Due to limited resources, hospital readmission in Canada has been rising. Each comorbidity requires various community services for follow-up and maintenance. In particular, seniors usually have several comorbidities, and with this population increasing, Canadian health care faces a sustainability challenge. To better care for seniors, we must first understand their service needs and health status; functional capacity, multi-morbidity and income distribution all shape current and future needs. Focusing on British Columbia (BC), this blog summarizes requirements that allow seniors to successfully remain in the community and prevent hospital readmissions.
Causes
As a Care Management Leader and an experienced Registered Nurse, I have cared for numerous seniors that failed to sustain in the community. This was mostly due to limited community resources. For example, seniors in rural areas usually have a harder time to sustain as resources are very limited (Select Standing Committee on Health, 2017). Understanding seniors’ health status within a community is vital to prevent hospital admissions and readmissions.
To better serve the seniors within the community, understanding their needs is the first step for successful planning. By using the Social Ecological Model (SEM), we should be able to identify the patient’s health status, need and view of health. The SEM is a helpful tool for patient assessment based on the social determinant of health. It is believed that less incidents will occur when the model is employed as it focuses on prevention of future incidents by allowing the planner to foresee what is missing to create a seamless plan (World Health Organization, 2019).
One major factor that may pose a challenge for seniors to sustain in the community is chronic disease. The Canadian Chronic Disease Surveillance System (CCDSS) maintains an annual record of diagnosed diseases within Canada. The CCDSS will alert the health ministry to perform prevention and management action if a certain disease becomes prevalent (Government of Canada, 2018). Chronic Obstructive Pulmonary Disease (COPD) is one of the most dominant chronic conditions that causes hospital readmission due to shortages of community resources to manage such disease (Alshabanat et al., 2017).
Other problems seniors face include poverty and unaffordable housing – two major social determinants of health. According to the United Way of Lower Mainland (2018), BC’s senior poverty is the highest in Canada. Not every senior owns a house, and affording rent is practically impossible for those living in poverty. Insufficient income greatly hinders seniors’ access to healthy living and proper care. Subsidized community supports perform a limited number of tasks, while many vital tasks – such as cooking and cleaning – require paid supports. This is unaffordable for many seniors and the lack of such tasks may be a detriment to health.
Resolution of the Causes
Once the cause of an issue is presented, it is my duty as a Care Management Leader to find a resolution to prevent future incidents. I have learned that collaborating with health care teams and curating resources is imperative for problem solving. Regarding seniors’ sustainability within the community, I have determined some answers to better serve this population.
To begin, funding is always an important aspect in resolving health care issues. Money is required for retaining staff and increasing supports. Beyond funding, the BC government should also begin to adopt the Poverty Reduction Plan. This plan presents recommendations to help those in poverty, such as providing supportive housing (Ivanova et al., 2017).
Secondly, home and community support services need improvement so seniors can access more support hours. For rural areas, government should hire more staff and implement better plans to retain staff so adequate supports can be provided (Select Standing Committee on Health, 2017). Regarding cities, the government should recruit more staff for disease management and increase community supports. Indeed, current hours of care for community supports are inadequate. In 2016, the average direct care hours for all facilities and community support was 3.11; the ideal is 3.26 and only 15% of 300 facilities met this goal (Government of British Columbia, 2018).
Finally, increases in Canadian Pension Plan and Old Age benefits are needed. Considering that senior poverty is so high in BC, increasing these benefits would help with the cost of living and hiring for services not publicly funded. Another idea would be to widen the scope of community resources, so seniors and their families do not have to pay for services out of their own pockets.
Future Plan
Helping seniors to sustain in the community is a major issue across Canada. Staffing shortages and resource limitations are the main concern. While every province is affected, BC’s health care system seems to better appreciate the urgency of this matter than others, notably Ontario. Through research with fellow classmates, we compared systems of senior care in Ontario and BC. We found that BC is more advanced in providing care for demented seniors and long-term senior care. While there are no immediate resolutions, BC has allocated additional funding for the next five years to increase community support (BC Care Provider Association, 2017). This funding will raise care hours from 3.11 to 3.26 over three years. The government has also drafted five-year plans to provide funding for staff recruitment, renovate long-term care facilities, increase support services and increase subsidized benefits (BC Care Provider Association, 2017).
The last goal of the health care system is to improve electronic health records and telehealth, giving those in rural areas easier access to primary health care services through technology (Riddell, 2019). Electronic health system was introduced many years ago in Canada, but because of funding and legal matter, introducing a comprehensive electronic health system to Canadian health care had became a challenge. The system is coming out to the Canadian Health care system slowly and once its fully functional, it is believing to bring multiple conveniences, such as reducing wait times and health care cost (Riddell, 2019)
Healthy aging is an essential part of healthy living. For our current system, healthy aging still poses a challenge. Understanding causes of sustainability issues in the community from assessments will inform the government and the planner to foresee requirements to provide better care for the vulnerable senior population. Although BC’s government is slow in meeting the demands of this population, there is an action plan in place. Provinces lacking motivation to resolve the issue may cause detrimental incidents in the future. As for BC, we should be responsible citizens and vote for representatives who will work to build a better health care system for our seniors and our future.
Reference
Alshabanat A, Otterstatter MC, Sin DD, Road J, Rempel C, Burns J, … FitzGerald JM. (2017). Impact of a COPD Comprehensive Case Management Program on Hospital Length of Stay and Readmission Rates. International Journal of COPD, 961. Retrieved from: http://0search.ebscohost.com.aupac.lib.athabascau.ca/login.aspx?direct=true&db=edsdoj&AN=edsdoj.5346a0b6f13c48c0ba6e87b9926d6b02&site=eds-live
BC Care Providers Association. (2017). Strengthening Senior Care: A Made-in-BC Roadmap. Retrieved from: https://bccare.ca/wpcontent/uploads/2017/01/BCCPA_Roadmap_ExecSummary_Jan2017.pdf
Ivanova, I., Daub, S., Cohen, M., & Jenkins, J. (2017). Poverty and Inequality Among British Columbia’s Seniors. Retrieved from: https://www.policyalternatives.ca/sites/default/files/uploads/publications/BC%20Office/2017/04/ccpa-bc_seniors-inequality.pdf
Government of British Columbia. (2018). B.C. Seniors to Get the Hours of Care They Need as Funding and Staffing Increased. Retrieved from: https://news.gov.bc.ca/release/2018PREM0072-001861
Government of Canada. (2018). The Canadian Chronic Disease Surveillance System – An Overview. Retrieved from: https://www.canada.ca/en/public-health/services/publications/canadian-chronic-disease-surveillance-system-factsheet.html
Government of Canada. (2018). Social Determinants of Health and Inequalities. Retrieved from: https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html
Riddell, C. (2019). The Future of Canada's Healthcare System. Retrieved from: http://www.personalhealthnews.ca/news/the-future-of-canadas-healthcare-system
Select Standing Committee on Health. (2017). Looking Forward: Improving Rural Health Care, Primary Care, and Addiction Recovery Program. Retrieved from: https://www.leg.bc.ca/content/CommitteeDocuments/40th-parliament/6th-session/health/Health_20170301_Report_LookingForward.pdf
United Way Lower Mainland. (2018). B.C. seniors’ poverty rate highest in Canada. Retrieved from: https://www.uwlm.ca/news/bc-seniors-poverty-report-card/
Comments