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“From Bad to Worse”: Residential Elder Care in Alberta.

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Focusing on assisted living [AL] and long term care [LTC], this report explores the
consequences of two major, interrelated shifts in Alberta residential elder care in recent years:

The replacement of Long term Care with Assisted Living.
Elders who would once have been placed in LTC have increasingly been diverted into AL.

The expansion of for-profit delivery of residential elder care
Elder care services in Alberta are delivered either by a public body,
a not-for-profit agency, or a for-profit business. Recent years have seen
a fall in publicly-delivered elder care and a spike in for-profit facilities.

Between 1999 and 2009, relative to the growth in number of Albertans over age 75,
the number of residential elder care (either AL or LTC) spaces fell by 4%, while the
number of LTC spaces fell by 20%. By 2008, Alberta had the second lowest availability
of LTC spaces in the country.

– Across residential elder care in Alberta, a significant gap exists between the care
provided and the care required to ensure residents’ dignity and comfort.
Examples of the consequences of the care gap include waits of up to 2 hours for
response to call bells, meals rushed to a point that choking risk is increased, and
inadequate staffing that puts both elders and caregivers at risk.
– Based on evidence from beyond and within Alberta, for-profit elder care
is inferior to care provided publicly or by a not-for-profit agency.
Measured against benchmarks established by elder care experts, LTC in
Alberta has often failed to achieve staffing levels that point to minimally
acceptable care. Between 1999 and 2009, for-profit facilities fell short of the
staffing levels that indicate reasonable quality elder care by over 90 minutes
of care per resident, per day. While public facilities also fell short, they did
significantly better than for-profit facilities.
– Significant offloading has left many elderly Albertans and their support
networks struggling to cope with burdens, both financial and otherwise,
that at one point would have been alleviated by the provincial government.
Offloading also has consequences for the wider community and the provincial

Between 1999 and 2009, private long-term care facilities in the province had an
average return on investment [ROI] of 2.1%. Private AL facilities had much higher
returns over that time, with an average ROI of 9.14%. This means that in recent years
the returns received by the private residential elder care industry in Alberta have been
higher than those of the US stock market, which over the same time-frame had an
average return of 1.23%.
The report also points toward difficulties in accessing information about
residential elder care. In light of the termination of the Statistics Canada
Residential Care Facilities Survey, the elimination of the Health Facilities
Review Committee, repeated changes in programmes and terminology
within Alberta, and the inconsistencies that characterize elder care across
Canada, there is a need to ensure elders do not become lost in a knowledge gap.

The evidence is clear: as more services have
been provided by for-profit enterprises and as the available
supports have decreased, elder care in Alberta has gone from bad to worse.
1) EXPAND home based forms of care.
2) IMPROVE staffing levels -The Government should ensure that all elder care
facilities are legally bound to minimum staffing levels established in relation to
experts’ assessments of the levels required to ensurequality care.
3)PHASE out private for profit care
4) INCREASE public access to information about elder care
5) CREATE a watch dog. Establish an elders’ advocate to report to the