Speaking Notes SALT Press Conference February 20, 2008
I want to give you a brief summary of the two reports included in your Media Kit. Those reports have a lot of detail to support the themes of this press release: Alberta’s elders have reason to be worried, and our Government has not kept its promises for continuing care.
Even to someone who’s been concerned about Alberta’s continuing care system for a dozen years, the Alberta’s Elders Are Worried! Report and a closer look at the explicit promises in the Broda-inspired policies of our Government are startling.
The reality is that our continuing care system has been fragmented, deskilled and downgraded. Both responsibility and costs have been off-loaded to those in need of care and their families. In the context of an increasing and an increasingly aging population, we’re confronted with a failed social experiment in rationing and privatizing health care for Alberta’s vulnerable elders.
These folks don’t complain. They can’t. Their families are overwhelmed with responsibilities they don’t have the special skills to deal with, with increasing demands on their time and financial resources, and with fear that complaining will only result in more stress with very little if any improvement. They are boggled by the complicated system and by the confusion of terms which can mean whatever someone wants them to mean.
Most of us know very little about the complex of illness and disabilities that aging can bring. But we know, from our own experiences and the research in the first report, that most of us will experience this situation either as a person in need of care or as an informal caregiver – or both.
The second report, with its ‘By the Numbers’ appendix, describes the changing context of the continuing care system from 1988 to 2007.
Alberta’s population has increased by more than 43% at the same time as number of continuing care spaces has decreased by 3.5%.
The resident fees charged for public care facilities have increased from 30% of an individual’s federal pension income, to a rate fixed by the government to recover the market cost of ‘hospitality’ or ‘hotel’ services – and which is higher than their total income for more than half the residents. Public funding now pays only for an increasingly narrow range of nursing care services.
The age and the severity of illness and impairment of the residents have increased, and the care provided no longer includes much except basic personal care. Private care, to supplement or replace facility care, is both very expensive and increasingly difficult to find.
The staffing shortages, which affect both the quality and the availability of care, are largely explained by the low wages of the care aides – the person who hands you your morning coffee at Tim Horton’s probably makes more money – and by the ‘efficiencies’ the facilities create by reliance on part-time and casual staff. Government and Health authority funding formulas have meant a steady decline in the level of skilled nursing staff providing direct care to residents.
The relentless shift to supportive living care for all but the most seriously ill seniors is worrying on several counts.
The most obvious is that we simply don’t have enough supportive and affordable housing in our communities; we’re years behind the predicted need.
A great deal of the recent ‘special funding’ to increase supportive housing has gone to compensate for a dozen years of failure to provide for repair, maintenance and renovation in our public lodges.
We don’t have the social supports (income security, transportation, household supports, and social involvement) that make supportive housing successful.
We don’t have adequate home care: it’s rationed, it’s intermittent, and it covers a very narrow range of services.
Too many folks are being placed in ‘assisted living’ settings where the skilled monitoring and care they need is not provided.
The shift to assisted living and Enhanced Designated settings comes with a shift of the costs of care to the individual and their families. Shifting the costs of care to the ‘consumer’ doesn’t save money; it just puts the burden on a few individuals – much like the auto insurance injury caps.
The role of informal caregivers is increasingly to replace, rather than to supplement, basic care.
Alberta’s policy for long term care reform have been very systematically developed and implemented over the last two decades. Elders and their families who suffer from delays in access to care, inadequate care, and the increased personal cost of even basic care, are experiencing the consequences of deliberate policy goals to spend less public money for continuing care.
What does SALT want?
We want every Albertan to have access to publicly funded, comprehensive, quality care at the end of life.
We want the Government to accept and fulfill our responsibility to provide care that respects each person’s dignity and quality of life.
That responsibility includes adequate funding; effective planning; provision for the necessary resources; regulation and oversight with monitoring and compliance authority – and real accountability. This is not a responsibility that should be delegated to individuals, their families, or the private market.
We want those initial promises fulfilled without the hidden agenda, without excuses, without continued delays - and without more unfilled promises.
We know it’s possible; let’s just do it!
Carol Wodak, for SALT; February 20, 2008
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