Wednesday, January 13, 2010

Seniors’ care recommendations snubbed by government

I doubt that growing old has ever been much fun. 

But the latest report on seniors’ care in B.C. — and the government’s reaction to it — should alarm people looking into residential care for themselves or a family member.

Maybe my generation, the Baby Boom crowd, expects too much.

But it’s hard to escape the sense that once you can’t make it in your own home these days, you diminish. You become more problem than person.

Consider a basic challenge — finding and then living in residential care when you no longer live on our own. 

Ombudsperson Kim Carter heard more and more complaints and concerns about seniors’ care in B.C. The office launched a provincewide investigation and delivered its first report just before Christmas. 

It was grim. And the government’s response was discouraging. 

Carter found the government hasn’t identified what it is prepared to do for seniors in residential care or told residents what rights they have.

It has failed to ensure families can get adequate information about residential care facilities, so they can plan and make informed decisions.

And although resident and family councils are important in ensuring the well-being of people in care, the government hasn’t supported them. 

Carter said the public response to the investigation was “unparalled” in the history of the ombudsperson’s office. (That’s the official name now.) 

About 900 people presented concerns; 200 individual complaint files were opened. The investigators went to 50 residential care and assisted living facilities, public and private, around the province.

The complaints covered a range of issues, from poor food to long waits for help with basic tasks like going to the bathroom to medication errors to neglect of residents’ needs. Many will be dealt with in a subsequent report.

A lot of the concerns centered around the huge difficulty in figuring out what care is available, what it costs and what’s covered. 

Families and individuals looking for care want to make the best decisions. But there is now way to get useful information on the private and public care facilities available in different communities without visiting each one. Responsibility for residential care is split between two ministries — the Health Ministry and the Ministry of Healthy Living and Sport — and the health authorities.

Families reported being panicked by the challenge of making snap decisions critical to a senior’s future with no real useful information. Standards are unclear and information about past problems sketchy.

Once seniors have landed in a home, it’s unclear to them and their families what rights they have or what they should do if they believe care is substandard. They’re reluctant to raise concerns, in case that brings reprisals.

And there is no effective process that lets the government monitor legitimate complaints and ensure they are being addressed.

Carter’s first report made 10 recommendations, all common sense and none obviously expensive.

The government committed to acting on four of the 10. It had already passed legislation on a residents’ bill of rights, one of the recommendations.

But on six of the 10 recommendations, including some of the most critical, Carter found the government’s proposed efforts “fall short of what is needed” to remedy the problems her office had identified.

The government wouldn’t commit to monitoring and reporting on whether residents’ rights were respected by operators.

It waffled on the recommendation that single website that allowed people to get the basic facts on every care facility — the costs, the services, the standards of care — be in place by Sept. 30.

And the government wouldn’t commit to prompt action to set out a clear role for resident and family councils.

The outpouring of concern to the ombudsperson’s review indicates significant concerns. The challenges are certain to increase with each year — by 2038, the number of people 80 or older in B.C. will have more than doubled, to 460,000.

And not enough is being done to face the challenges.

Footnote: The report is available online at ombudsman.bc.ca. Expect to hear a great deal about the findings and the fee increases for three-quarters of those in residential care when the legislature finally resumes regular sittings in March, after a three-month break.

7 comments:

DPL said...

Not to be trite, but if somehow those residential care places could be linked to the big circus the money would soon be in place.
The older folks without a lot of moeny end up in substandard places with limited staff, and the government keeps bragging about all those beds they opened.

BC Mary said...

Sincere thanks, Paul, for delving into this topic which most of us never think about.

Our family right now is confronted with the need to find a decent place for an elder who may need its facilities for 6 months or 6 years, who knows?

And the research tools? Not much help there. It's really quite scary when the government of the day is capable of chopping away services without warning, no matter how well we try to plan.
.

Step by Step Golf Swing said...

Hi there, very critics post you have here. I started to realize many people start to pay a close attention to what government do as they are the tax payer. Nice blog

Cheers,
Step by Step Golf Swing

StandUpforBC said...

Paul, your column is very welcome. I attended several of Kim Carter's open forums on the Inquiry.

The Ombudsperson's office has whitewashed far more serious matters including crimes in nursing homes -- physical and sexual abuse of residents, widespread use of the most powerful antipsychotics to make residents docile (and which have very disturbing side effects), staff raging against family members, records falsified, drugs disappearing, banning family members from facilities... Poor food is the least of it.

The Ombudsperson's recommendations were luke-warm, and some, downright laughable.

