Twelve joined this ASK Salt Spring gathering to welcome Island Health’s Ellie Parks and Lilian Heimbach. Ellie offered our Acknowledgement, reminding us that we live on territory that was never ceded by treaty. Cognizant of the debt owed by all Canadians, she asked us to heed both the ancestral roots and a growing physical presence of our First Nations on Salt Spring. She suggested we reflect upon our own relationship with the land and sea as well as our relationship with those who were here before us. 

After everyone had an opportunity to introduce themselves, we learned what “excites and delights” Ellie and Lilian. Ellie is thrilled that husband is soon to return from his walking adventure. She is also delighted by our long fall, despite concerns about the continuing dryness. We learned that fall is Lilian’s favourite season. To make this season even more special, she and her family have just returned from a camping/hiking adventure in Banff National Park, so looking forward to returning to continue their adventure in its splendid beauty. 

Both Ellie and Lilian are members of the Community Health Services of Island Health (https://www.islandhealth.ca/locations/community-health-services-locations), with a focus on offering the supports needed to live independently. Ellie, longtime Salt Springer with decades of experience as a community organizer and member of boards such as our Salt Spring Island Foundation, is an Island Health full time case manager and social worker. Lilian, who arrived on Salt Spring during COVID with her husband and two boys, is one of two of Island Health’s Salt Spring part-time occupational therapists..

Ellie, or the other case managers, are often on the front lines when a request for help is received, often by a call to 250-388-CARE (2273) or 1-888-533-2273. These calls for help can come from anyone – the person in need, a caring partner, a family member, a concerned neighbour. . . anyone can ask for help. The request will be referred to either a case manager, nurse, or occupational therapist, as needed. 

If case management is the first step, Ellie, or another case manager, will assess the need by determining the ability to fulfill what are characterized as ADLs, Activities of Daily Living, which are:

• eating,
• getting in and out of bed, 
• bathing, 
• getting around inside, 
• toileting, and 
• getting dressed.  

After this assessment has been completed our Community Health Services offers a wide range of supports to people living with life-limiting conditions that include nursing, palliative care, occupational therapy, social work, and case management supports. Case managers can also refer people to a range of services including home support and short term respite stays. 

Lilian is a key member of this Community Health Services team. An occupational therapist https://bchealthcareers.ca/professions/allied-health-professionals/occupational-therapists/, not to be confused with a physical therapist, Lilian’s role is the art and science of helping patients to care for themselves and engage in the activities that enrich their lives. Her work could involve assessing the home and suggesting modifications to it as well as providing the tools to make tasks easier. It could also involve exercises to provide the strength needed to accomplish needed tasks and exploring innovative techniques that make tasks easier. 

In some cases, the conclusion of the assessment is that the individual has the physical ability to live independently. Despite this physical ability, some face a challenges coping with other aspects of daily living, categorized as iADLs, Instrumental Activities of Daily Living. These include housework, grocery shopping, money management, laundry, getting around outside, telephone use, and preparing meals. These needs may only be supported by Island Health home support workers if a physical need has been identified. 

Without this physical need component, Ellie refers individuals to other nonprofits who can help provide these iADL services. Island Community Services provides many of these services, including Better at Home and a Navigator Program that connects clients to services. Other nonprofits also provide an array of senior services, like our ASK Salt Spring guest a few weeks ago, the Senior Centre (https://asksaltspring.com/2026/10/02/welcoming-our-senior-centres-elena/). To clarify this array of services, Ellie, in her volunteer role as a member of the Salt Spring Health Advancement Network, has created a list of senior services: (https://46cfb3d7-bf36-4376-8c27-8fd0187a2ff7.filesusr.com/ugd/ca2da4_a5210f7d39cb460a9c2e2996a815bab8.pdf).

While Community Health Services support all ages, the focus of this ASK Salt Spring conversation was upon the support seniors need to remain in their homes as long as possible. Over and over in our time together, we heard that advance planning is the key determinant of being able to stay at home longer. This involves a variety of actions, including:

1. Assess your home. What can you do to make it safe and more comfortable as you become less independent? Complete this Home Safety Checklist: (https://www.healthlinkbc.ca/sites/default/files/documents/home-safety-checklist-english.pdf) .
2. Have serious conversations with your family and others closest to you to make sure that your wishes are known. 
3. Complete your Power of Attorney for financial and legal issues.
4. Make your medical wishes clear by completing My Voice (https://www2.gov.bc.ca/assets/gov/people/seniors/health-safety/pdf/myvoice-advancecareplanningguide.pdf) and do more than complete it, make sure it is filed with your medical records
5. Make an appointment with your physician to complete the MOST, Medical Order for Scope of Treatment (https://www.islandhealth.ca/health-topics/planning-health-problems/medical-orders-scope-treatment-most). While MOST is often completed due to a medical concern, a participant told us of her experience filling it out with her doctor far before needed and highly recommended doing so. 
6. Explore and understand options should you be required to move out of your home. Staying in your home as long as possible is best for all as well as the least expensive for taxpayers, but you still need to understand the options so that you are not forced to make an emergency decision.
7. Recognize denial. Most of us will live long enough to face the realities of aging. While it is everyone’s right to deny care and make bad decisions, advance planning almost always has better results than emergency decisions.  
8. Ask yourself these questions below (*Age Well at Home), reflect, discuss with family, plan, and prepare.

While help is available from Ellie and Lilian’s Island Health’s Community Health Services as well as our other active nonprofits, there is never enough to meet the needs of our seniors. Ellie reminded us that we must go beyond depending upon governmental and nonprofit services to nurture that community cohesiveness that characterizes Salt Spring. Informal support systems; neighbours helping neighbours is key; friends offering shopping, a ride, or just some companionship can be emotionally lifesaving; offering to help strangers is also a part of that community safety net. It is possible that help will be rejected – that is everyone’s right – but the offering could be a vial link for the continued independence of some of our most vulnerable. 

