In the hospital we have a special term for older adults who are not really “sick” enough to be in the hospital, but who are also not well enough to go home on their own. The term is ALC- Alternate Level of Care. When slapped with this label, it means that you are taking up a hospital bed only because you are waiting for a bed in a long-term care facility or rehab facility. The patient might be waiting for a bed in a LTC facility because they need 24/7 supervision, or because they do not have the family, community, and home support services required to ensure their safety. They remain in the hospital, sometimes in a room, sometimes in the hall, sometimes in the emergency department waiting for somewhere to go. Medically they are stable, and they do not require hospital care, but they might have dementia and would be at risk if left alone, or they might need to use a wheelchair and their house has 5 stories. There are many reasons why older adults end up waiting for placement in the hospital.
The label ALC could be interchanged with the more derogatory term- bed blocker. This term is terrible because it seems to place the blame on the patient…somehow it is their fault that they are blocking a bed, delaying hospital admission times, and ER wait times because they don’t really need to be there. Often older patients labelled as ALC don’t get the level of care that they really need, so they actually get much worse during their hospital stay. Nurses and other hospital staff are busy with acutely ill patients, and don’t have the time or resources to ensure that these older patients get their exercise therapy, mental stimulation, adequate nutrition, proper skin care, and hygiene. It is the seniors in our community who suffer, our parents, and our grandparents.
I’m sure hospital discharge planners would agree with me that at least 80% of older adults who have been labelled ALC would be able to safely transition home with the proper supports.
CalaCare is committed to bridging the gap and providing the support that patient’s and their families need to stay safe at home, and out of the hospital for non-acute care.
-Jennifer Kazmaier RN