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May 2013

The Changing Landscape of Home Care

Last month, the Canadian Home Care Association, which is considered the voice for Home Care in Canada, released the 2013 ‘Portraits of Home Care in Canada’ report.   Released every five years, this extensive report is a reflection of how critical home care is as a component of an integrated, person-centred health care system.

Some of the key areas of focus in this report include Governance, Access, Funding, Service Delivery, Quality Assurance, Challenges and Opportunities.

Some of the staggering statistics that came out of the report follow:

• Number of individuals in Canada receiving home care in 2011:  1.4 Million
• Public expenditures on Home Care in Canada in 2010:  $5.9 Billion
• Ratio of Seniors (65+) across Canada receiving Home Care in 2011:  1 out of every 6
• Ratio of Seniors (65+) in BC receiving Home Care in 2011:  1 out of every 12
• Percent of publicly funded health care programs spent on Home Care (2010):  4.0%
• Number of Family Caregivers in Canada:  5 Million
• Percentage increase in the number of Home Care clients (2008-2011):  55%

The 55% increase in home care clients over a 3-year period is absolutely an indicator of things to come!  So yes, the landscape of our health care system is changing as the need for home care increases significantly.  In the last few years there has been much more emphasis on shifting care to the home and community (rather than hospital), as well as recognition of the family caregiver’s vital role.  The family caregiver’s role couldn’t be more important in this context.   Providing care, advocating for care, and arranging care are three of the most important roles for an aging loved one.

Access to home care services in BC may range between the six different Health Authorities in BC.   However, locally, Public Home Care service access (and speed of service) depends on urgency and scope of care.   More essential care such as medication administration, personal care, dementia care, respite care, and Palliative (end of life) care are high priorities.   Homemaking and housekeeping are not considered part of the Public Home Care mandate in BC.

It is widely discussed that public funding for home care cannot continue to meet the increasing need for seniors care/home support much longer.  Currently, for Public Home Care (VIHA), an income assessment is conducted and sets the cost of the publicly provided Home Care.   Private providers typically charge on a per hour basis.

The number of seniors (65+) is projected to DOUBLE from ~5 million to 10.4 million over the next 25 years.  According to STATS CAN, 33% of Canadians aged 65+ and 56% aged 75+ reported having a disability.   So without question bigger challenges lie ahead.   Some of the more critical challenges facing home care in the immediate future are:

• Accessibility to those who need help
• Funding (especially considering today’s cost-cutting environment)
• Fast Access to service
• How technology can support our seniors at home
• Increasing expectation of the public for home care services

According to the ‘Portraits’ report, “The challenge of managing increased demands with decreased resources will continue to limit the potential of home care across the country and increase the gap of unmet needs for aging Canadians.”

So what does this mean for all of us in the short term?    First you have to ask yourself how likely you think it is that funding for public home care will increase significantly in the years ahead.   Perhaps it is possible…  It’s also possible that you will win the lottery this week.

Otherwise, consider these likely scenarios:

More care will happen in the home.   There will be a higher expectation that family will be taking on a more significant role in advocating for, providing, and arranging care.

If you plan ahead, you may ask yourself, “With the significant amount of time that will take to help my parents, how will I manage that?”

Well…you could research all of the resources available for home care in our community yourself, or – when the time comes that a parent or loved one needs care – you could place two phone calls…one to VIHA’s Inquiry line at 1.877.734.4101, directly followed by a call to our office for concierge service and an educational discussion on how we can help point you in the right direction.   Both calls will save you valuable time and energy.

Chris Wilkinson, B.Sc. KIN is the Owner / GM for Nurse Next Door Home Care Services franchise serving Cowichan, Nanaimo, Parksville and surrounding communities.   Nurse Next Door provides award winning in-home care and support for seniors.  Call Chris for more information at 250.748.4357 or visit NurseNextDoor.com