seniors action plan

8/3/2019 Seniors Action Plan

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Improving Care forB.C. Seniors:An Action Plan



Page 1 Improving Care for B.C. Seniors: An Action PlanPage 1

Introduction

British Columbia's health system is one o our most valued social programs. Good health is a

undamental building block o a happy and productive lie and virtually all o us will access some

level o health care or health service during our lives.

Seniors are an important and valuable part o B.C.’s population. Although most o us will remain

active and healthy as we age, some o us may experience a signicant health issue, loss o

independence or isolation. When this happens, there are a range o home and community care

services available to help you maintain your highest possible quality o lie.

Over the past 10 years, the Ministry o Health and health authorities have invested signicant

resources in expanding the range o health services available to people in their own homes, and

upgrading and building new residential care acilities and assisted living residences. However,we have heard rom many o you that the system as a whole is unnecessarily complex. It can be

rustrating or you and your amily to nd the services you need, to understand the policies that

impact you, or to have your concerns heard and responded to in a timely and respectul manner. We

have all been concerned by recent cases where seniors have not received the quality o care they

required and suered as a result.

The Ministry o Health is taking immediate action to provide you and your amily with the

inormation you need to access services in a timely and inormed way, to ensure consistent and air

delivery o care, and to protect vulnerable seniors rom abuse and neglect. We are committed to

work together with you, your caregivers and community health care providers to support you in your

health care choices – rom prevention through to end o lie.

As we take concrete action over the next year to address the most pressing issues, we will also

engage in dialogue with you, your care providers and other stakeholders about the changes we

need to make to ensure B.C.’s home and community care services are responsive to the changing

needs and expectations o our aging population. We will compare B.C.’s current system with other

jurisdictions in Canada and the rest o the world to identiy opportunities or innovation. Together,we will create a sustainable system o seniors’ home and community care that will benet all British

Columbians or years to come.



Improving Care for B.C. Seniors: An Action Plan Page 2

Ombudsperson's Report

The Ofce o the Ombudsperson’s report on seniors' care in British Columbia, The Best of Care:

Getting it Right for Seniors in British Columbia (Part 2), provides a comprehensive review o a number o

services in the system o home and community care across the province. The report examines home

support, assisted living and residential care services currently provided to seniors and includes 143

ndings and makes 176 recommendations to the Ministry o Health and health authorities on issues

o administrative airness, including adequacy o inormation, program accessibility, standards o

care, and monitoring and enorcement o the standards.

The ministry continues to be committed to improving the home and community care system to

address the needs o B.C.’s seniors who require these services. This plan outlines numerous

actions ocused on addressing many o the ombudsperson’s ndings and recommendations. The

actions identiy changes that can be made across the system, resulting in sustainable and lastingimprovements that will better serve seniors across the province.

The complete ombudsperson’s report can be ound at: www.ombudsman.bc.ca



Page 3 Improving Care for B.C. Seniors: An Action Plan

Actions for Improving Home and Community

Care Services for B.C. Seniors

The goal o these actions is to establish an improved provincewide system o seniors' care by:

• Appointinganadvocatetoassistandprotectseniorsreceivingpublicandprivatecommunity and health care services and ensure complaints are resolved.

• Expandingnon-medicalhomesupporttohelpseniorsstayathomelonger.

• Providingclearpoliciesandmeasurablestandardsforhomesupport,homehealth,assisted

living and residential care services.

• Ensuringthatprovincialinspection,qualityassuranceprograms,enforcementandstatraining

in residential acilities align with standards.

• Strengtheningprotectionsfromabuseandneglect,includingimprovedprotectionsforthose who report care concerns or complaints.

• Increasingtransparencyandaccountabilitythroughpublicreportingofthequalityofcarein

publicly unded care acilities, such as patient and amily satisaction, and the incidence o alls.

Privately unded acilities will have an opportunity to participate.

• Improvingsystemexibilityandsustainability.




Action Theme 1: Concerns and Complaints

It is important that you and your amily are able to raise your concerns and complaints about home

and community care, have them taken seriously, and have them handled in a respectul and timelyashion.

