Focus on 'crisis' patients has moved spousal reunification down the priority list
'It's heart-wrenching': After 73 years of marriage, her parents are forced to live apart
Cynthia Hooper said, when her father moved into Perley and Rideau Veterans' Health Centre for his care, she didn't expect the process of spousal reunification to take as long as it has — 19 months and counting.
An Ottawa couple has had to live in separate care facilities for 19 months, despite their children's efforts to reunite them, which one expert calls a "human tragedy".
Their daughter Cynthia Hooper said she's concerned about the effect the separation is having on the cognitive health of her parents, John and Gwen Hooper. Her father, in particular, has suffered cognitive decline.
"Whenever he's agitated, he often, often calls out my mother's name," Cynthia said.
"It's heart-wrenching that after 73 years of marriage, they're forced to live apart."
The couple had been living at Portobello Manor in Orléans until June 2021. At that point, John had been leaving the residence — sometimes in the middle of the night — and needed to be moved to Perley Health for his care.
Cynthia said the family tries to help connect her parents with phone calls, but the visits are few.
Her 92-year-old mother's condition makes it hard to travel by car and sometimes her father is asleep when they arrive.
On top of that, COVID-19 outbreaks and lockdowns have aggravated the separation.
Cynthia said when John, now 95, suffered a near-fatal respiratory infection late last fall, she realized the urgency of reuniting her parents.
"It's just driving home [realizing] one or the other of my parents may die and not have [reunited] under the same roof," she said.
Cynthia said she and her brother reached out to local politicians and Ontario's Long-Term Care Action Line, but were given little hope.
"I think there should be some room too to reunite people who have been married for decades. There's a physical [care] need, but there's also a mental need and I think that needs to be addressed," she said.
'Human tragedy' to force couple to live apart
University of Ottawa professor Ivy Bourgeault is a co-lead on a research project that aims to add quality to late life for people living in long-term care and for their caregivers.
She said spousal reunification is important in improving the quality of life in care settings.
"It helps with familiarity. It can help ensuring appropriate care, helping to settle people down," Bourgeault said.
She said the system needs more flexibility when partners require different levels of care so they can at least be in the same facility or close.
Dying of a broken heart doesn't qualify as a community crisis.
– Dr. Samir Sinha, Mount Sinai Hospital
Dr. Samir Sinha, director of Geriatrics at Mount Sinai Hospital and University Health Network in Toronto, said spousal reunification has continually moved down the priority list in the long-term care admission system.
"To see them separated by a system that lowers the priority for these reunifications over other kinds of crisis placements, it really is a human tragedy," Sinha said.
"We have to remember that the average life expectancy in an Ontario long-term care home is about 18 months."
He said recent changes have put hospital-designated crisis patients at the top of the admission lists, followed by people living in the community whose health has been destabilized. He said the lack of resources in hospitals and for supportive home care mean there's a constant flow of crisis patients.
"While spousal reunification takes a bit more priority over people who just generally want to transfer … they're bumped lower down on the current waiting list by people who are in crisis," he said.
"Under the current system, she doesn't qualify because dying of a broken heart doesn't qualify as a community crisis."
In a statement, a spokesperson for the minister of long-term care said the highest priority for reunification is for those in the crisis category. Those in crisis can apply for the two reunification priority access beds located in every long-term care home.
Wait-list for spousal reunification in Ottawa area
Home and Community Care Support Services Champlain, which is responsible for long-term care placements in the Ottawa area, said 42 individuals are currently on the wait-list for spousal reunification in the region.
It said it does not report average wait times due to variables such as individual patient choice, patient need and a home's bed availability. The agency said 74 patients were placed in spousal or partner reunification between May 2021 and November 2022.
The agency said its teams continue to work with patients and their families to "find and offer creative solutions to bring spouses closer together."
Bourgeault said the current mechanics of the long-term care system and the pressure on workers exposed by the pandemic make it harder to serve the needs of families.
"There seems to be no space for that right now because the system is beyond lean, and that's really unfair," she said.
"We lurch from crisis to crisis to crisis. That is not a care system. It is not a system that enables care to happen in respectful care circumstances."
ABOUT THE AUTHOR
Matthew Kupfer has been a reporter and producer at CBC News since 2012. He can be reached at firstname.lastname@example.org and on Twitter @matthewkupfer
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