Eighty-five-year-old Dianna Ayotte says she doesn’t think she’ll still be around when Sioux Lookout, Ont., is finally given a new long-term care home.
The Ontario town, situated approximately four hours north of Thunder Bay, is home to a key hospital serving fly-ins from several First Nations. A lack of long-term care beds means around half of them are taken up by patients who should be elsewhere.
“Today there are some long-term care patients accommodated at the hospital using up about half the hospital beds, so there are fewer beds for acute care,” Ayotte told Global News. “In most cases, they end their days in hospital.”
Since before the turn of the century, locals have been calling for a new care home to take the strain off the hospital and allow people to enter care while staying close to family.
In 2018, there was a sign of hope for the northern hub: both Progressive Conservative Leader Doug Ford and then-Ontario Liberal Leader Kathleen Wynne promised new beds to the community.
Six years after Ford made that promise, the local community is still waiting for a sign he meant it.
“I have listened to many political candidates over the years and somehow it seems to me that I am skeptical of promises from all of them,” Ayotte said.
A promise made years ago
In the run-up to the 2018 election, Doug Ford made an audacious pitch for seats in northern Ontario, where the Progressive Conservatives rarely win, paying a visit to Sioux Lookout.
He told residents of the northern hub he would match a promise from then-Liberal leader Kathleen Wynne to build 76 new long-term care beds in the town. Those beds have yet to materialize and, in the intervening years, locals say the issue has worsened.
“In our area alone, we could definitely benefit from a 160-bed facility immediately,” Matthew Hoppe, the CEO of the Independent First Nations Alliance told Global News.
The local hospital’s CEO said the town is projected to need at least a total of 100 beds in 2025, 109 beds in 2030 and 111 beds in 2035.
The local Ontario NDP MPP Sol Mamakwa said people can wait four to six years for a long-term care bed. He said there’s local frustration seeing so many projects in other communities.
“This government is announcing these long-term care beds all over Ontario, except for Sioux Lookout,” Mamakw said. “It is as if we don’t matter. We’ve been promised 76 additional beds for years and we’re still waiting.”
Global News requested an interview with the Minister of Long-Term Care Stan Cho but the request was declined. A spokesperson for Minister Cho said the Progressive Conservatives had no plans to back away from their 2018 promisee.
“Our government understands the frustrations of the people of Sioux Lookout and is committed to the promise we made to expand the Meno Ya Win Health Centre,” they said, confirming 76 beds were allocated to be built in the town. “While the project is currently in the early planning stages of development, we are working with local partners to address the challenges that have delayed this project for far too long.”
Local hospital filling up
The lack of long-term care beds in the town is a problem that goes further than its senior population.
A lack of beds to care for the elderly means the town’s hospital, which serves more than 30 fly-in First Nations communities on top of Sioux Lookout’s 6,000 residents, is looking after them instead. Patients in hospital who could be cared for in other settings are referred to as alternative level of care patients, or ALC.
“The hospital’s becoming a long-term care facility,” Henry Wall, CAO of the Kenora District Services Board, said. “A significant portion of the beds are actually ALC patients — seniors and elders that should be in long-term care or should be in supportive housing for seniors.”
The lack of housing options for seniors is directly linked to hospital capacity, one advocate said. A lack of long-term care means emergency facilities have to step in.
“Because there’s such an incredible shortage of both supportive seniors housing in both Sioux Lookout and its surrounding communities,” Laura Tamblyn Watts, the CEO of the seniors advocacy group CanAge, said. “What happens is we’re getting people who are stuck in hospital.”
Hoppe estimated that more than half the beds in the hospital have been taken up by patients who could be in long-term care. He said it is only going to get worse.
“We got some additional serious (issues) that are compounding the problem right now,” he said.
The end of January saw 24 alternative level of care patients at Sioux Lookout Hospital — more than the entire number of long-term care beds in the town. The Ministry of Health said 10 of them were waiting for placement into long-term care.
Dean Osmond, president and CEO of the Sioux Lookout Meno Ya Win Health Centre, said those patients “drastically limit” the hospital’s ability to admit those who need it most from the emergency room.
He said that in a town of fewer than 6,000 people, there are between three and 17 people waiting for a bed on any given day.
“Acute patients are placed in overflow beds while regular beds are occupied with ALCs,” he said.
A unique location
Sioux Lookout’s role as Ontario’s hub of the north, means tens of thousands rely on it for care, with few other accessible options.
The hospital and town’s 21 long-term care beds are essentially designated for more than 30,000 people, with the majority living on reserves in Ontario’s far north.
“Rural communities like Sioux Lookout become regional centers for vast, vast areas around them,” Tamblyn Watts explained. “What that means is where there’s any kind of a health center, it becomes not just the health center for acute supports but actually becomes the default for long-term care, assisted living, rehabilitation therapy and everything else we need.”
The location also makes controversial legislation introduced by the Ford government in 2022 — allowing hospitals to move seniors out of alternative level of care beds into a long-term care home — significantly more challenging. Data shared with Global News by the Ministry of Health shows 20 patients have been transferred out of Sioux Lookout Hospital under the new measures since September 2022.
Sioux Lookout is an hour from Dryden, Ont., two-and-a-half from Kenora and over four hours away from Thunder Bay.
Moving seniors from a bed in the Sioux Lookout hospital to another town would, in many cases, make visiting impossible for friends and family, especially if the person has already travelled hours from the far north to get to Sioux Lookout in the first place.
“To get from a far north community to Sioux Lookout, you’re looking at (a) minimum (of) over $1,000 airfare alone for one person,” Hoppe said. “And you’ve got to jump from Sioux Lookout to those locations.”
Tamblyn Watts said the move can be “especially devasting” if you are in Sioux Lookout and are moved to a long-term care home in Thunder Bay or further afield.
“For many older people and their family members, that means they may never see them again,” she said.
Waiting continues
When the calls from Sioux Lookout for a new long-term care home will be answered is unclear.
A government source told Global News the Ministry of Long-Term Care remains committed to its promise but hasn’t received a formal application to start the work or allocate money.
To begin work in earnest on the project, they said Ontario generally needs the local municipality or a third-party partner to submit detailed proposals. Meetings are planned with local leaders soon after, according to the source, but the total funding and other more granular details will be decided as the process moves forward.
Osmond said an initial pre-capital submission was sent to the province in 2014. He said another application was sent in 2018 and regular spreadsheet updates have followed outlining “shortfalls in both capital and operations.”
He said the hospital cannot afford to run the new long-term care beds and a model hasn’t been found for it to do so.
“The delay centres around finding a funding model that works for small and rural communities such as ours,” he told Global News. “We are in constant communication with Ontario Health North, who have been advocating for us with the Ministry to find a solution to the funding.”
Others in the town, including local councillors, are calling for rapid action.
In 2022, local councillors passed a resolution asking the province to honour its commitment to build more beds, and in 2023 Coun. Reece Van Breda and local residents ran a letter-writing campaign to draw attention to the demand.
Hoppe even said a place to build a new facility has been found if Queen’s Park offers up the funding to exceed its promise and construct a 160-bed facility he estimates would cost more than $100 million.
“There’s land earmarked for that kind of facility in Sioux Lookout — that’s not the issue,” he said.
“It’s just how do you pay for a 160-bed facility and do it all?”
Mamakwa said the local community has been ignored for too long.
“Minister after minister, they promise these things and they do nothing,” he said. “And that continues to be the trend.”
This is the third story in a series set in Sioux Lookout, Ont., titled Hub of the North. Over three features, the series explored addiction, housing and long-term care in one of Northern Ontario’s most important communities.