Health Minister Adrian Dix says he needs to find not only more residential care beds for increasingly frail seniors, but an additional 1,500 care aides to bring their care up to the province’s own standard.
The NDP minister says the need is across the province, with baby boomers reaching retirement age and moving to B.C., people living longer and a residential care system that hasn’t kept up with demand. And it’s more than just increasing numbers. It’s memory loss, dementia and other chronic conditions of advanced age.
“A lot of care homes in B.C. used to deal mainly in what you’d call intermediate care, but the acuity of patients across care homes in B.C. has gone up,” Dix said in an interview with Black Press.
More publicly funded beds and staff mean hundreds of millions in additional dollars in the health care budget, which is approaching half of all provincial spending. The B.C. Liberal government succeeded in slowing the growth rate for health care spending, after Ottawa imposed a cap on transfer payments that were rising by six per cent each year. Dix is now dealing with the downside of that spending restraint.
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B.C.’s Seniors Advocate Isobel Mackenzie has been surveying the need, and one of her most startling findings is the number of seniors who aren’t receiving the province’s care standard of 3.36 care hours per day. For residential care, the standard means they might get two baths a week instead of one, or be allowed to use a walker to get to the dining room instead of being pushed there in a wheelchair to save time.
“In reports by the Seniors Advocate, in reports by the ministry, it was discovered before the election that 90 per cent didn’t meet that standard, and that was a significant fact,” Dix said.
Former health minister Terry Lake responded to Mackenzie’s findings with a pledge of $500 million more in the B.C. Liberals’ pre-election budget. Mackenzie also defined the staffing need as 1,500 more positions, and Dix has pledged to meet both of those goals in the first NDP budget in February.
Taking over private beds
One pressing area of need is Fraser Health, with the largest and fastest-growing population of B.C.’s five provincial health regions. In September, Fraser Health announced the addition of 20 beds at care homes in Chilliwack and 18 in Langley.
These are not newly constructed beds, but private beds taken over by the public system, making residents eligible for subsidies based on their income and care needs.
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“It does happen from time to time that we draw on surplus private beds in the community to increase our publicly funded bed stock,” Fraser Health spokesperson Tasleem Juma said in an interview. “It’s not unusual to look to our contractors and say, ‘if you’ve got private bed stock that is surplus, we would be interested in moving it to the public side’.”
Fraser Health is also increasing resources for home care visits, to keep more seniors out of residential care as called for by Mackenzie. Another issue in urban areas is the soaring cost of housing, pushing seniors into care facilities because they can’t afford rent.
Dix notes that these and other additional publicly funded beds are being funded to meet the hours of care standard.
Families seeking vacancies
For families looking for a space for a senior, the B.C. Care Providers’ Association has a website at mycarefinder.ca that tracks the inventory of subsidized and unsubsidized residential care.
Membership in the association is voluntary, and members agree to abide by its code of ethics, including compliance with all regulations. The code calls for members to treat patients and families with courtesy and dignity, and “refrain from conduct that undermines the role of the association and the credibility of the sector.”
Not all B.C. care homes are members.
Workers want fair treatment
Dix said recruiting care aides is difficult today, partly because of working conditions and the practice of contract care homes to reincorporate and rehire staff with new union contracts.
“I think it’s a serious problem,” Dix said. “It’s now not just a question of justice for workers and the flipping of contracts and the effect that has on care for seniors, but not respecting the sector is a genuine recruitment problem, a health human resources problem.”
Dix vows to improve job security for care aides, and also work with the B.C. Care Providers Association in an “aggressive campaign” to recruit and retain the needed staff.
B.C. Liberal critic Joan Isaacs says she is pressing Dix to get the additional funds promised by the previous government. She defends the practice of care homes reorganizing when taxpayer-subsidized public sector union benefits are too costly. With falling interest rates on safe investments, defined-benefit pensions have been eliminated in much of the private sector. Public sector unions battle to hold onto them.
“The biggest challenge is union contracts where we have to fund the pensions and employee benefits, and that becomes a huge cost for the sector to bear,” Isaacs said. “And I think this is where we have to be mindful of what is the most important thing, and that is that we deliver some form of accountability to our seniors so that our care is being delivered, whether it’s private or public, in a manner where people have a quality of life and get the care and attention that they deserve.”
– with files from Paul Henderson in Chilliwack
