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Dire Circumstances with ALCs:

8/21/2025

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 Andrew Waugh wrote a most interesting assessment of what he has determined to be the approach of the current government to New Brunswick’s Alternate Level of Care disaster.  As he reported in the August 9 edition of the Brunswick News publications, the direction apparently set by the Premier at the time of the State of the Province Address was to take steps to make sure the situation does not get worse.

Apparently, in that discussion with media, the Premier used the term “dire” to characterize the ALC crisis in New Brunswick.  On this topic, words matter.

According to Google and AI:  dire circumstances refer to a situation that is very serious, dangerous, or critical, often involving hardship, suffering or a potential disaster.

The reality, based on hard fact, is that the situation was at that level over a decade ago and all during those years, the service provider organizations have been trying to get the attention of government, both elected and civil service, with some clear ideas and probable directions that could serve to add relief and start the process of managing eldercare in a coherent, systematic, and compassionate manner.

Over-crowded emergency departments are no new thing.  They had symptoms of overcrowding back in the 1990’s and since that time it has gotten progressively worse.

The senior population, and I am certainly one of them, seem to have become “numbed” and tend to accept that hours of waiting in emergency departments, stretchers in the hallway for both young and old, staff run off their feet……. that’s the way it is.  Any other demographic would be up in arms very publicly demanding direction.  But not so much for my generation.  So much for “grey power”!

The evidence suggests that the situation was left in the “dire” level for so long it is now at the ‘disaster’ level.

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Horizon again: are we surprised?

8/6/2025

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Two weeks ago, they hit the 666 for ALCs.  Andrew Waugh’s article on July 31, 2025 should be sobering for anyone who has had those dreadfully long waits in the Emergency Departments of hospitals.  What does that have to do with old folks and alternate level of care, you ask?  Everything.

Running an efficient emergency department requires superb staff with lots of skill and training, good modern equipment, access to great diagnostic and therapeutic supports, and space that is properly laid out and equipped to function efficiently.  Our emergency departments have all that.  But they remain in a state of chaos during many hours of the day and week.

Chaos can be managed by these talented people when they are administering life-sustaining care to those whose conditions are medically life-threatening.  But when the department is overflowing with those whose conditions are concerning but not emergency, that is a different story.

Based on their training, staff know and are committed to giving care priority to people with acute chest pain, acute abdominal distress, stroke symptoms, premature labor, fractures and multiple trauma.  Having that compromised with frail elders who have problems but not at that level introduces a serious challenge to otherwise great care and public service.

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    ​Ken McGeorge, BS,DHA,CHE is a career health care executive based in Fredericton, NB, Canada. 

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