As you say, "investigators went into 50 homes around the province." Sounds good, right? Except for one thing, these were not unannounced visits. It's a common inside joke when Accreditation Canada comes around every 3 years to these places. Everyone's on their good behavour; things are at their best while "company" is present. Many of her public forum atttendees urged Ms. Carter to conduct unannounced investigations. Apparently, she didn't think that was necessary.

I heard Ms. Carter being interviewed shortly after this report was released. When asked what specific recommendations she was proudest of, she said that nursing homes were now required to post residents' rights where everyone could see them. Such a poster has been prominently displayed for the last year in the nursing home where my mother reported being sexually assaulted by staff. Her complaint was "investigated" by the care facility themselves (no police), and they concluded they could "not determine that anything occurred" despite actual evidence to the contrary.

Last month, an elderly woman was raped in Surrey Hospital, and similarly, the hospital "investigated" the crime themselves, did not inform police, and ultimately did nothing. Six months later, only when the family went to the media did the police step in.

Regarding medication errors, the report cites the case of a woman who found her mother experienced five medication errors in less than one year. The report states: If there had been a bill of rights in British Columbia that specifically established a right to be protected from abuse and neglect, Emily would have been able to assert this right in her complaints to the facility and the health authority.

Nonsense.

At my mother's facility which publicly displays the resident's bill of rights, the CEO, the Director of Medical Care, and the Director of Care all refused to acknowledge complaints of over-medication of my mother, including over a dozen medication errors within six months. Independent doctors and pharmacologists confirmed our concerns, but the only response we received from this facility to our politely expressed concerns was a letter from their lawyer saying that all staff had been directed not to talk to me about my mother's medical care.

By the way, one of the lawyers who sits on the board of this care facility is with a firm that is a prominent member of the BC government's Elder Law working committees which are, as we speak, quietly re-writing all the elder laws in BC. No one in the media has yet cottoned on to what's really happening beneath the surface with various laws affecting seniors.

The issues of daily fee increases and the poor quality of food pale in comparison to the actuall horrors that await unwitting people (and their unwitting loved ones) as they clamour to enter these "care" facilities. My mother is in "one of the best", a flapship routinely cited for how lovely it is. Outward appearance makes little difference to the real quality of life "enjoyed" in these places.

Anonymous said...

I agree with StandupforBC's posting above which certainly reflects my own experience with a parent in eldercare.

a) doping up residents with off-label use of antipsychotics with serious, life-threatening life effects.

b)in one ward of the hospital, not feeding seniors. Food would be set in front of seniors who were too weak or too befuddled to lift off the saran wrap to eat. The untouched trays would be whisked away. Also staff and patients were constantly rotating through the ward, so no one staff was responsible for patient X. Patients were dying all the time. I wonder how not being fed contributed to the mortality.

A girlfriend, in another part of the province (same health authority though) observed the same thing happening while she was caring for her dying father in hospital for four months. She would take off the saran wrap and lids for the seniors but staff didn't and no staff helped patients eat.

Then several years ago, my grandparent was in hospital for seven months with an undiagnosed broken hip because the same radiologist kept making the same mistake in viewing the three sets of X-rays. Her pain complaints were ignored, she was forced to have physical therapy on a broken hip. The hospital refused to do an MRI.

And she shut up, she was afraid she would end up being taken out of her home and shipped off to an old folks home. Then her hip reset incorrectly and then she had to have hip surgery in her 90s to fix her hip. No apologies from the hospital or the radiologist.

My grandmother had lots of caring family to look for her, as does my parent who is care. Without caring family, the over-worked staff, doing the best they can, come up short for many, many patients. Whether that is washing, providing wheelchairs, or food.

The Ombudsman report is a laughable farce. Bill of Rights and a website? not even close.

How about audits and inspections, advocates for seniors without families, more staff AND NOT GIVING SENIOR CARE TO FOR PROFIT COMPANIES who fire and rehire staff at will.

And oh yeah, Gordo's gang has made things worse for seniors in care, not better.

Icing on the cake? upping the amount charged for spouses in care leaving some spouses at home in near poverty.

Norman Farrell said...

The problems at seniors' care facilities are only beginning. Vancouver Coastal Health is replacing experienced RNs with lesser qualified practical nurses. This is definitely in the works for Evergreen House at Lions Gate Hospital and, presumably, for all other extended care units.

More here:

http://northerninsights.blogspot.com/2010/01/trouble-brewing-in-seniors-care.html

Anonymous said...

Please would these people who comment comment with a contact address so I know I am not alone.
audreylaferriere@yahoo.ca