In Alberta, we’ve begun to recognize that populations have changed significantly since funding models were developed in the mid-1990s, and there is a province-wide effort to increase care hours beginning in 2023. 

A typical resident in long-term care is allotted a certain amount of direct nursing care time from each staff type, plus some additional time from rehabilitation professionals and dietitians. Due to shifts in the composition of today’s long-living seniors, there are now recommendations nationally and in many provinces to increase direct care time from 3.02 total hours per day to 4.1 or more hours — that’s a recommended 36% increase in staff time.

This call for change is largely due to the number of residents with dementia, who often need more care and staff time. Funding models don’t always recognize dementia as a complex health issue requiring more time and specialized support for every aspect of daily living. 

Care Time Allotment

The funding formula for long-term care spells out how many minutes of time each resident should receive, on average, by each type of care professional. Under the formula, relatively health residents are allocated less time than more ill or frail residents. It is well known that residents with dementia need more care and staff time, but funding doesn’t always recognize dementia as a complex health issue requiring more time and specialized supports.

Alberta Direct Nursing Time By Staff Type
Nursing Care TypeRegistered NurseLow Acuity17 minutes per 24 hrsAverage Acuity31 minutesHigh Acuity68 minutes
Nursing Care TypeLicensed practical nurseLow Acuity12 minutes per 24 hrsAverage Acuity22 minutesHigh Acuity49 minutes
Nursing Care TypeHealth care aideLow Acuity68 minutes per 24 hrsAverage Acuity2 hrs, 8 minutesHigh Acuity4 hrs, 43 minutes

Average LTC Length Of Stay (LOS) In Years

Length of stay (LOS) is a system metric that helps us understand how long residents live in a care facility. The average LOS in long-term care has been dropping for two decades. Most of today’s LTC residents are in the last 12-18 months of life. This is a reflection of a population today that has more frailty and complexity than in previous decades.