Seniors in need, caregivers in distress:

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Contents 2 Introduction 10 Home care and seniors: A Canadian snapshot 26 Family caregivers 38 Integration matters 47 Challenges in home care 56 Concluding comments 58 References 62 Data sources 64 Acknowledgements 64 List of innovative practices 64 List of figures 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 systemwide 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. To download reports and other Health Council of Canada materials, visit healthcouncilcanada.ca. Councillors Dr. Jack Kitts (Chair) Dr. Bruce Beaton Dr. Catherine Cook Ms. Cheryl Doiron Dr. Dennis Kendel Ms. Lyn McLeod Dr. Michael Moffatt Mr. Murray Ramsden Dr. Ingrid Sketris, PhD Dr. Les Vertesi Mr. Gerald White Dr. Charles J. Wright Mr. Bruce Cooper (ex-officio)
Foreword In the last decade, the number of people receiving home care in Canada has grown considerably. Many home care recipients are seniors with chronic conditions and physical or cognitive limitations who want to stay in their homes as long as possible. Home care services help them to manage their health conditions at home and provide assistance with daily activities. The Health Council of Canada set out to examine the characteristics of older Canadians who are receiving home care and to highlight some of the challenges facing these seniors, their family caregivers, and the home care sector. We also reviewed strategies and innovative approaches that are underway in some provinces and other countries to provide comprehensive home care to seniors, and to support their caregivers. One of the key findings is that seniors with complex health needs receive, at most, a few more hours of home care a week than what is offered to seniors with moderate needs. A consequence is that many family caregivers of these high-needs seniors are stretched beyond their capacity, reporting high levels of stress, depression, and difficulties in continuing to provide care. Canadian governments are recognizing that an aging population, coupled with the need to control health care costs, requires a greater focus on home care for seniors. Home care has historically been considered a patchwork of services that are provided offside in the community, disconnected from hospitals and family doctors. But that’s outdated thinking. Home care is an integral part of the health care we provide to Canadians and needs to be recognized as such. Canadians would benefit from expanded efforts to integrate home care with other services in the health care system, particularly hospitals and primary care, and to ensure that family caregivers continue to receive support as needs change. In this report we highlight some examples, both in Canada and internationally, that could be adapted across the country. Finally, any thoughtful discussion about home care for seniors needs to include conversations about aging and our values, responsibilities, and expectations, both as a society and as individuals. There were many such discussions during the development of this report, derived from both the findings and the real-world experiences of report contributors who are caring for older family members and interacting with health care professionals, hospitals, and home care agencies on their behalf. No doubt many readers will view the information we present through a similar personal lens. Aging well is an issue that matters to all of us. Sincerely, Dr. Jack Kitts Chair, Health Council of Canada
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