According to statistics published in 2006 by the Public Health Agency of Canada, seniors numbered over four million - which meant that one in every seven Canadians was aged 65 or older. With seniors living longer than ever before, that 2006 statistic is projected to rise to one senior in every four Canadians by the year 2036. Aging in place - or remaining in their own homes for as long as possible - is the preference of most people as time marches on. Unfortunately, this desire is not always possible for a variety of reasons; the main one is a lack of home support.

“There are far fewer government-provided services now than there were 10 years ago,” says Dr. Reva Adler, MD MPH FRCPC, who has worked for 20 years as clinical professor of geriatric medicine at the University of British Columbia. “And the cost of services formerly covered by government funding has been shifted back on the shoulders of seniors.” The numbers of seniors wanting to remain in their own homes is going to increase, not decrease, Adler points out.

So, what provisions are being made to help seniors remain in their own homes for longer, which, in the long run, is more cost-effective than subsidizing them in a care facility?
Apparently not enough, though seniors trying to cope at home alone is not a new problem. Over the years, attempts have been made to alleviate the situation, but most strategies have failed. An accident involving a senior alone often results in the victim being rushed to occupy a much-needed acute-care hospital bed - sometimes for a lengthy stay because there is nowhere else for him or her to go.

What seemed to be a motherhood-and-apple-pie solution was launched in the 1980s when the non-profit organization Vancouver Homesharers opened. Their mission was to pair up home-owning seniors with individuals who needed low-cost housing - and were prepared, in return, to provide a degree of live-in help.

In theory, the idea was good, but in practice, homesharing was not viable for several reasons. First, by the time the senior decided they needed live-in support, it was often more help with cooking, washing and cleaning than most live-ins were prepared to give in return for a free room. Also, most of the prospective live-in applicants were either students - whose lifestyles didn’t mesh well with that of the senior - or middle-aged transient women, who often had drug, alcohol or mental problems. A few lasting matches were made, but Homesharers folded after a couple of disappointing years.

In the absence of solutions, the problem hasn’t gone away. As people age, their physical capabilities diminish. It becomes more and more difficult to bathe, shop, walk, visit or drive to a volunteer job, which means ongoing help becomes necessary. At one end of the scale is private home support, but the average cost of such a service provided in the Lower Mainland runs between $25 and $40 an hour, which can be prohibitive for some people. At the other end of the scale, for disabled veterans who qualify, Canada’s Department of Veteran’s Affairs (DVA), provides meals, light housekeeping and often helpful furniture - such as lift chairs that tip forward to assist in moving from a seated to standing position. For the majority of seniors who are somewhere in the middle, the best advice is to plan for the future before a move becomes a necessity because of a medical emergency. 

Gerontology experts counsel that seniors should put plans in place for the time they can no longer live alone - or for emergencies - while they are mentally capable of making independent decisions. While it may seem like a step in the right direction, seniors cannot put themselves on a government-subsidized facility’s waiting list - admission is only granted to those who meet certain criteria. To be eligible for permanent accommodation in any government-run care home, seniors must first be assessed by a public health nurse who decides if they are capable of living alone or not. If the situation becomes critical and a senior must be moved, he or she is sent to the first support home with an available bed - whether that facility is close to family and friends or not.   

But there are other solutions. If finances are not a problem, seniors can add their name to a waiting list in a private facility of their choice. A small down payment of a few hundred dollars secures a place on a list and that payment is deducted from the first month’s charges. If the senior’s name comes to the top of the list and he/she is not ready to move, their name doesn’t plunge to the bottom of the list but instead hovers near the top.

“The most important thing to do while you are still mentally capable of making decisions for yourself,” says Monica Webb, marketing manager of a private care facility in Richmond, “is to have a good plan. Today you might be a healthy, independent and capable person but tomorrow could be a different story and somebody else takes control of your life.”

The average cost of a private care facility is between $3,000 and $5,000 monthly, which often includes dinner. Extra services like laundry or personal care are available for a fee.

In today’s entrepreneurial world, many senior-focused services have sprung up to provide help - with as little trauma as possible - for an eventual move to a support facility or to stay with family. One such service provides support to seniors through the moving process, helping them decide what possessions to keep, which to donate, and what to offer up on consignment (there is always the trauma of what to keep and what to dispose of when downsizing). The service’s employees measure the new accommodation and report what items of furniture will fit and how much space there is for hanging pictures. They pack, hire the moving van, and unpack - even to the point of hanging those pictures on the walls. The service can run around $3,000 to move a senior from an average-sized two-bedroom home, but that figure could fluctuate widely depending on the distance and the time of a move.

In a recent interview, Jack Layton, new Leader of the Opposition noted that Canada needs a national plan to ensure “high-quality, non-profit, long-term care for all seniors.” You can bet there are many seniors who would second that motion.

AUGUST 2011 SENIOR LIVING MAGAZINE VANCOUVER & LOWER MAINLAND