Last week I had the pleasure of participating in a focus group organized on behalf of the provincial government to discuss seniors’ care.  The provincial government has created a new Seniors and Long-Term Care department to address the current care system of our aging population and develop new strategies to enable seniors to remain in their own home and community for as long as possible.

I received the invitation through my mom’s PCH and was delighted to attend. As an advocate for seniors’ care, I was looking forward to offering my feedback, but I was also interested in hearing what others had to say. 

Our current system forces seniors who can no longer live an independently into institutionalized facilities where they are likely to share a room with another resident. While I appreciate the value and need for personal care home facilities, I believe panelling and placing people into a care home should be based on their health care needs, not age based.

There were 11 of us in total, including the two facilitators. Those who attended ranged from directors of senior’s organizations, managers of an assisted living centre, former healthcare professionals and family members of residents who resided in PCHs. We discussed many issues with the current long-term community and facility care system as well as ideas we believed would help in the future planning for seniors’ care in my province.

Currently, our province has an all or nothing approach to aging. If you can live independently, you can stay in your own home, but if you can’t, you are institutionalized into a personal care home.  Seniors, with the help of their family members can choose one place to call their permanent place. However, due to long waiting lists, seniors are placed in what is referred to as an interim home while waiting for a room in their permanent place. The individual does not have a choice where they go. They are admitted into the first place that has a bed available. This approach doesn’t work for numerous reasons.

Concerns Addressed

As a group, we shared many similar concerns and what we saw as problems with the current system. They can be broken into 2 categories and include:

• Personal Care Homes:
  • For-profit homecare facilities that prioritize profit over quality care
  • Improperly trained staff
  • Lack of beds to meet the needs, room sharing
  • Government standards that are not enforced in for profit care homes
• Community:
  • Inadequate homecare servicesLack of community based transportation servicesNegative societal approach to agingLack of resources in rural areas, for example, medical services, home care, housing
  • Lack our resources and support systems to help seniors maintain their social, physical and personal needs

For-Profit Care Homes

Private, for-profit care homes were a serious concern for all of us. Because provincial and territorial governments regulate how much seniors are charged to live in personal care homes, for-profit places cannot set their own fees. This means, they have to find other ways to make a profit at the expense of the staff and residents.

According to one participant, profit earning care homes are also not regulated or monitored by the same standards as government run homes are so many problems that occur in profitable facilities, happen because the standards are lower.

Lack of Beds and Space

There are more seniors panelled for care homes than there are beds available. This means there are long wait periods to get into a facility and, when a senior is finally moved into to PCH, it’s usually not the place of choice and they are often forced to share a room. Those living in the community, whether urban or rural, face longer wait times because hospital patients have first priority. For those living in the community who do need 24-hour medical care, the extended wait times can create unsafe situations for the senior and increase stress for the families.

Trained and Qualified Staff

Another concern raised was improperly trained and paid staff. Again, profit-making companies were targeted for not hiring enough properly trained staff and paying their employees lower wages. During my years working for personal care homes and home care agencies, I also noticed salaries for profit care home staff were considerably lower than salaries for the same position in government run homes. I saw firsthand how properly trained and paid staff made a significant difference in the type of care seniors received.

Ageism

One of the first issues I brought up was how society views of aging and seniors. Historically, getting older has always been viewed negatively and older people have less value in society than younger people. This ageist opinion has been the foundation for many services, opportunities, healthcare, and resources developed for older adults. There is a clear difference in the type of services and care offered to seniors when they are treated as valued members of the community as opposed to when they are not. There are many organizations and housing projects opening that recognize, value, and cater to seniors but we need more.

Rural Concerns

Two participants live in rural communities. They voiced many concerns about lack of housing, transportation, and health care services available to seniors. This creates many challenges and problems for aging adults who left in dire situations or have to leave their community to access the services and housing they need. It also affects family who must travel further distances to see their loved ones. The two focus group members want to see more services in rural areas, so health care and housing are more accessible.

Community-Based Transportation Services

Before the pandemic, many housing and community-based agencies offered transportation services to seniors to they could shop, run errands and attend social functions. When Mom lived in her apartment, she enjoyed taking the weekly van to the nearby grocery store. Not only was it convenient and affordable, but it also allowed her to maintain her independence. The transportation services also created a regular social event for its riders. Mom and the other residents in her building enjoyed the weekly chats and developed friendships during their travels.

When the pandemic started, transportation operations stopped. Many have never resumed, creating challenges for many seniors who must find alternative ways to go from place to place. In rural areas, this becomes even more challenging because there are less public transportation options available.

Lack of Community Based Resources and Supports for Seniors

As a group, it was collectively agreed that communities still lack supports and organizations to help seniors live independently while ensuring their daily needs are met. This continues to create many barriers for older adults to stay in their own homes and communities.  In this province community-based supports are available for many vulnerable populations, so they are not institutionalized, but it is still lacking significantly for seniors.

Inadequate Community Based Home Care Services

While there is home care available, services are limited to a maximum four visits per day. Staff shortages, lack of resources, high community needs, weather and absenteeism creates a very unreliable system that doesn’t adequately meet seniors’ needs and puts a lot of pressure on families to fill in when home care doesn’t arrive or provide the needed services.

There are many non-profit organizations to provide 24-hour care and health services for other vulnerable populations in their home and community, there are no similar services for seniors in this province. Having similar services to cater to senior’s needs would reduce the strain on the government run system and allow more seniors to live in their own home and community.

Positive Qualities of the Current System

It was easy as a group to find multiple problems with the community-based and personal care home-based care services that are currently in place for seniors. The issues we all raised were similar, abundant, and affected all areas of seniors healthy living in their own homes and community. When asked, it was difficult for any of us to find positive factors to the current system. When asked, no one could find an answer.

Final Thoughts

I was happy to be invited to participate in this group. Not only did I had a chance to voice my concerns and views of the current system, I enjoyed listening to what others had to say. All the points discussed were valued concerns that will hopefully be used to create a better community-based health and home care system so our aging relatives can continue to live productive and valued lives in their own homes and communities for as long as possible.

I’ll cover each issue in its own blog post in the coming days and weeks. I would also like to hear from you, my readers. What concerns do you have regarding your area’s current services for seniors? Are there any positive features to the services offered? What changes, if any, would you like to see?