Monday, July 20, 2015

Housing options for seniors in BC

Information on the state of senior care in my home Province from the Senior Advocate Report (PDF File)

Half of B.C. seniors live on $24,000 per year or less and more than 50,000 seniors are living on $20,000 or less. These are incomes that will not rise and many costs related to declining health care are not covered for many of our lowest-income seniors. 

Some seniors are making ends meet by either living in substandard housing or by foregoing other basic needs and no one wants to see this happen to our seniors in their final years.

Many seniors accept that, as they age, changes to their health and mobility may necessitate a move to  housing that incorporates a support or care component. However, many feel frustrated that their housing options are limited by the availability of appropriate housing in their communities and by the policies, practices and regulations currently in place that determine eligibility for particular types of housing. 

They fear they will be forced into assisted living or residential care prematurely, or need to move to faraway communities where there is no support system of friends and family.

A snapshot of how B.C. seniors are living shows that: 
• 93% live independently in houses/town-houses/apartments/condominiums 
• 80% are home-owners, of which 22% carry a mortgage 
• 20% are renters, with 20% receiving some rent subsidy 
• 26% live alone 
• 4% live independently but receive provincially subsidized home care services 
• 3% live in assisted living, with 20% receiving a subsidy 
• 4% live in residential care, with 95% receiving a subsidy 

The financial circumstances of B.C. seniors show that: 
• The median income for seniors is $24,000 
• 35% of seniors who rent live on a household income of $20,000 or less 
• Average rents for a one-bedroom apartment vary from a high of $1,038 in Vancouver to a low of $547 in Quesnel 
• While the average house price varies greatly in the province, the average annual costs of home-ownership net of any mortgage payments is about the same regardless of where a senior lives, averaging around $1,000 per month 
• 36% of seniors with household incomes less than $30,000 believe they will need to move in the future due to affordability

Independent housing options for seniors include both home ownership and rental situations. Independent housing is a choice that is appropriate for most seniors if it is affordable, if there is housing available that can provide accessibility to services and supports, and if it allows for design features to make the environment safe and accessible. 

There are data to support that, if seniors choose to, they can be cared for in their own home to very high care levels. 

Assisted living in British Columbia takes various forms: publicly-subsidized Registered Assisted Living, private-pay Registered Assisted Living, and private-market assisted living Residences. Assisted living is a housing choice for many seniors who wish to live in a community with others and have hospitality services like cooking and cleaning provided by the facility. It is also appropriate housing for seniors who require care but have a level of cognitive function that allows them to engage with the community of seniors they live with while maintaining their independence.

The data also clearly indicate there are other seniors for whom subsidized Registered Assisted Living would be appropriate, but they are not eligible for this type of housing and care as a result of the current regulations. 

These seniors would appear to instead go prematurely to residential care. The affordability of subsidized assisted living appears to be adequately regulated by the current rate structure whereby seniors pay 70% of their net income, with a Temporary Rate Reduction available to those who need it. For seniors with very low incomes, however, these fees can leave very little disposable income for costs not covered by the fees. The availability of assisted living overall appears to be sufficient given there is an estimated 10% vacancy rate. 

However, the availability in smaller, more remote communities may be a challenge. In general, the availability of subsidized assisted living is difficult to assess as there is no standardized method used for tracking vacancies either within or between health authorities.

Residential Care sometimes called long-term care, facility care or a nursing home, residential care provides 24-hour professional supervision and care in a protective, secure environment for people who have complex care needs and can no longer be cared for in their own homes or in assisted living settings. Seniors with Alzheimer’s or other forms of dementia, those with significant physical incapacity, and those who require unscheduled and frequent higher level nursing care are all suited to live in residential care

The availability of residential care varies throughout the province. Waiting times for placement are greater in the north than in the Lower Mainland and waiting times are greatest for those who require highly specialized care such as a secure dementia unit. 

While it is difficult to assess accurately the sufficiency of beds overall, there is definitely a lack of availability of the bed of choice, or ‘preferred bed’. 

The affordability of residential care is assured by charging residents a percentage of their net income and by the availability of a Temporary Rate Reduction (TRR) in the case of undue financial hardship. However, awareness of the TRR and uniform application are lacking. 
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