The long-term care (LTC) system in Ontario is facing a perfect storm. With an aging population, increasing chronic disease rates, and critical infrastructure challenges, the need for reform and innovation in LTC has never been greater. According to a recent report by the Ontario Long Term Care Home Association (OLTCA), more than 40,000 seniors are currently on waitlists for LTC beds, and the strain on the system is only set to worsen as the population ages. In response to these challenges, specialized nurses like Nurses Specialized in Wound, Ostomy, and Continence (NSWOCs) emerge as critical players in addressing the gaps and inefficiencies in Ontario’s LTC sector.
The State of Long-Term Care in Ontario
Ontario’s long-term care system has been struggling to keep up with the growing demand for services. The OLTCA recently shared a report that highlights several pressing issues:
Aging Infrastructure: Around 40% of Ontario's LTC homes are over 40 years old, and the outdated facilities are ill-equipped to meet modern care standards.
Understaffing: LTC homes are grappling with insufficient staffing, which leads to increased burnout among healthcare workers and affects the quality of care provided to residents.
Waitlists and Bed Shortages: With 40,000 seniors waiting for placement, Ontario's LTC homes are struggling to meet the demand for beds. This often results in seniors staying in hospitals longer than necessary, exacerbating hospital capacity issues and healthcare costs.
As Ontario’s population continues to age, the need for a solution becomes even more urgent. One in four Canadians will be elderly by 2036, and 1 in 13 Ontarians will be over the age of 80 by 2040, further amplifying the demand for LTC services.
The NSWOC Power of 3 Campaign: A Solution for LTC Challenges
The NSWOC Power of 3 campaign highlights how Nurses Specialized in Wound, Ostomy, and Continence (NSWOCs) can address some of the critical challenges facing the long-term care systems in Ontario, and more broadly across Canada. NSWOCs are registered nurses with advanced training in three key areas: wound, ostomy, and continence care. By leveraging their specialized skills, NSWOCs are uniquely positioned to enhance care quality, reduce complications, and alleviate financial pressures on the healthcare system.
Wound Care Expertise: Chronic wounds, pressure injuries, and skin tears are common problems in LTC settings, particularly among elderly residents with limited mobility or cognitive impairments. NSWOCs are equipped with the knowledge and skills to design and implement evidence-based wound care plans that speed healing and prevent further complications. By using advanced products and strategies, NSWOCs can help reduce hospital readmissions due to wound-related complications, which in turn alleviates pressure on hospitals and long-term care facilities alike.
Ostomy and Continence Management: Continence and ostomy challenges are prevalent in long-term care, particularly among residents with dementia or other cognitive conditions. NSWOCs play a crucial role in preventing issues like skin breakdown caused by incontinence or improper ostomy care. Through their specialized expertise, NSWOCs ensure that residents receive the most appropriate and cost-effective products, minimizing discomfort and reducing the risk of infections or other complications. This is essential for maintaining residents’ quality of life and preventing avoidable hospitalizations.
Addressing Ontario’s Long-Term Care Crisis
The NSWOC Power of 3 campaign aligns with OLTCA’s mission to improve long-term care by addressing two key areas of concern: the quality of care provided to residents and the efficiency of the healthcare system as a whole.
Cost-Efficient, Evidence-Based Care
NSWOCs contribute to cost savings by reducing the likelihood of complications that often lead to hospital transfers. They also play a pivotal role in educating staff and residents’ families on best practices, which leads to more consistent, high-quality care. Given that healthcare spending in Canada exceeds $250 billion annually, with over 35% of provincial/territorial budgets dedicated to healthcare (CIHI, 2018), employing NSWOCs in LTC settings can help control costs while improving the quality of care.
Specialized Care for Complex Needs
As Ontario’s elderly population grows, LTC facilities face increasingly complex care needs. Older residents are more prone to conditions such as pressure injuries, skin tears, and continence issues, which require a high level of expertise to manage effectively. NSWOCs offer this expertise through their tri-specialization, providing not only direct patient care but also serving as leaders on interdisciplinary healthcare teams. By promoting evidence-informed practices and guiding treatment protocols, NSWOCs help ensure that LTC residents receive the specialized care they need to thrive.
Leadership and Research Contributions
NSWOCs are not just care providers—they are leaders and researchers who help shape the future of wound, ostomy, and continence care. They contribute to the development of best practices, inform healthcare policies, and conduct research that improves the quality of care provided to patients across the continuum. In Ontario’s LTC homes, where resources are often stretched thin, NSWOCs play a critical role in bridging the gap between clinical practice and the latest advancements in care.
Conclusion: A Sustainable Path Forward
Ontario’s long-term care system is at a crossroads. With rising demand, aging infrastructure, and persistent staffing challenges, LTC homes need innovative solutions to provide high-quality, cost-efficient care. NSWOCs, through their specialized expertise, offer a practical way to address the unique needs of LTC residents while also easing the financial burden on the broader healthcare system.
By integrating more NSWOCs into long-term care settings, Ontario can take meaningful steps toward improving the quality of care for its aging population, reducing healthcare costs, and ensuring a sustainable future for LTC facilities across the province. The NSWOC Power of 3 campaign shines a light on the vital role these specialized nurses play in helping Ontario navigate the complex challenges of long-term care and the broader healthcare landscape.
Sources
Statistics Canada (1971-2021), Ontario Ministry of Finance Projections.
Preyra Solutions Group (PSG), Ontario Long Term Care Association (OLTCA), and Ontario Ministry of Finance Projections.
Ontario Caregiver Organization, Spotlight Report 2023; Canadian Institute for Health Information (CIHI), Your Health System, Caregiver Distress, 2023.
Ontario Caregiver Organization, Spotlight Report 2023.
Canadian Institute for Health Information (CIHI), Your Health System, New Long-Term Care Residents Who Potentially Could Have Been Cared for at Home.
Intellihealth, CCRS main and assessment package 2022/23 data. Data retrieved December 2023.
Ontario Ministry of Long-Term Care, Inspector’s Quality Solution (IQS) Database, January 2024.
Ontario Ministry of Long-Term Care, Client Profile Database (CPRO), July 2024.
Ontario Long-Term Care Staffing Study, July 30, 2020.
Ontario Health, Wait Times for Long-Term Care.
Statistics Canada, Job Vacancies, Payroll Employees, and Job Vacancy Rate by Industry Sector, Monthly, Adjusted for Seasonality, Table 14-10-0406-01, Release Date January 25, 2024.
Ontario Long Term Care Association (OLTCA), internal analysis, Fall 2022.
Preyra Solutions Group (PSG).
Abacus Data, Survey of 1,000 Ontarians Aged 68-76, May 2023.
Ontario Long Term Care Association (OLTCA), The Data, https://www.oltca.com/about-long-term-care/the-data/.
Nurses Specialized in Wound, Ostomy, and Continence Canada (NSWOCC), Power of 3 Campaign, https://www.nswoc.ca/powerof3.
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