Caregivers not getting help they need
Most watchdog reports wind up advocating more services and more money. Seniors’ advocate Isobel Mackenzie says there is room for both in the field of respite care to relieve caregivers of the daily pressures of caring for seniors.
But she also found some startling information about how the current level of programming is used. She looked at 30,000 health assessments of seniors living in the community — as opposed to care facilities — and found almost a third of volunteer caregivers in their lives are stressed out to a considerable degree.
That’s exactly the problem respite care is supposed to address. The various programs take responsibility for seniors for varying lengths of time in order to give a break to caregivers, most of them spouses or other family members.
Adult daycare is one example. All the health authorities offer adult daycare, most of them in residential care facilities, where clients can spend all or part of a day. Most of them have waiting lists. But Mackenzie found 25 per cent of the available spots were unfilled. So at the same time care- givers wait for daycare programs to accept new clients, across B.C. a quarter of the spaces in such programs are vacant.
Transportation might partially explain the gap. It can be complicated to get seniors to the facility by way of HandyDART or volunteer drivers.
But the empty places contribute to the fact that only seven per cent of seniors assessed as needing some help reported using an adult daycare in the week the assessment was done.
And only a fraction of the families who truly need the service are using it. The report concludes 29 per cent of caregivers are in “distress,” but only nine per cent of the clients whose caregivers are in distress are using daycare. So 91 per cent of a population for whom a program has been specifically designed to help aren’t using it.
The Vancouver Island Health Authority reported 32 per cent of its adult daycare was unused in 2012-13 and 25 per cent in 2103-14. The vacancy rate swings all over B.C., from seven per cent in metro Vancouver to 44 per cent in the North.
“There are no data that explain the reasons for this unused capacity,” said the advocate.
Caregivers feel distress in direct relation to how many hours they’re spending (19 hours a week minimum). So adult daycare usage is one indicator of how the caregivers are faring. B.C. is providing an average of 41 days per year per client. In Alberta, the comparable number is 103. And the distress rate of caregivers there is 45 per cent lower than in B.C.
(Distress is measured when a client undergoes a detailed assessment of their health needs and anyone involved with the client notes that the caregivers are having a particularly difficult time.)
In-home respite is another program to alleviate pressure on caregivers, by having paid community health workers visit regularly.
Funding has increased over the years, so the number of clients and hours of care they are getting has increased. But it hasn’t kept pace with the growth of the seniors population. So in relative terms, there’s been a decrease in the service.
And as with daycare, there’s a curious gap. Only 53 per cent of seniors enrolled in home support reported getting such care in the week in which they were assessed. In Alberta, 65 per cent had received home support in the past week.
There are also respite beds in facilities to give caregivers longer breaks. Mackenzie found 15,000 seniors could potentially benefit, but only 3,700 used one last year.
The system is failing to connect with distressed volunteer caregivers and a rethink is required, she said.
Health Minister Terry Lake said the central finding of the high distress rate among caregivers is not a total surprise.
“Many people are raising children and caring for their parents at the same time, while both partners are working,” he said. “Their lives are complicated.”
He said spending on home care has increased, but conceded the growth in the seniors population might be outpacing the budgets. Mackenzie’s report “is good information to have.”