A survey of thousands of seniors in long-term care homes in B.C. recommends the provincial government increases staff, improves food and boosts access to community services so some seniors don’t need to go into care at all. Seniors Advocate Isobel Mackenzie is photographed at her office in Victoria on Dec. 15, 2017.CHAD HIPOLITO/The Canadian Press
Little progress has been made to improve the quality of life for long-term care residents in publicly subsidized care homes despite significant investments into the facilities in the past six years, B.C.’s seniors advocate said after her second province-wide survey was released.
The Office of the Seniors Advocate undertook the first provincewide survey of seniors living in long-term care and their frequent visitors in 2016-17. In a new report released Thursday, survey results show there has been little progress in areas such as frequency of bathing, help at meals, meaningful activities and engagement with staff. However, residents continue to give high marks to long-term care home staff for their skill, compassion and ability to treat residents with respect.
Funded staffing levels increased 10 per cent since the last survey and overall long-term care spending increased 45 per cent, but “not a lot has changed in six years,” Isobel Mackenzie told reporters.
“The inability to make progress absolutely will have been impacted by COVID-19. To what extent is very difficult to quantify.”
The survey covered 297 publicly subsidized care facilities in British Columbia and received responses from more than 10,000 residents and almost 8,000 family members and close friends.
Just over half of residents rated the overall quality of the care and services received in the home as “excellent” or “very good.” The majority of the residents reported that they trust staff to take good care of them and that the staff respected their likes and dislikes.
The 2023 survey added several questions regarding cultural safety in the long-term care setting. The overwhelming majority of residents reported they have never been treated unfairly by staff owing to their race, cultural background, sexual orientation or gender identity. But only about one-third of residents who self-identified their ethnicity as First Nations, Métis or Inuit said that an Indigenous patient liaison visits them in the care home where they live.
In addition, more than 30 per cent of residents report that they only “sometimes,” “rarely” or “never” get help to eat when needed. About 60 per cent of residents and 80 per cent of frequent visitors report they or their loved one only “sometimes,” “rarely” or “never” bathes or showers as often as they want – this rating showed no improvement from 2017, says the report. The majority of residents said they feel there aren’t enough meaningful activities in the facilities and find it hard to build friendships in care homes.
Ms. Mackenzie listed eight recommendations in her report, including increasing care hours from 3.36 hours per resident per day of care to the nationally recommended 4.1 hours.
When asked how to achieve that when the health care sector is struggling with staffing, she said the change won’t happen overnight, but the process begins by setting the target and making a commitment to meet it.
Ms. Mackenzie said the number of care aides has increased by 17 per cent over the past five years, 7 per cent alone in 2022. She predicts there will be a bigger increase at the end of this year.
The report also recommends improving the home support system in B.C. to allow more seniors to delay their move to long-term care and to increase social connections for residents by creating more meaningful activities.
“Money doesn’t totally solve engagement issues. A big part of it is our culture in long-term care. We have to fundamentally move away from telling people what to do, assuming we know what is best and listening to what people want and understanding that quality of life is not for me to decide for you, it’s for you to decide for yourself,” she said.
Ron Pike, board president for BC Care Providers Association, which represents non-government care providers, said at a high level his organization agrees with the direction of these recommendations in the sense that they are consistent with BCCPA advocacy of improving quality of life for older adults.
“Our collective challenge, however, is putting these thoughts and recommendations into practice. To this end we are committed to continuing our work with the Ministry of Health to improve the availability of health human resources in our province and establishing sustainable funding models that help achieve these goals,” he wrote in a statement.
The B.C. Ministry of Health said in a statement that it thanks the seniors advocate for the report and it looks forward to reviewing the recommendations. It says although the report indicates the results of the 2023 survey were very similar to the 2017 survey, it’s worth noting that province managed to maintain its standard in the quality of seniors care during the hardship of the COVID-19 pandemic.
According to the statement, the ministry is committed to developing a standardized province-wide funding model for long-term care that will provide greater transparency, equity, consistency and sustainability with respect to funding.
The seniors advocate’s recommendations related to food and meal-time experiences will help inform the model. It’s also committed to ensuring seniors are receiving dignified and culturally appropriate care and investing in the implementation of a new nurse-to-patient care model that will allow nurses to spend more time with the people they care for.