Recommendations on seniors’ care not implemented 7 years after report: ombudsperson

B.C. ombudsperson Jay Chalke is calling on the B.C. government and health authorities to act on recommendations for improving seniors care made seven years ago, saying he’s “dismayed and discouraged” by the lack of action.

Fewer than half the recommendations from a 2012 investigation by the Office of the Ombudsperson probing seniors’ care in the province have been implemented.

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Tasks left undone include criminal-record checks for home-support workers, tenancy protections for assisted-living residents and enforcing standards in residential care for such things as bathing frequency, dental care, call-bell response times and culturally appropriate services.

“To simply say we’re continuing to work on it after seven years is unacceptable,” Chalke said in an interview on Monday. “These are real tangible things that would make a difference. … I think this generation of seniors can’t wait forever for those standards to be achieved.”

B.C. Health Minister Adrian Dix said perhaps the most significant recommendation in the 2012 report was a requirement of a minimum of 3.36 direct-care hours per person in residential care per day — something the ombudsperson had hoped would be in place by 2014-15, and has yet to be implemented.

In September 2018, the government committed to provide funding to allow the 3.36 hour standard to be met as an average across each health authority by 2021.

“When I became minister of health [in 2017], 87 per cent of care homes did not meet that standard,” Dix said Monday, adding that $240 million in funding over three years was announced in the 2018 provincial budget, in part to increase those hours across all health authorities. “Have we achieved it fully yet? No. But we’ve made enormous progress in the first year.”

Dix said the care hours were unacceptably low when he took office “due to an enormous failure by the previous government.”

He said he welcomes the update because it highlights “the direct action we’ve taken on many of these issues on behalf of seniors in the last 12 months and I’m hopeful we’ll make even more progress in the next two years.” He said he agrees with many of the recommendations, and plans to look into progress on criminal-record checks for home-support workers.

The 2012 report — The Best of Care: Getting it Right for Seniors in British Columbia (Part 2) — made 176 recommendations. Part 1 was released in 2009 and made 10 recommendations. Both reports were produced under then ombudsperson Kim Carter.

Of the 176 recommendations in the second report, only 68 have been implemented. They include establishment of a B.C. seniors advocate, improvement in investigative procedures by the Assisted Living Registry — which looks into complaints about assisted living facilities in B.C. — and providing better information for seniors facing financial hardship on how they can have home- and community-care service fees reduced.

Chalke said those changes are worthwhile, but incremental. “The larger changes we recommended seven years ago that would really go a long way to improving seniors care haven’t happened.

“Frankly, in seven years I, and I think the public, would expect more in terms of improving critically important services for our aging population, some of whom are extremely frail and vulnerable.”

B.C. seniors advocate Isobel Mackenzie said she shares Chalke’s concerns. “There has been some progress to date, however much remains to be done and I think we need to have more vigorous oversight to ensure that the policies developed to ensure appropriate care for seniors, whether in the community or a licensed care home, are in fact uniformly applied across the province.”

Other key outstanding recommendations from the 2012 ombudsperson’s report include:

• Enacting legislation that has been passed but has not been brought into force, including: additional care to allow seniors to live in assisted living longer; safeguards to ensure capable seniors are not being admitted against their will to residential care; tenancy protections to assisted living residents where their only option now is court; changes to bring all residential care homes governed by the Hospital Act under one legislative framework to streamline standards and fees. “I agree with Mr. Chalke that they have taken too long,” said Dix, adding they will be put into force.

• A full evaluation of the effectiveness and cost of the home-support program.

“I think this is a question of political and bureaucratic and organizational priority, and I think it’s time that that priority be given to making these changes,” Chalke said.

The full report and update are available on the ombudsperson’s website


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