Thank you very much.
Good morning, members of the Standing Committee on Justice and Human Rights.
My name is Terry Lake. I am the chief executive officer of the British Columbia Care Providers Association. I speak to you this morning from the traditional territory of the Secwepemc people in the beautiful city of Kamloops.
The BC Care Providers Association is the largest organization representing contracted providers of long-term care and assisted living in B.C. We comprise both non-profit and for-profit organizations. Through our operating arm, EngAge BC, we also represent private home health providers and independent living providers.
While I have served in this role for the last eight months only, I was the B.C. Minister of Health from 2013 to 2017, responsible for seniors care in the province.
In B.C., long-term care is provided by health authorities, non-profits and for-profit corporations, with each responsible for about one-third of long-term care residents, of whom there are about 30,000 in B.C.
It is my understanding the committee is interested in knowing if there are sufficient measures in place to protect against elder abuse, if existing penalties are sufficient, and how the Government of Canada can improve elder protections. This study is aligned with the 2020 Speech from the Throne, which stated:
The Government will work with Parliament on Criminal Code amendments to explicitly penalize those who neglect seniors under their care, putting them in danger.
While I have heard others opine on the current Criminal Code provisions that speak to neglect, I cannot with any authority tell you if these provisions are sufficient, so I will focus my comments on how protection against elder abuse and neglect can be improved in two very important ways.
The average age of an elder in long-term care is about 85 years. The majority of residents have multiple chronic, complex conditions that require 24-hour care and monitoring. About 60% of residents have some degree of dementia. For this reason, staff include registered nurses and licensed practical nurses, but most activities of daily living and management are carried out by health care aides or, as they are known in Ontario and some other provinces, personal support workers.
In most provinces and territories, health care aides are graduates of recognized programs delivered by public and private post-secondary institutions, although there are some provinces in which this is not a requirement. In British Columbia, there is a registry of health care aides, and any health care aide working in a publicly supported seniors care environment is required to be on the registry. The goals of the registry are to protect vulnerable patients, residents and clients; to establish and improve standards of care; to promote professional development for care aides; and to assist these workers in identifying career opportunities. It is my understanding that B.C. is an exception in having formal recognition of HCA credentials. However, unlike the nurses with whom they work, HCAs are not self-regulated, although the former government and the present government in B.C. have indicated the intention to move health care aides into the newly expanded College of Nurses and Midwives.
The professionalization of health care aides is a very important way in which elders in care can be protected. Even if a care aide is found to have abused or neglected an elder in care, they can find themselves removed from the current registry, but they can continue to work in privately provided care, and potential employers are not notified of their removal from the registry. A robust self-regulatory college will ensure that those delivering care to vulnerable seniors are held accountable for their actions at the bedside, no matter who is providing their paycheque. Another benefit of the professionalization of health care aides would be continuing education opportunities and increased stature for this important role, which would likely draw more people into this important career.
This leads me to the second important way in which we can prevent the neglect of elders in care: addressing the critical shortage of care aides and nurses in seniors care in Canada. The Royal Society of Canada's report on long-term care recognized that this is the first thing we can do.
We all heard terrible stories of situations in the first wave of COVID, particularly in Ontario and Quebec, in which elders were found to be dehydrated, often sitting in clothing that was soiled, and that was the result of the lack of care aides available to work. Many were off sick. Many were afraid to come to work. However, this health care challenge has been recognized for many years, so I think if there's one thing that we can do, it's to address the health human resources challenges in seniors care and invest as much as we do in seniors care as our peer OECD countries do in theirs. They invest about 30% more than we do in Canada today.
Thank you very much. I look forward to your questions.