The issue of access to quality care in our senior years touches all of us, sooner or later. Unfortunately, increasing costs and decreasing government funding have made beds in both private and subsidized not-for-profit care facilities harder to pay for and harder to find for seniors needing these services in B.C.
“Government funding is contributing less and less to our costs, while our needs continually increase,” affirmed Deborah Geogan, Administrator of the 151-bed, non-profit Rosewood Manor in the Vancouver suburb of Richmond. “Our special case unit, opened in 2006 for dementia patients, has improved the lives of those residents. But the unit wouldn’t have been possible without our Rosewood Manor Care Foundation, established in 2000 in cooperation with Vancouver Coastal Health. We must raise money to augment care and services for our residents.”
B.C. boasts many care facilities, both private and subsidized, but the majority have long waiting lists and seniors usually don’t get their first choice of facility when they want or need care. The Vancouver Coastal and Fraser Health Authorities govern subsidized facilities. To be considered for care, a health authority professional assessor must first evaluate each client’s level of need. At that time, the level of care is decided, and location preferences of the client are noted. Occasionally, preference and availability coincide, but often a patient in need is placed in the area’s first available bed, and then can request a move to his or her first-choice - a transfer that may take years.
While an equal combination of money, health and availability govern whether or not a senior finds accommodation when needed, lack of availability means longer waiting lists. And long lists have consequences for the health of seniors who eventually find appropriate beds. In fact, there was a 60 per cent increase in the mortality rate for seniors in residential care between 2001 and 2006 - not because of negligence, but an unfortunate outcome of long waiting lists. Seniors were, and continue to be, in worse health by the time a bed is found.
An alternative to residential care is user-paid home care, which the present government has described as “an appropriate substitute for residential care.” As access to residential care has decreased, funding to home care should have increased. But according to a report by the Canadian Centre for Policy Alternatives, between 2001 and 2007 there was a 30 per cent decrease in home support for seniors 75 years and older.
It is estimated that chronic conditions such as diabetes, arthritis and heart disease comprise two-thirds of admissions to hospitals, where seniors often wait for residential care beds to become available. Known as “Bed Blockers,” these seniors occupy acute care spaces because they can’t be admitted into subsidized or private care. If facilities (which used to be classified as either Intermediate or Long-Term Care, but are now collectively referred to as Complex Care) were more accessible and more adequately funded, it would reduce the pressure on the province’s primary and acute care systems, which are both woefully overcrowded.
Eighty-one-year-old Rachel pre-registered (with a $100 deposit) at a private facility. After a six-month wait, her name rose to the top of the list, but she wasn’t ready to give up her home; she declined the accommodation. Her name remained on the list, although no longer at the top. At the beginning of July, Rachel had a fall in her home and was ambulanced to hospital, where she continues to occupy an acute care bed. Because she had postponed moving into the private care facility, she will now have to wait until a rehab bed within the hospital system becomes available.
Some seniors are fortunate and able to move into their preferred private care facility. Maxine Howarth, 87, is such a tenant. Wanting the safety and security of a shared residence, she moved into her first choice nursing home. “There is not one thing I don’t like,” she says. “I have company when I want it, and I can be a recluse in my suite if I so choose. I feel safe. There are lots of planned recreational activities. I could be busy all the time. The food is great, the main meal is provided daily and I’m happy.”
Costs at Maxine’s home, range from $2,410 a month for a studio suite to $3,650 monthly for a two-bedroom suite. For an extra person, there is a $550-a-month charged, and any special care is paid for by the resident. Presently the facility houses 123 people: six couples, 92 women and 19 male tenants.
At Rosewood Manor, Bea Skorstengard is a model tenant.
“Bea is our fundraising poster girl for the Foundation,” quipped Megan Kinghorn, the Recreation and Volunteer Manager. Bea, 94, is a registered nurse who trained at Royal Columbian Hospital in New Westminster and has nursed across Canada both in hospitals and privately. She has one son and a granddaughter who live nearby. “I do wish I had more visitors,” she quietly whispers. “You can be lonely in a crowd.” Fortunately, her new home offers a variety of programs. For fun and relaxation, Bea has learned to play Tone Bells. Cost at this non-profit facility ranges from $29.90 to $71.80 per diem based on taxable income.
These are examples of the kind of facilities, which may or may not be available in your area. Taking the time to do some advanced research on available options will help you make informed decisions when the time comes.
AUGUST 2009 SENIOR LIVING VANCOUVER
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