Lift standards for senior care

Anew report by Seniors Advocate Isobel Mackenzie demands our attention. Mackenzie surveyed 22,000 residents of long-term care facilities across the province. She also contacted 20,000 friends and family members. Her findings reveal a darker underside of residential care in B.C.

Almost two-thirds of residents cannot bathe or shower as often as they want. One in four can’t count on getting help to the toilet.

A third have no say in when they get up in the morning, and nearly 40 per cent report there are rarely, if ever, enjoyable things to do in the evenings or weekends.

Almost half have no close companion in the facility, and friendly conversations with staff are too rare. A striking 38 per cent are not consulted about their medications — more of that in a moment.

The results are not all bad. Family visits are frequent. Most residents believe they are treated with respect, and half rate overall quality of care as very good or excellent. That said, four out of 10 residents living in nursing homes do not want to be there.

The troublesome aspect of this report is that it follows on the heels of previous studies that raised similar concerns.

According to the Canadian Institute for Health Information, close to 30 per cent of long-term care residents in B.C. are given antipsychotic drugs with no diagnosis to justify this. In some circumstances, it appears likely the purpose is to subdue and tranquilize, not to treat illness.

Though misuse of these drugs has dropped slightly, we are still far ahead of the national average. And here a related issue arises.

Statistics Canada found that B.C.’s residential facilities have the lowest staffing levels in the country. Are tranquilizing medications being used to replace a missing level of personal care?

There are other gaps in our treatment regimes. We lag far behind some provinces in various forms of therapy.

Just over 12 per cent of long term care residents in B.C. receive physiotherapy. In Ontario, the figure is 50 per cent. Nearly one in five nursing home residents in Alberta get occupational therapy. Only seven per cent receive this form of support in B.C.

Why do these problems continue? One reason is that governments fear to provide a level of comfort that might relieve family members of caring for elderly parents. Numerous studies suggest that having a daughter is the best assurance of end-of-life solace. Let’s return to the matter of staffing levels. Setting an appropriate staff ratio and enforcing is fundamental to ensuring quality of care. Yet there is no national standard. That in itself is a measure of the neglect that residential care has been allowed to fall into.

Several years ago, the provincial Health Ministry conducted its own research and came up with a guideline of 3.36 hours of direct care per resident day. But little was done to achieve it. Close to 90 per cent of our long term care homes still don’t meet that standard.

After Mackenzie’s report was made public, the new health minister, Adrian Dix, promised action. Half a billion dollars has been earmarked over four years to improve quality of care and hire more staff.

This is an issue we all have a stake in. Long-term care residents are some of society’s most vulnerable members. Many can’t speak for themselves. Mackenzie’s report suggests some dare not.

We owe it to them to press hard for change, and to hold our politicians accountable for the assurances they offer.

Dix has made a good start in his new job. He clearly means well.

But we’re long past the point where good intentions matter. What we require are results.