Seniors Advocate Isobel Mackenzie is calling on the province to restructure home-support services, which she says are unaffordable for many, aren’t keeping pace with the needs of a growing population of seniors, and lag behind those of other provinces.
“When we examine the five-year trends, we find client complexity and frailty is rising, care hours are not growing to meet this need and more care is being shifted to family caregivers who continue to experience high levels of distress,” said Mackenzie, who released her second review of home support services Thursday in a news conference at the legislature press gallery. The last comprehensive review of home support was completed in 2019.
Home support is designed to help seniors live safely at home as they age by offering everything from assistance with bathing and daily personal care to more complex tasks such as catheter care, oxygen therapy and management of medications.
In B.C., home-support services do not include non-medical tasks such as housekeeping, laundry, grocery shopping and meal preparation.
The report notes that funding for home support has increased by 42 per cent over the past five years and the number of community health workers who deliver the service has increased by 25 per cent. However, the hours of home support delivered have only increased by five per cent.
Meanwhile, over the last five years, the number of home-support clients over age 75 is dropping — by 10 per cent for clients age 75 and older, and five per cent for those over 85.
Most provinces don’t charge for home support, and of those that do, B.C. is the most expensive, the report says.
A B.C. senior with an income of $29,000 a year, for example, would be charged $9,000 annually for an hour-long daily home-support visit.
That cost barrier is one reason why 61 per cent of those admitted to long-term care report are not receiving any home supports 90 days prior to admission, she said.
It’s also why B.C. has twice as many low-care-needs seniors in long-term care than Alberta and Ontario, two provinces that do not charge for home-support services, said Mackenzie. The number of seniors in long-term care in B.C. is above the national average.
Mackenzie argues it would cost health authorities $14,000 annually to provide one hour of home support per day compared with $60,000 annually for a long-term care bed for a senior with an income of $29,000 per year.
Cost barriers to home support are also partly to blame for increased wait times for long-term care and ER visits, the report says.
The review includes survey responses from more than 6,000 seniors who receive home-support services. Users reported having a high regard for the care they receive, although the number prepared to rate their home support services as excellent dropped 30 per cent from five years ago.
As in the first report, almost a third of home-support clients say they need additional services such as housekeeping, meal preparation and laundry, which are no longer provided as routine home-support services.
Slightly more than half of home-support clients are at high or very high risk of admission to long-term care, up slightly from five years ago.
The province spent $693 million on home support in 2021-22, a 42 per cent increase in the last five years, with about 40,000 seniors receiving care.
Nearly 60 per cent of those clients receive less than an hour per day of home support, while care hours by family caregivers over the last five years have increased to about five for every one hour of home support.
Family members reporting feeling distress as a result increased to 57 per cent from 34 per cent for those whose loved one receives less than an hour of care daily.
B.C.’s senior advocate made five recommendations:
• Eliminate the financial barrier for accessing home support.
• Increase respite care.
• Standardize and set targets for all aspects of service-delivery.
• Modernize care plans.
• Measure, monitor and report on performance.
The complete report can be found at seniorsadvocatebc.ca/reports.
The Office of the Seniors Advocate is an independent office of the government mandated to monitor seniors’ services and report on systemic issues.
It provides information and referral to seniors and their caregivers and can be reached toll-free at 1-877-952-3181, through BC211, or via email at info@seniorsadvocatebc.ca.
ceharnett@timescolonist.com
