This new development complements previous commitments we have secured from the government regarding HST rebates for non-profit care providers and hydro costs.

The BC Deputy Minister of Health has contacted health authorities and directed them to ensure "contracted residential care service providers are kept whole with respect to the financial impact of the HST".

BCCPA will be in contact with the Ministry of Health and Health Authorities in the coming weeks to discuss the administration of the government's directive with a view to ensuring a satisfactory and efficient mechanism is in place in time for the July 1, 2010 implementation of the HST. Rest assured we will keep members apprised of our progress.

In the meantime, BCCPA wants to thank all of our members for your ongoing support. Securing HST mitigation for all contracted care providers is a demonstration of how BCCPA can deliver real results for you and your bottom line. We look forward to more progress on other issues in the year ahead.

"This week, the House of Commons will convene in Ottawa for a new session of Parliament. As usual, Members of Parliament will be preparing legislation and debating the big national issues of the day.

On behalf of our members across the province, the BC Care Providers Association (BCCPA) is urging you to make the challenges associated with our aging society a top priority in the coming session.

Under the Parliament of Canada Act, the PBO is mandated to provide independent analysis to the House of Commons on the state of the nation's finances and trends in the national economy. It is our hope you will take the conclusions of his report very seriously and work with your colleagues to develop solutions to this challenge. Failing to act now will only increase the amount of corrective action required to achieve sustainability over the long term.

The PBO's startling conclusions are matched by January's report from the Alzheimer's Society of Canada (ASC) which predicted the number of Canadians living with the disease and other forms of dementia will more than double in our generation to 1.1 million. To accommodate this demand, the number of long term care beds in Canada will need to increase by over 140% to 690,000 by 2038.

BCCPA has been representing care providers on the west coast for over 30 years. Our members care for 10,000 seniors a day in residential care and another 4,000 each year through home support. While we are on the front lines of this crisis, we know the challenges confronting care providers here are taking place across Canada.

Recognizing provincial health care jurisdictions, national leadership is required on this issue and Parliament needs to focus on the challenges of our aging society. Here is a list of opportunities for you to consider with your colleagues:

• establish national senior's care fund to promote innovation, help achieve consistent quality standards and employ thousands of residential care aides and nurses across Canada (similar to previous federal Health Canada funds for primary care, rural health, health information technology)
• increase seniors' health promotion through an expanded New Horizons program
• expand home retrofit tax credits that facilitate improved home and community care options for seniors
• extend definitions in Federal Excise Tax Act to provide consistent exemptions for all long term health care providers
• direct Canada Mortgage and Housing Corporation to expand existing programs to support development of additional seniors housing and community care infrastructure
• use federal training funds to provide financial incentives, wage subsidies and new training spaces for Canadians seeking career in seniors' care sector
• publish analysis of the implications of demographic change on Canadian economy - as promised in federal 2007 Budget

BCCPA is working very closely with the BC government to ensure our seniors' care system is more efficient and sustainable - with some success. Now it is time for our federal leaders to understand that the challenges of our aging society are no longer arriving at the feet of future leaders. They are knocking on the door today."

Canada's last known First World War veteran, John Babcock, has died at age 109, the Prime Minister's Office says.

Born on an Ontario farm in 1900, Babcock enlisted to join the war at the tender age of 16. He lied about his age to join the Canadian Expeditionary Force in Sydenham, Ont., and arrived in England a few months later.

Read more: http://www.cbc.ca/canada/story/2010/02/18/war-veteran018.html

At the time of the report's release, BCCPA thanked Kim Carter and her team for their comprehensive analysis of our sector and promised to prepare a full response to her recommendations. That response is now complete and it has been forwarded to Health Minister Kevin Falcon and the Ombudsperson's office. Read the full response to Ombudsman's Report. BCCPA is committed to working with the provincial government to renew our seniors' care partnership and make sure the Ombudsperson's recommendations are put into action for the seniors we serve.

MASTER Seal of Approval - Introductory Package

The creation of a provincial registry for senior care aides and community health workers at publicly funded facilities has drawn widespread support both from employers associations and the Hospital Employees Union, which represents workers.