• Consultationoverthenextfourtosixmonthswillprovideseniors, caregivers, service providers

and other organizations with the opportunity to have direct input into the uture role o a

seniors’ advocate.

• AsofJune1,2012,asingleprovincialphonelinewillallowyouandyourfamilytoreport

concernsaboutyourcare.Youwillbeprovidedwithdirectsupportandtimelyfollow-upthrough

to resolution.

• TheProvincewillestablishanOceoftheSeniors’Advocate.

Sandra lives in Ft. St. John and talks with her 91 year old mother, who lives in Abbotsord,

by phone regularly. She is concerned because her mother has become conused and

doesn’t seem to be ollowing her usual routines or dressing, meals and medications.

She is not sure her mother is managing saely on her own.

When she called the health authority oce, she was told that they had not received any

request or assistance rom her mother. She met with similar rustration when her mother’s

amily physician was unable to provide inormation on her mother’s health due to doctor-

patient condentiality.

Sandra wants to be sure that someone is checking on her mother’s well being, but doesn’t

know who to ask or help.

Sandra will be able to call the provincial phone line and speak with someone who will connect

her with a care manager in home and community care services. The case manager will set up a

home visit with her mother, develop a care plan i needed and let Sandra know the outcome o the assessment. The provincial phone line lead will ollow up with Sandra to make sure she has

received the assistance and inormation she requested.

Concerns and Complaints




Action Theme 3: Standards and Quality Management

It is important that consistent provincewide standards are established or all o your residential care

services, protected by inspection and enorcement.

• Overthenext12months,improvementswillbemadetothecare seniors receive in residential

care through regular medication reviews, enhanced training or care providers and consistent

medical oversight.

• Increasethefocusofresidentialfacilityinspectorsonhighriskareasandensureanynecessary

changesaremadetomaintainsafetybeginninginApril2012.

• Plantostandardizebenetsandprotectionstoallresidentialcareclients,regardlessofwhere

careisreceivedbyJanuary2013.

Action Theme 2: Information

It is important that you and your amily can easily access and understand all o the inormation you

need to make inormed choices about your care.

• Advancecareplanninginformationandtoolstohelpyouprepare or your uture health care needswillbeavailableonlineandthroughyourlocalhealthauthoritybyApril2012.

• Enhancementstowww.SeniorsBC.cabySeptember2012willprovideyouwitheasieraccessto

inormation on home and community health care programs and other services.

• Onlineaccesstodetailedresidentialcarefacilityinspectionreportsandassistedlivingresidence

investigationreportswillbeinplacebySeptember2012tohelpyouandyourfamilychoosea

care acility.

• Moreonlineinformationaboutyourcareandsupportoptions,howtoaccesshealthcare

services, eligibility criteria or publicly subsidized services, wait times, urgency criteria, patient chargesandhardshipwaiversbySeptember2012.

• InformationprovidedinOctober2012toassistyouandyourfamilytounderstandandlivewith

dementia, including support provided by the Alzheimer Society’s First Link program.

• UpdatedBCSeniors’GuidewillbepublishedbyDecember2012.




Action Theme 4: Protection

It is important that strategies and measures are in place to provide you with protections rom abuse

and neglect.

• Ensuretheprotectionandsafetyofseniorsthroughconsultation and the development o a provincialelderabuseprevention,identicationandresponsestrategybyDecember2012.

• InvestintheoperationandexpansionofCommunityResponseNetworksacrosstheprovince

over the next three years, which support coordinated local actions and work jointly with other

organizations to prevent and respond to elder abuse and neglect.

Henry sufered rom Alzheimer’s disease anddiabetes. As his care needs increased, his amily

arranged to have him placed in a residential care

acility. The amily chose the acility based on

inormation provided online and a visit. The acility

had developed a care plan or him and members

o his amily visited regularly to stay involved in

Henry’s daily lie.

Henry wandered away rom the acility in winter

and passed away ater complications rom

pneumonia. An investigation into his deathsuggests that the emergency action taken by the

acility was not adequate, the care plan was not

being regularly adhered to, and that previous amily

concerns with Henry’s saety and his care had not

been addressed.

