Seniors advocate faces many battles

I t took a friend and her husband months to get her elderly parents into adequate care. I asked what advice she would give to somebody facing similar challenges. “Don’t get old,” she said. Then she clarified: “Don’t get old. And whatever you do, don’t get old in B.C.”

That was before the government appointed a seniors advocate for B.C. Since 2014, Isobel Mackenzie’s role has been to support the province’s seniors, gather information about issues they struggle with, recommend solutions and call on government and other stakeholders to act.

Mackenzie has been prolific and vocal in investigating problems and speaking out for seniors, yet she’s fighting a long battle.

Numbers released by Statistics Canada in June show that, unlike in the rest of Canada, the incomes of B.C. seniors are slipping. Senior families in the province saw their median incomes slide 5.7 per cent, and singles’ incomes declined 6.3 per cent.

Factors driving the slide likely include low interest rates and the failure of private pensions to keep up with increases in cost of living.

Some minor financial assistance for low-income seniors exists — reduced health-care premiums and PharmaCare, for example. Other sources — the B.C. Seniors’ Supplement or the federal Guaranteed Income Security and Old Age Security pensions — haven’t kept pace with the province’s skyrocketing cost of living.

On top of that, the increase in the population 75 and older since 2012 has significantly outpaced the increase in the number of residential-care beds in the province over the same period, while the number of subsidized assisted-living units has increased by less than one per cent.

The province’s 4,600 subsidized assisted-living units have wait lists 2.5 times as long as those for the 27,000 subsidized residential-care beds.

The recently introduced changes to the province’s Community Care and Assisted Living Act will allow seniors in assisted-living residences to live there longer and get more help. Under the old rules, seniors who required two or more prescribed services, such as assistance with eating or hygiene, financial management or medication management, would be forced to move into a full-service residential-care home.

Although the changes provide more options for seniors already in assisted living, they mean seniors waiting to get into those facilities will have to fend for themselves even longer or resort to residential-care homes.

And for those living at home, homesupport hours for seniors have decreased since 2012 in most health regions, while the number of clients has increased — further increasing pressure on seniors and their families, and likely leading to further increased demand for care facilities.

However, staffing levels at government-funded long-term care homes for seniors in B.C. also failed to meet Ministry of Health guidelines in 201415. The seniors advocate reported that fewer than 18 per cent of the province’s 292 publicly subsidized residential-care homes receive enough funding to provide the provincial standard of 3.36 daily direct-care hours per senior. Direct care includes assistance with tasks such as bathing, feeding or using the bathroom.

As a result of that report, the Ministry of Health is reviewing staffing guidelines.

According to another seniors advocate report, released in June, lowerthan-adequate hours of care might be linked to increased aggression among residents of long-term care facilities. While the difference in per-resident care hours is only three minutes per day, in an 80-bed facility, that represents four hours less of direct care each day, or 182 fewer eight-hour shifts per year.

The study also found that facilities with violent resident-to-resident incidents tend to have more residents with complex care needs, such as behavioural problems and higher incidences of psychiatric disorders — conditions that require more time and more care, and higher levels of staffing.

There are also the high levels of anti-psychotic prescriptions given to B.C. seniors in care homes without corresponding medical diagnoses, inadequate opportunities for exercise, physio- or occupational therapy, food that seniors find difficult to cut or chew, and the difficulties even independent seniors may face in getting around town, and it’s clear Mackenzie still has many battles to fight on behalf of the province’s elderly.

As do all of us — in caring for and advocating for our own aging parents and friends, and in preparing for our own advancing years.