Elsie Dean, president of the board of directors with the 411 Seniors Centre Society, is worried about seniors’ issues in the upcoming provincial election. (Jason Payne/PNG)

By Sam Cooper, The Province

Elsie Dean is on the front lines of a potential crisis for seniors in B.C. 

The 89-year-old Burnaby woman volunteers with the 411 Seniors Society, so she literally hears the cries for help. From seniors living in isolation due to lack of home support and residential care spaces, to elderly citizens forced to leave homes because of skyrocketing rents, to HandyDart transportation routes cut. Last year, like many seniors, Dean was looking forward to positive reforms after provincial Ombudsperson Kim Carter published a series of investigations that exposed flaws in B.C.’s fragmented and hard-to-navigate senior care system. 

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The Province’s national award-winning Boomerangst series — which recommended 10 policy and community-based solutions for system problems — was also influential in pointing to needed changes, the government said. 

About a year later, depending who you talk to, overhauls needed to handle B.C.’s rapidly aging population are basically complete, or lagging woefully.

“In some ways it is getting worse in the past year,” Elsie Dean said, adding the government has yet to buy into supporting crucial community, home support, and medical care programs.

“I find people living alone that never should be,” Dean said. 

Elsie Dean of the 411 Seniors Centre talks about what a good system for seniors might look like.

Ombudsperson Kim Carter said she sees progress on about 25 per cent of 176 recommendations made in her final report, “The Best of Care.”

Carter urged the government to clarify system standards and report crucial public information — expected wait times and available beds and services in different regions, for example. 

Two different sets of health system laws that provide varying rules and standards need to be harmonized, Carter said. Seniors and families needed better information and guidance to navigate the province’s bewildering and Byzantine system, Carter said. And perhaps most crucially, in line with all expert opinions, Carter stressed the need to shift health budgets towards community care and home support, with proper regulation and enforcement regimes.

The government has responded with better information for seniors on health authority websites, and there are more inspections of facilities, Carter told The Province. But little or no improvement in public reporting of key standards has occurred. And there has been no real response to the major recommendations concerning a new community-care model, which is strange, since there is universal agreement such a system would provide better service at big savings for taxpayers, Carter said. 

Ombudsperson Kim S. Carter made 176 recommendations in her report on seniors’ health care, ‘The Best of Care.’ She’s only seen progress on around 40 of them. (PNG files)

The top recommendation in The Province’s Boomerangst series was a call for an independent advocate for seniors, a position that Carter, the NDP, and countless seniors also asked for. In response, the government rolled out a “stakeholder” consultation to plan for such a position.

The feedback across B.C. was resounding: the position should be a strong, independent advocate, much like Children’s representative Mary Ellen Turpel Lafond. That’s why the government’s recent enactment of a senior’s advocate role that will be “buried” in the Ministry of Health and reporting to the government, “was a tremendous disappointment and real opportunity lost,” said BC Health Coalition co-chair Rick Turner. 

“They didn’t respond to what the community said was needed,” Turner said. “I’m left thinking the government was scared of criticism.”

Turner said on key recommendations made by both the Ombudsperson and The Province — such as moving to a community care health model, the government has basically failed to respond.

“More community care means more seniors could stay in their homes longer, instead of going to the hospital and taking expensive acute care beds,” Turner said. “If the resources are there for improved home and community support, you can take care of someone for about $30 bucks a day, instead of $1,200 per day in the hospital.”

Lyne England, a Victoria senior who attended the first of the consultations on the senior advocate position with then health minister Mike de Jong, said “the senior’s advocate has to be independent, much like Mary Ellen Turpel Lafond. Why do seniors deserve any less than children?”

On the campaign trail last week, NDP leader Adrian Dix said his party would replace the seniors’ advocate introduced by the Liberal government with a new independent seniors’ representative, at a cost of $14 million.  

Dix pledged at least $70 million over three years to improve home support for seniors and community care in the province, plus $35 million to improve residential care. 

 In an interview Katrine Conroy, the NDP’s seniors care critic, said despite the government’s efforts last year, the senior care system remains fragmented, so users are left rolling the dice and hoping for the best of care.

“We need to ensure there is care in place across the province, and it is well regulated,” Conroy said.

But MLA Ralph Sultan, who served as the first Minister of State for Seniors, said his government’s overhaul of the senior care system is adequate and, about “as done as it is going to be done.” 

Sultan says the “core ideas” from Kim Carter’s report have been implemented, and about 30 per cent of her recommendations — such as harmonizing laws and standards of care across the system — are impractical due to the “legalistic interpretation,” of Carter. 

Despite widespread criticism, the new seniors’ advocate will be adequately independent, highly paid, and “set their own agenda,” Sultan argued.

Sultan acknowledged that B.C. eventually must reform the health system towards a greater community care focus, to address aging society challenges. Currently, Sultan said, about 80 per cent of health budgets in B.C. are spent on acute care. That is in contrast to Denmark’s highly successful model, Sultan said, in which about 70 per cent is spent on community care, and 30 per cent on acute care. Sultan pointed to $20-million in home-support spending in 68 communities across B.C., in a three-year pilot project. The spending is “scratching the surface,” Sultan acknowledged, but is a start in the right direction.

BY THE NUMBERS

Perhaps more than any province, as a retirement mecca, B.C. faces the greatest challenges to fund skyrocketing costs associated to aging. 

By 2021, the population of seniors in the Lower Mainland will nearly double, reaching about 500,000. And according to provincial projections, over the next 10 years, the most elderly segments of the population will grow the most. The population group of 60 to 64-year-olds will grow 29 per cent. From 65 to 69, 52 per cent. From 70 to 74, 65 per cent. And from 75 to 79, 79 per cent. Those over 90 will have grown by 63 per cent. 

According to health-care experts, those aged 65-to-69 use twice the health services of those aged 45-to-49. A 75-year-old uses twice the health services of a 65-year-old, and an 85-year-old uses twice the health care of a person 10 years younger, on average. 

At the same time, as baby boomers retire, the workforce and tax-base is shrinking. After years of study and debate, there seems to be consensus that shifting resources to home and community care and away from large hospitals and acute-care beds, is the key to revamping health care for an aging society. But statistics show spending is heavily skewed to the old model. 

In 2011-12, B.C.’s health authorities spent $943 million on the home and community care, including residential care. In the same year, acute care cost the province $7.4 billion.

The cost of treating a senior in hospital is estimated to range from $825 to $1,968 per day, while residential care can cost less than $300 per day.