Presently a new industry has sprung up across Alberta and even across Canada. Entrepreneurs are setting up Designated Assisted Living facilities to house the frail, dependent elderly. Because they are not subject to the Nursing Homes Act, they do not have to fear regulations, monitoring or standards that regulate auxiliary hospitals or nursing homes. They are not likely to be held accountable to ensure that proper ethical care will be given to these vulnerable persons.

The Reality of Such Facilities?

The “Dumbing Down” Factor.

Because these facilities are not subject to the Nursing Homes Act, there is no legislated requirement to have a Registered Nurse on site.(though presently some do throughout the day i.e. Vista Village, Pincher Creek, AB.). There may be an RN on 24 hour call.

LPN’s may be on site though their services will be stretched thin, necessitating professional nursing care, dressings and even medications to be administered by care aides who may have little or no training. This all takes us back to the 80’s when persons were hired off the street to give care to nursing home residents – some us worked in those situations – we lived it!

In one such facility, the Director/ Administrator had no professional health care training whatsoever. Her work experience included charge of the local Seniors Drop In Center.

Furthermore, residents who are very ill, are sent by ambulance to emergency wards because there is no one in the facility who possesses adequate assessment skills. Therefore situations that could have been remedied or dealt with by a professional RN becomes a hospital trip. It also becomes a frightening experience for the older person.

The Cost Factor.

In a nursing home setting, the Nursing Homes Act defines the following types of services as basic care in long term care facilities which is covered by the basic fee of approximately $1,400.

1. accommodation and meals;
2. facilities services;
3. necessary nursing services;
4. personal services;
5. therapeutic and special diets as required;
6. drugs and medicine specified by the Minister for use on a routine or emergency basis as prescribed by a physician;
7. routine dressings as required;
8. life enrichment services.

However in assisted living facilities, some of the monthly costs which are assigned to the elderly client, above the basic rent, are (these vary from facility to facility):

• Basic rent which may be between $1,100. – $2,000 or more
• Meals 3 times a day (snacks) – $450 – $500
• Laundry bed linen – $30.00
• Medication administration assistance – $150.
• Blood pressure check – $50.00
• Blood sugar monitoring $150.00
• Assistance to dining area – meals – $150.00
• Bath – $25.00
• Hygiene care incontinent management – $150.00
• Companion services – $12.00 – $20.00 hour

The Accountability Factor.

This trend has produced a hybrid of choices for seniors, which on the surface, appears to be desirable. Free market choices.

However one assisted living facility which we have visited has a hotel catering license posted, another has a city rental accommodation license posted. In these instances, all is well as long as all is well. However if all ceases to be well, no one can be held accountable.

If the resident/family complains or the resident becomes unsuitable or for some reason undesirable to the administration, under such licensure, the elderly resident can be evicted without notice/cause.

Because of the difficulty of accessing long term care beds (Please see “The Long Term Care Bed Crisis (PDF)“, vulnerable, dependant elderly are forced into such facilities.

The Alberta Government is converting Long Term Care Facilities into Assisted Living Facilities known as Designated Assisted Living Facilities (as defined by Alberta Seniors & Community Supports).

In Alberta centres like Pincher Creek, Hinton and Lethbridge, these Designated Assisted Living facilities are replacing or have replaced long term care facilities, all under the watchful, approving eye of Alberta Health and Alberta Seniors and Community Supports. Some of the same elderly who were residents in a long term care facility suddenly find themselves residents in assisted living facilities. The care may not have improved but the cost has dramatically escalated. However they do remain in their own communities. Sadly, those who are too dependant and too ill, are sent out of their home community to a distant facility where it may be next to impossible for friends and family to visit, monitor, give comfort and care.

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