Ellie reminded us that it is our many seniors (1/3 of our total population) who sit on our boards, volunteer endlessly, support businesses and services, and provide (through their pension and investment income) our single largest source of income. They work hard, contribute selflessly, and bring the creativity and wisdom of elders. Yet some seniors need more supports, especially those with declining physical health and/or limited supports.

Ellie and Lillian are on the front lines providing as much care and support to as many as qualify and accept this help as possible. Focused on their clients, they reminded us that Island Health policy decisions are not theirs to make. (You will have an opportunity to ask these policy questions at ASK Salt Spring Friday, October 30, 11-1, in the SIMS classroom when Island Health’s Lady Minto Hospital Administrator, Erin Price-Lindstrom and Max Jajszczok, Regional Health Director/Rural Remote Health Services join us.) 

Neither are serious senior transportation gaps theirs to fill. . . . But that did not stop participants from launching into an emotional discourse about the damages to the spirit of those who are isolated, unable to go to social events, meet friends for lunch, indulge in some recreational shopping, smell our forest, or access our beaches. 

A huge “Shout Out” was given to Country Grocer’s free (tips welcome), pet friendly, on demand shuttle available from10am–6pm by texting or calling 250-538-2398. Despite this appreciation, it was clear that we should not be relying upon a local business to solve our transportation needs. A very big concern for many in the room as well as the Senior Centre which just identified senior transport as a top strategic priority, it was clear that solutions will be sought with, hopefully, the needed funding soon also identified.

NOTE: It is also important to know that Salt Spring seniors are being targeted by scammers, so be extra cautious. If you get a call or email asking you to provide personal information or funds, hang up or delete. If you are concerned you might be missing something important, call your bank or CRA directly, not using the number in the email. Beware of grandparent scams, calls stating your grandchild is injured or arrested and needs immediate cash. Create a family password at your next in person family gathering and request that password from anyone purporting to be a family member in an emergency. Be suspicious.

As our time together was drawing to a close, a participant told us that Ellie and Lillian had just provided the best ever ASK Salt Spring she had even attended – and she has attended a lot! With this grateful acknowledgement, we applauded Lilian and Ellie, so appreciative of all the information they shared, their deep care for our Islanders, unceasing hard work to provide the best support possible, and optimism about the strength of our community to fill in the care gaps. (Thank-you Ellie and Lilian!)  

*Age Well at Home 

PLANNING 

• Plan ahead, the earlier the better
• Consider the unexpected; health decline, widowhood, loss of driving, loss of mobility 
• Doing the research and making choices now will give you great control over your quality of life, and independence

Your HOME 

• Assess your home for your changing and/or future needs
• What modifications are needed? 
• Safety hazards- walk through, look at removing scatter rugs, add grab bars, etc
• Consider structural changes like widening doorways, or accessible bathrooms
• Organizational changes- items off high shelves, items out of awkward storage areas
• Downsize your belongings- sell, donate, gift
• Do you need to move to a more manageable home?  For example, a home with no stairs, or closer to town
• Research housing options; eligibility for subsidized housing, assisted living options
• Think about how to maintain your home if you need help? Yard work? Maintenance? 
• Are subsidized services available? Can you afford private pay services? 

Your Community 

• How age friendly is your community? 
• What support and services are there nearby?
• Do you need to consider moving to a community with more services? 
• Should you move closer to family members? 
• Are there the medical services and GP you need or might need in your community? 

Getting Around 

• Can you get to the services you need and activities you enjoy? 
• Do you have medical conditions that might impact your ability to drive? 
• If you could no longer drive, can you access reliable and affordable transportation? 
• Do you have friends or family that can drive you? 
• Does public transit serve your area? 

Supports in the home

• Do you or will you need help with day to day activities? (such as bathing, dressing, toileting, mobility or meal prep, housework, laundry, medication, yard care, shopping) 
• What supports are available? In the public and private systems? 
• Do you qualify for public services? 
• Can you afford private pay services? 
• Are there informal supports; family, friends and neighbors that I can ask? 

Staying healthy

• Do you have a GP and a dentist? Do you see them as needed? 
• Do you get your hearing and vision tested regularly? 
• Are you eating well? Sleeping well? 
• Do you need to add more exercise to your daily routine?
• Do you challenge your balance? 
• How do you stay active in different seasons? 
• Are you tending to your mental health? 
• Social connections- are you keeping connected to friends and family?  
• Medications- are you taking as prescribed? Do you need a med review from a pharmacist? 

Financial Security

• What income will you need to maintain your desired standard of living? 
• Do you have a financial plan that includes emergencies?
• What benefits and assistance is available to you? 
• Are you receiving all the benefits you are eligible for? 
• Is anyone in your life asking you for money? 

Caring for others 

• Are you providing care for a spouse, child, grandchild? 
• What supports are available to help a caregiver? 
• Consider formal and informal supports 

Safety

• Do you feel safe in your home and in your neighborhood? 
• Do you know how to contact the local POD?
• Are you aware of fraud and scams and how to protect yourself? 
• Do you know who to contact if you suspect abuse, for yourself or others? 
• Are you prepared for natural disasters?

Advance Planning 

• Have you written a will and named an executor?
• Do you have a MOST? Talk to your GP
• Do you have a Power of Attorney? Important if ever you are not capable of managing your finances  
• Do you have a Health Representation agreement (health rep) in place? Important if you cannot express your health care decisions
• Review My Voice and discuss your wishes with your family and loved ones 

Just in case you are interested. . . .This report has been written by Gayle Baker, founder of ASK Salt Spring. It has been reviewed by Ellie.