Access to seniors’ care worse today than in 2001: Bold action needed

It is becoming far too common. Many of us have a parent, relative or neighbour who has struggled to get the home support they need. Perhaps they have even waited in hospital because residential care or rehabilitation services were not available. 

Thousands of BC seniors rely upon and are well served by the province’s publicly funded home and community care system – home health, assisted living and residential care services. However, current resources are inadequate to meet the demands of our aging population, and too many seniors can’t access needed residential care beds or they go without the services needed to remain at home. 

In early March, two months before the May election, the BC government announced $500 million in new seniors funding over four years, primarily to increase staffing levels in residential care homes that fall below the provincial guideline. Research shows that adequate staffing is critical to provide seniors with the level of care required to improve their health and quality of life. 

The government should be applauded for this much-needed investment although, at most, it will bring seniors’ care to the province’s own minimum standards. The funding, however, will not reverse 16 years of declining access to home and community care services. 

When we account for the growing number of elders in our province, seniors have less access to home health services, assisted living and residential care today than in 2001. 

Between 2001 and 2016, BC’s population aged 75 and older increased by about 50 per cent. During that time: 

• access to residential care and assisted living declined by 20 percent. The number of beds increased, but beds as a share of the population over age 75 dropped.
• in both rural and urban communities, home support (such as assistance with meals and bathing) was less accessible than in 2001.
• a greater share of seniors over age 75 received home care, including physiotherapy and home nursing, but each client had fewer visits and less time with these professionals. 

In February, the BC government once again touted a strong economy and tabled another surplus budget. So why has access to seniors’ health care services deteriorated? 

Funding decisions are policy choices and an opportunity to invest in the public services we value and depend on. And, funding for seniors’ care must be seen within the context of provincial health care spending over time, not just election-year announcements. 

Over the last 16 years, BC’s public health care spending declined relative to other provinces. In 2001, BC ranked second in per-capita provincial health care spending, but by 2016 we ranked eighth out of Canada’s ten provinces. During this period, the BC government also eroded the province’s fiscal capacity and ability to increase health care spending by ushering in an era of tax cuts for the wealthiest while diminishing tax fairness for low- and moderate-income British Columbians. 

Also during this time, provincial policies led to the privatization of seniors’ care. Specifically, residential care spaces operated by public health authorities and non-profit organizations declined, while beds in the for-profit sector increased rapidly. Research shows, however, that privatization has failed to increase access to residential long-term care, and that residential care provided by for-profit facilities is generally inferior to care delivered in public or non-profit facilities. 

Unfortunately, the trends documented in a report I just published are not encouraging, and they are consistent with four previous CCPA reports that raised similar concerns. 

Increasing access to home and community care will not only improve seniors’ well-being and independence, it will improve health care services for all British Columbians by reducing hospital overcrowding and surgical wait times. 

Improving BC’s home and community care system will require a change in policy direction. In order to increase availability of these vital services, the provincial government must stop the privatization of seniors’ care, improve access to publicly funded services delivered by health authorities and non-profit organizations, and develop a framework and action plan with legislated province-wide standards. 

All of these measures will take bold and progressive leadership, but it can be done.