Health Minister Kevin Falcon announced the B.C. Care Aide and Community Health Worker Registry last week. Registration is now mandatory for employment for both classes of workers at publicly funded facilities. They now have until April 28 to register. After that date, workers will be required to demonstrate they have the required knowledge and patient-care skills to be accepted.

"It's a good thing for our unionized workers who do not have a professional organization to represent them," Stevenson said. Registered nurses and licensed practical nurses each have an organization that sets standards of certification and performance. The registry will now serve that function, she said.

"As care becomes more complex and training requirements increase, there is an increased level of education and training required," she said. Stevenson said the introduction of the registry would not affect Fir Park/Echo Village, because workers already employed can register automatically.

"It will affect the screening of new applicants," she said, noting that B.C. has attracted new care workers who will now have to establish their certification and skills to the new body.

Ministry spokesman Shae Greenfield said the goal of the registry is both to protect clients in care and to provide care workers with recognition of their skills and opportunities for advancement, by making their skills portable. The registry will not act as a disciplinary body, but it will provide information to employers.

"If a worker is working at Vancouver Coastal Health, for example, and is terminated [for cause], and they try to go across the street to seek employment, there is a permanent record," Greenfield said.

Workers can register online by logging on to www.cachwr.bc.ca. Greenfield said the registry is optional for workers in private facilities, but they are welcome to join.

"We are working with our partners and stakeholder groups to encourage workers to register, although at this point, it won't be mandatory," Greenfield said.

Politicians think short-term, especially in minority governments. The media report on yesterday and try to anticipate tomorrow. But not many institutions or individuals think about, metaphorically speaking, the day after tomorrow; that is, starting in about five years when the aging of the population will begin to become apparent.

Yesterday, for example, Finance Minister Jim Flaherty held his pre-budget consultation with a group of economists. They talked about the "fiscal outlook," growth, unemployment for the next year or two. But unless something remarkable happened behind closed doors, they likely didn't spend much time discussing what's coming in less than a decade: our aging population.

Provinces are already being pinched by the burgeoning health-care costs. The pinch will get tighter when older individuals such as Newfoundland Premier Danny Williams won't wait for treatment, assuming they could find it in Canada. People with money just won't stand for health systems telling them they cannot spend their money to fix ailments as their bodies age.

Aging will mean fewer people working to support more who are not, which will likely force governments either to raise taxes, reduce non-health-care spending or borrow.

Every country in the advanced industrialized world faces the costs of aging. Japan and Europe have it worse than Canada, the United States slightly better. But none can escape. Even mighty China will feel the pinch, because its one-child policy will produce a strange demographic bulge with so many old people.

Canada can't avoid what's coming. No political manoeuvring can dance around it; no wishful thinking will eliminate it; no upping of immigration targets will change it. Aging is a fact. Its first effects will show up soon. We don't know how much it will cost, what changes it will bring, and a host of other questions. It's time to find out at least some of the answers, so that we can plan intelligently.

Therefore, the federal government should establish a blue-ribbon panel to investigate and report to the country in time for the next federal budget on a range of questions about the impact of aging. If we rely only on politicians, we will get rhetoric and procrastination.

A lot of research about the effects of aging lies within government departments. Think tanks have poked at the issues. So have academics. What we need, however, is a group to pull this material together, do further research, then lay the facts, as best they can be known, before us with some options for how to cope.

We know, for example, an aging population will push up health-care costs. The increase won't be drastic but economist Pierre Fortin has estimated that health-care costs will rise by $17-billion a year by 2010.

Within the health-care system, aging raises many issues, from long-term care, financing of pharmaceuticals, end-of-life decisions and whether people should be able to spend their own money on their own care as their lives shorten.

Prof. Fortin further estimates that pension costs for governments will go up $12-billion, while revenues will fall by about $20-billion because fewer people will be working, thereby reducing the tax take for governments. The fiscal stress is obvious: more costs, fewer revenues. The answer is less clear. A blue-ribbon panel could provide some clarity for both sets of challenges.

