scilly

I think we are in the same boat as many immigrants ........... we're the senior members of the family. Our daughter lives in another province, one niece lives in northern BC, a second in another province

Basically we have to provide for ourselves AND advocate for ourselves.

We are in a better situation than many in that OH's job had good benefits, with Extended Health, and we could take that over when he retired ....... so we pay the premiums every month to have that extra security. That helps cover some costs now, and could be used if care is needed.


But there are some things that anyone could do, especially if they own their own home.

Manulife offers a program where they will offer a Line of Credit based on 50% of the assessed value of the house when the program is set up. it can just sit there waiting to be used, for a charge of $7 per month.

Then, care needed, start drawing on that line of credit ................ they get their money when you sell the house.

There are probably other companies that offer a similar program, this is the one I know about.

geoff52

Calling it a dementia tax is rather insulting to people with dementia.

BristolUK

I can't speak to the care levels but the whole thing is a bit crazy.

There are "bed blockers" (a very unfortunate term but one that highlights the effect) in hospital for no other reason than they are waiting for a nursing home place. Particularly daft is the cost to the Province of them being an in-patient greatly exceeds the cost to the Province of the nursing home place (and that's without other losses from being unable to treat someone in hospital to get them productive again).

We even had a situation here where someone who already operated 2 or 3 homes to everyone's satisfaction had a facility ready for over 20 people just waiting for a couple of formalities to be done but the Province was dragging their heels over getting it done.

In my first couple of years there was a case in the paper of a couple who supposedly got divorced because the contribution taken from the spouse in the house towards the care costs of the spouse in the home left insufficient funds for their own needs.

I don't know how true that was because a few years later, a similar situation arose where a couple were considering divorce for the same reasons.

But there was more information this time and from the details mentioned the one left in their own home was left with an income some way in excess of what we had for four.

Shard

Not sure which politician came up with the term, but it's not insulting at all. It's just a quick label to highlight the consequences of the policy. A bit like the "bedroom tax" which is not a tax, but a removal of a subsidy. In any case, I doubt dementia sufferers would give a monkey's about what it is called.

Piff Poff

This is how it has gone with the couple I am very close to. Elderly immigrants, no offspring or relatives in this country, distant nephew in the UK. She had a stroke 7 years ago that left her partially paralyzed, had a home carer come to sit (and facebook) with her twice a week for 3 hours whilst he ran errands.

He got ill and needed a heart valve year before last, refused as there was no one to look after her.

Last summer she had another stroke that left her with no mobility and limited speech, she was a bed blocker - paying the rate she would for a care home for 3 months whilst waiting for a bed, during that time there was no speech therapy or physio to try and get her back on her feet.

He has had lots of heart issues, mainly due to medications and has spent 10 days in a hospital, he came home on Thursday only for her to have another stroke on Saturday (it's been a nightmare and is not looking great). He was assessed in the hospital to see if he is coping on his own, I personally think he should be in assisted living but he will not go in a home. He would be entitled to the Handi Bus, but they only operate in city limits now, he has been offered home help but as all they do is sit there, he has declined.

Her care is costing both of their state pensions. As I have said before, thankfully they have some savings (from some vehicles we have helped them sell, there is still another couple to go if it comes to it).

He has mentioned getting one of those modulars placed on their land, so she can come home and pay for full time care, I think if he were to get a reverse mortgage this would be easily do able, I have also suggested the reverse mortgage and a small home in town where he can use a scooter to run errands. He wants to keep the acreage and horses and cats and dogs - he pays for someone to look after the horses now.

The care she gets is good, but there is little stimulation after the 'activities' and little one on one people contact. The carers are caring but there isn't enough of them. I also don't think it's right for mentally challenged (dementia/alzheimers) and those that have got their mental ability to be in the same home as it gets really upsetting for the one that has got mental ability when it's all kicking off - we have occasions almost every time where a dementia type will come for example try to steal the bed clothes (last night).

I would like to know how people are funded when there is only one pension to pay for the one in the home or likewise when there are two people in the home as in both those scenarios the cost of care is at least double the pensions.

BristolUK

I think it's a similar idea to England (Scotland, I believe, treats it as if it's NHS care in hospital). In this province, they assess the income of both, taking a contribution to the costs and leave the person in their own home with whatever amount is deemed needed for them plus a 'personal' amount for the one in care. Or just leave the personal amount if both are in care.

There's a ceiling applied to the real cost.

Bizarrely, they don't touch monetary assets. The government proposed to increase contributions by a small percent of savings/investments (not their home) in excess of $100k.

