1. Long Term Care Administration Agenda Thursday, January 15, 2009 1. News Stories 2. Study of Aging 3. BC Ministry of Health 4. Coffee Break 5. History and Evolution of Long Term Care 6. Group Presentation Prep Time

2. History and Evolution of Long- Term Care Long Term Care Administration January 15, 2009

3. History and Evolution of Long Term Care

4. Gerontology is the study of aging. It is to be distinguished from geriatrics, which is the study of the diseases of the aging (medical studies). Gerontology covers the social, psychological and biological aspects of aging. Gerontology includes these and other endeavors: studying physical, mental, and social changes in people as they age. investigating the effects of our aging population on society. applying this knowledge to policies and programs. As a result of the multidisciplinary focus of gerontology, professionals from several fields call themselves "gerontologists".

5. History of Evolution of Long Term Care The term "gerontology" was introduced in 1903 by Elie Metchnikoff, a Nobel laureate and professor at the Pasteur Institute of Paris. In North America, the emergence of gerontology as a scientific movement can be traced to a small group of leaders who, in the mid-1930s, recognized that the health of the American population was undergoing a change from domination by infectious diseases to chronic diseases. The Gerontological Society of America was founded in 1945, and the International Association of Gerontology about five years later.

6. History and Evolution of Long Term Care Earliest References to the Aging Process? King Solomon Ecclesistes Chapter 12 1 Remember then thy Creator in the days of thy youth, before the evil days come, and the years draw nigh, when thou shalt say: 'I have no pleasure in them'; 2 Before the sun, and the light, and the moon, and the stars, are darkened, and the clouds return after the rain; 3 In the day when the keepers of the house shall tremble, and the strong men shall bow themselves, and the grinders cease because they are few, and those that look out shall be darkened in the windows,

7. History and Evolution of Long Term Care 4 And the doors shall be shut in the street, when the sound of the grinding is low; and one shall start up at the voice of a bird, and all the daughters of music shall be brought low; 5 Also when they shall be afraid of that which is high, and terrors shall be in the way; and the almond-tree shall blossom, and the grasshopper shall drag itself along, and the caperberry shall fail; because man goeth to his long home, and the mourners go about the streets; 6 Before the silver cord is snapped asunder, and the golden bowl is shattered, and the pitcher is broken at the fountain, and the wheel falleth shattered, into the pit;

18. BC Ministry of Health

19. Ministry of Health

21. 2006 Budget Spending

22. Ministry of Health Budget 2006 More than $100 million over three years for operating costs associated with government's commitment to add 5,000 new residential care, assisted living, and supportive housing beds with home support by December 2008. This builds on the $75 million in each of 2005/06 and 2006/07 that was provided in the September Update to strengthen and modernise the full range of health care services for seniors, including purchasing temporary residential care and assisted living beds, increasing home support hours, enhanced adult day care, falls prevention, palliative care, health promotion programs, and acquisition of specialised equipment.

23. BC Ministry of Health Our mission is to guide and enhance the province's health services to ensure British Columbians are supported in their efforts to maintain and improve their health. The Ministry of Health works together with BC’s health authorities to provide quality, appropriate and timely health services to British Columbians. The ministry sets province-wide goals, standards and performance agreements for health service delivery by the health authorities.

24. Home and Community Care Home and community care services provide a range of health care and support services for eligible residents who have acute, chronic, palliative or rehabilitative health care needs. These services are designed to complement and supplement, but not replace, the efforts of individuals to care for themselves with the assistance of family, friends and community.

25. Home and Community Care, cont… In-home services, for eligible clients, include home care nursing, rehabilitation, home support and palliative care. Community-based services include adult day programs, meal programs, as well as assisted living, residential care services and hospice care. Case management services are provided in both the home and community.

26. Home and Community Care Services support clients to remain independent and in their own homes for as long as possible; provide services at home to clients who would otherwise require admission to hospital or would stay longer in hospital; provide assisted living and residential care services to clients who can no longer be supported in their homes; and provide services that support people who are nearing the end of their life, and their families, at home or in a hospice.

27. Home and Community Care Philosophy home and community care services will promote the well-being, dignity and independence of clients; palliative care services will provide the best possible quality of life for people nearing the end of their life and their families; clients and their families should have the information required to make their own decisions about lifestyle and care; and clients have the right to make their own care decisions.

28. Community Care Services Home Support Choice in Supports for Independent Livingin Supports for Independent Living Home Care Nursing and Community Rehabilitation Adult Day Centres Caregiver Relief/Respite Assisted Living Residential Care Group Homes Family Care Homes

29. Community Care Services Home Support Home support services are designed to help clients remain independent and in their own home as long as possible. Home support provides personal assistance with daily activities, such as bathing, dressing, grooming and light household tasks that help to maintain a safe and supportive home. If home support assistance is recommended, a case manager will help the client determine the assistance that will best suit their needs and will make the necessary arrangements.

30. Community Care Services Choice in Supports for Independent Living (CSIL) Choice in Supports for Independent Living (CSIL) is an alternative for eligible home support clients. CSIL was developed to give British Columbians with daily personal care needs more flexibility in managing their home support services. CSIL is a "self-managed model of care". Clients receive funds directly for the purchase of home support services. They assume full responsibility for the management, co-ordination and financial accountability of their services, including recruiting, hiring, training, scheduling and supervising home support workers.

31. Community Care Services Choice in Supports for Independent Living (CSIL) Who is Eligible for CSIL? Eligible clients: require daily personal assistance; have the ability to direct all aspects of their care or have a client support group to do so; and have demonstrated the ability to manage care services.

32. Community Care Services Choice in Supports for Community Independent Living (CSIL) Getting Help Managing CSIL Services Seniors and people with disabilities who are unable, or not always able, to direct their own care can obtain CSIL funding through the formation of a client support group. What is a Client Support Group? A client support group consists of five people who have registered as a non- profit society for the purpose of managing support services on behalf of a CSIL client. Family members, friends, neighbours, an advocate, family physician or others may be members of the client support group. The client support group takes on all the responsibilities of an employer. CSIL funds go directly to the group to purchase home support services on behalf of their client.

33. Community Care Services Choice in Supports for Independent Living (CSIL) Payment to Family Members Home and community care recognizes that families have the primary responsibility of caring for and assisting family members. Families remain the most important source of support for clients. CSIL clients have greater flexibility in their care options and the opportunity to pay some family members as caregivers. Family members who do not live with the client, such as siblings, aunts or cousins, may be eligible. Although family members who do live with clients are not usually eligible, some exceptions may be made.

34. Community Care Services Home Care Nursing and Community Rehabilitation Home care nursing and community rehabilitation are professional services, delivered to clients in the community by registered nurses and rehabilitation therapists. Nursing care is available on a non- emergency basis for British Columbians requiring acute, chronic, palliative or rehabilitative support. Rehabilitation therapists can also provide assessment and treatment to ensure a client's home is suitably arranged for their needs and safety.