While on an outreach tour around the province in early 2008, Kim Carter, the BC Ombudsperson, heard extensive public concern about seniors care. To find out more about the problem, she asked the public to let her know if they had concerns about the care of seniors that were not being reasonably or fairly addressed by provincial authorities. In less than two months she received 50 individual complaints.
As a result of these complaints, the Ombudsperson initiated a province-wide systemic investigation into seniors care in August, 2008. The investigation focused specifically on issues of access to information, access to services, quality of care, standards of care, monitoring and complaint processes in home support, assisted living and residential care.
First Report: Focus on Licensed Residential Care Facilities
In December, 2009 the Ombudsperson issued the first of two reports. It noted that “the response to this investigation was unparalleled in the history of the office.” Since initiating the investigation, her office received more than 600 responses to the questionnaire posted on its website, spoke to 300 people my phone, and opened more than 200 individual complaint files.
This initial report focused on BC most vulnerable seniors — those requiring 24-hour care in residential care facilities. The report identified three interrelated areas where “straightforward changes could quickly improve the quality of life for these seniors.” She recommended that the provincial government:
1) Legislate a bill of rights for seniors in long-term care. In addition, she recommended that the government monitor, evaluate and report every year on how well these rights are being upheld.
2) Establish a single web site with information about every licensed residential care facility in the province, including the number of staff working in different occupations (e.g. as nurses, care aides, activity aides etc.), ownership, social activities, extra charges to seniors, previous complaints, standards of care and more.
3) Provide family members and residents with a greater say in their care by:
- Expanding the role of family and residents’ councils, and entrenching this expanded role in legislation or regulation;
- Establishing a staff position in each facility and health authority to assist and respond to family and resident councils in a timely manner; and,
- Providing support to establish regional family and residents councils.
Unfortunately, the provincial government’s response to the Ombudsperson’s first report has been very disappointing. It did agree to implement the first recommendation -- and the government has passed a Residents’ Bill of Rights. However, it did not comply with the most important aspects of this recommendation -- to monitor, evaluate and report annually on compliance with the bill of rights. The provincial government also agreed to establish guidelines for operators on how they would to support resident and family councils but it did not agree to mandate family councils, to provide staff to support these councils or to set up a web site with information about every care facility.
Second Report: Comprehensive Review of BC's Home and Community Care System
The Ombudsperson's second report, "The Best of Care: Getting It Right for Seniors in British Columbia (Part 2)," was released February 14, 2012. With 176 recommendations, it provides an extremely thorough, precise and do-able roadmap for rebuilding BC’s home and community care system. It outlines measures for improving quality, accessibility, and accountability in home and community care, in particular for home support services, assisted living, and residential care.
On February 14, the provincial government released its own "action plan" for improving seniors care. Its plan does outline some small positive steps, but does not commit the to fully implementing the Ombudsperson's recommendations.
Implementing the Ombudsperson’s roadmap for seniors care would help BC’s growing population of seniors to live independently for longer, and respect seniors’ right to age and die with dignity. It would also go a long way to reducing strain in acute care, the most expensive part of the health care system, since any of the problems related to overcrowding and wait times in hospitals result from poor coordination and lack of access to home and community-based services.
From Recommendations to Action
As the Ombudsperson has been clear time and again, her job ends when these reports are released. After that it is up to us as citizens to support her recommendations.
A commitment by the provincial government to fully implement all of the BC Ombudsperson's recommendations in a timely way is needed. You can help by contacting your MLA by letter, email or phone (find your MLA here) — let them know that you support the Ombudsperson's recommendations, and want to see strong provincial leadership in solving the crisis in seniors care.
You can also order a copy of The Remaining Light DVD and organize a screening -- in your living room, your classroom, at a local seniors centre, etc. A kit with background information and a discussion guide is available on request.