Choosing home health care

Canada’s population is aging and by 2024, StatsCan estimates about one-fifth of the national population will be seniors.

With this in mind, Justin Trudeau’s Liberal government has committed to spending $3 billion over the next four years on home health care as part of the proposed national Health Accord, which would work in collaboration with provinces and territories.  Financial supports for family care and greater access to in-home caregivers are included in the Health Accord budget.

“Because we don’t have a plan or a national strategy and we’re in the midst of a huge tsunami of aging . . . there’s no consistent effort and a lot of services aren’t being delivered,” said Katherine Arnup, retired Carleton professor and author of I Don’t Have Time for This! A Compassionate Guide to Caring for Your Parents and Yourself.

Arnup cared for her sick sister and elderly parents and has volunteered at a hospice for 14 years. She said there are resources on the logistics of caregiving, but little on emotional and relationship changes.

This motivated her to write her book and she said “people are hungry to hear this kind of thing.”

“People are very tired, they’re really exhausted… and that’s only going to grow,” she said, referring to the demand for home caregivers. “There are particular challenges in caregiving we haven’t dealt with yet as a nation.”

The financial burden

When Arnup cared for her sick father, her family spent about $65,000 in care over a few years. There are 2.2 million Canadians who require home health-care services, according to a 2012 StatsCan report. Many people can’t afford what Arnup’s family had to spend.

That’s why government-funded programs like the Community Care Access Centre (CCAC) exists.

The centre is an agency that provides home health care, support with transitioning from hospital to home or into a long-term facility and runs many other community services. The Champlain branch serves the Ottawa region and provides care to more than 59,000 patients every year.

“People don’t really want to go into long-term care homes unless they really have to,” said Dr. Denise Alcock, director of the CCAC and former dean of the University of Ottawa’s faculty of health sciences.

Long-term care homes are expensive, a heavy emotional transition and waitlists are so long it can take years to get a room. Alcock said this is why people are increasingly choosing to stay at home and seek services that allow the health care to come to them.

The demand

Last year, the Champlain branch launched Health Links, a provincial program that improves care for seniors with complex conditions by providing them with a co-ordinator who connects the client’s doctors and specialists. According to Health Canada, about 75 per cent of seniors with complex conditions discharged from the hospital receive care from six or more physicians and 30 per cent go to three or more pharmacies.

The goal of Health Links is to help seniors with complex needs navigate the system, said Sophie Parisien, director of clinical care at Champlain’s CCAC.

Since the program launched in May, she’s seen improvement in patient experience and a reduction in number of unnecessary visits to the emergency room, which reduces costs.

“Care co-ordinators provide a crucial service to patients because it helps them manage the health-care system rather than bounce around from departments and doctors,” Parisien said. “The patient gains quicker access to these services and gets better care and often needs less urgent care when they have a co-ordinated care plan.”

Health Links first began in Toronto in 2012. With its success in regions like Champlain, Parisien said the provincial government has made a commitment to continue the program.

Sherry Cooper is the former chief economist at BMO and author of The New Retirement: How It Will Change Our Future, which focuses on how the aging baby boomer population will affect the Canadian economy.

She said reducing costs with health care initiatives for seniors is a main issue for the new government.“You’ve got to deal with an ever-increasing demand for services, so that’s where the issues come in. Do you give less service or do you keep people waiting?”— Dr. Denise Alcock

“We know that the health-care budget is going to increase dramatically,” she said, adding that this is because Canadians spend about 80 per cent of lifetime health-care expenses in their last years.

Alcock of the CCAC said these changes are already evident with the centre’s growing number of requests.

“You get a set amount of money from the government and you’ve got to deal with an ever-increasing demand for services, so that’s where the issues come in. Do you give less service or do you keep people waiting?” Alcock said.

Alcock said it’s not only in-home medical needs that require attention and funding. The CCAC offers transitional affordable housing for patients who aren’t sure if they’ll go home or to a long-term care facility.

“It’s scary when you’re in the hospital and you’ve been getting all this care and you’re not sure if you’re going to cope at home or not,” Alcock said, adding that moving in and out of hospitals can be exhausting.

Other CCAC services include nursing clinics for seniors who are well enough to leave the house, exercise classes and instruction on the use of helpful technology, like immediate reminders to take pills. Alcock said these are a few “good programs, but they need money to grow.”

With the expansion of Health Links and the federal government’s commitment to home health-care funding in the next few years, Alcock said it’s a good start.

Cooper said she also sees the potential for progress in the federal government’s role in home health care, but warned it’s still in its early days.

“They’ve said the right things and now it’s a matter of what happens,” she said. “It’s going to boil down to what is the financial reality. How much will they be able to use for home care? It’s a big question, but it certainly makes a lot of sense.”

Header photo [© Erica Howes]