven years.
“It’s super fast,” her son Tony Wong said.
Her son said that it has been two years since she was admitted and Lily Wong is doing well in a home that meets her cultural needs. This is also a relief for her children.
“If you can enter a nursing home environment that speaks your language, has specific cultural activities, and has food you remember, it’s just a huge weight,” said Tony Huang.
“It’s incredible to be able to experience this.”
Part of the reason for the long waiting time is that the Yikang Aged Care Center is one of the few culturally distinctive families serving the Chinese-Canadian communities in Toronto and surrounding areas.
Experts say that long-term care waiting times are the longest in nursing homes of a specific culture. A study by the Wellesley Institute, a non-profit organization engaged in health research and policy work, found that more than half of the top 20 houses with the longest waiting time in the Greater Toronto Area are nursing homes with cultural characteristics, reflecting the need More such facilities.
“The demographic change has [driven] The demand for this kind of care is increasing,” said Seong-gee Um, a researcher at the Wellesley Institute.
“It is very important for the system to adapt and develop and reflect the diversity of its current and future residents.”
Longer waiting time
More importantly, in 2017/2018, those who want to live in a nursing home with cultural characteristics It’s 246 days on average than people waiting for mainstream housing, Even if they have the same level of demand.
These long waiting times may have health effects on elderly people waiting for long-term care.
“We do know where [are] The different health outcomes of people from different communities,” said Ashley Flanagan, whose work focuses on gender identity and aging issues at the National Institute of Aging, a think tank on aging in Canada.
“Whether it’s entering the waiting list for houses with cultural background, [that] It often takes longer to be admitted.Therefore, you will see a decline in health, instead of [being] Can get care. “
Stella Lang, a senior manager of Mon Sheong Long-Term Care Centre, has four locations in the Greater Toronto Area. She says simple things, such as the language spoken by people who take care of residents.
Lang said that having health care providers and staff who can serve patients in Mandarin or Cantonese is of great significance to residents who may lose their ability to speak English in old age, which is a common situation among residents with dementia.
The staff can even help native Chinese residents and family members who may be the second generation in Canada and therefore understand English better.
Lang said: “That’s why they don’t feel so isolated and don’t have too much depression.”
Although the appreciation of houses with cultural characteristics is obvious, it is not enough to meet the demand level of the province. According to Ontario Long-Term Care COVID-19 Commission Final ReportThis requires the construction of more culturally distinctive residences to meet the needs of Ontario’s diverse population.
‘Developed by the community’
According to AdvantAge Ontario, an advocacy organization dedicated to advancing aged care, families with cultural characteristics often provide high standards of care, partly because of their funding structure and community support.
“They are developed by the community for the community,” said Lisa Levin, the group’s chief executive officer.
Community integration is an integral part of its structure, because most of them are established in this way. More importantly, the board that manages a particular cultural house represents the community they provide care for.
“This means nursing philosophy, nursing methods, nursing language… food, traditions, celebrations, volunteers, they are all culturally appropriate,” Levine said.
Culture-specific nursing homes are also often non-profit. Advocates of the elderly believe that because of their operation, nursing homes play an important role in the health and well-being of residents.
All long-term care homes in Ontario receive the same funding formula from the province, which is sufficient 2.75 hours of direct care per resident per day.
Dr. Samir Sinha, director of geriatrics at Sinai Health, Toronto Academic Health Sciences Center, said culture-specific nursing homes and municipally funded nursing homes often further subsidize care.
Sinha said: “They usually raise funds, hold parties, conduct baking sales, they will conduct a lot of fundraising activities, and the community will invest additional funds to build better facilities, beyond the scope of government funding.”
In addition to government funding, AdvantAge Ontario reports that in Ontario alone, non-profit and municipal nursing homes contribute more than $300 million in additional funding each year. According to AdvantAge, the extra money is used to pay for higher salaries for employees and the facility itself, which helps improve the standard of care.
Strong demand but short supply
Although there are few data that specifically study the health status of elderly people receiving culturally appropriate care, the employees and children of residents of the Mengshang Long-term Care Center and Yikang Elderly Care Center support the view that elderly people will Do better. it.
For example, at the Mon Sheong Long-Term Care Center, residents can enjoy familiar dishes such as porridge at breakfast. Lang said that because they like food, they are more likely to eat it, which can provide better nutrition and improve overall health.
Despite the overall socio-psychological and physical benefits, there are still significant differences in visits and waiting times.
According to a Wellesley Institute ResearchThe waiting time may vary depending on factors such as personal health or the urgency of long-term care admission. However, the waiting time is particularly long for those seeking to be placed in religious, ethnic or cultural families.
The same study found that families serving Chinese Canadians have a longer average waiting time than other groups, ranging from two to seven years.
Due to the lack of culturally appropriate options, some home caregivers may delay placing loved ones in long-term care.
A study in Journal of the American Medical Guidance Association It shows that elderly people from different backgrounds are under-represented in the Canadian long-term care population. The study stated that immigrants who arrived in Canada after 1985 accounted for only 4.4% of Ontario’s long-term care residents, even though they accounted for 13.9% of the total population.
Although the facts have proved that nursing homes with cultural characteristics are very popular, some cultural groups are too small or have insufficient mobilization capacity to start their own families.
Generally, these communities are relatively new to Canada or lack critical mass or fundraising capacity.
“When you have an Ismaili, a Somali, an Afghan who needs cultural security and proper care, there is no specific home that can meet the needs of these communities,” Sinha said.
The way forward
Solutions to eliminate cultural safety and proper care barriers can be found in the data.
A recent study looked at Enhancing data collection in Canadian long-term care institutions Call on the government to collect a standardized set of socio-demographic information, including age, gender assigned at birth, gender identity, sexual orientation, race, ethnicity, language and indigenous identity-many other countries, including the United Kingdom, Australia and the United States, have done so .
“I think if we accept this task and advocate better collection of sociodemographic data, we can better understand who is visiting and who is not, which will enable us to understand where to start to guide policies and implement measures,” Lanagan said.