Why BCCPA is advocating for longer home support visit times

Column by Rebecca Morris

Imagine being eighty years old.

Defeated by chronic pain, you have finally agreed to have someone help you get dressed in the mornings. They remind you to take your medications, too.

You never thought that you would need home support. But who does?

You ate well, exercised and managed your own business up until your seventy second birthday. But things began to change last year. When the arthritis was in your back it was painful, but manageable, but now you barely recognize your own hands – swollen and unrelentingly stiff. It seems that they no longer want to listen to your brain. And that doesn’t seem to be working right either. Or at least that’s what they tell you.

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Like you, many people do not anticipate needing home health care services, yet these services are an integral part of supporting B.C. seniors to age in place and manage disabilities and chronic illnesses. In 2015 there were 31,084 B.C. seniors receiving home care services and 42,170 registered for publicly subsidized home support services. [1]

Home support helps seniors with things like bathing and personal care, meal preparation, getting dressed, using the bathroom and taking medications. In 2015 the average number of home support hours delivered per year, per client decreased by approximately 2 per cent from the previous year, while the number of clients increased by 2 per cent. On average, this has resulted in fewer hours of care per client.[2]

This has real impacts for B.C. seniors like you. While you know you need the help, you seem to have a new person in the apartment each day. Racing in the door with jackets on, hurriedly sneaking glances at the clock.

Fifteen minutes, on the dot.

Currently, B.C. home support visits are as short as 15 minutes in cluster care situations (i.e. congregate building settings and cluster neighborhoods). Even a six-block radius circle in Point Grey, Vancouver can be deemed a “cluster”, which can make it difficult to meet the needs of all clients. In non-cluster, or community care settings, visits are typically 30 minutes, 10 of which are allocated for travel. This means community health workers must do personal care as well as complex delegated nursing tasks in very short periods of time.

Short visit times have affected the continuity of care and in turn, the quality of care, as consistency makes it possible for workers to build strong relationships with clients, reducing social isolation and enabling workers to monitor and report on any changes in the health status of the person they are supporting.

Imagine, what you really need is someone to put the dishes away, but they tell you they can’t do that any more. Some do anyways, charmed, you tell yourself. Or perhaps taking pity on you as they see the evidence that the contents of your once neat and tidy cupboard have migrated down to your kitchen counter.

There are many other B.C. seniors who, like you, report needing help with housekeeping tasks like these, yet they are no longer funded. Without this help some of your peers are led to transition into assisted living or care homes prematurely. Rodger, who used to live down the hall, seems to like the lodge okay but you just don’t feel ready yet.

Seniors like you are the reason why the BC Care Providers Association has identified short visit times as one of the most critical issues facing the home health care sector. It is also why BCCPA is recommending that action be taken immediately. Increasing funding for publicly-subsidized home support visits is more necessary than ever before. Given the wishes of many seniors to age at home, along with the impetus to support a quickly aging population in an affordable way, it is critical that we act now to ensure that B.C. seniors are supported.

Maybe it is time to move you think, somewhere where you can get more help. You are getting sick of soup from a can anyways.

Read about this recommendation and seven others in B.C.’s recently released policy paper Health Begins at Home.

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Rebecca Morris is BCCPA’s Manager, Public Affairs for Assisted Living and Home Care