B.C. seniors’ advocate calls on province to drop fees for home care

British Columbia’s seniors’ advocate is calling on the province to scrap fees on home support for seniors who wish to remain at home as they age.

Isobel Mackenzie made the recommendation Thursday as she released a new report on the province’s home care system titled We Must Do Better.

“We need a fundamental restructuring of our home support program if we are going to meet the needs of a growing seniors population,” Mackenzie said.

Home care provides seniors who choose to age in place with help for basic care needs, including bathing, getting dressed, medication and other personal care needs.

The services are delivered by trained community health care workers under the supervision of nurses.

The review, which heard from more than 6,000 seniors, found the average age of home care clients was 84. Two-thirds were women, half lived alone and one-third were married.

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About one-third have dementia, and more than half were at risk of needing admission to long-term care.

The 2021 census found British Columbia had one of the four largest populations of seniors in Canada, and Mackenzie noted that seniors are living longer and in better health.

That demographic shift, she said, risked putting even more pressure on the province’s over-burdened health-care system.

Mackenzie said provinces like Ontario and Alberta have eliminated user fees for home care, and that B.C. could “do it immediately.”

“The key program that is aimed at keeping seniors out of hospital and reducing the need to move into long-term care is our provincial home support program,” she said.

“The biggest barrier to accessing home care in this province is how much we charge you for it … I think the evidence is fairly compelling that we are seeing premature admissions to long-term care in part because of the cost barrier.”

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According to the report, a B.C. senior with an annual income of $29,000 faces a bill of $9,000 per year for daily, hour-long support visits.

Keeping seniors at home, she said, can provide a higher quality of life while saving the province billions of dollars.

She concluded that just 14 per cent of B.C.’s $4.8-billion budget for seniors care goes to home care options, with the lion’s share of funding going to the long-term care system.

The B.C. Care Providers Association said there are creative models used in other Canadian provinces which would reduce costs and improve living conditions for seniors.

“In Quebec you can choose the level of home support you need up to a certain amount of money. You get that back as a tax credit,” association CEO Terry Lake said.

While B.C. seniors getting home care have been required to co-pay for decades, the provincial government says two-thirds of them don’t pay at all for the services they receive.

“We spend not far from a billion dollars on home and community care. About $30 million of that comes back in fees, so its a relatively small amount,” Health Minister Adrian Dix said.

Dix said his discussions with the federal government about health-care funding included home and community care, and said the province was also investing heavily in adult day programs this year.

“We are going to be increasing long-term care resources and spaces to meet that demand — but regardless we are going to have to significantly improve access, build out access to home support, to home care, and to community-based services, adult day programs and the rest, that whole package,” he said.

“Not simply because of this issue of cost, but because people want to live at home as long as possible.”

Along with removing financial barriers, Mackenzie’s report calls on the province to increase respite care, to standardize and set targets for service delivery, to modernize care plans, and to better measure and report on performance.