One senior spoke about the anxiety she feels not having a family doctor after losing four in the past eight years.

Another, the president of the local seniors centre, asked what she should tell a woman in her 80s crying on the phone because she’s got nowhere to live and is reduced to the indignity of couch-surfing with friends after a lifetime of paying taxes.

The scarcity of physicians and homelessness were just two of the issues that surfaced at a town hall meeting in Campbell River, B.C., on Wednesday with provincial Seniors Advocate Isobel Mackenzie.

The independent advocate is touring smaller towns and cities to talk about trends and issues impacting seniors provincially and to hear concerns unique to individual communities.

One in five B.C. residents is 65 or older, and that demographic is only on the rise, Mackenzie said.

The good news is that seniors are living longer, healthier lives and the risk of dementia isn’t increasing overall with advanced age, she said, adding 80 per cent of people over 85 don’t have dementia.

Additionally, the vast majority of seniors in the province, 95 per cent, live independently in their own homes, she added.

Seniors Advocate Isobel Mackenzie said seniors who aren't necessarily ready for long-term care are moving into facilities because there aren’t services in their community or they can’t access them. Photo by Rochelle Baker

However, positive trends are tempered by some serious challenges — first and foremost is low incomes, Mackenzie said.

The scarcity of physicians and homelessness were just two of the issues that surfaced at a town hall meeting in Campbell River, B.C., on Wednesday with provincial Seniors Advocate Isobel Mackenzie. 

“Half of B.C. seniors have an income of $31,000 a year or less,” she said. “Which is (equivalent) to a minimum wage job, to put it in perspective.”

Nothing other than primary health-care services is covered by the province’s medical services plan, Mackenzie said.

Dental care, followed by hearing aids and glasses are the top health-care costs seniors call her office about, she said.

“If you have to go to a podiatrist … or you need a walker or wheelchair, none of it is covered in B.C.,” she said.

Health care versus help care

Many seniors are invariably left on their own after a partner dies, Mackenzie said.

Those individuals, and seniors lucky enough to have family members helping them, are often confused about what community supports are available due to a badly fragmented and complex delivery system, Mackenzie said.

It’s not necessarily a question of poor health but insufficient help that’s negatively impacting seniors, she said.

Folks must wade through bureaucracy and multiple agencies to get simple supports such as housekeeping, home support and aid for renovations so they can age in place.

“We send you from pillar to post,” she said. “We’re leaving people on their own to figure out how to get this piece and this piece and this piece.”

Many seniors who do not want to — or necessarily need to — live in long-term care are moving into facilities because there aren’t services in their community or they can’t access them, Mackenzie said.

“People are completely overwhelmed,” she said. “And the only solution we offer is long-term care, and it's costing us more.”

There should be an identifiable franchise of senior hubs — a one-stop-shop for services, health supports and programs with case managers on-site to help seniors and their families navigate the system — in every town, Mackenzie said.

Campbell River service providers at the meeting agreed but noted there weren’t enough resources or funding available from senior levels of government, particularly for a smaller community, to service existing programs or establish a bricks-and-mortar hub.

Marcia McKay, president of the Campbell River Seniors’ Centre Society, said the Better at Home program in the community could only provide its88 clients with an hour a month of housekeeping — and there were another 44 people on the waiting list.

Rural communities lack appropriate housing or rentals

But even more concerning, McKay said, was the problem of housing seniors in Campbell River.

A low vacancy rate and restricted rental stock, along with rents comparable to urban centres such as Vancouver and Victoria, are leaving seniors in a precarious position, McKay said.

A recent housing report by the Strathcona Regional District, which includes Campbell River and surrounding communities including the Discovery Islands, found housing and supports for seniors were a prominent concern.

Seniors made up approximately 29 per cent of the population in the Strathcona Regional District in 2021, and that was expected to rise as high as 35 per cent by 2031, the report said.

The survey highlighted a need for affordable and accessible multi-unit housing, particularly rental housing, along with increased home care or supported options.

Although only 20 per cent of B.C. seniors rent, affordability is definitely a big concern for those contacting her office, Mackenzie said.

“But for seniors, it's also the lack of appropriate housing,” she said.

Homeowners in cities can sell their home and downsize to a condo in an area with public transportation and walking distance to services.

But it’s another matter for seniors living in rural communities like Port Hardy or Port McNeil on Vancouver Island, she said.

“Particularly in rural communities, there's nowhere to go if you sell your house,” she said.

“There's a real lack of places for seniors that can provide any kind of support and services and that isn't long-term care.”

While there are common seniors issues across B.C. and ones particular to individual communities, more widespread issues such as the lack of doctors, housing choices and support services are amplified in rural communities, Mackenzie said.

While the federal government shouldn't be shaping the delivery of seniors' services in communities, it can do more to fund them, said MP Rachel Blaney, the NDP critic for seniors. Photo by Rochelle Baker

Rachel Blaney, MP for North Island-Powell River and the NDP critic for seniors, told Canada’s National Observer the town hall underlined the critical need for safe and appropriate housing for seniors across the country.

“Here in Campbell River, one of the things we’re hearing is more and more seniors are at risk of being without a home at all.”

Blaney agreed navigating the system of services is onerous enough that people might give up getting help even if services exist in the community.

The federal government shouldn’t really be shaping changes to service systems, as communities and provinces have a better understanding of local and regional needs, she said.

“I don’t think a national solution is the best solution,” she said.

“I really think that has to come from the community. But in terms of resources, we know that’s something that needs to happen at the federal level.”

An important factor fuelling the shortage of family doctors across B.C. is that wages are not competitive with other areas of medicine, especially once the overhead and administrative hassles of a practice are factored in, Mackenzie said.

Senior Bonnie Thomson said she began experiencing difficulties securing a doctor when she moved to Campbell River eight years ago.

“But it's a problem for everybody, obviously, and seniors in particular,” Thomson said.

“And I'm just wondering if there's any kind of action plan to address that concern?”

Mackenzie isn’t confident the province or the federal government is prepared to spend what it will take to deal with some of the critical issues facing seniors.

“Is there a plan?” Mackenzie said. “The government will tell you they’re working on one, but I would not be optimistic.”

Mackenzie said she’s been hearing about doctor shortages in rural communities for the entire eight years she’s been the seniors advocate.

But the issue is only gaining serious attention now the crisis has reached urban centres, she said.

“So my joke is now that it's affecting the city folk, maybe it will finally get fixed.”

Rochelle Baker / Local Journalism Initiative / Canada’s National Observer

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On the housing, obviously the public sector, whether at the provincial, federal, or municipal level or all three, should simply build some.

On the family doctor issue . . . I think it's time for BC to start moving towards alternatives to the small-business fee-for-service family doctor--especially since big corporations are starting to move in and snap up clinics, and that can't end well. They should start public clinics with doctors, and office staff, on salary. Ideally, those could have some testing facilities, plus a physiotherapist, dietitian, maybe a chiropractor . . . you'd go to the one place and get your health needs taken care of. Then if the salaries aren't sufficient to attract doctors, you can increase them without having to go through the whole mess of rejigging the fees, which always takes forever and involves a ton of politics and horse-trading. Plus, doctors on salary wouldn't be rewarded by number of appointments, number of prescriptions or whatever, and they wouldn't have to muck about trying to run a small business, so they could just concentrate on making you well. Anywhere there aren't enough family doctors, put in one of those clinics. Gradually move towards more of those and less of the free-markety small business doctors, a model which really isn't working well these days. It would cost money to get going, but I bet it would save quite a bit in the end, and improve outcomes a good deal, especially in underserved areas.