Provinces that deliver social services are likely to suffer more fiscal erosion than the federal government. That shift raises a host of issues. Should Ottawa assume some costs now borne by provinces, as in creating a national pharmaceutical program? Should Ottawa offer more tax to the provinces, as in giving them a share of the goods and services tax? What about the already less-advantaged provinces in Atlantic Canada whose young and middle-age populations are hollowing out and will have more old people than elsewhere? How do provinces with huge debt levels such as Quebec cope? How do we increase national productivity, the best antidote to fiscal pressure?

Budgets and taxes. Health care and housing. Debt levels. Federal-provincial relations. Just about all the core responsibilities of governments will be affected by aging.

There isn't a single politician who is talking seriously about the challenge. That's why we need a blue-ribbon panel to alert the public to the inescapable challenges and debatable options ahead.

In addition to keeping up with the growing complexities of care and the challenges of our aging society, care providers are struggling with underfunding and the lingering impacts of the global economic slowdown. The HST, new program cuts, collective bargaining and increased EI and MSP rates have only made things more difficult.

And despite these challenges, the BC Care Providers Association is making progress and advancing many of the issues facing care providers. For a complete list of our 2009 accomplishments click here. In the meantime, here are just a few examples:

For those in the food and equipment distribution business, long-term care and retirement home facilities offer massive growth potential in Canada.

When you think of fine food, retirement and long-term care homes may not come to mind, but the industry is catching up by expanding its menus beyond the traditional meat and potato dishes of the past.

Compared to the restaurant industry and its struggles of late, homes for aging Canadians are booming.

"What we know is that sector between now and 2025 is expected to double in size in terms of population," says Gord White, CEO of the Ontario Retirement Communities Association, based in Oakville, Ontario.

Because of the numbers of aging baby boomers hitting retirement age, White says the government is not able to keep up with building the number of long-term care homes needed to meet demand.

The alternative is the building of more private sector retirement homes, where the resident pays for amenities that include all meal service, personal care, laundry, housekeeping, recreation and social activities.

"Retirement homes will have to expand like an accordion and pick up the slack," White says.

Because retirement homes are market driven, the range of services and programs has expanded to make them more attractive to potential residents.

Today, some homes are equipped with spas, movie theatres, private dining rooms, exercise gyms, swimming pools, lounges and indoor gardens, and also have a range of dining options.

"Retirement homes always build private rooms because no one wants to share unless they share with their spouse. The rooms are getting larger in size (and) people want large rooms. Some are built with two or three rooms," White says.

"The expectation of the consumer is changing. They want to be treated like individuals."

Residents' rooms have changed as well, with separate bedrooms, dens, living and dining rooms and even more than one bedroom in suites the size of a newly built condo in downtown Toronto.

Amica Mature Lifestyles has adapted that model in the way it operates 25 retirement homes across Canada, in Ontario, British Columbia and Alberta.

"Amica communities reflect that of a five-star hotel in look and feel, including fine dining rooms, pubs, exercise centers, swimming pools, spas, beauty salons, garden conservatories, computer lounges--to name a few," says Barry Copeland, the company's manager of food and beverage.

The company's dining facilities are decidedly high-end, with open seating times, fine table linen and meals prepared from scratch by trained Red Seal chefs and served on Royal Doulton china.

Copeland says the retirement sector has no choice but to raise the standards of dining and accommodation as competition increases across the country.

"Residents and families are looking for a better quality of life, which evolves from dining services," he says.

"The retirement industry is evolving to higher and healthier levels from coast to coast. More and more families and guests use our catering menus and venues to host their social events for all ages."

Menus are constantly varied, with more priority on healthier meals made with fresh and local in-season ingredients, which has become the expected standard for the industry, even with higher product costs.

"Local seasonal meats and produce are a must. B.C. prides itself with local seafood (and) Ontario (with) berries, corn and peaches, and all local herbs and vegetables are served during the growing season," Copeland says.

Many retirement and long-term care homes are utilizing the services of trained chefs to prepare restaurant-style meals to bring creativity and variety to residents' dining options.

In the mid-90s, more high-end retirement homes started popping up in Canada, and with the higher price tag came the expectation from residents for more amenities and an expanded dining program.

Revera Care brought in chef Gary McBlain to come up with nutritious, diverse and quality chef-inspired meals for the company's dining program. Revera is one of Canada's largest operators, with 98 retirement residences and 107 long-term care homes in Canada.

