By Alex Sangha

I worked as a clinical social worker for a health authority in older adults for several years and I am currently trying to support my father who is terminally ill.  The quality of life that seniors can expect in their so-called "golden" years has been at the forefront of my mind.

In BC, there is a senior's model designed around how sick you are.  You will move from independent living to assisted living to a long-term care facility.  I found our system really based heavily on the medical model and an institutional framework.  I did not find the care of the elderly to be very dignified.  In fact, I felt that there were very serious risks of neglect, social isolation, and a lack of staff to patient care.

It did not surprise me that seniors in "for-profit" long-term care facilities were dying of Covid-19 at much higher rates than in public facilities.  There should not be an incentive to make money off the care of our vulnerable seniors who may not be able to advocate for themselves.  Should not long-term care facilities fall under the regulations of the universal health care act and be publicly funded?

I would like to propose a few modest changes to our approach in caring for the elderly.

 Accommodation – A senior's village instead of an institutional setting.  Perhaps, the village could open onto a partially covered courtyard with benches, fountains, and have a coffee shop, pizza slice store, convenience store, recreation room, and television lounge, etc.  At least the seniors would be encouraged to get some fresh air anytime they want and get to know fellow residents.

Fresh Meals - Nutrition can play a big role in improving health outcomes.  Food needs to be prepared fresh daily.  Frozen, microwaveable, and artificially processed food should be banned.  The PICS Assisted Living Complex in Surrey makes fresh Indian meals every day.  I don't see why other facilities cannot follow in their footsteps.

Social Interaction – Maybe open a preschool or daycare in the long-term care facilities and allow children to learn about the life stories and lived experiences of the residents.  Maybe schools of social work, nursing, or gerontology can send university students to visit and learn from the residents.

Virtual School or Work – We provide prisoners with school or work opportunities. Why cannot we provide seniors who have a lifetime of experience with opportunities to advance their education or utilize their skills?  Everyone needs a purpose or a goal or some routine.  With virtual technology, seniors can be linked up with the outside world and share their knowledge, skills, expertise, and wisdom.  If some seniors want to go to school or work, they should be encouraged and provided the opportunity.  Every long-term care facility should have a library with computers for residents to use.  The residents can also be hired to complete tasks at the senior's facility, and they can use the money to purchase items or obtain services in their senior's village.

Strategic Admissions - A husband and wife should be admitted into the same facility and not separated at their end of life.  LGBTQ+ people should be admitted to facilities that are queer-friendly if that is what they prefer.  People who speak various languages should have the option of living in a facility that is culturally sensitive.  The government should aim to develop a portfolio of unique senior facilities that can address these diverse needs.

Natural Living – A natural environment with plants and related activities such as gardening would be a good idea to improve the resident's mood and mental state.  I also think doctors need to consider holistic natural medicine and treatments if that is an option.  A pill is not always the answer.

In conclusion, our society needs to make seniors a priority in principle and practice.  They spend their entire lives raising their families and working hard as citizens.  The end of life should not be dreadful.  It should be hopeful and full of exciting things to look forward to and accomplish. 

We need to change the narrative around seniors and focus on their strengths, skills, and success. 

Alex Sangha is a Registered Clinical Social Worker and Registered Clinical Counsellor in BC.  He is the recipient of the Meritorious Service Medal from the Governor General of Canada.  For more information:  https://alexsangha.com/