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Aging in Place: The Ideal, The Promise and The Reality

When Seniors Advocate Isobel Mackenzie reported earlier this year that up to 15 per cent of B.C. seniors living in residential care may be incorrectly housed, it was a call to action. The report noted that as many as 4,400 seniors in residential care in B.C. –15 per cent of the total—could potentially live more independently. They had lower care needs than residential care is designed to accommodate and could be cared for in other settings either at home with support, or in assisted living residences.Aging in place Carole Holmes, president of the B.C. Seniors Living Association states that “we need improved planning and implementation of home health services provided by the Ministry of Health and the health authorities to residents of independent living communities to allow them to remain in the communities for as long as possible (Vancouver Sun, 2015-10-03).
 When Erin Ellis wrote that a not-for-profit provider of homecare services is laying off 89staff at the end of October because Vancouver Coastal Health is turning the work over to volunteers (Vancouver Sun, 2015-10-19), alarm bells rang out. Bonnie Wilson, director of home and community care for VCH replied “Over the past three years, Vancouver Coastal Heath has been reassessing the authorization of home support hours to ensure they are being applied fairly and are consistent with provincial guidelines. The primary focus of home support is on personal care with services that include bathing, dressing, toileting, mobility assistance, medication management and meal setup.” The purpose of home care services administered by health authorities throughout the province is to help clients stay out of institutional care… but many seniors in Vancouver had their home care hours cut to a weekly one-hour window for a shower after years of receiving help in taking care of their home.

Herein lies the dilemma: all statistics support the medical and fiscal value of allowing seniors to stay in their homes for as long as possible. However, without adequate home support services, most seniors are unable to sustain their health and an adequate lifestyle.

We offer, in this section, three perspectives on the issue:

Binny Goldman

The review of Marcy Cohen’s presentation to guests of Jewish Seniors Alliance’s Fall Symposium, challenging the B.C. government to fulfill their promises “Living up to the Promise” written by Binny Goldman.  Read More…



Edith Shier’s first-hand account of her arduous move out of her apartment, into one senior residence and then, forced by circumstances, to move again. Read More…

Dan Levitt

Dan Levitt’s article “Beyond the Comfort of Home: New Residential Model of Living Turns Traditional Nursing Care Model Upside Down”. Read More…

We at Jewish Seniors Alliance suggest that seniors explore all their options carefully when it comes to deciding whether to downsize and move out of the family home or condo. When the decision is made to do so, have a frank discussion with your physician or family friend about potential health issues and the consequences of such problems. Lastly, before signing a lease for an apartment in a seniors’ residence, ask a lot of questions—and perhaps get a lawyer to look over the lease before you sign.

By Dolores Luber

Review Of Marcy Cohen’s Presentation At The Fall Symposium Aging In Place: Living Up To The Promise, Now What?

Gloria Levi introduced Marcy Cohen of BC Health Coalition, an adjunct member of Simon Fraser University and a Research Associate with Canadian Centre for Policy Alternatives who recently coauthored a study that was critical of BC’s home support system–Living Up to the Promise’.

Marcy Cohen adamantly stated that the goal is to create a better world for future generations but first we have to change the system, which is fragmented and broken. We need a ‘One Stop Shop’- where a team of health providers- a care advocacy group can provide services and supports needed for seniors to maintain their independence, remain socially active yet still be supported as their health declines.
Rising health costs of an aging population and finding solutions that maximize both cost effectiveness and health outcomes is one of the biggest challenges facing BC’s health care system and therefor affecting seniors.

From 2002 to 2010 access to home support services for people 75 and over declined by 30 percent. In 2014 the number receiving services was virtually unchanged. Yet, over those intervening 12 years, from 2002, there was a 49 percent increase in clients 80 and over and an increase in demand for home care.

BC had been a leader in providing prevention oriented home support services from 1960’s-to the mid 1990’s but this is no longer true. Now it provides the least. There is no continuity in caregivers and thus time is wasted in learning anew what the needs of each client are. Task-oriented care workers are unable to provide the care that the person in need is asking for at the moment since it wasn’t specified in the originally requested care package.

Discouraged, lonely, isolated, many seniors present themselves at the ER, blood pressure elevated from not having eaten, disoriented, depressed, they are admitted to the hospital as “social admits”.

