Currently, more than 85,000 people are living with dementia in B.C. — and without a cure, that number is going to balloon to 250,000 by 2050.
While the impact that will have on our health-care system is not a new conversation, so much of our attention has been focused on long-term care and home support, but there’s a missing puzzle piece: what will the impact of dementia be on acute care — our hospitals and our emergency rooms? How bad will things get if we don’t do something about it?
In an ideal system, people needing acute care would go to the hospital, receive the treatment they need and either be discharged or transitioned somewhere for more ongoing care and support. Unfortunately, this isn’t a reality here or in many other places across the country. For many, acute care becomes a kind of Hotel California — they can check in but can never leave.
When someone isn’t well enough or safe enough to go home and the ongoing care and support they need isn’t available, they require an “Alternate Level of Care” (ALC) and remain in the hospital or emergency room even though it is no longer appropriate for their needs. And because that person can’t be discharged, someone else can’t be admitted. This results in longer wait times in emergency rooms and delayed admissions to hospitals.
According to a recent study published in the Canadian Geriatrics Journal, people living with cognitive impairments like dementia are at higher risk of needing an Alternate Level of Care.
Half of all ALC days in Canada today are for someone living with dementia. Part of the reason for this is that many people living with the disease need the support of a caregiver to safely return home, but many caregivers struggle with their own health due to burnout.
Forty per cent of family caregivers for someone living with dementia report symptoms of distress, according to a 2024 report by the Canadian Institute for Health Information.
In 2023-24, there were 6,500 people waiting for a publicly subsidized long-term care bed, a 150 per cent increase from five years ago.
To reduce ALC rates, creating more long-term care spaces is an essential piece of the puzzle.
The Office of the Seniors Advocate reported in 2023-24 that the average wait time for long-term care was 225 days for seniors in the community and 35 days for seniors moving from hospital. Clearly, more long-term care spaces are a necessary part of the solution to reducing ALC rates.
A 2017 study by the Conference Board of Canada estimated close to 31,000 new long-term care spaces will be needed in B.C. by 2035. However, after years of underinvestment, B.C.’s ability to create so many new spaces is unlikely. This doesn't mean we stop trying to expand access to long-term care; it means we take a comprehensive approach that doubles down on providing community supports for people who are waiting for access to it.
While we must address the issues with our health-care system on a number of fronts — such as eliminating co-pay for home support and more broadly ensuring the home support system can meet people’s needs — we must also provide resources and education to help people manage so people living with dementia and caregivers will be more likely to return home after a trip to acute care.
In 2050, family caregivers across the province will provide nearly 200 million hours of unpaid care annually to people who living with dementia. Ensuring that they have access to support as early as possible through approaches like the Alzheimer Society of B.C's First Link® dementia support is critical to helping them weather the journey.
During Alzheimer’s Awareness Month in January, we talked about how there’s no roadmap for dementia — but we can be your guide.
Last year, the programs and services offered through First Link® provided a lifeline for more than 14,000 people affected by dementia, helping them feel less alone and more confident in handling the challenges that come with the disease for both the person living with and the people caring for them.
But the need is growing. As we continue to wrestle with a changing world and an aging population, we must ensure that people who need support on the dementia journey will be able to find it — for their own good, but also for the good of B.C.’s acute care.
To learn more about the Alzheimer Society of B.C. and how we support people on the dementia journey, visit alzheimerbc.org.
Jennifer Lyle
CEO, Alzheimer Society of B.C.
