In presentations to the Island Health board of directors, three Comox Valley seniors advocacy groups criticized the recent residential care bed RFP, said Island Health doesn’t provide us with an equitable share of resources and exposed mistreatment of seniors and a new hospital that isn’t clean

Judging by the “surprisingly” large number of Comox Valley citizens who flooded the Crown Isle ballroom March 29 to hear their concerns presented to the Island Health board of directors, there is a widespread belief that the health authority has shortchanged the north Island, especially in health care for seniors.

Five community groups made presentations to the board, which did not speak or respond, except for brief remarks by chair Leah Hollins.

Three of the five presentations bemoaned gaps in health care for seniors, one asked Island Health to give back land it owns in Cumberland and another asked the board to include breathing clean air as a criteria in awarding Community Wellness Grants.

Here is a summary of the three presentations relating to health care.

Comox Valley Elders Take Action

Jennifer Pass, representing more than 70 members of this group, criticized Island Health for how seniors are treated at the Comox Valley Hospital, the cleanliness of the hospital and for its slow response to a critical lack of residential care beds in the region.

Pass recounted the story of an 88-year-old woman, an avid gardener, who experienced serious hand pain and, on the advice of friends, called an ambulance at 7:30 p.m. to take her to the hospital. She waited 14 hours, until 10 a.m. the next morning, before a doctor told her she had arthritis and lectured her on wasting ambulance time for such a trivial matter.

But a second opinion the woman sought later revealed she actually a severe nerve condition relating to her spine. She’s been scheduled for neurosurgery this summer.

Pass also told the board about an 88-year-old woman who experienced a possible Transient Ischemic Attack (TIA — a mini-stroke) and arrived at the emergency department with blood pressure of 185. She was told she “wasn’t a spring chicken anymore” and that she was wasting the ER’s time.

It was later determined by her own doctor that a conflict between two of her drug prescriptions had caused the problem.

These two anecdotes showed that hospital medical staff are “making assumptions about people’s health and diagnoses based on their age … and the elderly are being treated with disrespect,” Pass said, “as if their medical conditions aren’t important.”

Decafnation has received numerous similar reports of mistreatment, which have been reported in a series of articles and as recently as this week.

But Island Health CEO Kathy MacNeil told reporters after the meeting she hasn’t heard of these or similar incidents. That’s surprising from the CEO because people have filed complaints through the official VIHA process.

FURTHER READING: Island Health CEO disappointed by poor treatment of elderly

Pass also commented on the lack of cleanliness in the hospital. During a visit for day surgery, she tried to use one bathroom that had feces on the seat, and other bathrooms that were also filthy.

She was told the dirty bathrooms were a consequence of having so many elderly patients awaiting placement in residential care who were incontinent.

“Seems like the preconditions for a perfect storm,” Pass said.

Pass cleaned one bathroom herself. She also observed beds that hadn’t been cleaned or remade for days.

Sources have told Decafnation that the hospital is generally dirty — dirtier than St. Joseph’s Hospital ever was. They said the uncleanliness is a result of the inefficiencies of public-private partnerships (P3), where housekeeping is contracted out and not as closely managed. 

FURTHER READING: Dissecting a a P3 — Part 1

Pass also criticized the recent Request for Proposals to build “up to 120” additional residential care beds that Island Health hopes to open sometime in 2020.

“That’s too long to wait for new beds,” she said.

In response, Island Health board chair Leah Hollins said, “Bad news is good information. It’s good to hear these stories.”

Power of 5

Melanie Olson spoke on behalf a group of five “frustrated” family caregivers who are trying to keep their loved ones who are suffering with dementia at home.

Olson said their group shares the distress of more than one million unpaid, family caregivers in British Columbia, but with the added frustration of accessing too little support services provided by Island Health for the Comox Valley.

She noted that people over age 65 comprise a higher percentage of the Valley’s population than Victoria, and that it’s nearly 50 percent higher than the provincial average. And, that demographic is growing rapidly.

Yet, residential care beds and support services for family caregivers lags most other communities.

The shortage of residential care beds in the Comox Valley, which Olson estimated at a minimum of 160 beds, is only one of the factors plaguing caregivers.

