I stood in the hallway of Moncton City Hospital last Wednesday, watching as nurses navigated between temporary beds that lined the corridor. A patient in her 80s, whom I’ll call Marie to protect her privacy, had been there for 97 days. Not because she needed acute hospital care, but because there was nowhere else for her to go.
“I’m blocking a bed someone else needs,” she told me, her voice barely audible above the constant beeping of monitors. “But what choice do I have?”
Marie represents hundreds of elderly New Brunswickers caught in healthcare limbo – medically stable but unable to return home, waiting for a long-term care placement while occupying valuable hospital resources.
The provincial government announced yesterday a significant policy shift designed to address this growing crisis. Starting September 1, hospital patients awaiting long-term care will receive temporary priority placement, even if it means being moved to a facility outside their community of choice.
“This is about making difficult but necessary choices to ensure our healthcare system can function properly,” said New Brunswick Health Minister Bruce Fitch during the announcement in Fredericton. “We cannot continue having patients who don’t require hospital care occupying beds needed for emergency and surgical care.”
The new policy stems from alarming statistics. According to Department of Health data, approximately 20% of New Brunswick’s hospital beds are currently occupied by patients who no longer require acute care. These patients, officially designated as “alternative level of care” (ALC), cost the system an estimated $185,000 per bed annually – significantly higher than the $88,000 average annual cost per long-term care bed.
For healthcare workers on the frontlines, the impacts of this bottleneck are painfully evident.
“Every day, we’re making impossible decisions about who gets admitted because our emergency department is backed up with patients waiting for beds,” explained Dr. Sarah McKinnon, an emergency physician I spoke with at the Saint John Regional Hospital. “Meanwhile, we have people in beds upstairs who could be better served in long-term care.”
The New Brunswick Association of Nursing Homes cautiously welcomed the announcement but raised concerns about implementation. “Our facilities are already operating at 98% capacity,” said Julie Weir, the association’s executive director. “Without additional resources, we risk compromising care quality by taking in more residents than we can properly support.”
For families, the policy creates complicated emotions. When I visited the Kensington Court care home in Saint John, I met David Peterson, whose mother has been waiting in hospital for seven months for placement in this specific facility.
“I understand the logic,” Peterson said, standing in the sunny common room where he hopes his mother will eventually spend her days. “But being moved to a temporary placement an hour away makes visiting nearly impossible with my work schedule. And transitions are especially hard on someone with dementia.”
The temporary priority placement mechanism will work as follows: When hospital patients have waited more than 30 days for long-term care, they’ll be placed in the first available appropriate bed within a 100-kilometer radius, even if it’s not in their community of preference. They’ll maintain their position on the waitlist for their preferred facility.
This approach mirrors similar policies in Nova Scotia and Ontario, where healthcare systems face comparable demographic pressures. In Nova Scotia, the policy helped reduce ALC patients by 15% within its first year of implementation, according to a 2023 evaluation by Dalhousie University’s School of Health Administration.
However, the Canadian Centre for Policy Alternatives has documented significant drawbacks, including increased family caregiver burnout and transportation costs. “These policies often disproportionately impact rural residents and those with lower incomes,” noted their 2022 report on long-term care access.
Indigenous communities have raised additional concerns. “Our elders need culturally appropriate care, which often isn’t available in mainstream facilities,” explained Miigam’agan, an elder from Esgenoôpetitj (Burnt Church) First Nation. “Being placed far from community and family can cause profound spiritual and emotional harm.”
The core problem isn’t just about bed management but reflects deeper demographic shifts. New Brunswick has Canada’s second-oldest population, with nearly 24% of residents over age 65, according to Statistics Canada. Projections indicate this will reach 31% by 2038.
Despite these challenges, some communities are developing innovative solutions. In Sackville, a cooperative housing model for seniors combines independent living with graduated care services. In Moncton, a hospital-to-home transition program provides intensive in-home supports for the first 30 days after discharge.
“We need to think beyond institutional care,” said Dr. Suzanne Dupuis-Blanchard, Research Chair in Aging at the Université de Moncton. “Most seniors prefer to age at home when possible, and it’s often more cost-effective for the system.”
As I left the hospital that day, Marie was being helped back to her temporary room. “I’ve worked and paid taxes my whole life,” she said, “I never thought I’d end up stuck in a hallway.” Her eyes filled with tears as a nurse gently guided her walker around an IV pole. “I just want to be somewhere that feels like home.”
The new policy may help Marie and hundreds like her move out of hospital limbo sooner. But as New Brunswick continues to age, the province faces difficult questions about how to build a long-term care system that truly honors the dignity and preferences of its most vulnerable citizens.