The amily eels that this incident was preventable,

and wonders what action could have been taken

to ensure the acility was better equipped to meet

their ather’s needs.

The licensing ocer will immediately initiate an

investigation to review the circumstances, put

measures in place to keep the residents sae and

establish regular monitoring o the acility based on

provincial standards. These reports will be available or

amilies to review online.

Rose lives in a small town, next door to herneighbour and good riend Charlotte. The two

women are in their late 80s. Rose ell and broke her

hip and had been receiving home health services.

A ew months ago, her daughter and son-in-law

moved in to look ater her. Since then, Charlotte

has noticed a new car in the driveway and that the

daughter has taken several extended trips while

Rose is let alone unattended. Rose has become

withdrawn and evasive when Charlotte asks her

i she is comortable with the situation at home.

Charlotte is very concerned that something iswrong, but doesn’t want to urther alienate Rose.

She doesn’t know who to ask or help and what

community resources exist or Rose.

With the new provincial elder abuse prevention

strategy and additional resources or local Community

Response Networks, there will be enhanced

coordination, more public awareness and education,

and community outreach to prevent and respond to

abuse o older adults.

The networks will ensure that the appropriate

community supports are oered, that Charlotte knows

where to ask or help and that Rose gets the care she

needs.

Standards and Quality Management

Protection




Action Theme 5: Flexible Services

It is important to have access to the majority o your care needs and support within your own

community.

• Invest,inpartnershipwiththeUnitedWayoftheLowerMainland, in the expansion o non-medicalhomesupportservicesinupto65communitiesacrosstheprovinceoverthenext

three years, to help you age in place.

• Strengthenfamilyphysiciansandhomehealthteamsprovidingendoflifecarethroughtraining

beginninginApril2012.

• Provideprovincewideafterhourspalliativetele-nursingsupporttocaregiversandfamiliesin

yourhomeasofApril2012.

• EstablishclinicalguidelinesbyJune2012forfrailseniorsinemergencyandhospitalstoimprove

care outcomes and establish ollow up care and supports or a successul return home.

• Establishpoliciestoprovideexibilityinaccommodatingspouseswithdierentcareneeds

withinassistedlivingandresidentialcareresidencesbySeptember2012.

• Produceguidelinesfordementiacaretosupportcaregiversandpromoteevidencebased

practiceinallcaresettingsbyOctober2012.

• Overthenexttwoyears,innovativeapproachesforhomesupportserviceswillbepilotedin

dierentcommunitiesacrosstheprovince,providinggreaterchoiceandexibilityforyouand

your amily.

Richard and Betty have been married or 65 years, and have lived in the same community or

the past 30 years. At 89, Richard has signicant health issues that require care and assistance

with basic activities (eating, dressing, etc). With his complex and declining health, Richard’s

care needs qualiy or admission to a residential care acility. However, Betty is still active and

ully independent and does not need residential care services. Although the couple recognize

that they have very diferent needs at this stage in their lie, they do not want to be separated.

They wonder i there are other options to help them stay together.

New fexibility in housing and care options will allow Richard and Betty to stay together, including

individualized health care supports in their own home, and greater fexibility or assisted living and

residential care providers to accommodate spouses with dierent needs.

Flexible Services




Action Theme 6: Modernization

It is important that our home and community care system is sustainable and continues to meet the

needs o B.C. seniors.

Over the next two years, the Ministry o Health will work with seniors, health authorities, and careproviders to modernize and renew B.C.’s home and community care system. This will include:

• Areviewofexistingbestpracticesofseniors'careacrossCanadaandinotherjurisdictionsto

help us design a system o care that best serves your needs.

• Anindependentreviewofthehomeandcommunitycarelicensingandenforcementsystemfor

residential acilities to identiy what changes are needed to ensure consistent standards o care

are met across the province.

• Implementingtheprovincialelderabuseprevention,identicationandresponsestrategy.

