Dr. John Hirdes was commissioned to provide data analyses of Canadian and international RAI-HC data for our report. Dr. Hirdes is a Professor in the School of Public Health and Health Systems at the University of Waterloo and a senior Canadian Fellow and Board Member of interRAI, an international consortium of researchers from 29 countries.
It’s a saying that often comes to mind for travelers who have become weary of their time away. The familiar sights and sounds of home, the comfortable bed, and the companionship of family and friends - all take on greater importance with prolonged absence. For older Canadians, returning home from hospital or staying at home rather than entering long term care is an almost universal preference.
More than ever, home care is an essential service. It acts as a hub connecting primary care, acute care, and long term care settings. Home care professionals provide a broad array of services that help older Canadians live as independently as possible despite health challenges resulting from aging and its associated illnesses. For Canada’s health care system to be sustainable, home care needs to succeed.
The Health Council of Canada’s new report entitled, Seniors in Need, Caregivers in Distress, sheds new light on the experience of home care clients and their caregivers. For the first time, we have a coast-to-coast view of home care. While we often think about advances in health care as being driven by new technology, the emergence of high quality evidence is one of the most important innovations in home care that Canadians generally don’t know about. The implementation of a standardized health assessment across the country provides insights into home care that were unimaginable less than two decades ago. Eight Canadian provinces have adopted a common home care assessment system developed by interRAI (www.interRAI.org) to evaluate the strengths, preferences and needs of home care clients. When compiled at the regional and provincial levels, this information can provide vital insights to variations in the patterns of care in response to needs. The Health Council of Canada report is the first national study to use data from the first five provinces that have adopted this system.
What emerges is a picture of heroism by family members and friends whose commitment to care often determines whether older Canadians can stay at home. Many caregivers work the equivalent of a full-time job to help seniors with serious physical and mental health concerns. In fact, about three quarters of the care that frail older Canadians get at home comes from their family members.
The paid services offered by home care agencies throughout the country are vital supports to seniors and their family members, but the level of care being provided is simply too low to meet their needs. According to the Canadian Institute of Health Information’s (CIHI) 2007 report, home care expenditures grew rapidly in the 1990s, but then flat-lined between 1998 and 2004. Canadian caregivers need more help to support their family members at home. Putting more priority on funding for home is the right thing to do because it helps Canadians achieve what they want, but it is also a sound investment. Home care costs a fraction of what we spend on nursing homes. A day in hospital costs more than two weeks of home care for older Canadians.
Health care decision-makers have difficult choices to make at the best of times. When we face economic constraints, the choices become tougher and have greater impact. Canadian caregivers already do most of the heavy lifting in home care. The best way to save money in the expensive parts of the health care system is to respond to the calls for help from caregivers and home care clients in the greatest need