By Krysta Krupica
As baby boomers in Centretown and across Canada get older, local and national home care providers are asking if Canada’s health care system can handle an influx of people needing health care.
Ten million Canadian baby boomers have begun entering their 50s. By 2030, an estimated one in three Canadians will be a senior.
Federal Health Minister Allan Rock, among others, has suggested that one way to deal with the aging population is through a national system of home care paid for by a federal-provincial partnership.
“I think for the seniors and those with chronic illness, [home care] means the ability to remain in their comfortable surroundings, without being institutionalized,” says Nadine Henningsen, executive director for the Canadian Home Care Association. “I really think it’s the wave of the future.”
But Cathy Daley, Nurse Administrator for the Community Nursing Registry of Ottawa says too much emphasis is being put on a growing senior population and the number of available chronic care beds.
She says that for Centretown, and Ottawa-Carleton in general, there is a need for nurses and technicians skilled in caring for the acutely ill.
“There are a lot of sick people,” she says. “There are children and all ages.”
Daley says patients who are at home following surgery and those fighting disease make up a large portion of those needing home care. The larger number of seniors doesn’t necessarily mean they will be chronic care patients.
“It depends on their health status,” she says. “A healthier senior may not need chronic care, but may develop an acute medical problem.”
She says home care will grow. As more resources are developed to allow the sick to remain at home, she says patients will use them.
Richard Allard, general manager of We Care Home Health Services, which provides home care in Centretown, says Canadians aren’t fully prepared for the burden that an aging population will place on home care.
Hospitals, which largely deal with acute care are keeping patients hospitalized for increasingly short periods of time. This means staff from companies such as We Care Health Services look after patients who have been discharged from hospital and work in short-staffed long-term care facilities.
Since the provincial health plan pays for some home care services, the provincial government operates 43 Community Care Access Centres (CCACs), including one in Ottawa-Carleton.
The Centres are responsible for determining what kind of services a patient needs, as well as how much home care they should get. The CCAC contracts out to various home care providers who supply the care. Ministry guidelines say how many hours of home care are covered under insurance.
“This may or may not be enough in the perception of the client,” says Sue Williams, president of the Registered Nurses Association of Ontario.
If a client wants more services, they can always pay for them.
Allard says baby boomers with disposable incomes are willing to spend more money on things that are not covered by the CCACs, like private nursing.
Home care isn’t just about nursing. In Ontario, services include social work, personal care and home support. Services like Meals on Wheels help ensure complete care of a patient.
Currently, home care services are decided by each individual province. No national standards exist yet to govern insurance coverage.
“One of the challenges and one of the benefits of home care is that it’s so diverse,” says Henningsen. “It really services each community.” The Canadian Home Care Association wants a national home care system.
Henningsen says that although developing national home care standards will take lots of discussion between the federal government, the provincial governments, home care advocacy groups and the medical community, she is hopeful that some of the key elements of home care will be covered under medicare.
The provincial health ministries would continue to administrate the services and pay for them, but the types of services available would be more consistent province to province.
“Right now what you’ll find is that, depending on where you live, you’ll have different coverage,” says Henningsen “What we’re advocating for at the Canadian Home Care Association is to standardize that coverage.”
Sue Williams says the provinces feel the federal government should not be able to run a national home care system if it isn’t willing to pay for a large chunk of it.
At a ministers’ meeting in Quebec City, ministers appealed to the Prime Minister to increase yearly transfer payments by as much as $4 billion. Costs in health care are expected to rise an estimated 10 per cent each year.
“I’m more in favour of principles and guidelines and an incentive kind of approach from the federal perspective . . . and the financial support for it, which encourages the provinces to deliver in a uniform kind of way,” says Williams.
For the past three years, the Ontario government has put money into home care, and it continues to make changes to its system.
“Per capita, Ontario doesn’t necessarily come out as the highest funder for home care,” says Henningsen.
“But they do have quite an extensive system, and certainly there are a lot of initiatives in the works to really make it one of the leading systems in Canada.”
Henningsen says home care has an important effect on both chronic and acute patients that make it a necessary part of health care.
“It’s about empowerment,” says Henningsen, of her husband’s experience with home care.
“When he was in the hospital, people just came in and did things to him. He was really and truly a patient . . . But when he was at home he took control [of his care].”