But the experience of trying to get a loved one onto the list for a residential care bed can be long and frustrating. It’s at least a 12-month wait list, and the patient must not only meet the “complex care” requirement, but must also exceed the care that Community Health Services (formally called Home and Community Care) are able to provide.

But the lack of access to Adult Day Care (ADC) programs and respite beds is just as concerning for Olson’s group.

Respite beds give caregivers a chance to take an extended break (up to two weeks) from the 24/7 job of caring for loved ones. There are only three publicly subsidized respite beds in the Valley and one is not secure enough to accept dementia patients.

That leaves two for a large population of caregiving families. Caregivers are entitled to five weeks respite a year, but they don’t get it. Last time one caregiver needed respite, the entire next year was booked by the end of December or early January. A shortage of beds, means caregivers have to schedule respites too far in advance.

There is one private respite bed available at $223 per day, which most families cannot afford.

The situation is similar for ADC programs, where caregivers can take their loved ones for one or more days per week. But multiple times are virtually unavailable to due the area’s large demand. There’s a two-month wait list just to get ADC for one day per week.

Olson told the board she was disappointed the RFP for “up to 120” new residential care beds doesn’t include any requirement for ADC programs or respite beds.

Olson also asked the board for more access to home support services. She said the home support policy is to provide 120 hours, but only provides about 20 hours in the Comox Valley.

She said funding more caregiving training programs and providing practicum opportunities at Comox Valley facilities could help ease caregiver stress, which has reached the breaking point in many cases.

In an August 2017 report, B.C. Seniors Advocate Isobel Mackenzie said 31 percent of unpaid caregivers were in distress in 2016, the highest in Canada.

Board chair Hollins said in response that “there’s no question we need to put more dollars into the community.”

Seniors Voices Comox Valley

Peggy Stirrett spoke on behalf of a grassroots seniors advocacy group that has collected data from a broad spectrum of community inputs to put a big picture perspective on a local crisis.

Stirrett’s PowerPoint presentation used data to show that the demand for seniors health care and related services has already outstripped local capability and is destined to get worse.

She told the Island Health board that the RFP for “up to 120” new residential care beds does not adequately address the Comox Valley’s demographics or the rate at which the population will grow.

The group’s data suggests there is an urgent need for up to 506 additional residential care beds.

Seniors Voices chart shows the Comox Valley has a higher concentration of seniors

Therefore, building “up to 120” beds by 2020 will neither solve the problem for seniors needing complex care facilities, reduce the distress of family caregivers or diminish the overcapacity problems afflicting the Comox Valley Hospital.

Stirrett said the Comox Valley has a higher concentration of low income households than the provincial average and a higher percentage of them are low income seniors. We also have almost 13 percent more people over the age of 75 than the Greater Victoria area.

But, Stirrett said, “the Comox Valley gets less than its fair share of the resources.”

She plugged data into two different formulas used by the provincial government for calculating a community’s need for residential care beds.

In the first formula, based on 75 beds per 1,000 people aged 75 and over, the Comox Valley should have 525 residential care beds, but has only 374 available.

Calculated as a percent of of the age 75 and over population, the Comox Valley has only 5.4 beds while Victoria, with a lower concentration of over 75 population, has 12.6 beds. The Valley’s ratio is the lowest on Vancouver Island.

“By any calculation we could develop,” Stirrett said, “an equitable allocation could be anywhere between 151 and 506 additional beds … This suggests that 120 additional beds is not enough ….”

She said the group is alarmed by wait times for residential care beds of a year or more and a hospital operating at 138 percent capacity.

“We can only imagine how difficult an experience this is for those seniors who are directly affected … and how much the uncertainty adds to their anxiety,” she said.

Stirrett implored the board to add more residential care beds immediately, even considering using St. Joseph’s capacity as an interim solution.

They also asked Island Health to develop a long-term residential care bed plan for the Valley that addresses the equity issue and takes our unique elderly demographic into consideration.

Finally, Stirrett asked the board to publish information specific to our local area on a regular, timely and transparent basis to help community groups assist seniors with their healthcare needs.

FURTHER READING: Decafnation series on the Comox Valley Hospital; Island Health RFP for residential care beds; The Views considering a bid for more beds