Care Facilities

The subject of Care Facilities is where it gets really interesting and boy, do we have categories. COSCO provides a general label, Long Term Care, to others it is Continuing Care, Complex Care, Campus of Care, Care Centre, Hospice Care, Rehabilitation Care, Nursing Homes, but to name a few.

In general, long term care refers to residential facilities that provide 24 hour care and supervision, to individuals, who are no longer able to live in their homes or an Assisted Living facility.

The Health Regions direct admissions to subsidized nursing homes or subsidized beds within a facility. Publicly funded facilities make up 70% of the available space, while the private sector makes up the balance.

Over the past several years the actual number of rooms gained or lost and in particular the 5,000 room number has been a contentious issue. In a policy paper prepared in 2008 by the Physicians of BC, the provincial government has been "critiqued for changing the definitions and numbers to conceal the fact that although new beds are being created, many beds are being closed." The report went on to say that from 2001 - 2004 there was a net decline of 1,464 residential care beds.

For a government that is always preaching austerity, this lack of forward thinking might turn out to be very expensive in the future. As I have mentioned previously, 2011 brings the front edge of the largest demographic in the history to the senior's sector. We will see the percentage of senior's increase every year until 2040 when we (I have to say we as I will turn 65 with that front edge) will see the percentage reach 25% of total projected population, which according to Translink will reach three million. Without proper preparation, we will be a tsunami.

And for a government that is profit motivated, these policies are providing little financial incentive over the long term. And without the beds, we end up in emergency wards, expensive emergency wards, staying in expensive hospital beds, competing for expensive assistance. However, on the government side, there is a lot of empty inventory and for an industry that was accustomed to long waiting lists, this is perplexing.

As perplexing as it maybe, numbers are still being tossed around, an example is Amy O'Brian's article in a Vancouver Sun which tells of the Ebenezer Home closure. The home is closing after 37 years of community service to Abbotsford.

The 91 room home had both publicly funded and private beds however, the Fraser Health Authority, has withheld funding to the 26 public beds. In answer to the closer, the article did say that the health authority is opening 369 beds in Maple Ridge, Surrey and Langley. These beds will be or already are in the mix of subsidized public and private beds with most of the new properties being managed by private operators as apposed to non-profit societies.
For their part the private operators should be lauded for taking on the risk in a time of surplus of inventory and for their sake, I, like others hope, it is due to this recent down turn in the economy. However, it should noted, that the private operators are getting more than their fair share of publicly funded beds, therefore dramatically reducing their risk.

The article itself, goes on to say that part of the problem for the Ebenezer Home was public demand for public beds, not private, as the monthly cost difference is significant, leaving the home with empty private beds, its principle source of operating capital. It has been public beds that allowed the home to continue, but not providing the funds needed for upgrades.

So what makes us think that these private operators will be any more successful?
There a definite pressure being applied to the older and mostly non-profit operators to upgrade and as many of us know it's cheaper to build new, than renovate. Thirty seven years ago there weren't nearly as many wheel chairs or walkers in the hallways or trying to get through doorways. Again, we cannot say that the government is not supporting upgrades, an example of this, is their recent support of the Langley Lodge upgrade.

The cost of housing our elders is and will continue to escalate and that issues a principle question; will those more financially challenged individuals and couples, be able to stay in their community? If not it becomes a health issue, causing stress for seniors, which increases health costs, creating a domino effect. It may be less expensive long term to have more subsidizes in the short them.

The greater the public's involvement, the greater the chance for success!

Live well and be involved,

David Hutchison