• Anindependentreviewofthecurrentpatientcarequalityprogramtoexaminehowyour

concerns and needs are being met and how you can best be served.

• Examiningwaystoimprovetheexistingprotectionsforpatientsandproviderswhoreportcare

concerns or complaints.




What We've Done

Population aging is a success story – the act that British Columbians are living longer and that

the province has a growing senior population is something to be celebrated. The action plan will

continue to build on the changes and improvements that B.C. has introduced over the years to

ensure continued support or you and your amily.

Housing and Home Support

• In2001,theprimarychoiceswereresidentialcareandcareathome.Today,assistedlivingand

supportive housing with home support are an important part o the housing and care mix.

• AsofSeptember2011,B.C.has31,051residentialcare,assistedlivingandgrouphomebeds–a

22percentincreasesince2001(approximately6,000newbeds).

• Inthelast10years,B.C.hasalsorenovatedandupgradedmorethan13,000residentialcarebeds to meet modern standards.

• EectiveFeb.1,2012,residentialcareclientswillhaveoneofthehighestminimumretained

incomeamountsinCanadaat$325permonth.

• In2001,medianwaittimesforaccesstoresidentialcarewereuptooneyear.Today,theaverage

is45days.

• Healthauthoritiesexpecttospendover$2.5billiononhomeandcommunitycarein2011/12–

anincreaseof60percentfrom2001.

• Healthauthoritiesexpecttospendalmost$754milliononhomehealthservicesin2011/12– anincreaseofalmost86percentsince2001.

• Thereare23percentmoreclientsreceivinghomecareprofessionalservices(nursingand

communityrehabilitation)thanin2001.

• Approximately71percentofallhomesupportrecipientspayabsolutelynothingatall.

• In2009,B.C.enactedtheResidents'BillofRights,settingoutclearcommitmentstocareandthe

rights o seniors living in residential care acilities.

• TheB.C.CareAideandCommunityHealthWorkerRegistrybecameoperationalonJanuary29,

2010,toprotectvulnerableBritishColumbiansandsupportcaregivers.




Improving Care and Quality o Lie or Seniors

• InSeptember2011,theprovincelaunchedAge-friendlyBC,agrantandrecognitionprogramto

help local governments create environments that allow seniors to enjoy good health and active participationintheircommunity.InFebruary2012,newage-friendlygrantswereannounced

for52B.C.communities.

• Since2007,theMinistryofHealthhassupportedB.C.communitiesbyprovidingtoolstohelp

them respond to an aging population. Across the province, 86 local governments rom Alert

BaytoWestVancouverhavetakenactiontomaketheircommunitiesage-friendly.Examplesof

age-friendlycommunitychangesincludewideningsidewalks,installingbenches,maximizing

green space, or making programs and services more accessible to the older population.

• B.C.businessesnowhaveaccesstoacomprehensiveguidethatprovidesinformationonhow to create a business environment that is sae and comortable or seniors – a collaborative

release between the Ministry o Health and the BC Chamber o Commerce.

• B.C.isrecognizednationallyandinternationallyasaleaderintheeldoffallprevention–the

biggest cause o injury among B.C. seniors.

• The$68.7millionHealthyFamiliesBCstrategywaslaunchedinMay2011.Asthemost

comprehensivehealth-promotionprograminthecountry,HealthyFamiliesBCishelpingBritish

Columbians, including seniors, make the healthier choice the easier choice by oering supports

to help them manage their own health and reduce chronic disease.

• In2008,theprovinceprovided$1.8millionto18communitiesthroughoutB.C.toestablish

Seniors’ Community Parks to help older adults stay mobile, physically active and healthy in their

communities.

• In2009,theprovincepartneredwiththeUnitedWayoftheLowerMainlandtodevelopandpilot

theCommunityActionforSeniors’Independence(CASI)projectinvecommunitiesaroundthe

province to help seniors stay in their own homes. CASI gives seniors access to a range o

non-medicalhomesupportservicessuchastransportation,housekeeping,homerepair,yard

maintenance, riendly visiting, and inormation and reerral to help them remain independent.

seniors action plan

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