In the last issue of News & Views, I wrote about the sad state of Alberta’s continuing care system for seniors whose physical or mental capacities have deteriorated and who are neither wealthy enough to hire a personal care assistant nor poor enough to qualify for the Alberta Seniors’ Benefit.
To address the inadequacies of the current continuing care system, the Seniors Task Force of Public Interest Alberta developed the ALBERTA SENIORS DESERVE BETTER campaign that advocates five steps:
- Provide quality public homecare.
- Ensure Quality, affordable and accessible care facilities.
- Stop turning long-term care facilities into assisted living facilities.
- Create advisory councils in all seniors care facilities.
- Establish an Independent Seniors Advocate (ISA) as an officer of the legislature.
Let’s begin to examine some of these steps a little more closely.
HOMECARE
The Alberta government’s “aging in place” strategy should be a win-win proposition. The longer seniors remain in their own homes (houses, condos or apartments) the less strain there is on health care or continuing care institutions — the government wins. Very few seniors relish the thought of leaving their own home to move into an institutional care facility — seniors win.
However, in addition to the many other factors that tend to drive seniors out of their homes, the aging in place strategy fails if the necessary support is not in place when a senior’s physical or mental health deteriorates to the point that they can’t manage at home without trained medical help.
The amount of public homecare available in Alberta has varied in the different regional health authorities but is almost universally inadequate for anyone who requires more that a one-hour visit, perhaps three times a week. There are, of course, many private homecare services, but the workers are not always well trained or reliable. Additionally, rates of $52/hour for private medical homecare and $25/hour or $220/day for private personal homecare are beyond the reach of most seniors on fixed incomes.
Accordingly, we have been urging government to expand the scope of public homecare services and make them available as part of medicare to all Alberta seniors who require such care.
CARE FACILITIES
While the Alberta government does help to fund publicly and privately operated seniors care facilities that provide a range of care levels, over the past fifteen years or so the balance has swung drastically. It has moved toward facilities that, ironically, are really alternative forms of accommodation to staying in one’s own home and provide no care or very minimal levels of care. It has also swung very markedly toward facilities that are privately operated for profit.
Access to subsidized facilities such as lodges, often operated by non-profit foundations, is only for able bodied seniors and is “means tested,” making them available only to those eligible for the Alberta Seniors Benefit. In many of the supportive living facilities, the care is limited to whatever the health authority makes available or, if provided by the facility, care is a billed “extra”. Frail seniors in these facilities are actually required to pay to be helped out of bed, toileted, bathed, dressed, taken to the dining room, fed, etc. Such personal care is essential not only to these seniors quality of life, but also to the preservation of life itself.
When the time comes that seniors can no longer stay in their own homes, because of dementia or physical frailty, the type of facility they really require is the nursing home (long term care facility) that does provide qualified nursing care. Interestingly, this is the only facility in which accommodation rates are controlled by the provincial government and is also the type of facility that is in shortest supply.
A recent article in the Calgary Herald estimated that there are about 500 frail seniors in the Calgary area alone that have been medically assessed as requiring long-term care but are awaiting such placement. More than a hundred of them were being accommodated in scarce hospital beds. Seniors can wait years for a LTC spot to open and then, it is often available far from their home and support network.
CONVERSION OF LTC FACILITIES
Despite the chronic shortage of long-term care facilities, the government continues to promote the conversion of such facilities to Assisted Living. The non-profit operator of one of these facilities was reportedly paid $500,000 to downgrade it. When these conversions occur, nursing and personal care are drastically reduced, and the cost of whatever care remains is passed on to the residents or their families.
GETTING GOVERNMENT TO ACT
All of this has been drawn to the attention of senior government officials, but they seem to be in denial, preoccupied with the cost and ‘sustainability’ of including medical and personal care for frail seniors as part of medicare.
Getting government to take action on these steps will require a major campaign to educate our MLAs on the realities of our current seniors care system. To that end, PIA is currently forming MLA contact groups in each constituency. These contacts will be provided with briefing notes as the basis of meetings with their local MLA, perhaps three times per year. They will also be asked to report back by email on their MLA’s reaction at each meeting.
Anyone interested in participating on an MLA contact team should apply using the following web link: http://teams.pialberta.org: click on “Seniors Campaign” and complete the application under “… or Apply”.
Noel Somerville, Chair
Seniors Task Force
Public Interest Alberta
