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B.C.'s seniors advocate blames long-term care waits on lack of home support

British Columbia's seniors advocate says an increasing unmet demand for home support services and lack of new long-term care spots for a growing population, are likely to blame for the ballooning wait-list to get a bed. Seniors Advocate Isobel Mackenzie is photographed at her office in Victoria, B.C., Friday, Dec. 15, 2017. THE CANADIAN PRESS/Chad Hipolito

VICTORIA — British Columbia's seniors advocate says the increasing unmet demand for home support services is likely to blame for a ballooning wait-list to get a bed in long-term care, with the problem worsened by population growth.

Isobel Mackenzie says while the availability of some home and community care services has increased over the past five years, it hasn't been enough, and the rate of services relative to the population has fallen.

"Despite the fact that we have spent significantly more, despite the fact we have added some more long-term care beds, we have added some additional supported housing units, we have increased our number of home support clients, all that's true," she said at a news conference on Thursday.

"But the population growth has basically dwarfed those investments. And the rising costs … is meaning providing just the same level of service is going to cost more."

Mackenzie's final report before she leaves her position this month was released Thursday. It says the rate of home support clients among seniors aged 75 or older has decreased seven per cent over the past five years, and the average hours of support per client has decreased four per cent. 

Mackenzie told reporters that cost pressures are going to intensify.

"The oldest baby boomers are only turning 78 this year and you're really not seeing pressures until people get into their mid-80s. And the big bulk of our population is going to shift into that cohort over the next 10 years," she said.

"We're already seeing these worrisome trends, they're only going to amplify in the future. And so I think that governments have to recognize that, and the public has to recognize that, as we plan for the future."

Terry Lake, CEO of the BC Care Providers Association, which represents two-thirds of the providers of long-term care and assisted living in the province, said the concerns Mackenzie raises in her report accurately reflect the current situation.

"I know the government is working on many of these things. We've seen a lot of announcements, but it's going to take quite a bit of time to turn this around," he said.

In 2019, the B.C. government moved privately run home support services back under health authorities in Metro Vancouver and southern Vancouver Island, ending a previous system that relied on contracting.

Lake, a former health minister for the BC Liberals, now known as BC United, said it might be time to consider reversing course.

"We have many private providers around the province, that would be willing to take some of this on at a lower cost than is currently being provided by health authorities," he said.

"So we're getting less hours of care for a higher price and that's concerning. Not that people shouldn't be paid well to do this kind of work. But at the end of the day, if it's reducing the amount of service available, something needs to be addressed there." 

The advocate's report says the average wait time before admission to long-term care has increased 54 per cent from 2019, growing from 136 days to 209 days in 2023. 

Lake suggested there's not enough money in the province's capital budget to meet long-term care needs, so the government should turn to non-profit and for-profit providers to build facilities.

"We have about 29,000 to 30,000 people in long-term care and we have another almost 5,200 on a wait-list," Lake said.

"And we know that hospitals are full of people that would be more appropriately cared for in a care home rather than in hospital. It shows that the demand is far outstripping the supply."

In her report, Mackenzie says subsidies for the one in five seniors who rent have fallen "dramatically short" of what they need to continue living in their own homes and meet their basic needs.

At the news conference, Mackenzie was particularly critical of the Shelter Aid for Elderly Renters program, also known as SAFER, which is meant to support low-income renters but has a maximum subsidy of $803 a month.

She said the average rent in Vancouver is more than twice that.

Mackenzie said when seniors get annual increases in pensions and other supports, that is considered an increase in income, so their rental subsidy is reduced.

She said the average person using SAFER is making less than $21,000 a year.

"At a minimum, (the rent ceiling) should be raised to meet the average rent of a SAFER recipient, that's already below market rents," she said, adding that the ceiling should be raised every year to reflect the allowable rent increase in the province.

Mackenzie said BC Housing is working on updating the program but "they have been working on it for rather a long time and there are people out there who are increasingly finding it difficult to pay their rent each month."

A statement from the Ministry of Housing says eligibility for rental assistance and the Shelter Aid for Elderly Renters programs was expanded in 2018 and payments were increased.

"Even with these changes, the Province and BC Housing recognize that the SAFER rent ceilings have not kept up with market rents and with increased living costs many low-income seniors are struggling in the current rental market," it says.

The statement says BC Housing and the minister have completed a review of SAFER and the rental assistance program and are "working through the recommendations."

"As the ministry works through options for the programs, more information will be shared," it says.

Mackenzie's report says there are "concerning trends" of abuse, neglect and property crime against seniors that likely warrant discussions with law enforcement on how to better support them.

Seniors represent 20 per cent of the provincial population, the report says, compared with 18 per cent in 2018 and 16 per cent in 2013.

The report warns that there are "fault lines" appearing in other areas of support including transportation and adult day programs.

It says they'll need to be monitored to see if the current decrease in services is a residual impact from the pandemic or a longer-term trend.

"Overall, the report highlights the growing challenge facing the federal and provincial governments as our population ages," the report says.

"The cost of providing the same level of support and services is also rising as inflation impacts labour rates. Costing more to do the same is bad enough, but we have layered on the need to also provide services to more people, creating gaps that grow each year."

— By Ashley Joannou in Vancouver

This report by The Canadian Press was first published March 14, 2024.

The Canadian Press

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