Often, even after a needed hospitalization for a procedure, there can be a gap upon release because although capable to function when fully recovered, the period to recovery – is the gap time, where the system fails them. Some resort to private care but it is beyond the means of many at $24,000.

What makes a quality care health system? One that helps people remain functioning, capable and mentally stimulated. The Medical Association is now on board and suggesting that help is needed earlier on so it won’t be as traumatic when the time comes to help with personal care. Community health care workers and the system must support seniors with early intervention by alerting case managers or primary caregivers.

Multi-Disciplinary teamwork is a definite need, one based on Restorative Care focused on rebuilding connections for the seniors and helping them do tasks for themselves – although more time-consuming for caregivers – may result in assisting the seniors back into community life.

Marcy Cohen recommended an excellent pamphlet as a guide. It is called ‘My Voice’, DOWNLOAD IT HERE.

Gloria Levi summarized the session by saying that senior care is a complex issue on many levels that needs to be dealt with by continual discussion and adjustment. She stressed the need to combat society’s biased concept of ageism.

By Binny Goldman

My Odyssey

Hello from me again, giving you another update of my trials and tribulations. When I arrived here from Montreal in 2004, I was very fortunate to find a lovely, spacious apartment on Balsam St. close to all the charming shops on 41st Ave. Living there was comfortable and having my car here made shopping and socializing so easy. However, I always believed in “Aging in Place” and often said I won’t ever move from my place. However, the day came when I developed very bad osteoarthritis in my knees and was forced to make the decision to give up driving and sell the car! This was very traumatic for me, having driven for more than fifty years in my capacity of Interior Designer. I now found myself in a wheelchair, sitting in front of the TV all day long and becoming more depressed not seeing enough visitors.

Last January, my children suggested that I look into senior residences so as not be alone so much. I agreed to research this option and settled on a new Seniors Residence in a convenient neighbourhood. It looked like a five-star hotel and they signed me up for a tiny apartment for a big rent and I moved in mid-March. Imagine directing the downsizing from a wheelchair, without any help at all (All my family live in the USA – nobody is here)—deciding which furniture to give away, which to sell, which to keep, which antiques to sell to a dealer.

There was also the kitchen – what do I keep, what do I give away! All this was a gargantuan job but it had to be done—I had to check everything for a decision and I made numerous lists.

Well, the move went pretty well but a month later, I had an overdose of Coumadin (blood thinner) and was rushed to the hospital where VGH welcomed me again with four pints of blood (I hope it was from a healthy and strong guy). After three weeks of bed rest I was transferred to a rehab floor where a very talented Physio Therapist took me in hand to help me learn to walk all over again. You can be assured that this is more difficult than it sounds. After two months I was ready for more intense P.T. but with my painful luck, I pushed too hard on the brake of my chair and tore a ligament in my left hand.This kept me there another two months for this to heal enough so I could use a walker to learn to transfer (to a chair, to the bathroom, to the bed). Finally I was able to be transferred to Holy Family Rehab Hospital where I spent the next five weeks doing more intense P.T.

These events kept me out of my new apartment at the Seniors Residence for five whole months. As I was now in a power-chair, I understood that the situation had changed, and I preferred to move on to a more accommodating environment.

So, while still at Holy Family, I searched the web for a seniors’ residence on the west side and luckily found Crofton Manor, which turned out to be a wonderful,

CroftonManor_Gallery-Entrancewelcoming facility for seniors. Another move had to be arranged! Although everything from there came with me, and my son came up from Seattle for two days to facilitate this move, it was a formidable task. I have now moved in and am living comfortably in a spacious one-bedroom, very nice apartment and happily, thank G-D. I pray to G-D I never have any more unpleasant occurrences. Perhaps the lesson to be learned is that seniors, once they move out of their home or condo into rented accommodations, must try to anticipate their future needs and rent from an appropriate facility.

