BC Faces a Crisis in Long-Term Senior Care, Says Advocate

British Columbia needs to immediately invest around $17 billion to make sure seniors in the province are properly cared for over the next decade, according to a new report by the Office of the Seniors Advocate.

That number is based on the estimate of B.C. needing an additional 16,858 long-term care beds by 2036, said Dan Levitt, B.C. seniors advocate, at a press conference Tuesday.

While Levitt acknowledged that $17 billion is an extraordinary cost, not taking action will add up to an even greater impact on seniors, their families and society at large, he said.

That’s because not acting downloads the government’s financial and care responsibilities onto families, who are less equipped to provide adequate care than professionally trained staff at long-term care facilities, he said.

This downloading of responsibilities is affecting all British Columbians, even if they’re not currently caring for senior loved ones, he said.

When seniors aren’t able to access long-term care there’s an increased financial burden on families, where family members or spouses often have to leave their jobs to care for their loved ones, Levitt said. There’s increased pressure on family doctors — who are caring for older patients with more complex needs — and on emergency departments.

Older patients tend to have more chronic health issues and complex care needs, and they recover more slowly, which means they need to stay in hospital beds longer, Levitt said. If a senior isn’t able to be safely discharged to recover in their own home they’ll also have to stay in hospital until a long-term bed becomes available.

Seniors may not be able to be discharged home if they are, for example, no longer able to properly care for themselves, Levitt said.

This creates a backlog in hospitals because there are fewer beds available for other patients, Levitt said.

Seniors need to be cared for in long-term care facilities, not in the hallways of hospitals, he added.

Due to how long-term care beds are prioritized, seniors being admitted to hospital in crisis will be placed into long-term care faster than someone who has access to some home supports, but ideally no one would have to be admitted in crisis at all, he said.

The Office of the Seniors Advocate report highlights every year how the government doesn’t step up its investments in building more long-term care beds and the gap between the current demand and what is available grows.

In an emailed statement to The Tyee, Minister of Health Josie Osborne said she welcomed the report’s recommendations and that the ministry recognized “the growing demand for LTC and assisted living spaces and are reviewing how future beds are planned and delivered to ensure we are achieving the best possible value for public investment.”

In the same email, the Health Ministry pointed to ways it is working towards all of the recommendations laid out in the report but stopped short of saying it would create a detailed action plan with set timelines and deliverables to measure progress.

The report said a decade ago there were 77 long-term care beds per 1,000 people 75 and older. That’s dropped to 58 beds per 1,000 seniors today. If the population keeps aging as is predicted, there will be 41 beds per 1,000 seniors in 2036, which is a 30 per cent decrease from where we are today.

Since 2020 the province has said it will build 3,300 new public beds at 30 long-term care facilities, but to date only 380 beds have been built, Levitt said.

There’s already a 2,000-bed wait-list for the province’s 29,000 beds, he said, adding there’s also no plan to be building new beds after 2030, although there will be an increasing demand for them.

In its emailed statement, the Health Ministry said it has adopted recommendations from the seniors advocate before, pointing to 2019 when it updated the provincial policy for access to long-term care, and to 2017, when it established a capital funding envelope for long-term care renewal and expansion. Since the 2018-19 fiscal year the government has invested over $3.5 billion to improve care for seniors in B.C., and its 2024 budget invested $354 million over three years to help seniors keep aging at home.

The ministry also pointed to an agreement between the province and federal government for $733 million over five years to address the health needs of seniors.

The report had six recommendations to address the shortage of beds.

1. Add more beds

The Ministry of Health and Ministry of Infrastructure need to extend and update the Long-Term Care Bed Expansion Plan to build more beds and to plan for building beds past 2030, the report says.

This will help reduce wait times and let seniors access the care they need, when they need it, Levitt said.

2. Expand community-based supports

This would include expanding the provincial home support program, adult day programs and respite care, where caregivers can get a day, night or week’s worth of a break from caregiving.

This may help families care for their loved ones longer, thereby reducing the demand on beds in long-term care facilities.

B.C. could follow in Alberta or Ontario’s footsteps and make home supports free, which would allow seniors an hour of care at home per day. Right now if a B.C. senior is earning $30,000 per year they will have to pay one-third of that to afford home supports, he said.

Levitt said that right now not a lot of caregivers know about community-based support programs and there’s a lack of availability.

Investing in community and home-based supports help seniors age in place, which is what the majority of them want, Levitt said.

3. Ensure greater transparency

B.C. needs to create a transparent system so people can easily navigate the application process to get placed in publicly funded long-term care, and understand real-time updates to their wait times, he said.

If a senior has applied for a bed and has been placed on a wait-list, they shouldn’t have to pay out of pocket for home support or community care services, he added.

4. Add more publicly subsidized housing

The ministries of health, housing, and infrastructure need to work together to expand publicly subsidized seniors’ housing options like assisted living, the report says.

B.C. introduced publicly funded assisted living programs 25 years ago to provide “long-term care light” but hasn’t expanded the program to keep pace with the aging population, Levitt said, and last year around 1,200 people were on wait-lists for this service, he said.

5. Make plans to reduce wait times, and 6. Address this report

The Ministry of Health needs to do a comprehensive review of health authority wait-list management practices and develop wait-time targets, Levitt said.

Setting benchmarks was helpful in addressing hip and knee surgery wait times and would be similarly helpful here, he said.

He also called on the Ministry of Health to develop a detailed action plan to address the findings of the report by this October. The action plan should have clear timelines and deliverables, Levitt said.

* Story updated on July 29 at 8:40 p.m. to add comments from B.C.’s Ministry of Health.