Research Project

Who Uses Assisted Living in British Columbia? An Initial Exploration

 

The vast majority of older adults in Canada wish to remain independent and living in their own homes for as long as possible. Eventually, however, some people need more personal assistance than can be provided by home-based health services. Assisted Living is a relatively new form of care in British Columbia which is a middle option between independent living (with some limited support) in one’s own home, and living in a residential care facility.

Objectives

  • Define and describe the context for Assisted Living in BC and how it compares to other jurisdictions, both in Canada and internationally
  • Describe the current publicly-funded Assisted Living resident population in British Columbia, including how long they stay, from what care settings they arrive in Assisted Living, and to what settings they go when they leave Assisted Living.

This is not a formal evaluation of Assisted Living, but is instead a first descriptive report about how this new care model is working in BC. This work is timely given current policy focus on better integration of care provided in the community.

 

Main Messages

  • There is no consistent definition of Assisted Living, or consistent use of terminology, either in Canada or internationally, so readers should exercise caution when reading about this sector.
  • There are, however, a few principles that define Assisted Living (and whatever else it might be called), the most fundamental of which is providing supports for seniors (and in some jurisdictions, disabled adults) in a less formal institutional setting than long-term care.
  • In BC, there is a formal framework for Assisted Living—this is more structured and organized/formalized than in other parts of Canada.
  • Half of Assisted Living residents are 85 or over, three-quarters are female, and about half subsequently move on to residential care.
  • Length of stay is often measured in years, and females tend to stay longer.
  • Use of other health care services and polypharmacy appear to decline after moving to Assisted Living.
  • Dementia diagnoses increase substantially in the first year after moving to Assisted Living, and a diagnosis of dementia is associated with a much shorter length of stay.
  • More generally, more than a quarter of people leave Assisted Living after less than one year.
  • Use of benzodiazepines and atypical antipsychotics in this population is high.
  • Only one-third of people who die do so in Assisted Living, suggesting a need for more attention to end of life care in this care setting.
  • Our understanding of this population is limited to the extent that we are missing information on private payment for Assisted Living and other services.

Prepared on behalf of

Home and Community Care and Performance Accountability Branch, Health Authorities Division, BC Ministry of Health

Funding

  • BC Ministry of Health