B.C.’s ombudsperson is optimistic that if seniors speak up about reasonable expectations seniors care will improve in the province.
Speaking to local seniors at a meeting hosted by Independent MLA Bob Simpson at the Pioneer Complex in Williams Lake Tuesday, ombudsperson Kim Carter and her colleague Bruce Ronayne, executive director of intake and systemic investigations, presented the ombudsperson’s latest report — The Best of Care: Getting it Right for Seniors in British Columbia (Part 2).
The report was first released in February and outlines 143 findings and 176 recommendations to the Ministry of Health, Ministry Responsible for Housing, and five regional health authorities.
It investigated home and community care issues, home support, assisted living and residential care and a spirit of ensuring people are treated fairly.
“We found people need assistance to navigate the system, that people who deliver care need support, and that there needs to be clear, objective, enforceable standards,” Carter says. “There also needs to be a straight forward and responsive complaints process. We found they weren’t there and in some cases people were not getting any answers.”
Highlighting statistics, the report shows payments for home and community care can range from $10 a day for home support to more than $2,900 a month for residential care.
Seniors can be paying up to 80 per cent of their income as long as they have $325 left for themselves.
Carter says seniors are the consumers and have the ability to have an influence.
When it comes to reporting abuse and neglect, the report looks at the requirement of staff to report abuse, and discovered that some workers said they were afraid to speak up.
The report includes both shorter-term and longer-term recommendations.
For the shorter term, one of the key recommendations suggests standardized training and registration for community health workers.
Under its longer-term recommendations, the report calls on the Ministry of Health to report out every year.
“An annual home and community report needs to be put out there so people understand what’s happening,” Carter explains.
In 2009/2010, at least 24,500 seniors received subsidized long-term home support services, of which health authorities spent approximately $339 million providing subsidies.
Interior Health expended 582,632 hours in subsidized long-term home support services and supports of independent living in 2009/10, down from 882,283 in 2008/09 and 919,999 in 2007/08.
“These are the types of figures people need in order to have a good conversation,” Carter says.
Specific cases are outlined in the report, one about a woman’s home support hours being reduced by half.
“We learned that health authority staff had approved a reduction in services because they believed that the same number of tasks could be performed in less time,” Carter says. Later the health authority acknowledged that wasn’t the case and agreed to restore most of the original time allotment.
When it comes to home support, the report calls on the Ministry of Health to establish clear, specific and enforceable standards.
Ronayne said there were 194 registered assisted living residences in B.C. as of May 2011, with five regional health authorities providing $74.7 million in funding in 2010/11. A total of 4,380 units were subsidized; 2,451 were not. The Interior Health Authority in 2010/11 had 57 residences, 926 publicly subsidized units and 904 private pay units.
Subsidized residents pay a maximum of 70 per cent of their after-tax income — an amount that ranged from $801 to $3,860 per month, and averaged $1,224 per month as of March 2010.
In 2008/09 the average wait after assessment for placement was 185 days for residents in IHA, 146 days in 2009/10, and 160 in 2010/11.
One of the shorter term recommendations around assisted living is to provide legal authority to recognize a wider range of relationships for residents who can no longer care for themselves.
A longer-term recommendation focuses on legally-binding quality care of standards around things such as food safety and records keeping.
Another recommendation advocates that the office of the assisted living registrar be expanded to have broader powers.
In 2010/11 there were 5,279 publicly subsidized residential care beds up from 4,304 in 2005/06 for IHA. Daily hours of direct care provided per resident in 2011 averaged 2.85 hours in IHA, up slightly from 2.80 hours in 2008.
There are no legislative requirements around time, the number of staff or who should be on duty. While child-care facilities have strict guidelines, elder-care facilities do not, Carter observes.
“In the Ministry of Health’s report to us, one of the recommendations was that the report would benefit from direct input from seniors,” Carter says.
The Ministry of Health is also soliciting feedback on establishing a seniors advocate.
While public consultation meetings are not being held in Williams Lake, local seniors are encouraged to submit feedback either by mail, e-mail or phone.
Simpson says people can either contact his office or MLA Donna Barnett’s for more information.
Seniors Advisory Council member George Atamanenko wonders if there’s a “true” buy-in from government and public health authorities to the recommendations and how long it will take for any of them to be implemented.
Carters says there’s the voice of buy-in.
“We’ve made the recommendations. There can be buy-in, but it’s easy to be distracted. What’s really going to make a difference is that public interest in getting key recommendations implemented.”