Aging at home with home care services

This pandemic has many caregivers rethinking both the present and the future in terms of care planning. The home has become more appealing than ever compared to long term care homes and other congregate settings like retirement homes.  Home care services are one of the keys, if not the key, to making this happen in a way that works for all family members. At the same time, caregivers have many questions about home care services.

“Aging in place”: welcome home

Most people want to live and age and die in their homes and communities. This is not new but the COVID-19 pandemic experience has really highlighted and intensified this preference.

Personal care and support at home can help older adults age in place and prevent or at least delay a move to a long-term care home. Home care is critical for caregivers because they can’t provide the personal care and support on their own. And the more home care there is, the less worry and guilt there is for caregivers.

Adult daughters and sons are understandably asking how they can keep their aging Mom or Dad safe at home. And now, more than ever, caregivers want options other than long-term care.  They are asking questions about how to get home care services, the cost, and the types of services available.

The role of the government

Provincial, territorial and some municipal government are responsible for the delivery and regulation of home health care services. The federal government provides financial support through transfer payments for health and social services.

Home care services: what’s available

Caregivers are often surprised by what is available to support and help people manage in their homes. Home care services are flexible, convenient, and usually customized to your needs and your schedule. Some nursing and personal support services are even available 24 hours a day, 7 days a week.  Here is a list of what is typically available in each province:

• Personal care (e.g., help with what is referred to as activities of daily living (ADL) such as bathing, dressing, and feeding
• Hands-on help with instrumental activities of daily living (IADL) such as laundry, light housekeeping, cooking
• Nursing care, for everything from foot care, to wound care, to diabetes education and management to cancer care and end-of-life care
• Specialized medical equipment and supplies
• Occupational therapy and home adaptations
• Physiotherapy
• Nutrition counselling
• Social work (to help with things like finances, housing, future planning, and relationship issues)
• Speech language therapy
• Palliative and end-of-life care
• Respite (temporary relief from caregiving responsibilities)

Who pays for home care services?

Home care services in most provinces are publicly funded, so there is no cost. There are some caveats here. There is no cost if you qualify (see eligibility criteria below).

If you want more care in addition to the care which is publicly funded, you have the option to pay privately for home care services from a home care agency. Some people also have insurance coverage for some services provided in the home.

Note that the home care agencies that provide private pay home care services are often the same ones that are contracted by the provincial government to provide the publicly funded care services.

Are their eligibility criteria? Do you have to qualify?

The short answer is yes. Typically, a health care professional will come to the home and complete an assessment to determine if the person qualifies and how much care they are eligible for in the home.

How do I get care in the home?

Each province has slightly different home care eligibility criteria, services available and financial arrangements. You can contact your provincial health authority or telehealth number to learn more about funded home care services.

Advocacy and the future of home care

The home-care sector is currently both underfunded and undervalued. Canada has one of the highest rates of institutionalization and one of the lowest rates of home care among developing countries. And we are all painfully aware of the high death rates in nursing homes with the COVID-19 pandemic.

Adult daughters and sons and their parents are on the same page. They want more home care services so that they can age in their own homes. Both federal and provincial government officials have acknowledged that the current system is broken and needs to be fixed.

This is an ideal time to advocate to shift the priority from institutionalization to home care. If interested, you can call both your local Member of Parliament (MP) and Member of Provincial Parliament (MPP) to demand ask for more funding and value directed to home care services.

Is home care a safe option during pandemic?

The health and safety of clients, their families and home care workers is the top priority of home care organizations. There are infection prevention and control (IPAC) standards for home care and these standards have been updated to specifically include COVID-19.

Infection prevention and control is a joint effort and responsibility. There are checklists available on  of what to expect from your home care worker AND a checklist for your part in reducing the spread of COVID-19 and protecting yourself, the person you are caring for and home health care workers.

We would love to hear what is on your mind about home care and the future.