It can be difficult and confusing to choose the housing appropriate to the needs of Seniors. One reason for the confusion is that the different types of housing provide differing services and levels of care.
In B.C. we have several levels of housing: Independent (or Supportive); Assisted Living, and Complex Care. Independent Living generally provides some meals, maybe one, two or three per day, or maybe a certain number per month. Generally, there are call/alert systems in the units. Recreation, limited housekeeping and laundry services are available. Personal care is not provided. Complex care is what used to be called Nursing Homes and Extended Care, in which nurses are providing direct care around the clock.
Assisted Living provides the services of Independent or Supportive housing, with the addition of personal care services provided by the operator. The services are limited, and there are regulations as to who is eligible and how much service the Residence is allowed to provide.
In British Columbia, Assisted Living residences are Registered with the Office of the Assisted Living Registrar and conform to the Office’s regulations as set out by the provincial legislation. The operator must provide two of the prescribed services below.
An assisted living Residence may provide each resident up to two of six “prescribed services.” Residents who need three or more are determined to need complex care. The following are the prescribed services under the Community Care and Assisted Living Regulation:
- Regular assistance with activities of daily living, including eating, mobility, dressing, grooming, bathing or personal hygiene;
- Central storage of medication, distribution of medication, administering medication or monitoring the taking of medication;
- Maintenance or management of the cash resources or other property of a resident or person in care;
- Monitoring of food intake or of adherence to therapeutic diets; 5. Structured behaviour management and intervention;
- Psychosocial rehabilitative therapy or intensive physical rehabilitative therapy.
Costs of Assisted Living vary tremendously. In the publicly funded Residences, it is 70% of someone’s after tax income. In the private sector it can be up to $5,000 per month and more. Some Residences have both provincially subsidized and private Assisted Living accommodations available.
Some Seniors Housing operators provide more than one level of care. They may have Independent living, Assisted Living, and Complex Care. In some Supportive living residences, a Resident may be able to purchase additional help either privately or through (but not provided by) the operator. This situation may allow the individual to stay in the Residence if they become frail.
To apply for publicly funded Assisted Living, contact your local Health Authority. To apply to a private Residence, contact the residence directly. Diamond Geriatrics can help you or your clients with selecting, applying for, and moving to the Residence of your choice. With our partners, we can help arrange the packing, moving, and unpacking as well.
For more information on Assisted Living in British Columbia, see http://www.health.gov.bc.ca/assisted .
Click here to see our Guide to Needs and Wants for Seniors Housing:
An Interview with B.C.’s Assisted Living Registrar
Susan Adams has been the Registrar of Assisted Living since 2003. Seniors, caregivers, and all of British Columbians are lucky to have her. We spoke to her this month–here are some of the things she told us:
B.C. currently has over 6300 Assisted living units, and another close to 300 are coming soon. Of those over 65% are publicly subsidized.
Although there are a range of services that an Assisted Living residence is allowed to provide, they must choose two, and for the most part, operators choose help with medication and help with personal care (dressing, grooming, bathing, using the toilet, etc.)
One of the basic requirements of Assisted Living is that residents be able make decisions necessary to function safely in the residence.Practically, this means things like being able to find their way around, use the call bell or call system to summon help, recognize that certain actions of theirs will have consequences, be able to respond to an emergency, such as a fire alarm, and find their way back to the residence independently.
Assisted living is a semi independent environment. Residents should not need supervision of their basic, daily functioning. If they do, or if they are not able to make appropriate decisions areound safety, they most likely need complex care.
An Assisted Living residence must have enough qualified staff to do what they say they will do. They must have a Registered Nurse or Licensed Practical Nurse involved, but that does not mean on-site. There may not be any staff on in the evening or overnight, especially in some of the smaller residences.
Assisted Living is not covered under B.C.’s Residential Tenancy laws, but residents and family members should receive a contract and make sure they read it carefully. The contract should describe the conditions under which someone may be asked to leave, and contain the notice time either party must give to vacate. Typically it must be on the first of the month.
When someone is asked to leave, a publicly funded Assisted Living residence will usually contact a Health Authority Case Manager and an “exit plan” will be developed. A private residence may do the same. (Note that this transitional process is where Diamond Geriatrics’s expertise can help you plan for your “next step.”)
Anyone may make a complaint to the Office of the Registrar, and complaints can be handled anonymously. The Office of the Registrar has jurisdiction to investigate complaints regarding health and safety and the operation of unregistered Assisted Living residences.
Complaints that are most frequently investigated by the Registrar’s office include site management, followed by medication administration, meal services, and the operation of possible unregistered Assisted Living Residences. Communication between staff and residents/families is another area which they are often asked to investigate.
When asked what she would like people to know about Assisted Living, Susan said that the purpose of Assisted Living is to help Seniors remain independent for as long as possible. The Registrar’s Office office provides oversight to insure health and safety, and that if anyone has concerns in those areas, or about unregistered Assisted Living Residences, they should contact the office: firstname.lastname@example.org .
Beware of Mounting Costs
We recently had a client who elected to live in a private Seniors Residence. The original cost he was quoted was about $150.00 dollars a day. However, it turned out he needed help with medication–this added on daily costs. In a short time, he needed help with personal care: dressing and bathing, and getting to and from the dining room. This added additional costs. All told, additional costs went up over $50.00 per day, or $1500.00 per month. What seemed affordable in the beginning, became less so as his needs increased.
When looking at private housing, always ask what the initial costs, what other potential costs might be, and what costs the Resident will be responsible for.
Seniors and Caregivers always need to look at the “worst case scenario,” and ask if they can afford the residence if this were to come to pass. They might choose it anyway, but they need to be aware of what additional costs might be, and have a “Plan B” in mind if they really want to live there, in case the costs become more than they can afford.
Advice from the Registrar of Assisted Living:
- Do your research about housing options.
- Be realistic about the level of support/care you need.
- Identify what is important to you.
- Read the occupancy agreement carefully.
- Understand your rights and responsibilities.