Towards a Better Quality of Life What are the challenges? In most polls that ask seniors and people with disabilities what they want, they say the same thing — a good quality of life. They want to remain independent for as long as possible and to have choices for the type of care they receive. Few choose to die in a hospital or long-term care facility, and yet that is what happens to thousands of seniors each year. Many of them may have been able to avoid such institutional settings had there been affordable alternatives such as assisted living. These are home-like residences that provide some care, such as help with daily living activities. Currently, the bulk of spending — 70 per cent of home and community care costs — are devoted to the 30 per cent of seniors living in long-term care facilities. With the aging population, the number of clients needing home and community care services will increase by about 1,600 people every year. This will mean a greater demand for services and a wider range of care options. How are these challenges being addressed? Increasing care options that help people to stay in their homes longer is the underlying objective of the government's new strategic direction. This means a shift from a system dominated by institutional solutions to one that offers more home- and community-based solutions. The goal is to deliver the independence, choice and quality of life that people want. To ensure sustainability of the system, services are being targeted to those with high-care needs and low-to-moderate incomes. Health authorities are embarking on a major redesign of their home and community care services, which involves: providing thousands of assisted living units, including 3,500 under the Independent Living BC Program with BC Housing; ensuring a more appropriate use of long-term care facilities to focus on the frailest of seniors and those with high-care needs; enhancing home care services such as home support and adult day centers; expanding palliative care services to provide dying people with greater choice and access to services to ease the passage of death; developing alternatives to acute care services such as sub-acute care and hospice; and providing appropriate community and supportive post-acute care to enable timely discharge of patients to their homes from hospital once the need for acute medical care has ended. How is progress being measured? The ministry is monitoring two indicators in 2003/04: the use of acute care beds by seniors who could be better served in the community and the percentage of clients with high-care needs living in their own home rather than a facility. It plans to add additional indicators that measure the quality and appropriateness of home and community care services and palliative care.