The corporate chef heads up a team that prepares many items from scratch and sources local in-season produce from suppliers whenever possible, while meeting Canada Food Guide standards.

"Services offered, especially culinary services, at a retirement residence or LTC facility are just as important as location or price, so it's paramount to provide the best dining experience for residents," McBlain says.

"I think, as well, that we're living in the 'culture of the chef', where new trends and tastes are splashed on the Food Network or other cooking shows. As a result of this trend, when residents and their families are touring prospective residences, they are looking for imaginative and healthy menu choices."

He says the chefs at the company's facilities try to avoid what McBlain calls "food fatigue', where residents are served similar meals day in and day out. The company once held a nationwide recipe contest to gather up new menu ideas to bring to residents.

The winning dish was poached salmon filet with an orange hollandaise sauce, something that would not look out of place in a fine-dining restaurant.

"We try to keep a balance between the familiar dishes residents love and newer dishes that provide a wow factor. A chef inspired menu is better because it pairs the creativity of dishes and flavour combinations with experience handling and managing labour and purchasing concerns," McBlain says.

It wasn't always that way, however.

"There was a misconception that seniors wanted plain food. When you couple that with low food budgets, the results were a lot of pre-made, unimaginative meals and less-than-exciting menus," McBlain says.

Even with the variety and fresh products, what Revera serves now is no more expensive; in fact the company has stretched its food budget further as a result.

"We've always had the labour and skill in the kitchen, we're just using them more effectively by creating meals from better quality raw ingredients as opposed to pre-manufactured items. Actually, in some instances, we have been able to provide better quality meals at lower costs simply by cooking from scratch."

Greg Boudreau, administrator of Pine Grove Lodge in Woodbridge, Ontario, a long-term care home owned by Chartwell Seniors Housing, says each home tailors the individual menus to reflect ethnic or regional variations.

"All menus corporately and at a facility level are reviewed by registered dieticians to ensure we meet their needs," Boudreau says.

"Additionally there is increased demand for vegetarian, gluten free and lactose free menu options. Enhanced customer knowledge and travel has increased the requests for menu items that were not as well known in the past."

Some Chartwell facilities even use local providers to supply staples like produce, bread and milk, depending on availability.

"In the past menus were generally limited to two choices and staff knew residents' likes and dislikes, so if neither (choice) was suitable would do something special," says Chartwell corporate manager of food service, Ian Sarfin.

"Today we are moving to offering a lot more choice. You could have a daily special then anywhere from four to 15 alternates that are available every day. These choices can include items to meet various dietary restrictions."

Sam Sharples, a Red Seal chef and director of operations at Maple Ridge, B.C-based Greystone Manor, owned by Park Place Seniors Living, agrees that the days of pre-packaged food has gone the way of the dodo.

"Retirement homes had no real identity for food vision, with unappealing main courses that had no real nutritional value due to overcooking," Sharples says.

He believes the change started happening about five years ago when a younger generation of chefs started working in healthcare kitchens, bringing a "vibrant energy" to the sector.

"If you want to retain your residents' interest, long gone are the days of just overcooked large pieces of meat and potatoes. We are serving more diverse culturally enhanced menu items and focusing on robust flavours that are appealing to the palate," Sharples says.

Chefs now have the freedom to be creative in their menus, as they focus on plating complex and flavour-rich meals that place as much importance on presentation as they do on taste. The goal is to combine a resident's specific wishes with the need for something healthy and nutritious.

"I feel that there are many misconceptions within the food service industry about how seniors actually want to eat. Health and nutrition are just part of the equation," Sharples says.

"Well-presented, appealing, tasty meals-- plus a dash of fun--improve social interaction among residents, infusing a feeling of well-being and enhancing life by way of the dining room."

Providing unique and creative dishes is all well and good, but residents still have to like what they are eating. Chefs at Revera braise a lot of the meat to make it easier for seniors to eat and they serve a large selection of fish and poultry for both the taste and nutritional value. A la carte menus are always available should the resident not like what is on the menu on a particular day.

"We've heard great responses from both the residents eating the meals and from the staff producing them. All of the meals are familiar to the residents, but the quality is much better and we've thrown in a few twists here and there," McBlain says.

