Provincial Ombudsman Raymonde Saint-Germain noted continuing problems in senior care in her annual report made public on Thursday, noting the government has reduced the number of inspections of long-term-care facilities.

"The report presents situations where administrative expediency took priority over citizens' needs," Saint-Germain said.

The government stresses the importance of certification to ensure seniors' residences meet provincial standards of care.

"A rigorous certification process, followed by regular inspections based on reliable indicators, is urgently needed," she said.

In the past, 12 per cent of residences were inspected each year, Saint-Germain noted. Now only 10 per cent will be inspected annually.

The Health Department gives the residences 48 hours' notice before an inspection.

With the government increasingly turning to private residences for seniors, she added, the level of quality and controls to ensure adequate care should be key factors in awarding contracts.

At the same time, seniors like to stay in their own homes as long as possible. A report issued in 2008, after Seniors' Minister Marguerite Blais led province-wide hearings, recommended more money for home care.

"This is a choice we must respect, and to which we must respond by providing appropriate services," Saint-Germain told reporters.

The ombudsman found the home-support policy was not being implemented as quickly as expected or at the same pace in all regions.

In the National Assembly, Lisette Lapointe, the Parti Quebecois seniors' critic, cited the Manoir-de-l'Age-d'Or in downtown Montreal . She said staff cuts there mean there is only one night nurse for about 200 residents with little autonomy.

Health Minister Yves Bolduc answered that other night staff can call the nurse or a doctor if necessary.

"It's unbelievable," Lapointe said. "These people, most of them, cannot move by themselves."

Saint-Germain also found shortcomings in Quebec 's palliative care policy.

Complaints came from outside palliative care facilities - in short-term care units, such as emergency rooms, intensive care units and even seniors' residences.

She gave the example of an 84-year-old woman who was treated in hospital for multiple cerebral hemorrhages. After 24 hours, it was clear the woman was near death. Her family complained that measures to make her comfortable were inadequate, and that hospital staff asked the family to leave because visiting hours were over.

Saint-Germain said hospital staff must be better trained to deal with end-of-life situations.

She noted improvements in hospital emergency rooms, but said the introduction of staffing changes is uneven.

In outpatient care, the Ombudsman described the "shift in waiting time" phenomenon - when a patient is given an initial appointment, followed by delays that "can take months, even years" before treatment is given.

Saint-Germain also called for better supervision of private adoption agencies. Delays in international adoptions can result in prospective parents being judged too old by the time a child can be found in another country, she said.

At the Regie du logement, which judges appeals on rent increases, the average time before a case is heard is 17.3 months, the Ombudsman noted. There were 20,110 cases on the Regie waiting list last March 31.

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