BC FORUM News - from the Vancouver Sun website

Published on: October 6, 2017

Opinion: Providing seniors customer service, can we do better?

Dan Levitt

The results from a recent customer-service survey conducted by the B.C. Office of the Seniors Advocate speak for themselves. Fifty per cent of seniors rated the overall quality of their care home as very good or excellent. Only 57 per cent of residents report that the care facility regularly feels like home.  Four out of 10 residents living in residential care do not want to be there.  Is this a sustainable business model, when nearly half of the customers are dissatisfied? What would Starbucks, Apple, McDonald’s, Amazon or Air Canada do if their customer base was cut in half? The sad reality is that seniors aren’t given a viable choice for an alternative accommodation to the current under-performing, residential care system.

What happens when decision-makers responsible for customer experience don’t listen to their clients? Do you remember video stores and film cameras? It’s time to ask, “why not try a new model?”  

Globally, B.C.’s senior-care system is coveted for its universal access to residential care and the single point of entry. Where other jurisdictions do perform better is in homecare access and in grouping seniors by cultural background, rather than diagnosis.

In Canada, geriatricians are under-resourced or non-existent — Saskatchewan has only one. Doctors have had minimal training in geriatric medicine, but yet have the primary responsibility for medical care, including prescribing medications which, on average, amount to nine per day. Access into residential care is being tightened, with seniors who live in care now moving in much later in their terminal-disease process, with shorter lengths of stay, and receiving palliative care from an industry and workforce that wasn’t trained in this hospice-care model.   

Some seniors are subject to baths or showers once a week at a time slot that fits into the staff schedule from the previous-now-deceased-senior whose spot the newly arrived senior now occupies. Can you think of anyone else but a senior in residential care that must live a daily life devoid of choice, freedom and independence? Each day many seniors are awoken and rushed through their morning routines to arrive in the dining room and wait to be served just to meet prescriptive government rules. The rest of the day is filled waiting for the next regimented activity, watching TV often alone in their small bedroom or wandering around trying to find the way out.    

Nutrition in residential care is institutional with prescribed meal times and limited options if your personal preference isn’t on the cook’s daily menu. Having unlimited access to the fridge and pantry is a human right. If Denny’s restaurant can serve cost-effective meals 24/7 why can’t residential care-providers do the same? Perhaps a lesson could be learned in individualized food service from the airline industry that has drastically improved customer satisfaction in recent years.

Emotional and social support is fundamental to the human condition. For seniors, this need is even more important. What is inadequate is the decision not to employ full-time, spiritual care professionals, social workers, and music and art therapists, who help add meaning to meet these human needs. The bigger tragedy is the lack of family and friends that come to visit as grandma appears to no longer be herself. She is still the same person, her perception and reality may have changed from a progressive cognitive impairment, but she continues to have the same wants and desires that include her need to have meaningful interactions with friends and family.   

The current institutional model of residential care has limits to what can be achieved. With outdated care homes in need of replacement, the hospital-style institution will never feel like home. The current goal is to appear “home like.” However, this “home like” is often a senior’s last home at a time when a seniors’ dependence on the world around them has never been greater. New design guidelines are needed to enable the kind of built environment where six to 12 people live in a small household — each person with their own one-bedroom ensuite, shared common-area dining room, kitchen, living room and den, with continuity of staff who know the senior as a whole person. These homes are part of a larger neighbourhood that might include a community centre, restaurant, library, multi-generational living apartments and freedom to access the outdoors. The daily life in these homes is filled with mealtimes where seniors may feed farm animals, arts and crafts studios are always open, the aromas of freshly baked bread and the smell of home-cooked meals fill the air, seniors have access to their favourite music song list and meaningful relationships are expected as the norm. Doesn’t this sound like a place that you would like to spend your final years?  

All great companies succeed from asking their customers about the client experience to improve products and services. Industries that have struggled with complaints and reputation have focused their brand on enhancing their customer experience from surveying their clients and understanding what matters most. In the airline industry, customers are routinely asked about the airport, on-board dining, cabin crew and overall experience, with opportunities for additional comments and feedback. For the airline industry, noticeable improvements in quality experiences for clients and staff have led to higher profits. It’s simply a win-win.     

With billions in government expenditure supporting the most frail in society, something has to change. But who will lead the change in reforming industry rules and revolutionizing how seniors are treated by society?

Never underestimate the power of the silver economy to change our value system. Just imagine if seniors had the choice of where to live in government-funded residential care rather than the government choosing where grandma lives. What outcomes would this consumer-based model produce? Publishing the results of a customer survey in residential care demonstrates that frail elders with dementia have a voice that society must pay attention to. Now seniors must use their words to advocate for their rights for a more dignified life. Society must hear their voice and be prepared to answer their call with innovative solutions that transform the aging journey.

Dan Levitt is executive director at Tabor Village, an adjunct professor of gerontology at Simon Fraser University and an adjunct professor in the school of nursing at the University of B.C.