"Staff likes the fact that they are developing their culinary skills and are using actual cooking techniques as opposed to a 'twist and pour' approach.

Laeora Ryba, regional director of foodservices with Western Health in Cornerbrook, NL, believes that long-term care homes have no choice but to adapt more nutritional food as the average age of Canadians increases.

"In our larger facilities, there is emphasis on healthier desserts, inclusion of more fruits and vegetables and fibre, while reducing sodium and saturated fats," Ryba says.

"Truly, we struggle with wanting to serve a healthy restrictive diet that we know is good for you and tastes good, but we also know that food is one of the simple pleasures of life and we want to include foods that our residents have grown up with and that provide a source of comfort," she explains.

Western Health has also brought its general meal service closer to its residents, with dining rooms on the same floor as the rooms, giving residents a place to go and socialize during dinner.

In the past, Ryba says, meals were prepared down in the basement kitchen, well away from residents, and the choice was limited.

"For the most part, you didn't know what you were having on a specific day. Foodservice has certainly evolved, for the better over the yeas," Ryba says.

As facilities change, she says the approach for long-term care and retirement homes is less of a one size fits all mentality to one focused more on individual needs.

"We'll be serving lattes instead of coffee. Traditionally you had a hair salon and a little gift shop; now there are home theatres. There is no choice but to go that way."

From BC Local News

Here are copies of the Executive Summary and full report.

Source: Burnaby Now

Good, but not good enough. That's some of the reaction stirred up by the provincial ombudsman's recommendations on improving rights for seniors in residential care.

The suggestions are a step in the right direction but not enough to deal with cuts to health care and lack of affordable housing, according Elsie Dean, a Burnaby seniors' advocate. Dean works with Women Elders in Action, a group for female seniors.

On Dec. 17, ombudsman Kim Carter released the first of two reports as part of her systemic investigation into seniors' care. Carter called for the government to draft up a bill of rights for seniors in residential care, ensuring it's displayed prominently in seniors' facilities. She also wants a website listing comprehensive and comparable information about seniors' care facilities, listing things like per diem government funding, staffing levels and the number of daily care hours each resident gets. The idea is to make it easier for seniors and their families to make informed decision about care facilities. Also, she wants an expanded role for resident and family councils, entrenched in legislation, and support for the development of regional family councils.

"I don't think it's good enough," Dean said, referring to how seniors struggle with limited incomes, lack of affordable housing and cuts to health care.

Meanwhile, the B.C. Nurses' Union issued a statement, also supporting the recommendations but saying they don't go far enough.

"Nurses applaud ombudsman Kim Carter's recommendations," said union president Debra McPherson.

She called on the government to follow through with all of the recommendations and wants Carter's next report to go even further.

"Nurses are now hoping that the ombudsman's second report will call on the government to stop slashing seniors' services and reinstate the programs it has already cut."

Christine Nidd of the B.C. Care Providers Association said her organization would release a full response to Carter's report in January.

Carter started investigating seniors' care in August 2008.

Her findings and recommendations were from the first of two planned reports.

The second and final report addressing a broader range of seniors' care options should be released in spring 2010.

OMBUDSMAN KIM CARTER OUTLINED THREE MAIN FINDINGS, RELEASED DEC. 17:

- The Health Ministry and the Healthy Living and Sport Ministry have not adequately identified the province's commitment to care and rights for seniors in residential health facilities.

- They have not ensured that the public can get adequate information about residential care facilities so seniors and their families can plan for and make informed decisions about residential health care.

- Resident and family councils are important for ensuring the well-being of seniors in residential care facilities, and the two ministries have not taken steps to ensure that the resident and family councils are adequately supported.

Carter came up with 10 recommendations to help fix the problems. The key ones are:

- to set up a bill of rights for seniors in residential care and to make sure it's posted in a prominent place in every facility. (The government has agreed to this one.)

- a provincial website be created so people can look up comprehensive, comparable information on residential care.

- an expanded role for resident and family council entrenched in legislation and support for the development of those councils.

There are 10 recommendations in all, four of which the government has agreed to.

For the full list, see the website at www.ombudsman.bc.ca.