A steadily increasing number of complaints about home health care in Fraser Health and across British Columbia has the province’s senior’s advocate concerned.
More than 30,000 people in the Fraser Health region receive home care, but while that number has only been slowly growing, the number of clients filing official complaints about home care has nearly doubled over the last three years.
Last year, the Patient Care Quality Office received 356 complaints in Fraser Health, according to a report issued in December by the province’s Office of the Seniors Advocate. That figure is up 25 per cent from the previous year and more than double the number of complaints in 2015/16.
A similar story can be seen across the province, where the number of complaints has risen by triple digits each year since 2015.
Those increases can’t be explained away by a similar jump in the number of people receiving home care, which was increasing at the same rate. Despite B.C.’s aging population and the desire by health authorities to treat more patients outside of hospitals, the number of home care visits grew by less than one per cent.
“There are more complaints relative to the number of hours and number of clients,” Isobel Mackenzie, the province’s Seniors Advocate told The News.
Mackenzie said many of the complaints relate to dissatisfaction about both access to services, and the actual services received by clients.
“I think that part of it is people are not getting as much services as they have in the past.”
In Fraser Health and across B.C., the average number of hours for each home support client decreased between 2017/18 and 2018/19.
Mackenzie says there is a structural problem related to the fact that many people have to pay for home care services. That, she said, incentivizes people to seek treatment in hospital, where the cost for such help is no cheaper, and often more expensive, than to have that care delivered at home.
“If I go to the hospital it’s free,” she said. “If I get home support, you’re charging me for it. I think we’re underestimating the impact that is having.”
British Columbia’s hospitals are increasingly crowded, Black Press has reported, with the provincial in-patient occupancy rate exceeding 100 per cent for each of the lasts five years.
Communication about home support is also flawed, Mackenzie says. She points to brochures that focus as much, if not more, on services not offered at home than those at are.
“I think we need to do a better job of being quite responsive to the needs of the patient.”
The findings in her office’s report, Mackenzie says, shows “we are not delivering the amount of home support we should.”
Fraser Health’s own data suggests growing problems connecting seniors to home health care. Only 40 per cent of clients were connected with services within benchmark targets. (Targets depend on the priority level given to different clients.) In 2017/18, 48 per cent of clients were provided service within an appropriate amount of time. That year was a high-water mark; Fraser Health has never connected even half of its clients to services in a timely fashion.
Also worrying is the number of emergency visits by home health clients. The number of unplanned ER visits by clients has remained well above the health authority’s targets. Fraser Health records nearly one unplanned ER visit a year for every client it serves.
Health Minister Adrian Dix said the province is working to improve care for seniors and that feedback and information from the Seniors Advocate informs how the province will proceed.
“This is the system we have and we’re trying to make an incremental improvement to it and I think you’re seeing that and a lot of what we’re doing is based on her recommendations.”
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