The Alzheimer Society of B.C. is encouraged by both the recent Ombudsperson's report, "The Best of Care: Getting it Right for Seniors" and the Ministry of Health's Action Plan, "Improving Care for B.C. Seniors."
Although we recognize the challenges, the Alzheimer Society urges transformational change of the health-care system to ensure person-centered care and services for families facing dementia. As noted in the Ombudsperson's report, there are significant gaps in the care for people with dementia and their families that must be addressed. Her report references the Dementia Service Framework, 2007, an excellent blueprint for further action.
Implementing the Ombudsperson's report would go a long way to achieving the goal of humanizing care in residential care facilities. The Alzheimer Society of B.C. is actively engaged in efforts to improve the quality of life for people with dementia who live in care facilities and who now make up the largest group of residents. Our public position "Changing the Culture of Care" is available on our website: alzheimerbc.org.
We look forward to the Minister's review of existing best practices for seniors' care and the redesign of the system. Connecting people newly diagnosed with dementia to the education, information and support programs is one example of how redesign can strengthen the health-care system. The Action Plan referenced our innovative First Link program which is funded by the Ministry of Health and partners with physicians and other health-care providers, making it easy for them to connect their patients impacted by dementia to the Society.
Frail elders with physical challenges living alone can often be safely supported at home very late into their illness because they are able to collaborate and cooperate with community support staff. People with dementia most often must move into residential care when they experience challenges with behavioural and psychological symptoms. The challenges of care eventually outstrip the capacity of family caregivers to be able to support them in their own homes and inadequate community support no longer ensures their safety.
Once in the care facility, the behavioural symptoms of the person with dementia confound staff who are under-prepared for effectively managing the care required. Behavioural symptoms are now understood increasingly to be expressions of unmet needs. Most of the time, the unmet needs can be identified and, if care is planned accordingly, can be supported with non-pharmacological care and minimal psychotropic medication use.
People with dementia living in care facilities need in this situation:
- To have their needs recognized and managed appropriately.
- To be known first as a person with a rich and complex story that is understood and valued.
- To be recognized as a member of a family and that the family members also have important needs for education and support.
- To have an accurate diagnosis, where the journey is acknowledged, respected, and communicated with family.
- To have disability minimized through symptom management, support to enhance mobility, and the appropriate use and review of medications.
- To have direct care providers who are educated and supported in personhood and are committed to enhancing dementia care through their attitudes, knowledge and skills. Most effective is consistency of care, rather than staff moving between units.
- To live in a physical environment that is homey, supports mobility, and enhances the person's capability.
- To live in a facility with a culture and philosophy of care that balances care for the human spirit and the human body and is dedicated to building a community both inside and outside the facility.
Jean Blake, Alzheimer Society of B.C.