The combination of the Island’s escalating healthcare costs and the state of elder care is a “sleeping time bomb” in need of an immediate fix, seniors’ advocate Claudette Fleming has claimed.And pensioners can’t afford to wait until a Government review of healthcare is completed, she insisted.“I understand that the acting manager of National Office for Seniors and the Physically Challenged has been charged under the National Health Plan task force to look at the issue extensively. However, most individuals who need long-term care need viable solutions today,” said Ms Fleming.Residential elder care in Bermuda means “long waiting lists, limited facilities and sizeable monthly fees and crippling staffing costs with little private financing options and no insurance provisions private or public”.She continued: “It’s the sleeping time bomb of the ageing population. Most people in need of immediate long-term care can expect to encounter a waiting list, limited facility options and sizeable monthly fees. Those wanting to get into and stay in the business have to be creative of how to avoid crippling staffing costs.”The costs for residential care range from $3,500 to $14,000 a month.Ms Fleming noted: “There are few private financing options except perhaps individual private savings, and no long-term care insurance provisions private or public.“The Government heavily subsidises long-term care through grants to facilities such as Lefroy House, Sylvia Richardson and the Continuing Care Unit. Individual seniors who are deemed poor enough can get support through Financial Assistance but even the Financial Assistance Department will have to establish its support limits as the population ages, if it has not done so already.“Perhaps the most efficient and cost-effective way to go is to provide financial support to families to keep their ageing relatives at home for as long as possible.“But, this will only prove to be a viable option if families are supported financially and in the workplace and if we transition to a more community-focused delivery of healthcare within the home setting that supports the family’s efforts.“Still, there will always be those persons who will require residential, long-term care so there will always be a need for some facilities to be in existence.According to the Organisation for Economic Cooperation and Development, Bermuda is the second most expensive country for healthcare and that’s without universal coverage. Senior citizens also represent the fastest growing segment of Bermuda’s population.Ms Fleming said: “The silence on the issue of long-term care is deafening. To say the buck keeps getting passed is an understatement, we can’t even find the buck anymore.“We could help tremendously by implementing a national agenda on how to systematically address these types of ageing issues. We continue to extend our support, wherever possible, to bring a national ageing plan into fruition in the sincere interest of the successful ageing of the people of Bermuda.”Elder care is one of many issues being tackled under the proposed National Health Plan.“CCU continues to be over-subscribed,” said Health Minister Zane DeSilva at a recent press conference. “The long-term task group, that is in their remit and I expect that to be part of their final report. It won’t be in the new hospital. The CCU will stay where it is and it will continue to be funded as it is and you will know that most of that funding is through subsidy through the Government.“There is a long waiting list for CCU as there are for many of our homes throughout the Island, that is going to be addressed by the long-term task group.”Westmeath Residential and Nursing Care Home raised residential rates this month. Administrator Chrissie Kempe would not state what the new fees were.“Disclosing to you the details of these increases would breach private contractual information between residents and Westmeath,” she said“In the current economic climate Westmeath, as a non-profit organisation, must be mindful of the increasing costs associated with care and the obligation to our employees. Westmeath does not believe this is a topic to be debated in the press.”The general consensus expressed at other rest homes was that they “could use a rate hike to match rising costs”.A spokeswoman at Matilda Smith Williams Home said they haven’t had an increase in years.That sentiment was echoed at Packwood Home where there are 28 residents in a facility with 30 beds paying approximately $5,000 a month for elder care.Jennifer Attride-Stirling of the Bermuda Health Council said: “The Bermuda Health Council doesn’t regulate the price of residential care facilities. There is no legislated mandate to do so.“The extent to which long-term care is deemed an essential health service is an issue that is being considered under the National Health Plan.”