Edith Shier

Beyond The Comfort Of Home: New Residential Model Of Living Turns Traditional Nursing Care Model Upside Down

Maria is 105 years of age. In her bedroom, the centenarian sits comfortably in a high-back chair with a view of Boston Harbour. Within an arm’s reach is a remote control designed for her with large numbers to enhance independent TV watching.Home-articleLarge

Next to her wall-mounted flat screen TV is a chalk board with the activities of the week: hairdo every Tuesday, bingo at 2 p.m. every Tuesday and Thursday, communion at 10 a.m. on Sundays, and the times and channels for her favourite TV shows. Her bed is adorned with a knitted wool artisan comforter that matches the colours of her window coverings. A hand pendant is within easy reach should she need assistance and a large numbered digital clock is placed on top of her bedside table

Her home at the Leonard Florence Center for Living in Chelsea, Mass., is the newest model of care combining the comforts of home with individualized complex nursing care. It does not look like a nursing home. It looks like a home, providing dignity, privacy and the comfort of living in a household environment. Her residence is the first urban multi-storied Green House building as conceived by Dr. Bill Thomas, a Harvard-educated geriatrician who helped create a nurturing living model. The Green House Project is a radically new approach to long term care in which conventional nursing homes are replaced with small, homelike settings where people can live a full and interactive life.

There are 10 seniors living in each of 10 households. As you enter the homes, one is greeted with a front porch doorway, complete with a welcome mat, mailbox and doorbell. Each resident has a private space with a bedroom, bathroom and shower. A single ceiling track allows seniors to be lifted and transferred from the bed into the bathroom. In many nursing homes, seniors share their room with another resident that also includes sharing a standard toilet and sink with privacy and dignity neglected in the design. Losing privacy is among the issues that seniors fear the most when moving into a traditional nursing home.

The private bedrooms open into a comfortable living room centered around a fireplace, dining room and kitchen, all within a small open floor plan. All the action is visible for the residents simply by wandering out of their room to look at what is going on and to decide if they wish to participate. An outdoor area is accessible in each neighbourhood with patio furniture and views of the gardens below.

This senior living residence is all about choice. A full working kitchen, one of which Julia Child would have been proud, is at the center of the house providing lovingly prepared meals, served family-style at a single dining table. Each of the 10 households operates its kitchen independently. There is no central kitchen shipping prepared meals on steam tables to each dining room. There are no name cards on the dining room tables. As a result, seniors can sit wherever they wish.

Menu and dining times are chosen by the seniors so they can eat what they want, when they want. A ADVOCACY COMMUNITY NEWS ON TOPIC Beyond the comfort of home: New residential model of living turns traditional nursing care model upside down wheelchair-accessible countertop displays delicious home baked goods next to a bowl of bananas, pineapple, cantaloupe and honeydew. Another bowl is filled with green and red grapes. The menu and recipes would satisfy even the most discerning palates. The majority of the residents living at the center were once esteemed cooks in their households and expect the same quality in old age.

Of the 10 homes, one household is designated for people with Multiple Sclerosis and one for people with Amyotrophic Lateral Sclerosis, Lou Gehrig’s disease. These houses employ technology that provides people living there with more freedom to live independently. The residents have complete control over the doors, lights, thermostat, elevator, home theatre, and window coverings. With a sensor on his eyeglasses, a resident is able to pinpoint letters on his computer to form words and sentences that are spoken through automation. As a result, he can communicate with all the eye-gaze technology in the home. The technology application in the home extends individual freedom in one’s living environment.

The Main Street ground floor is where residents find Betsy’s Bakery Cafe, Eisenberg’s Kosher Deli, Adelson Field Synagogue Chapel, a living room, conference room and a European day spa. Some residents spend their time in common areas relaxing. A nearby cascading waterfall feature that provides a calming background sound while other residents choose to participate in group activities. It’s their preference. The residents have the choice to dine in their household or go to the main floor eateries.

It takes the nursing-home industry as we know it and it flips it, creating a very homelike residential model of care. There is no central nursing station and no long corridors as those in a traditional nursing home. When you enter the home you feel a sense this is the best place for your mom or dad. The Center for Living creates a private residence where 10 people live and complex care is offered in that household. It is difficult to see anything that would tell you that you are in a nursing home. Each residence has a multi-skilled worker who provides personal care, prepares meals and performs housekeeping for elders. Known as a Shabaz, the versatile caregiver becomes recognized by the people living in the Green House as a friend, not as someone who is just another employee.

It takes visionaries to create a home that redefines institutional living. The home gives residents, families and friends their lives back.

By Dan Levitt