Executive Summary

This report was based on a sampling of institutional clients who were receiving facility care as of May 31, 1998 and clients who had received facility care between January 1, 1992 and December 31, 1997.

The average age of Veterans Affairs' (VAC) institutional clients had risen from 75 in 1992 to 80 in 1997. The distribution on the total admissions ranged provincially from 18% in Quebec to 6% in Newfoundland and Prince Edward Island with the age cohort 75 to 79 being predominantly the largest group. The marital status of the clients was fairly equivalent with 50% married and 48% single but with provincial variances.

Supports or services in the home prior to institutionalization showed consistent use of home care programs and the availability of a caregiver in the home. Minimal assistance was utilized from outside the home, such as peers and friends in the community, with sporadic use of assisted living arrangements. Acute care admissions were common followed by direct transfer to institutional care.

Several reasons were found for placement in institutional care, with many clients showing a combination of reasons. The principal ones found were the declining health of the client, the inability of the caregiver to provide the level of care required by the client and the absence of a caregiver.

At the time of admission, the physical and mental needs assessed to determine level of care indicated that the principal physical factors were decreased mobility, increased personal care needs, the need for supervision and a high incidence of urinary incontinence. Mental factors indicated a high number of cognitively impaired clients with increased memory loss or confusion, diagnosed dementias and behavioural or cognitive disturbances. Neurological and psychiatric disorders were less prominent.

Following admission, the average length of stay was seventeen months with 79% exiting due to death. Sixteen percent (16%) of the clients were able to be discharged, many of them returning home or closer to family, some with improved health. The average length of stay included any transfers from one chronic care facility to another. A small number of clients did transfer for various reasons, the most common being that the facility was unable to meet the changing health needs, or they wished to transfer closer to family.

Fifty seven percent (57%) received their eligibility to facility care because of their overseas service status.