ABSTRACT
This chapter looks specifically at how the failure to develop explicit and adequate policies in medical care for the elderly is evidenced in Canada and elsewhere by a persistent inability to appropriately discharge acute care hospital geriatric patients to suitable long-term care facilities once the acute medical episode has passed. Increasing numbers of acute hospital patients are old, and a significant proportion of them suffer protracted stays once hospitalized. The effects of policy inadequacies at a macro- or structural level have an undeniable impact on individual family members at a micro-level. The long-stay patient situation is frequently attributed to a shortage of long-stay beds, i.e., to a dearth of nursing home and chronic hospital beds. In Canada, long-term care policy is a provincial rather than a federal matter. In contrast to the rest of the country, the four western-most provinces have well-developed long-term care policies and programs.
