Alternative Level of Care is defined as the use of hospital beds for clients who are deemed to no longer require acute care beds, but are stuck in the hospital system. ALC is a system problem relating to the care for older adults (OHQC, 2010) indicating problems of access and efficiency. This problem results in increased wait times for surgery, emergency and unnecessary expensive care. The average client is eighty years of age, 23% have dementia and 43% are awaiting a long-term care bed, (Canadian Institute for Health Information, 2009).
Themes that surfaced that gave clients a feeling of uncertainty:
- Problems with communication. I don’t know. Clients were unaware of medical assessment, diagnosis and prognosis. Clients were unaware of the hospital process, placement process and didn’t know what questions to ask.
- Waiting in limbo. Waiting for care, waiting to be more mobile, waiting for activity, waiting for reunification with my partner and waiting for placement.
- I didn’t think I would end up like this. In the past I was active, now I’m here. What is there to look forward to at my age?
- Lack of interaction with healthcare providers and clients/families
- Barriers to inter-organizational collaboration
- Barriers to collaboration at the federal, provincial and regional level of government
Implications for Policy Change:
- Reduce the number of ALC cases
- Allocate activity and mobility resources. Lack of physical activity leads to a decline in mobility in older adults, leading to an inability to perform ADL’s.
- Review policies re: ALC copayment, couple reunification and LTC wait lists
- Review of discharge planning
- Use a humanistic approach when informing and communicating with client/family