Many seniors living in long-term care facilities feel safe but continue to experience loneliness and a lack of autonomy and purpose, according to new report from B.C.’s seniors watchdog.
Seniors Advocate Isobel Mackenzie says her recent survey of about 11,000 long-term-care residents and 8,000 visitors — which follows a similar survey six years ago — found there continues to be insufficient staff to help residents with bathing and eating. It also showed a 12 per cent increase in residents taking anti-psychotics without a diagnosis.
While staffing levels for long-term care rose 10 per cent and overall long-term care spending increased 45 per cent, survey investigators found little has changed since the 2016-2017 survey.
“Some areas are a little better, some a little worse, but overall, we still find a need for improvement that is significant in some areas,” Mackenzie said in her report. “We have not seen the amount of progress we hoped for in elevating the quality of life for people who call long-term care home.”
The seniors advocate said it’s unclear to what degree the pandemic hindered progress, “but it is reasonable to assume it had an impact.”
More than 28,000 seniors live in publicly subsidized long-term care in B.C. — about three per cent of the seniors’ population. The average age of residents is 83, 63 per cent are women, the same percentage have dementia, and the median length of stay is just over a year at 481 days.
The survey, carried out by about 500 trained volunteers, was administered in 297 publicly subsidized long-term care homes — owned and operated by a health authority, a not-for-profit society, or a for-profit company — across the province from spring 2022 to summer 2023.
The report’s first recommendation calls for staffing levels in all care facilities to meet the national recommendation of 4.1 hours of direct care per resident per day, up from the 3.36 hours set by the province many years ago.
“When we continue to see more than half of residents unable to bathe as frequently as they want, and over a third unable to reliably get help to eat their meals, we must recognize that despite significant funding increases in the past five years, staffing levels are not sufficient to meet the needs of many residents,” the report says.
Other recommendations include making scheduling more flexible so residents can more often wake and eat when they want, offering more meaningful activities that better use residents’ physical and cognitive abilities, providing better-tasting and more culturally specific food, requiring education for all care-home staff, and allowing residents to name their essential visitor.
The naming of an essential visitor became important during the pandemic, when visiting was restricted to one essential visitor per resident to help prevent the spread of COVID-19.
Mackenzie also described a sort of one-size-fits-all approach to programming in care homes wherein one activity might be scheduled each day to accommodate both a senior who might be highly physically active but cognitively impaired and another alert resident limited in mobility.
She said many seniors surveyed reported not having a friend in their care home, or anyone with whom they had common interests.
The report also recommends long-term care homes work closely with the newly established independent Long-Term Care Councils Association of B.C. and increase the function of resident and family councils.
It also called for an increase in the accessibility of home-care support, so residents aren’t forced to seek long-term care before it’s required.
Forty per cent of of residents who answered the survey said they didn’t want to live in their care home, the report says.
The survey also showed more than 60 per cent of newly admitted long-term care residents had no home support prior to their admission.
“We must remove financial and other barriers that are preventing seniors from seeking home support in the community to ensure their placement in long-term care comes after all other options have been exhausted,” says the report.
In February, Mackenzie called on the province to eliminate or drastically reduce home-support fees for seniors, saying the high cost is prematurely forcing people into long-term care.
Most provinces don’t charge for home support, and of those that do, B.C. is the most expensive, Mackenzie reiterated in a media availability on Thursday in Vancouver.
Mackenzie said B.C. has twice as many low-care-needs seniors in long-term care as Alberta and Ontario, two provinces that do not charge for home-support service. The total number of seniors in long-term care in B.C. is above the national average.