Home Care - We need to translate findings into real solutions

Kevin Mercer is the Chief Executive Officer of the Waterloo Wellington Community Care Access Centre in Kitchener, Ontario. He is the Editor-in-Chief of Healthcare Management Forum and was a member of the expert panel for Seniors in need, caregivers in distress: What are the home care priorities of seniors in Canada?

First of all, if it hasn’t been said, it needs to be said – kudos to the Health Council of Canada for recognizing the importance of home care and publishing this report.  After working for 20 years in home and community care, you realize that despite the compelling research on the value and the importance of home care, policy papers and policy shifts have not kept pace with the directional advice of the research.  As a society, we have remained committed to a health care model developed predominantly in the 1950s.

The Health Council of Canada’s Seniors in need, caregivers in distress: What are the home care priorities of seniors in Canada? reminds us on the one hand how far we have advanced with home care services and on the other hand how far we have to go.  We have a long ways to go and some very vulnerable people are depending on us to do it.  This report puts a face to the policy issue and redefines “home care” from a “nice-to-have” substitute to acute care and long term care to an essential prerequisite to maintaining the health of both seniors and the caregivers.  We have made assumptions about the availability and the capacity of caregivers at home.  The report reminds us that these are flawed assumptions and we need to recognize the caregiver burden and provide more assistance.  The report tells us that the caregiver situation in terms of the ageing population is going to continue to grow.  The negative effects, if remedies are not implemented, are going to be felt in the health system and in the work force.  Caregivers are going to increase in numbers and so are the distress levels if action is not taken and soon.

In many respects, the Health Council report provides a picture that many of us have understood intuitively for many years.  Our front line staff, the advocates for seniors and caregivers, has articulated very well the caregiver burden they witness as they try to assist home care clients and families.   However, the empirical evidence has never been as clearly demonstrated as it has in this report.  Thanks to Dr. John Hirdes and his team of researchers, the RAI-HC data has been assessed and a scientific validation of the caregiver burden is provided.  The value of the RAI assessment data in this report is instructive in helping us appreciate the needs of home care clients.  Governments have often challenged the field to provide the data that supports claims of increased acuity demands in the community.  This report provides the evidence as illustrated in this quote.

“About one-third of the seniors in our analysis of home care recipients have high needs, often involving both physical disability and cognitive impairment such as dementia.  Despite this, they may receive only a few hours more of publicly funded home care each week than seniors assessed with moderate needs.”

The challenge for all of us now is to translate the findings in this report into real solutions for vulnerable home care clients and their caregivers.  At least in Ontario a commitment to home care of a 4 percent per year budget increase for the next three years is a step in the right direction. 

This is positive news and if there was any question as to the need, one just needs to read Seniors in need, caregivers in distress: What are the home care priorities of seniors in Canada?  A very timely report.

PLEASE NOTE: On May 9th, the Health Council of Canada held a webinar Canadian Home Care Priorities for Seniors: What Can We Learn From Australia? with our special panelists:

• Jeff Fiebig, Manager, Program Development of the ACH Group in Adelaide, Australia
• Pamela Fralick, President and Chief Executive Officer of the Canadian Healthcare Association
• Nadine Henningsen, Executive Director of the Canadian Home Care Association

The webinar expanded upon many of the issues presented in our recent report, Seniors in need, Caregivers in distress: What are the home care priorities for seniors in Canada?

You can download the PowerPoint presentation or listen to the webinar.