A recent report shows many residents in assisted living private-pay units don't have all their needs met because they can't afford to pay.
That was one of the key findings in the study called The Place of Assisted Living in BC’s Seniors Care System: Assessing the Promise, Reality and Challenges was conducted by the Canadian Centre for Policy Alternatives, the Hospital Employees Union and the BC Health Coalition. The study shows that after paying the basic fee, seniors and their families can't afford services that come with an extra charge.
The study was based on Interviews with care aides, licensed practical nurses, frontline managers, residents and family members and showed some residents were using towels as diapers or for wound care, had to skip meals not included in basic food packages and were wearing dirty clothes because laundry detergent was too expensive.
The study shows concerns for an under-regulated, under-researched and mostly privatized assisted living sector in the province.
It seems a large number of seniors in assisted living residences don't qualify for assisted living under provincial legislation which requires residents to be able to direct their own care and independently respond in case of an emergency.
Staff in the care homes reported they were not able to meet all the needs of residents with moderate to advanced dementia or those experiencing major mobility limitations while those residents were living on their own in publicly subsidized and private-pay assisted living.
“Working as an LPN in assisted living can be heartbreaking," Anita Dickson, president of the Licensed Practical Nurses Association of BC., said. "We routinely encounter situations where residents are clearly suffering because they aren’t getting the level of care they need, but we are told not to interfere because they have the right to live at risk. This violates our code of ethics and standards of practice to provide safe and compassionate ethical care.”
The assisted living model allows residents to make the choice to 'live at risk' to remain independent but it can easily become a way for operators to cope with or justify low staffing numbers. But the situation can often leave residents open to neglect.
In the study, frontline workers report being unable to do what they know they should but are not authorized to do because of low staffing levels, a lack of resources while following the directive of allowing residents to “live at risk.”
Frontline staff interviewed for the study said there was a high rate of emergency room visits and admission into hospital largely due to falls.
“We know seniors want to live in the more home-like environment that assisted living can provide,” Dr. Karen-Marie Elah Perry, author of the report, said. “But I am concerned many seniors and frontline workers are instead dealing with a poorly coordinated sector that increasingly resembles under-resourced and more lightly regulated long-term care.”
Assisted living is considered a housing model, as opposed to long-term care where operators are responsible for overall care of residents and provide 24-hour nursing care and personal supports. In assisted living, the unit in which the resident lives is considered their own home, with operators providing non-medical services like assistance with dressing, bathing and administration of medicines, but not responsible for providing traditional medical care like nursing, physician or rehabilitation service or mobility aides as is found in long-term care.
“More than two decades have passed without a comprehensive assessment of seniors’ care services in BC,” Marcy Cohen, CCPA-BC research associate and member of the advisory group for the research project, said. “The recommendations in this report provide a road map to the Seniors Advocate and the provincial government for a more comprehensive assessment of assisted living, driven by the experiences and voices of seniors, their families and the front-line workers who provide care amid frequently impossible circumstances.”
