What is Complex Care?

Government agencies often refer to complex care as “residential care”. These two terms, complex care and residential care, are interchangeable. So if you hear someone referring to “residential care” they are talking about the highest level of care available in a residential setting outside a hospital.

For individuals requiring daily nursing care as well as other support, Residential Care residences provide 24-hour professional supervision and comprehensive care services in a supportive, protective environment.

Residential Care usually falls under government subsidized care, In other words, it is provided through funding by the government, facilitated by health providers. But if you have the ability to pay, and can contract your own services, you can purchase residential care services as a private individual (see more about private-pay later on).

While residential care is often viewed as a last resort, it may in fact be the best setting for an individual with multiple needs, requiring complex types of services.

Residential Care facilities are able to address the most debilitating conditions, like dementia or palliative care, for example.

Long-term residential care services can include

Accommodation ranging from rooms with multiple beds to single-occupant suites

A carefully monitored care plan

Clinical services such rehab, occupational therapy,

On-going physical, social and recreational activities

Meals, including doctor prescribed diets, and tube feeding

Meal replacements, nutritional supplements as prescribed by doctor

Laundry of bed linens, towels and personal clothing

Scheduled bathing, and requisite hygiene supplies

Routine medical supplies

Incontinence management and supplies

Basic wheelchairs for personal exclusive use, and maintenance of same

Any specialized service as needed by the client that the provider has been contracted to provide

Management of resident’s cash for small expenditures

Qualifying for this level of care requires a doctor’s assessment that the patient’s needs cannot be adequately met in the home or by other available services and that there is significant risk to the patient and/or other family members by staying in the current living environment.

Clients must be willing to accept the first appropriate bed and occupy it within 48 hours. For any benefits not covered by government subsidies, the client must be willing to cover the cost of these options.

To apply for services under Residential Care, you can have a health care professional (doctor, nurse, pharmacist, social worker) make a referral on your behalf or contact the Home and Community Care office of your regional Health Authority.

Veterans should contact Veterans Affairs Canada for an assessment of eligibility for federal benefits and to be placed on the waitlist for facilities that offer priority placement to veterans.

Residential Care facilities sometimes also offer respite services in the form of short term stays to give family members some relief from care giving or supervision.

All Residential Care facilities offer palliative care services. Some have a small number of hospice beds that can be used by people who have been cared for at home but who require more extensive professional nursing care during end-of-life.

The Application Process

BC has a province-wide, single point of entry system to manage how seniors access residences providing complex care. This program applies to all five health regions.

Fraser Health                       604-587-4600

Interior Health                     250-862-4200

Island Health                       250-370-8699

Northern Health                   250-565-2649

Vancouver Coastal Health    604-736-2033

Almost all complex care services for seniors, including home care, adult day centres, residential care, respite care, and specialized services are available by contacting the Home & Community Care office in your region (see above).

This should put you in contact with an intake worker or case manager who will answer your questions and get the process started for you.

They will set an appointment to see you for an assessment of your physical, emotional, and psychological status. This includes memory and other cognitive functions as well as your ability to perform tasks (referred to as Activities of Daily Living or ADLs) such as bathing, dressing, feeding, grooming, toileting, medicine taking, shopping, cooking and cleaning. The case manager also looks at the supports that are in place to assist the caregiver and will take into consideration the level of stress the caregiver may be under.

People who are assessed as requiring complex care must fit certain requirements in order to be eligible. The case manager can explain these requirements. Those who do not qualify for complex care, may qualify for assisted living. (Assisted living is for people who can direct their own care but need some help with one or two daily living tasks. They need to be mobile or at least able to transfer on their own. )

If a case manager feels a person is in need of complex care placement, and the client is willing to go into care in three months or less, their name is submitted to the placement committee in that health authority’s region.

If the client prefers a placement in a region in the province other than the one they currently live in, they can request this. However, they may have to first be placed in a residence in their immediate area and then put on a transfer list to the other region, which is under the direction of a different health authority.

The client will be asked to select their preferred residence. The committee will attempt to match the client with this residence, but if a bed is not available in that residence the client may need to accept a bed in a different residence and put their name on a transfer list for when a bed does become available in the preferred residence, which can be any length of time.

If the client refuses an offered bed, their name will be dropped from the placement process.

Admission is based on need and the acuteness of the situation, not the length of time the person is on the waitlist. There is also a loose rotation system whereby a residence will offer the first available bed to someone in the hospital, the next available bed to someone in the community and the next bed to someone waiting for their preferred choice. However, this system is often interrupted by factors such as hospital discharge needs, community emergencies, cultural factors, particular skills offered at the residence, etc.

Want more information about making a housing decision?

INSPIRED Senior Living magazine publisher Barbara Risto is the author of “To Move or Not To Move? – A Helpful Guide for Senior Considering Their Residential Options”.  This 128-page book can be purchased for $14.95 from the INSPIRED office at 3354 Tennyson Avenue, Victoria BC.  Or you can order it online at www.seniorlivingmag.com/product/to-move-or-not-to-move or call 250-479-4705 ext 100.  Taxes and shipping costs are extra.

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