Seniors needing the most help are not getting the care they need, says report

The Health Council of Canada releases a new report on home care in Canada

TORONTO, Ontario April 16, 2012 – Today, the Health Council of Canada released Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada? Download report here (.pdf).

The report provides the first cross Canada snapshot on the needs of home care clients and their caregivers. The report looked at data from five regions including Nova Scotia, Ontario, Manitoba, British Columbia and Yukon and found that seniors who need home care the most are not getting the level of care they need. One-third of seniors in the Health Council’s sample have complex health needs, often involving both a physical disability and cognitive impairment such as dementia, but these people receive only a few more hours of home care services per week than what is offered to seniors with moderate care needs.

This leaves the burden on the shoulders of many family caregivers in Canada. Caring for a high-needs senior with limited outside support may stretch family caregivers beyond their capacity. Approximately 40-50% of seniors with the most complex health needs have distressed caregivers, who report they are finding it difficult to continue to provide care, and that they have feelings of stress, anger, and depression.

A burned out caregiver cannot help anyone if they end up in the hospital or become otherwise unable to function. In fact many caregivers are seniors themselves, at risk of health crises under stress. The report calls for a system that regularly assesses the situations of seniors and their family caregivers and provides support, whether it is additional hours of home care or faster placement a loved one into a long-term facility.

“Home care has become an integral part of the health care system, not something that happens off-side in the community,” said Lyn McLeod, Councillor with the Health Council of Canada. “Governments need to make home care a priority by developing and implementing an integrated continuing care strategy. Jurisdictions can adapt what is working by learning from innovative practices.”

The most successful programs and policies bring together, home care, primary care and acute care under one coordinating body. To do this, the report suggests a change in the way funding is allocated. Canada currently spends considerably more on long-term care facilities than home care. Among countries monitored by the Organisation for Economic Co-operation and Development (OECD), Canada has one of the larger gaps between spending on long-term care and home care, 0.96 % of GDP for long-term care and 0.21% of GDP for home care.

The report also calls for integration of home care across sectors and services as well as the provision of support for family caregivers. As hospitals are the main source of referrals to home care, when seniors leave the hospital, they should experience a smooth transition from hospital to home care. And once a senior is receiving home care, the family physician should be included as part of the home care team.

“When home care is properly valued and integrated into the health care system, it can improve the health and well-being of many seniors and their families, and reduce costs to the health care system,” said John G. Abbott, CEO of the Health Council of Canada.

The report also addresses the issue of the Alternate Level of Care (ALC) patients – people who don’t need the acute care of a hospital, but still need some care. Often they are awaiting placement in a long-term care institution or rehabilitation facility. ALC patients use an average of 5,200 hospital beds every day, at high cost to the health care system. Many of these people are seniors who could be cared for at home if appropriate supports were in place.

About the Health Council of Canada

Created by the 2003 First Ministers’ Accord on Health Care Renewal, the Health Council of Canada is an independent national agency that reports on the progress of health care renewal. The Council provides a system-wide perspective on health care reform in Canada, and disseminates information on leading practices and innovation across the country. The Councillors are appointed by the participating provincial and territorial governments and the Government of Canada.