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Rural nursing homes facing challenges

While there is a penchant to focus on the bad news from the recent health minister's report on the status of nursing homes in Saskatchewan, rural residents can take some solace in the report's good news.
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While there is a penchant to focus on the bad news from the recent health minister's report on the status of nursing homes in Saskatchewan, rural residents can take some solace in the report's good news.

At least compared with their counterparts in the cities, rural nursing homes seemed to fare slightly better.

Health Minister Dustin Duncan last spring asked the chief executive officers of each health district to tour every nursing home facility, talk to staff, patients and family members and report back.

What resulted is a 311-page report released on the Government of Saskatchewan website that outlined some disturbing accounts of the care provided to our elderly.

Some of the worst stories came from the Saskatoon Health regions including "delays in toileting that result in continent residents soiling themselves" and residents being put to bed at 5:30 p.m. and awakened at 5:30 a.m., but not fed breakfast for hours.

Also disconcerting is Regina home residents getting baths less than once a week - a problem brought to the attention of the legislature this spring that sparked Duncan's call for this report.

In all cases, the culprit wasn't so much neglect of the patients but simply a lack of staffing - an especially acute problem in the cities.

Of course, this doesn't mean there aren't problems in rural areas. Nor does it mean dedicated and caring of nursing home staff everywhere aren't doing their best under the circumstances.

But if rural nursing home staff are doing slightly better, one can see why.

In many smaller communities, a solid job in a nursing home may be slightly more prized and appreciated, so they may not necessarily suffer from shortages as much as nursing homes in the cities where there may be more job options.

Also of consequence is the fact that rural nursing home employees - especially those in smaller communities - are very likely looking after someone's loved one that they have known all their lives. Regardless of staffing levels, this automatically makes the desire to go that extra mile - perhaps a trait more common in those who come from smaller communities.

And while many rural communities are contending with aging facilities, the staff and community is inclined to compensate to produce a better nursing home experience.

But the very fact that there seems to more problems in the cities isn't great for rural nursing care in either the long- or the short term.

The immediate "fix" is a $10-million "Urgent Issues Fund" set aside by Duncan in the wake of last week's announcement. It's not much and the lion's share will likely be gobbled up by urban nursing homes where the need seems greatest.

But if one looks at Saskatchewan's demographics, it may not be good for rural nursing care in the long run, either.

Currently there are some 8,700 beds available in the province's 156 nursing homes and 17 hospitals and health centres. Of those, 62.8 per cent are Level 4 care.

It is a system costing $749 million a year - $619 million of which comes from the province and the remaining $130 million from fees that currently range from $1,025 to $1,951 a month. That works out to a cost of $76,896 per resident per year.

And the frightening reality is that it will become much more expense in the next few decades with rapid inflation in health care and that baby boomers coming of age in the next 20 to 25 years.

However, the rural Saskatchewan has a higher proportion in that geriatric demographic now. It also has less baby boomers.

That may mean a shift of emphasis on nursing homes to the urban centres that have more baby boomers.

For as big a challenge as it is for rural communities to care for their elderly now, that challenge may have just gotten greater.

Murray Mandryk has been covering provincial politics for over 22 years.

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