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Long-term Care Residents Praise Staff but Quality of Life Largely Unchanged

The Senior’s Advocate of BC says a survey of more than 10,000 long-term care home residents at 297 publicly subsidized facilities in the province and nearly 8,000 family members and close friends found there has been little improvement in the quality of life.

Isobel MacKenzie says despite a 45 per cent funding increase and 10 per cent more staff over the past six years, the overall rating for quality of life among elderly residents in long-term care remains relatively unchanged.

However, those who took part in the survey gave high marks to care home staff for skill, compassion and respectful treatment.

MacKenzie says little improvement was found in such areas as meaningful activities, help at mealtime, bathing frequency, or engagement with staff or other residents.

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One of the main recommendations is to increase the hours of care per person each day to more than four hours.

“While B.C. was at one time a leader in the amount of direct care hours residents received with 3.36 hours of care per person per day, we must recognize that changes in room configuration, resident population and expectations have expanded the care needed. National standards now recommend 4.1 hours of care per person per day as the minimum.”

The report also recommends improving the home support system in BC to allow more seniors to delay moving into long term care.

“We have 40 per cent of residents who do not want to live in their care home,” according to MacKenzie, “and assessment data tell us that some of these people could continue to live at home with supports.”

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She says all options should be exhausted before a person is required to move into long-term care, which will require changes to the home support program, including the removal of financial barriers.

As for how the COVID-19 pandemic hindered improvements in the quality of care, MacKenzie says it’s difficult to quantify but it’s reasonable to assume there was an impact.

She says while the report has not shown the hoped for improvements, “it is important to recognize long-term care is working well for some people and the goal is to raise the quality of life for all residents.”

She says support for seniors remains strong and notes that hundreds of British Columbians volunteered almost 20,000 hours of time.

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“This alone gives me hope for the future,” MacKenzie concludes.

Highlights from Every Voice Counts-Long-Term Care Resident and Visitor Survey Results–2023 :

• 54% rated the overall quality of the care and services received in the home as ‘excellent’ or ‘very good’

• Almost 80% of residents felt they could express their opinions ‘always’ or ‘most of the time’

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• 81% of residents decide how to spend their time

• 85% of residents felt their privacy was respected during care ‘always’ or ‘most of the time’

• 95% of residents reported they have never been treated unfairly by staff due to their race or cultural background, and 97% reported they have never been treated unfairly due to their sexual orientation

• 88% of residents feel safe when they are alone ‘almost’ or ‘most of the time’

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• 87% of residents reported they trust staff to take good care of them and staff treat them like a whole person ‘always’ or ‘most of the time’

• 48% of residents feel their care home ‘sometimes’, ‘rarely’ or ‘never’ feels like home

• 51% of residents said staff only ‘sometimes’, ‘rarely’ or ‘never’ make time for a friendly conversation or ask how to meet their needs

• 50% of residents reported they ‘sometimes’, ‘rarely’ or ‘never’ had the same care aide most weekdays

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• 33% of residents report that they only ‘sometimes’, ‘rarely’ or ‘never’ get help to eat when needed

• One-third of residents only ‘sometimes’, ‘rarely’ or ‘never’ get to decide when to get up

• 29% of residents only ‘sometimes’, ‘rarely’ or ‘never’ get help right away if needed although 79% report they could get the services they need ‘always’ or ‘most of the time’

• Almost two-thirds of residents only ‘sometimes’, ‘rarely’ or ‘never’ find enjoyable things to do on evenings and weekends, or find opportunities to explore new skills or interests

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The report includes the following 8 recommendations:

1. Increase staffing levels in all care facilities to the nationally recommended 4.1 hours of direct care per resident per day.

2. Increase flexibility of scheduling.

3. Increase social connections for residents by creating more meaningful activities to improve resident engagement.

4. Improve food and mealtime experience to meet residents’ preferences, including nutritional and culturally-specific dietary needs.

5. Implement compulsory professional education for all care home staff in cultural safety and emotional health and well-being of residents.

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6. Allow all residents (or substitute decision maker, if appropriate) to name their “essential visitor”.

7. Work closely with the Independent Long-Term Care Councils Association of BC to raise awareness and increase the function of resident and family councils at all long-term care facilities in B.C.

8. Improve community-based services, in particular home support, to ensure seniors are not required to seek long-term care unless their care needs cannot be met in the community.

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