No Place to Age: The costs and indignities of long-term care in Alberta

By Hope Smith, Alberta Views“I used to think I preferred getting old to the alternative, but now I’m not sure. Sometimes the monotony of bingo and sing-alongs and ancient dusty people parked in the hallway in wheelchairs makes me long for death. Particularly when I remember that I’m one of the ancient dusty people, filed away like some worthless tchotchke.” —Jacob Jankowski, in Water for Elephants“No pleasure is worth giving up for the sake of two more years in a geriatric home…” —Kingsley AmisRetired provincial court judge Tom McMeekin became a bit of a minor celebrity a few years ago when he decided it was time the world knew what life was like in a local nursing home. McMeekin’s multiple sclerosis had progressed to a point where he and his wife couldn’t meet his needs at home. Like everyone else going into long-term care in Alberta, McMeekin had to take the first bed available. “Life was hell, quite frankly,” he recalls. “There were four of us sharing one bathroom: two women and two men. The staffing was so bad that I launched a petition. I described sitting and waiting, desperate to go to the bathroom, and so on. I got 1,500 signatures.” There was a brief media storm, and things got a little better, but for 16 months McMeekin had no space to call his own; his roommate wouldn’t even allow him to watch the tiny TV he had on his bedside table.He’s now more comfortably ensconced at the Colonel Belcher Care Centre, one of Calgary’s newest facilities, where each resident enjoys the precious privacy of their own room. “When I moved in here, I thought I’d gone to heaven,” he says. Mind you, he only gets one shower per week, so he pays for two more at $40 each. That’s $80 per week out of pocket—or more than $4,000 a year—for something most of us take for granted.McMeekin may be in one of the newest facilities in Alberta, but even here things aren’t perfect. “The staff are excellent,” he says, “but there aren’t enough. They’ve done away with registered nurses . Licensed practical nurses do most of the work.” And there’s the regimentation of the institution: dinner at 5:00 p.m.—“One hundred ways to cook hamburger,” he smiles.McMeekin’s experience, however, could be called cushy compared to the neglect many senior citizens experience in long-term care in Alberta. And even the limited resources being put into long-term care in this province are in jeopardy. The Alberta government, like those in most provinces, now proposes that many seniors currently in publicly funded nursing homes shouldn’t be there. Instead, they argue, these seniors should be in some other type of assisted living arrangement (including private facilities and “aging-in-place”) where necessary health services would be delivered by home care while other services—including “unnecessary” services like showers—would be paid for by senior citizens themselves.It’s a proposal based on shaky premises. “Where is the data showing that those people don’t belong ?” asks Donna Wilson, professor of nursing at the University of Alberta. “The government hasn’t collected data for 10 years.”Seniors advocates are also up in arms about the shift. “The promises that care will be virtually the same, but they pass it off to investor-owned facilities,” says David Eggen, executive director of Friends of Medicare. “There aren’t the same regulations regarding nurses or the same provisions for training.”The cost implications for individual seniors could be enormous, he adds. “Once you move from long-term care to assisted living, you’re not afforded the protection of price controls,” Eggen says. (Alberta seniors pay from $16,000–$20,000 a year to live in publicly-funded long-term care; they can pay up to $72,000 a year for private assisted living facilities.)Also in the works is a new omnibus Health Act, which will supersede all current health legislation, including the Nursing Homes Act. The Nursing Homes Act sets out standards which guarantee residents a minimum level of care. Under the proposed new legislation no such specifics are laid out. “What is proposed is an Act with principles that are so vague as to be meaningless,” says Noel Somerville, chair of the Seniors Task Force for Public Interest Alberta (PIA).Most Albertans haven’t thought past the “elderly” stage to the “incapacitated” stage, and even fewer have any idea of what awaits them in long-term care. “Doing some market research five or six months ago we found that people don’t think about it until there’s a crisis,” says Greer Black, president and CEO of Bethany Care Society, a not-for-profit organization that operates close to 800 long-term care and supportive living beds in the province.…The story continues on the Alberta Views website.Hope Smith is a freelance writer whose first-hand experience with senior care in Alberta prompted her to write this story.