CARE BOOST OVERDUE
Gudrun Langolf, president of the Council of Senior Citizens’ Organizations of B.C., welcomes the NDP’s newly budgeted goal to increase direct care for seniors’ home residents to 3.36 hours per day. But she notes that it’s bare bones compared to Ontario, w
So what difference would 22 minutes of extra care really make in the day of a senior living in one of B.C.’s care homes?
It might mean showering more than once a week. Or going to the toilet when they want. Or receiving more help at meal times.
It would mean regaining some dignity, advocates say.
“The difficulty is if you cannot choose how your day goes. It’s bad enough to lose your dignity when people have to help you toilet and bathe, but if you have no control over when you eat or when you go to bed, these are not happy situations,” said Gudrun Langolf, president of the Council of Senior Citizens’ Organizations of B.C.
“These are the most vulnerable of our citizens. Those are the people who cannot take care of themselves, and I’m glad that the (recent) budget started there.”
The NDP’s first budget, released Tuesday, made headlines for its pledges to improve child care and affordable housing in B.C. But the document also earmarked some money to help seniors, ranging from expanding a rental assistance program to cutting ferry fees.
The most significant investment to help B.C.’s aging population, though, was $548 million to improve seniors residential care, which includes home and community care, as well as assisted living. A significant portion of that money will be aimed at increasing the number of care hours residents in seniors’ homes receive each day.
Seniors in these homes currently receive an average of 3.14 hours of direct care per day. B.C.’s Seniors Advocate Isobel Mackenzie and others have long argued this should be increased to a minimum of 3.36 hours a day, or an average increase of 22 minutes.
Only 15 per cent of B.C.’s nearly 300 residential facilities are meeting this target.
Improving those care hours will not revolutionize residential care, Mackenzie said, but will offer some much-needed improvement.
“It’s still never going to be perfect,” she said, but noted it will be better than it is today. “Who out there wants to have a bath or shower only once a week?”
It will cost $110 million annually to increase staff so that all homes can offer an average of 3.36 care hours per resident, but this won’t happen all at once — change is expected to be phased in over the next three years. It will be a reversal of the slashing of government funding that “put us in this glue” in the first place, Mackenzie said.
“We cut a little, cut a little, cut a little. We thought, ‘Ah, what is five minutes a day to an individual?’” she said.
A recent report by Mackenzie’s office analyzes 293 residential care homes with 27,142 publicly subsidized beds in B.C. One-third are run directly by health authorities, and tend to have more complex clients. The remainder are run by private contractors, but with funding from health authorities.
Only four per cent of private operators, who negotiate their contracts with the health authorities, meet the goal of 3.36 direct care hours, while a third of the health authority-run facilities meet it.
Mackenzie anticipates the focus of new funding over the first two years will be to improve the service provided by the homes with the lowest care hours per resident.
Daniel Fontaine, CEO of the B.C. Care Providers Association, which represents these private contractors, said reaching the 3.36-hours benchmark is “absolutely critical” so that his members cannot only provide quality care, but also improve seniors’ quality of life.
“For these seniors, the quality of life is also important. ... When you don’t have enough staff, those are the things that are cut back,” he said. “It absolutely has a huge impact, both to the staff but to the seniors as well.”
But he said the “vast majority” of contractors are not given funding from the health authorities to offer the targeted number of care hours. Right now, private contractors provide on average only 3.01 direct care hours per resident, according
to Mackenzie’s research.
“Now with this new funding, we are hopeful that many more will get close to the 3.36. But remember, the commitment on the part of the province is only to bring it
up to an average of 3.36,” he said. “We have advocated that it be a minimum per site of 3.36.”
Earlier this month, health authorities told the private contractors to start moving staff from
part-time to full-time positions, and asked how many new people they will need to hire to reach the target, Fontaine said.
“The bigger alarm bell we’ve been raising for the provincial government is where are all these people going to come from to work
in these positions? We have significant concern,” Fontaine said. “Seniors care is the fastest-growing sector in the province, in terms of
job growth, and we need to get people really excited and interested in working in the sector.”
He likens the situation to school boards in B.C. that were mandated after a court ruling to hire thousands of new teachers, but many
have struggled to find enough recruits.
Health Minister Adrian Dix estimates roughly 1,500 new jobs will need to be filled, including 900 care
aides and 465 nurses. He said government has been working with Fontaine’s association, as well as post-secondary institutions and various health-care unions, on how to
ramp up training and recruitment.
Dix agreed that another challenge is to resolve the much lower funding contracts that health authorities
have traditionally provided to private contractors to run their seniors’ homes. This is a throwback to an old system when the private contractors
had few complex patients, but with an aging population, an increasing number of seniors require higher levels of care.
“If we are going to make 3.36 — and when 67 per cent of the beds are private ... and those beds have
a lower average — then clearly very significant portions of the funds have to go there to raise those
up,” Dix said. “But we have some work to do on the health authorityowned and -operated ones as well.”
Mackenzie is concerned, though, that B.C. doesn’t have an audit system to track whether the money is being spent specifically on increasing care hours.
For example, when care aides call in sick or go on vacation, she wants to know that they will be replaced. Or if there is a staff opening, she wants to know that the money for that person’s salary will not be redirected to other spending while a replacement is sought.
“You don’t want to have incentives to operators to leave positions unfilled,” she said. “We need to do a better job of making sure that the money is being spent on the items that we have funded that facility to spend the money on.”
Dix said this is a high priority for his government and that the money will be properly tracked.
“We’re in a position to do that, working with public and private providers, because we’ve come to the table with credibility here. We’ve said this is a major issue, one of the most significant issues facing B.C.,” he said.
The previous Liberal government acknowledged the care home problem with a $500-million announcement last year, but $276 million of it was federal dollars intended only for home care, not residential care, Dix said. When the NDP formed government last summer, it forged ahead with about $20 million set aside by the Liberals to start improving care hours, and have now added the additional money in this budget.
“A lot of what we do in seniors care is about safety,” Dix said. “But I do think we have to make sure in long-term care, that we are also focused on quality of life. This is not just a matter of preventing death, or a place for people to go at the end of life, but that, wherever they are, they are living life to the fullest.”
Langolf, who has toured seniors facilities as president of the umbrella organization that represents many seniors groups in the province, welcomes the move to 3.36 care hours, but argues it is still bare bones. Last year, she noted, Ontario pledged to increase direct care hours in seniors’ homes to four hours per day per resident.
And she said waiting until 2021 for all the homes in B.C. to get up to that “low standard” is unfair to suffering seniors.
“Three years is too long. We’ve been waiting 16 years or longer. But, I’m still saying this is a good start,” she said.
“They are trying very hard to fulfil some of their promises. We applaud that. Would we like to see more? Of course.”
It’s still never going to be perfect. Who out there wants to have a bath or shower only once a week?