B.C. Seniors Advocate Isobel Mackenzie

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B.C. Seniors Advocate Isobel Mackenzie is a realist

On Nov. 3 she released the findings of a survey of more than 13,000 residents and family members in long-term care homes. Two of her three recommendations called for not only longer visits by those currently allowed into homes, but also to have more people cleared to visit.

She had no idea when she presented her findings that the province was going to be hit with record numbers of new COVID-19 cases in the Lower Mainland, which included numerous outbreaks in long term care homes.

“The sense is that everybody, right now, is scrambling to deal with the issues in the Lower Mainland,” she told iNFOnews.ca.

She had hoped to meet with health officials this week to try to get them to move ahead on her recommendations.

READ MORE: B.C.'s seniors advocate calls on province to make family members of longer-term care residents essential

That didn’t happen but that hasn’t stopped her from lobbying to have, at least, her first recommendation implemented.

That calls on care homes to allow those currently approved for visits to have longer and more frequent visits.

“I’m corresponding with health authorities and care homes directly to try to remind them that the current provincial health orders do not limit the frequency of visits, the duration of visits and allow visits to be in the residents’ rooms,” she said.

Already about 20 per cent of the survey respondents are allowed frequent visits and 21 per cent are allowed in residents’ rooms.

That needs to expand to other facilities, Mackenzie said.

Health Minister Adrian Dix has suggested that visits can’t be increased until about 2,000 more staff are hired specifically to assist with those visits. He said, in a news briefing this week, that 826 full-time equivalent positions had been filled.

But, argued Mackenzie, having visits in residents’ rooms will actually reduce the burden on existing staff.

Right now, visitors have to be screened and supervised and residents have to be moved to common areas, often by wheelchair. Then the visits have to be supervised to make sure, for one thing, there is no touching.

But, if a visitor were screened on their way in, they could then be trusted to go to their loved one’s room and stay for more than half an hour without a staff member listening in. If they’re gowned and hands are washed, touching should not create a hazard, although hugging and kissing should not happen.

When they leave the visitors area would not have to be wiped down and the residents wouldn’t have to be returned to their rooms, all of which take up a lot of staff time.

When she put out her survey she expected the major complaint would be that people were not allowed into long-term care homes for any visits.

Instead, 64 per cent of respondents were already designated visitors. They just wanted more and better visits.

That would work fine for the 76 per cent of long term care residents who are in single rooms, would not be a burden on staff and would not significantly increase the risk of spreading COVID-19.

Mackenzie pointed out that there are no documented cases of COVID-19 outbreaks in long term care homes being triggered by visitors.

“Many, many of the letters that came with the survey talked about, how are the visitors a greater risk than the staff members are?” she said. “People talked about observing staff members not doing what they’re supposed to do. They aren’t in bubbles when they leave the workplace.

“The average age of visitors is 62. The kind of person who’s going to visit their spouse or their mom or dad is not a person who is out at the karaoke bars.”

Mackenzie is hoping that changes will start happening in the next week or so, especially if the number of daily new COVID-19 cases starts dropping but she won’t know for sure if her lobbying efforts are paying off unless she were to do another survey.

Her second recommendation would require Provincial Health Officer Dr. Bonnie Henry to change her existing order that allows for only one designated, non-essential visitor per resident.

Given the current situation with outbreaks in more than two dozen B.C. care facilities, Mackenzie doesn’t see that order being cancelled or changed right away. But, she is hoping that there will be some easing for Christmas visits, at least in facilities outside the Lower Mainland where infection rates are much lower.

Her third recommendation is one that will carry the greatest long term impact and is long overdue. That calls for the creation of a provincial association of family councils.

Mackenzie sees that as being modelled after the Parents Advisory Council system that exists in each public school and has a central B.C. Association of Parents Advisory Councils.

One major difference is that the parents’ councils are run by parents without administrative control by the schools. In long term care, many, if not most, family councils are run by the management of care homes.

For years, those studying the future of long term care homes have “defaulted” to listening to the operators of the facilities with no voice from the residents, Mackenzie said.

“Part of it is a sense of paternalism – protection for people living in long term care – that we’re really here to keep them safe and to keep them out of harm’s way and they really don’t understand some of the risks,” Mackenzie said. “I think some people in long term care are absolutely capable of understanding risks and understanding choices and their voices need to be heard and, if not directly, those residents have chosen somebody who will be their voices.”

But it will take money time to get the association set up.

The cost could be as little as $500,000 Mackenzie suggested, referring to it as “not even pocket change.”

Right now, the Ministry of Health and Provincial Health Officer are focused on the current spike in COVID-19 cases and Mackenzie is concentrating on trying to improve life for existing visitors.

She also wants to lobby for proactive CVOID-19 testing of all staff in care homes, not just those where there are outbreaks.

So, it will be some time before the push for funding for a family council association will be her key focus but Mackenzie is determined to make it happen this time.

It’s been almost four years since she completed a previous and very in-depth survey of the situation in care homes in B.C. and an association was one of the recommendations that came out of that report.

With long-term care likely to be a major topic of discussion provincially and nationally for the next few years, residents' voices need to be heard, not like in previous efforts.

“I would see photos of groups of people meeting together to design the future of long term care except everyone was under 65 and in a suit,” she said. “There’s no voice at the table representing the residents and the family members.

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