Low-income seniors in B.C. are required to pay one-third of their income to access supports that help keep them living at home, says Dan Levitt, B.C. seniors advocate.
Several organizations are calling on the province to make changes that would put those supports in reach for more seniors in B.C.
The organizations say home supports can radically reduce health-care costs and the strain on the province’s health-care system — while also helping seniors remain independent and maintain their community ties.
Home support services help with non-medical daily living needs, such as bathing, dressing, toileting, meal preparation, light housework, laundry, medication reminders and companionship. Home supports are delivered by community health workers.
“Most provinces, including Alberta and Ontario, do not charge for home support. However, in B.C., seniors with an annual income of $31,000 must pay $10,000 per year for one hour of publicly subsidized home support per day,” Levitt said.
B.C.’s co-payment model creates barriers to accessing care, said Jeff Moss, executive director of the Jewish Seniors Alliance of British Columbia.
The Jewish Seniors Alliance joined seven other seniors’ organizations representing 400,000 seniors last week to launch the Health Care Needs Home Care campaign, calling for B.C. to fully publicly fund home support.
About 65 per cent of all seniors in the province earn less than $37,000 a year, Moss said.
When seniors struggle to pay for rent, food, home supports and other supplemental health costs such as hearing aids and walkers, they have to choose what to give up, he continued.
“Which one are you going to give up first? It’s typically home support. That leads to increased levels of hospitalizations and premature admissions to long-term care,” Moss said.
Levitt calculates that in B.C., 12.5 per cent of long-term care admissions are premature, meaning the senior could have continued to live at home independently with minor supports.
He added that premature long-term care admissions drop to 6.1 per cent in Alberta and just 5.5 per cent in Ontario, where home supports are fully covered.
Just over 60 per cent of seniors in B.C. who enter long-term care weren’t able to access home supports for the last three months.
When seniors aren’t able to live independently and there are no beds available at long-term care facilities, they often end up in hospitals as “alternate level of care” patients. ALC patients don’t actually require the high level of care offered by a hospital but aren’t well enough to be discharged home. Often, the patients can get stuck in uncomfortable stretchers in a hospital’s emergency department while they wait for a bed elsewhere, experiencing delays in receiving food, water and medication, and sometimes developing bedsores. The health of these ALC patients often deteriorates more rapidly than it would otherwise.
The Ministry of Health previously told The Tyee that for 2024-25, the ALC rate for all hospitals across B.C. was just under 16 per cent, which is equivalent to about 1,600 beds.
Levitt said B.C. needs a provincial senior-care plan that focuses on the full spectrum of senior care. This includes investing heavily in building home supports, home care, adult day programs, overnight respite care and assisted-living and long-term care facilities.
The senior-care plan should also cover affordable and accessible housing and transportation, focus on reducing long-term care facility wait-lists and recognize the differing challenges in rural and urban settings.
For example, many rural communities lack housing options to downsize to, and once a senior gives up their driver’s licence they can become quite isolated, Levitt said. Seniors should also be able to access long-term care in their community, and smaller communities could focus on building smaller facilities to accommodate locals.
Investing in home supports would reduce health-care spending too.
Home supports cost about $1,200 per month, which is a lot more affordable than paying $1,000 per day to house an ALC patient in a hospital, Moss said.
ALC senior patients cost the health-care system between $500 million and $800 million annually, Moss said.
It would cost a health authority $15,000 to provide one hour of home support per day for a year, and just over $100,000 to house that same senior in a long-term care bed for a year, according to the Office of the Seniors Advocate.
Boosting support in remote communities
The small, remote communities of Hornby and Denman islands have been modelling how to care for seniors for more than 40 years. Denman Island is accessible by ferry from Buckley Bay, an hour north of Nanaimo on Vancouver Island. Hornby Island is accessible by ferry from Denman Island.
A recent shakeup has required them to pivot in how they deliver care, but the communities are still focused on helping seniors stay at home for as long as possible.
In 1979, a group of local nurses , who were mos…
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