But the local seniors group kicked up such a fuss about "going after seniors' assets" that the government backed down.

It seemed entirely reasonable when the province has so little money, that people sitting on a lot of money paid a small amount of it extra (100k totally untouched) especially when it came hand in hand with reduced contributions from people with no assets and low incomes.

Wealthy seniors had all the representation and over protection while the worse off remained worse off.

dave_j

First of all I should state that as a pensioner many of the comments I'm making will apply to me, probably faster than I would ideally like.

As a social minded individual I am of the opinion that it is the responsibility of the state to help ensure the general health of the nation in a similar way that it seeks to protect the nation from outside threats and that it should do this using the NHS model. Some nations achieve this better than others since their political classes are subject to different pressures and inducements.

Such services need to be paid for and general taxation is how it's done whether through an income or other tax although a compulsory sliding scale state insurance would be my preferred method.

The issue of dementia is tricky though since unlike an unexpected burst appendix or a broken bone the patient is unlikely to get any better and what the service is asked to provide is not a health service as such but one of continual care and hospitals are ill suited to this purpose.

So the question to be answered is: 'Should the state accept responsibility for care of those with dementia and should the individual make provision for that time of life when he or she should anticipate the need for caring?'

Unfortunately it has become commonplace for some dementia patients to remain in inappropriate care in places like hospitals because authorities find they have no alternative where they seek to squeeze budgets to fund an ever expanding call on their services. This impacts the health service in general and I am in favour of those that can afford it to pay for their own care doing so. The question then arises, 'Should those with assets help fund those with limited or no assets?' It is patently unfair that those who foresaw the need and saved to service that need should help pay for those who chose not to. So what should a society do to help those who have no assets but need long term care? Should the state fund it or should the state make a charge on their close relatives or should they simply refuse to offer the service to those who cannot or will not pay?

For politicians, these are uncomfortable questions since there are no easy answers and as we see with the current debate politicians will queue up to promise to spend other people's money where it offers a quick way out.

The principle of health care free at the point of need has become one that extends to long term care, is this appropriate?

The state could extend a national insurance scheme to contribute towards long term care and some might argue that it already does this. If this is so then care should be handed out equally and no charge made for anyone since the poor will never be able to contribute and the rich will argue that they have already paid.

One solution that I can see is for the state and the private sector to provide a multi-tiered service but be open and honest about it and accept the implication of providing unequal care on the basis of available wealth. For those who cannot or will not pay the state should provide a very basic service that would be understood to be basic and would not be as good as that already provided but would be comfortable and extend life, a no frills service. For those with assets, there would be a charge on those assets and this would pay for a better type of care. This would be compulsory and there would be no cap on the charge from the estate. This would be very unpopular since family members would see their inheritance seep away to nothing and it might be in their interests to care for their family member in return for the state making a payment similar in amount to that offered for basic care. It may well pass that those with no assets could also be cared for by relatives who might see the payment as a welcome contribution to the family budget. No doubt there will be assets that suddenly vanish only to leave the unfortunate patient with basic care and their relatives buying new houses. This would help to reintroduce the concept of family members caring for family members.

As I have said, these are uncomfortable questions to answer and we shouldn't shy away from discussing them.

scilly

In effect, BC does have 2 tier senior care, whether that be medical or physical disability, or dementia.

There are the homes run by the health authorities, and these can vary enormously between the different authorities, where the patient has no choice or little choice of home, and where their income is taken to pay for the costs, leaving them with a small amount of personal use.

Then there are the privately run for-profit facilities, charging $4,000 to as much as $10,000 a month, with top restaurant quality meals, lots of activities, etc etc etc. I can count at least 10 of those types of facilities within a 2 mile radius of my home.

dave_j

I've no doubt that such systems exist because it really is one that satisfies so many requirements.

The beef that I have, and I hinted at it, is that it exists by default. We, the clients, have to find this out for ourselves because politicians and service providers dare not spell it because it deals with such a delicate topic.

We need those responsible to do what they're paid for and make clear just what services are available and to whom and at what cost and stand up and be counted.

Shard

The "two tier" system exists in the UK too. It's not really any secret, though granted it's less of a concern to 20 year olds than 60 year olds.

The issue seems to be the squeezed middle, once again. Someone with millions in assets may well be indifferent to applying a portion of those assets to superior care/surroundings, but for most it will be a case of diminishing a life's wealth accumulation only end up in the same tier of social care as someone who was unable to accumulate wealth.