For individuals already disabled to the point of requiring daily nursing care as well as other support services, continuing care facilities provide comprehensive care services in a single setting. While most older persons and their families see continuing care usually as a last resort, it may in fact be the best setting for disabled persons with multiple problems, requiring multiple types of services.
BC has a province-wide, single point of entry system to manage how seniors access facilities providing complex care. This program applies to all five health regions, including Vancouver Island Health Authority (VIHA).
Almost all complex care services for seniors, including home care, adult day centres, residential care, respite care, and specialized services are available by contacting the Home & Community Care office in your region. This office can be located by looking in the Yellow Pages. In the light blue pages, which contain provincial resources, you will find several pages with the title "HEALTH AUTHORITIES" at the top. The offices within the telephone directory's region will be listed by municipality under "Home & Community Care". By calling the toll free number 1-888 533-2273, you can obtain the office phone numbers of other municipalities outside your region. This should put you in contact with the appropriate office and an intake worker or case manager will be able to take your call, answer your questions and get the process started for you.
They will set an appointment to see you for an assessment of your physical, emotional, and psychological status. This includes memory and other cognitive functions as well as your ability to perform tasks (referred to as Activities of Daily Living or ADLs) such as bathing, dressing, feeding, grooming, toileting, medicine taking, shopping, cooking and cleaning. The case manager also looks at the supports that are in place to assist the caregiver and will take into consideration the level of stress the caregiver may be under.
People who are assessed as requiring complex care must fit certain requirements in order to be eligible. The case manager can explain these requirements. People who do not qualify for complex care, may qualify for assisted living. (Assisted living is for people who can direct their own care but need some help with one or two daily living tasks. They need to be mobile or at least able to transfer on their own.)
If a case manager feels that a person is in need a complex care placement, and the client is willing to go into care in three months or less, their name is submitted to the placement committee in that health authority's region. If the client prefers a placement in a region in the province other than the one they currently live in, they can request this. However, they may have to first be placed in a facility in their immediate area and then put on a transfer list to the other region, which is under the direction of a different health authority. The client will be asked to select their preferred facility. The committee will attempt to match the client with this facility, but if a bed is not available in that facility the client may need to accept a bed in a different facility and put their name on a transfer list for when a bed does become available in the preferred facility, which can be any length of time. If the client refuses an offered bed, their name will be dropped from the placement process.
Admission is based on need and the acuteness of the situation, not the length of time the person is on the waitlist. There is also a loose rotation system whereby a facility will offer the first available bed to someone in the hospital, the next available bed to someone in the community and the next bed to someone waiting for their preferred choice. However, this system is often interrupted by factors such as hospital discharge needs, community emergencies, cultural factors, particular skills offered at the facility, etc.