Seniors Housing: An explanation
Regardless of efforts and desire to help adults living with disabilities and frail elders continue to live in their ‘homes’, the day might come when that works so poorly or not at all, and the option of ‘seniors housing’ comes up.
Sometimes, regardless of the number of outside support services we bring in such as Home Support, Meal Services, etc., it’s just not working. N.B. While we think of Supportive Housing, Assisted Living, and Residential Care as being for ‘seniors’, many also offer housing for non-seniors.
These types of housing form what is known as a ‘continuum of care’. It ranges from low-level (Supportive Housing) to high-level (Residential Care) of care. In some buildings/complexes, more than one type of housing is available in a given housing development – e.g. in different buildings on a site or on different floors of a building. When there are different levels of care provided in the same space, it is referred to as ‘a campus of care’. It can make future moves from one level of care to another – should that be needed – much simpler than moving to a different place. Regretfully there are not many campuses of care in BC.
At the light care end of the spectrum is SUPPORTIVE HOUSING (also called Congregate Housing, Independent Housing, and Retirement Community Living). It typically offers meals, suite cleaning, and social/recreational activities. The next level of care is ASSISTED LIVING which typically adds bathing and medication management, as well as meals, suite cleaning, and social/recreational activities. residential care (also called Long-term Care, Complex Care, Continuing Care, Facility Care, and Nursing Homes) is for those who require 24/7 care and monitoring.
There are also different kinds of providers of the above three specialized types of housing. When the government offers a low-cost version, it is referred to as PUBLIC or SUBSIDIZED. Some non-profit societies offer some NON-PROFIT HOUSING types. ‘Seniors housing’ offered by the business sector is referred to as PRIVATE or FOR PROFIT and it costs the most.
As with many of the resources we list, there are 3 kinds of housing providers:
- GOVERNMENT (also known as Public or Subsidized)
- NON PROFIT SOCIETIES (also known as Non Profits or Not for Profit Organizations – NPO’s)
III. BUSINESSES (also known as Private or For Profits)
One unbiased source of comprehensive information on ‘seniors housing’ which explains each type and their regulatory bodies, locations, how to access them, costs, etc. is the Metro Vancouver Family & Friend Caregivers Information and Resources Handbook parts VI, VII and VIII.
Seniors Housing: Groups advocation for improvement
Advocates for Care Reform (ACR), a non-profit society dedicated to improving the quality of care and quality of life for people living in Residential Care in BC, worked many years to create awareness and facilitate dialogue and consultation around the issues of care and quality of life for those living in RC through advocacy and education. This includes offering family council guidelines and a Family Council Handbook. In October 2012, the non-profit was dissolved but members have kept a great deal of information and materials on the website
Antipsychotic Drug Use. The BC Ministry of Health report “A Review of the Use of Antipsychotic Drugs in British Columbia Residential Care Facilities” (2011), explains antipsychotic drugs were originally developed to treat schizophrenia and other psychoses, but have increasingly been used to treat behavioural and psychological symptoms (e.g., delusion, aggression and agitation) of people with dementia. The appropriate use of antipsychotic prescription medications for residents with dementia is a complex concern, as persons with advanced dementias might experience symptoms including delusions, hallucinations, verbal outbursts, agitation and physical aggression, creating challenges related to the safety of staff and other residents. At the same time, inappropriate medication or medication errors can have serious adverse effects. There are many calls to better manage the aggressive behavioural and psychological symptoms of dementia to reduce antipsychotic use using new BC guidelines.
Research conducted in 2014 by the Canadian Institute for Health Information (CIHI) shows that 33% of residents in BC RC may have their quality of life affected because they are taking potentially inappropriate antipsychotic medications. The BC Patient Safety and Quality Council (BCPSQC) has launched a Call for Less Antipsychotics in RC (CLeAR) and is working towards reducing the number of residents on antipsychotic medications by 50% across BC.
Advocates for Care Reform has a fact sheet Antipsychotic Medications In Long Term Care (2012) with guidelines on What You Can Do As An Involved Family Member. In April 2015 the Office of the Seniors Advocate released Placement, Drugs, Therapy Report, it too expresses concern about the overuse of antipsychotics in RC.
Family and Resident Councils In addition to the regulations and rights in long-term care, some facilities have Resident Councils, and Family Councils so that residents, family members, and staff can connect and work together to promote quality of life in a facility. If the facility of your care recipient does not have a family council and you would like to help establish one, or if you are looking for ways to help strengthen an existing family council, the Ministry of Health provides a short guide book Guidelines for the Development of Resident or Family Councils, google the title for the pdf. More information on the topic can also be found online.
Office of the Seniors Advocate Toll-free: 1-877-952-3181. In March 2014, Isobel Mackenzie was appointed as BC Seniors’ Advocate, Canada’s first person to have that provincial role. The Office monitors seniors’ services, promotes awareness of seniors’ issues and works collaboratively with seniors, families, policymakers, service providers and others to identify solutions, and makes recommendations to government about system-wide issues facing seniors in five key areas: health care; personal care; housing; transportation; and income support. Since the appointment of Isobel Mackenzie, almost a dozen reports have been published.
The April 2015 “Report – Placement, Drugs and Therapy…We Can Do Better” includes some focus on misuse of drugs in Residential Care including the fact that “While 47% of residential care clients are being prescribed antidepressant medications, only 24% of these clients have actually been assessed as experiencing depression.” N.B. In November 2016, the report was updated with Report – Making Progress: Placement, Drugs and Therapy Update
The May 2015 report “Seniors’ Housing in B.C.: Affordable, Appropriate, Available” examines housing issues across independent living, assisted living and residential care
In June 2016 Report – Resident to Resident Aggression in B.C. Care Homes reviews incidents of resident to resident aggression in B.C.’s licensed residential care facilities.
British Columbia Residential Care Facilities Quick Facts Directory (2017) published January 25, 2017 lists information for 292 publicly subsidized facilities in British Columbia. (Note it does not cover Residential Care provided by non-profits or private businesses.) The Directory contains a range of information from a variety of sources, including facilities themselves, health authorities, licensing bodies and the Canadian Institute of Health Information. Excluded from the directory are facilities that offer specialized services to unique populations that are not part of traditional residential care.
Updates occur each January and reflect the latest information available on B.C.’s publicly-subsidized residential care facilities.
Sometime in 2017 the Office of the Seniors Advocate will release the results of a survey of 27,000 seniors living in 300 residential care facilities across BC and their 27,000 ‘most frequent visitor’ which in many cases will be a Family Caregiver. The survey is collecting feedback on the quality of their residential care and accommodations and is designed to give residents and their families a voice. Results will provide a road map for improvement of the quality of care and services provided to residents and their families in residential care.
QMUNITY Generations – Aging Out Project Policy Dialogue. 604-684-8449, BC’s Queer Resource Centre had a two year public education and policy development LGBT2Q project Aging Out Policy Dialogues through its Seniors/Generations program. The purpose of the dialogues was to create policy recommendations and competency training that effect positive change regarding the understanding of the needs and issues of LGTBQ2SQ seniors, including those in seniors housing. The competency training was meant to ensure that proficient care is provided by all staff, in a way that creates an inclusive environment. Organizations that have undergone competency care training display the rainbow sticker on their property and in their materials. You can also ask what queer competency training staff has received and if there are queer staff, or queer clients. The Qmunity Generations staff can assist.