The phasing out of extended-care beds at Mount Sinai Hospital (MSH) in Côte-St-Luc, Que., will not result in a shortage of long-term care for members of the Jewish community and none of the current 45 long-term patients will be forced to move out, says the regional health authority that administers the institution.
The plan was a surprise to patients and their families, many of whom are worried about the effect the change will have on these vulnerable people.
“Between the 707 beds at Maimonides Geriatric Centre and Jewish Eldercare Centre (JEC), there are absolutely sufficient beds (for the community),” Barbra Gold, director of support for the autonomy of seniors at CIUSSS West-Central Montreal and manager of MSH, told The CJN. Maimonides and JEC are the only other kosher long-term care facilities in the CIUSSS’ territory.
The changeover will be accomplished by attrition and is expected to take a “few” years, she said. “No one is going to be forced out of MSH.… Typically, long-term care is one or two years, not 10 or 12.”
Gold said that the number of long-term beds required in the Jewish community has declined over the years, in contrast to the shortage that was once a chronic problem for an aging population.
A former Maimonides executive director, Gold said that, when she began working there 28 years ago, virtually all of the residents were Jewish. “Now, it’s 90 per cent or less, and it’s similar at JEC,” even though priority at these institutions is given to Jewish clients.
At MSH, about half of the long-term patients are Jewish, Gold said.
In June, MSH informed patients and their families that it was ceasing long-term admissions and that the beds would be converted to what the government calls “post-acute care.”
Gold said there is a shortage of such beds in the CIUSSS’ territory. She described post-acute care as designed for, usually elderly, people who have been discharged from hospital but still need a place to recover. During this period of convalescence and light rehabilitation, which usually lasts for a couple of months, they are assessed as to whether they can return home, or if they should be placed in longer-term care.
The introduction of these beds at MSH is a plus for the Jewish community, she added, because such care is currently not available in a kosher facility.
Founded by the Jewish community in 1909 near Ste-Agathe in the Laurentians as a tuberculosis sanatorium, MSH moved to Côte-St-Luc in 1990. Since then, the McGill University-affiliated facility has divided its 107 beds among intermediate care for respiratory patients, palliative care and long-term care.
The elimination of MSH’s long-term beds will be offset to a certain extent with the opening late this fall of a 96-bed institution designated by the government as a “ressource intermédiare” (RI) on Jean Talon Street near Décarie Boulevard, Gold said.
This is a public-private partnership undertaken between the CIUSSS and the company that owns the Lev Tov seniors’ residences, which are kosher, she said. Although this RI will not be kosher, Gold said she feels it is likely that Lev Tov’s owner will be “sensitive” to the needs of Jewish patients.
RIs provide permanent care for people who do not need more intensive nursing care, she explained. The owner is building, and will run, the RI, while the CIUSSS will provide the professional services, Gold said.
These reassurances are little comfort to sisters Karen and Gail Herscovitch, whose 76-year-old brother Ronnie, who suffers from cerebral palsy, has been an MSH resident for 28 years. They describe his care there as “fantastic,” although they have seen a deterioration since the implementation of Bill 10 four years ago, which consolidated the administration of health and social services. MSH is one of more than 30 facilities under CIUSSS West-Central Montreal.
They were shocked when they were told about the plan, although staff members have since told them privately that this was in the works for a couple years.
“We’re very disturbed.… Our brother is very nervous. We can see a change in him already. Nobody is happy about it, it’s sad and scary,” said Karen Herscovitch.
Although they have been told that no patient will be transferred, she noted that the day after they were informed about the impending closure, they were given a list of alternative long-term care facilities.
“We were told MSH patients would be fast-tracked to them,” she said.
The transition period will not be easy for patients, the Herscovitches fear. They wonder how services, which now include on-site seven-day-a-week medical assistance, will be affected.
“Not everyone in long-term is elderly; some are in their 20s and 30s,” Karen Herscovitch noted. She also cited the case of a woman who got her husband into MSH after a two-year wait just before the cutoff on long-term admissions and now worries what will happen.
“My question is: say in three years there are just a handful of long-term patients left, are they not going to be pressured to go somewhere else?” she asked.
Gold acknowledges the apprehension that many are feeling. “I can understand the worry, but we have assured them no one will be forced to move.… Nothing much is going to change in care. There will still be occupational therapy, physiotherapy, music and art programs – these are sponsored by the foundation – and the doctors are not leaving.”