B.C.’s senior advocate is calling for more clarity to help families better understand the difference between assisted living and independent living facilities, in order to make the right decision for their loved ones.
Isobel Mackenzie released her latest report, “It’s Time to Act: A Review of Assisted Living in B.C.,” Wednesday (June 28) detailing issues surrounded assisted living, such as affordability, and five recommendations for the province.
The findings, Mackenzie said, can be broken down to four key issues: confusion about what’s included with assisted living and what’s not; affordability in both public and private facilities; tenancy protection; and quality assurance.
In B.C., about 95 per cent of seniors live in their own homes, with about half of those in single-family dwellings and the other half in “common-walled” buildings, like condominiums, apartments, townhouses and duplexes.
The remaining five per cent of people aged 65 and over live in a variety of shared housing options: independent living, assisted living and long-term care.
Mackenzie said independent and assisted living facilities can “look and feel exactly the same.” They’re buildings where people come together in a dining room for two or three meals a day, they have social activities, outings and people have their own lockable units.
However, it can get confusing in a facility where the operator has chosen to mix assisted and independent living.
“This leaves everybody utterly confused, frankly, including myself.”
It can lead to families and residents wondering why some residents get care aides and nightly checks, while other don’t. Mackenzie said it’s clear there needs to be some significant clarifications, changes to legislation and practice in the industry to “ensure seniors and their families are very clear on what they’re getting, what they’re paying and what their protections are.”
The other major issue is around costs, she said.
In theory, Mackenzie said living in a publicly subsidized unit should be “completely affordable,” and in long-term care she would argue that’s true.
“In assisted living, this is not the case. We take 70 per cent of income … but there’s a lot that’s not provided in assisted living,” she said, pointing to equipment needs, medication, telephone and cable bills and tenant insurance.
The median subsidized income for assisted living is about $21,861, with a monthly income of $1,822. The client contribution toward housing is 70 per cent, for about $1,275, but Mackenzie said there are additional expenses that could be upwards of $625.
“You can see that they’re in the hole at the end of each month.”
She’s been hearing increasingly from residents in assisted living that they’re finding it “very challenging financially” to stay in that type of housing and are instead choosing to move to long-term care facilities.
“In B.C., we have a very relatively high percentage of long-term care residents whose care needs don’t warrant long-term care. They could be in assisted living or at home with home support.”
The report recommendations include increasing the capacity of publicly subsidized assisted living programs with more units and expanded services; reducing confusion that seniors and their families face as they navigate assisted living and other congregate living arrangements; providing explicit tenancy protection under the Residential Tenancy Act for all residents; addressing affordability for both private and public and strengthening the effectiveness of current monitoring of facilities and their enforcement systems.