Seniors cry out for help as home care aide hours cut
But health authority says it’s following the rules
Isabell Mayer takes the bus wearing her slippers because her feet are often too swollen to fit into shoes.
The 81-year-old has a tough time getting to her favourite cut-rate grocery store because it takes more than an hour using her walker — including all the rest stops.
These are the downsides of aging in ill health that she’s taking in stride, but losing half of the home support hours she used to receive from the Vancouver Coastal Health authority sent her looking for help from her MLA.
“I haven’t been able to vacuum for 15 years,” she says in her tiny living room in a subsidized seniors’ apartment in east Vancouver.
“I can’t wash the floor. The back and forth makes me dizzy.”
These are tasks that home support workers, paid by the health authority, used to do for her.
But Vancouver Coastal has revisited the files of some seniors — the actual number was not available by deadline Thursday — to trim hours back. Only medically required assistance and personal care, typically a shower, are allowed.
Seniors must find help for house cleaning, shopping or errands elsewhere, either by paying privately, relying on family and friends or turning to a replacement program funded by the United Way called Better at Home, which has received $22 million from the province.
Vancouver-Mt. Pleasant NDP MLA Jenny Kwan says Mayer’s story is similar to those she’s heard from other seniors in her riding during the last month. At least five couples and individuals — most of them Chinese-speaking — contacted her about having their weekly home care hours cut in half. Most have gone from two hours to one, just enough time for a bath.
“The government wants seniors to live longer at home, but if you don’t provide the supports for them to live successfully and safely, how are they going to manage? That will only mean they are going to need hospitalization, residential care or assisted living,” Kwan said.
“It’s pay now or pay later and pay more,” she added, noting that a day in an acute care hospital bed costs taxpayers about $1,500, enough to pay for plenty of routine in-home care.
The change in home support hours from Vancouver Coastal Health is part of a move to follow provincial rules more closely, said Bonnie Wilson, director of home and community care for the health authority.
Home support is supposed to help clients with daily needs including bathing, dressing, using the toilet, taking medication or setting up a meal. These are considered medical services.
Home support workers are paid only to do those tasks and not a wider range of duties that were covered before policy changes about 10 years ago: visiting, transportation, light yard work, minor home repairs, light housekeeping and grocery shopping.
“VCH’s home support guidelines are consistent with the Ministry of Health and other health authorities. Historically the mandate for home support services used to be broader, but this was sometime before 2004 (the guidelines that preceded our current ones),” Wilson explained in an email.
“This was at a time when there was no distinction between medical and non-medical support services, and when clients went to residential care much sooner than they are now.”
The complex medical problems experienced by some of Canada’s oldest residents reflect a growing trend: people are living much longer, but not necessarily in good health. They can often stay at home — and avoid the high cost of either private or publicly funded nursing in residential care — but home support workers are being called upon to deliver some services that formerly fell to nurses. Doing laundry or picking up groceries are long gone from their to-do list.
Exceptions to that, says Wilson, are allowed if it’s unsafe for workers or the client to be in the home because of the mess, or if a client risks eviction or has been refused other government-subsidized services such as HandyDart because of a lack of cleanliness.
In British Columbia, home care is typically provided and subsidized — depending on income — by a local health authority that contracts the duty to a handful of accredited private companies. Clients with higher incomes often hire their own help. In 2013-14, B.C’s health authorities spent $1.1 billion on home support for about 39,000 clients. That compares to $1.8 billion spent on residential care for 27,308 seniors.
In 2012-13, the province funded 7.37 million hours of home support, according to the Ministry of Health, 23 per cent more than three years earlier.
B.C.’s Office of the Seniors Advocate is planning to survey all recipients of publicly funded home support in the province about their experiences for an upcoming report.
The Minister of Health was unavailable for comment by press time.