One senior's complaint has prompted a conversation about minimum requirements for bathing for seniors in care.
Earlier this year Northern Health's eight-bed McBride facility moved from two-a-week to once-a-week bathing.
That put it in line with the standard at the health authority's 24 residential care facilities, said spokesman Jonathon Dyck.
"The minimum is for the facility standards but each person would have a different care plan," said Dyck, who couldn't confirm by deadline when the once-a-week minimum became its policy. "Each person when they come into a residential care facility has a care plan tailored specifically for them.
"If somebody, for a clinical need or other needs, needs more baths a week than what the minimum is, or a day for that matter, we make sure that that happens."
The Rocky Mountain Goat, Valemount's local paper, reported on the new Bulkley Valley bathing requirements after speaking to 73-year-old Edna Monroe - who it should be noted is in community care not residential care - had her number of baths per week reduced.
For those in community care, Dyck said Northern Health sends case managers to meet with patients for an assessment to determine the level of service required.
Lola-Dawn Fennell, manager of Prince George Council of Seniors, said policies should be made in consultation with seniors.
"I don't know if that's how a once-a-week bath has come about in this health authority but I am concerned that it was a decision that was made without consulting the elders who the decision is being made for," she said.
"That's their policy and I'm sure it's for a reason, probably a staffing reason."
Fennell referred to the provincial organization's slogan for guidance:
"No decisions about us without us. I think that that should be applied in all situations where elder care is being discussed," she said.
"I think we have a bad habit of top-down decisions where someone else is telling the senior what they need or what they should want."
But even Northern Health's minimum is more specific than provincial regulations.
"There are no minimums set out in legislation or regulation or policy regarding bathing plans in residential care," said Ministry of Health spokesman Stephen May.
"We rely on the clinical expertise of health care professionals to determine appropriate personal care plans for clients, whether they are using home care or in residential care. That would include the type of bath and frequency of baths required based on the client's needs, mobility and health."
Regulations demand that facility operators have enough staff on duty to meet patient needs.
For home support services, bathing can be one part of a client's care plan, and a rate is determined based on that person's income, May said.
A 2015 senior's housing report from the Office of the Senior's Advocate (an independent office of the provincial government) didn't address bathing minimums, but advocated for single room occupancy in residential care.
"I think we can all agree that in the 21st century we should be ensuring that seniors are bathed when it is necessary and as much as possible when they want," said Isobel Mackenzie, senior's advocate, by email.
"Staffing resources need to align with this objective and we should continue to move to a single room with ensuite bath/shower for all residence which will go a long way to improve the frequency of bathing and reducing the strain on staffing."
Fennell noted that bathing can be a labour intensive exercise for nurses and care aids.
"I know how they struggle with bath days, because there's a fair amount of lifting and moving people around. It's hard on the staff, it's hard on their backs," she said, adding it can be difficult for those being bathed too.
Fennell said she didn't necessarily have a number in mind for minimum baths, but it goes back to consultation.
"I think there should be a conversation with the seniors who are in care about what they think their requirements are."
Schaffer Residences offers private residential care in Prince George, Quesnel and Salmon Arm.
Its approach is bathe "as required," said spokesman Jeff Peretz, but also has one per week as the base requirement.
"Some of these people have dementia and other mental illness and either won't recognize that they require bathing. They may be reluctant and we have to coax them and help them."
Schaffer Residences' exceeds the Ministry of Health's guidelines of 2.8 hours per resident, Peretz said.
"Private pay, which is what we are, if we didn't provide the level of care that people required, their families would move them," he said.
"We're in a little different position than a funded facility that you probably need that to make sure everyone gets that as absolutely a bare minimum."
Dyck encouraged anyone in care to speak with Northern Health staff or managers directly if they have problems with the level of service.
"If people have concerns, come in and talk to us," he said. "It's important to note that the policy's in place to make sure there are minimum standards at our sites so that people do receive care that people can be guaranteed care."
