Advocating for Older Adults in Home Care and Senior Housing

This chapter offers some advocacy tips and outlines different avenues for resolving issues that arise in home care and care facilities for older adults.

Advocating for Older Adults

Older adults who are living in long-term care are likely to be physically or mentally vulnerable, and dependent on others for care. They are in the final years of life, and time is precious. Enjoying loved ones or favourite activities is likely to be a priority. Therefore, when advocating for this group it is important to aim for solutions that can be achieved in a timely way. Advocates may need to adjust their usual strategies.

When addressing problems that arise in home care and care facilities, it is important to:

• Listen to the concerns of the adult receiving care
• Involve family members and/or representatives and substitute decision-makers;
• Identify the desired outcome and timeframe for achieving it;
• Gather relevant records (with the consent of the resident, representative, or other decision-maker) including admission intake notes, initial care plan, last care plan, relevant medical diagnoses, prescriptions, and advance planning documents;
• Gather relevant rules and guidelines, such as legislation, regulations, facility policies or health authority policies;
• Consider the context in which care providers are working;
• Follow existing complaint processes respectfully;
• Keep a diary of issues, photos, and notes of all discussions with staff; and
• Keep in mind that exceptions to rules or policies can be made in some circumstances.

It is important to address the older adult’s expressed needs, as well as to involve their family or representatives. Particularly if an older adult experiences some dementia, involving loved ones may help identify issues and possible solutions. It can also be helpful to bring family members and other loved ones together to discuss concerns and develop a united message for communications with the care facility or any other authority. Caregivers sometimes feel caught between conflicting directives from different family members.

Consider advocacy approaches that the older adult will be comfortable with, and whenever possible, ask for their consent. Confronting and negotiating with service providers or outside authorities may lead to anxiety and fears of repercussions.

Consider whether the adult (or their representative) is seeking short- or long-term solutions, individual improvements, or collective policy change. Are they looking for an acceptable solution that will immediately improve their quality of life, or aiming for a policy change that could benefit many people receiving services but may take more time to achieve? Both are valid goals, but the first may be the priority for the adult receiving care. Residents or their advocates may want to pursue policy change after resolving the immediate individual issue.

Home care services and care facilities in BC are required to have a “fair, prompt and effective process” in place for addressing concerns and complaints from adults receiving care, their family members, or their substitute decision-makers. Consult the facility’s policies and wherever possible raise concerns through the processes they have in place. However, there may be circumstances where bypassing these processes is in the best interests of the resident, for example if the people who are the source of the problem are the same people responsible for overseeing complaints.

When approaching staff, keep in mind that most care facilities in BC (and across the country) face chronic staffing shortages that are beyond their control. Care quality issues may be a result of understaffing and time pressures rather than care providers lacking the skills or desire to provide excellent care.

As with any advocacy situation, it is important to document all interactions and to consult relevant documents and resources that address the issues you are concerned about.

Keep in mind that, despite extensive legislation, regulations and policy guidelines, some authorities are allowed to make exceptions to the rules if the situation calls for it.

This information applies to British Columbia, Canada. Last reviewed for legal accuracy by Seniors First BC, February 2024.

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