B.C. seniors in assisted living face conditions ‘that border neglect’, according to new report

VANCOUVER (NEWS 1130) – From towels used as adult diapers to meals skipped because of affordability issues — assisted living is leaving too many seniors in British Columbia in situations “that border neglect,” according to a new report blasting the province’s care model.

The Canadian Centre for Policy Alternatives says it started its review before the COVID-19 pandemic focused attention on problems in long-term care, and the think tank believes it is time for B.C. Seniors Advocate Isobel Mackenzie to step in and review the province’s assisted living sector.

Assisted living is often called “long-term care lite” – meant for seniors who can direct their own care needs but require help with things like bathing, getting dressed, or taking medications.

It is meant as an alternative to 24-hour nursing care and mobility support at a long-term care facility, instead providing a living unit considered to be an individual’s home along with non-medical support services.

After interviewing care aids, licensed practical nurses, front-line managers, as well as residents and their families, the CCPA found many seniors have care needs that are not being met because of low staff levels and affordability challenges.

The report suggests it is particularly a problem in private-pay units where the senior or their family pay the full cost and are charged for each additional service beyond the basic minimum required.

“For example, LPNs and care aides reported residents using towels as adult diapers or for wound care, skipping meals not included in basic food packages, or wearing dirty clothing because laundry detergent was too expensive or residents could not afford to buy new clothes,” reads a summary of the report.

The CCPA also finds a significant number of seniors in assisted living residences do not appear to qualify for assisted living under provincial legislation, which requires that residents are able to direct their own care and independently respond in case of an emergency.

“LPNs and care aides overwhelmingly reported struggling to meet the needs of residents with moderate to advanced dementia or significant mobility limitations – but who were nevertheless living on their own in both publicly-subsidized and private-pay assisted living,” the report’s authors state.

Wishing to remain anonymous, one care aid outlines her struggles.

“We see changes in the level of care, more dementia patients. They are not moved right away, they are left there, but our employer doesn’t provide more staff. We want to give the care that’s needed but we don’t have the time or staff,” she says. “We have to make decisions as to whether or not we’re sending residents to hospital, especially during the night shift. We send residents to hospital often.”

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The report  finds the assisted living model allows residents to make the choice to “live at risk” in order to remain independent, but it can easily become a way for operators to cope with or justify low staffing levels, and too often leaves residents in situations that border on neglect.

“In subsidized and especially private-pay assisted living, front-line staff reported being unable to do what they ethically know they should as a result of institutional constraints like low staffing levels, a lack of resources and the philosophy of allowing residents to live at risk,” the report concludes.

“We know seniors want to live in the more home-like environment that assisted living can provide,” says author Dr. Karen-Marie Elah Perry.

“But I am concerned many seniors and front-line workers are instead dealing with a poorly coordinated sector that increasingly resembles under-resourced and more lightly regulated long-term care.”

Read the full report.

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