Our home care system is failing. The article written below perfectly expresses the significant ramifications of a poor quality home care system. Two new reports underline the need for senior care in the community.
- A woman goes without eating or drinking for two to three days, even though she was under the supervision of Ontario’s home care system.
- Patients receiving palliative home care get cut off because they don’t die fast enough.
- A patient with diabetes gets sent home after a heart attack. The expectation is that a friend will take care of her. She returns to hospital in a diabetic coma.
Those are just three tales from the trenches from personal support workers, patients, nurses, community service provider agencies and other groups involved with home care in this province.
Their testimony is contained in a two-year study, The Care We Need, released this week by the Ontario Health Coalition, an advocacy group that is rightly calling for a complete overhaul of the home care system.
If that message isn’t strong enough to be heard by the Ontario government, many of the group’s findings are reinforced by a second report on home care, made public on Thursday by a group of experts commissioned by the Ontario government.
That report, Bringing Care Home, contains 16 recommendations to streamline and integrate services to make it easier for patients and caregivers to navigate a system that is now overly complex and unresponsive. As the experts say, the current home care system simply “fails to meet the needs of clients and families.”
The health coalition’s exhaustive study details what happens when:
- People are forced out of hospitals to free up beds and cut costs without a coordinated, well-financed home care system in place to support them.
- Patients end up back in expensive hospital emergency beds because they haven’t been given enough home care hours.
- Elderly patients end up in expensive long-term nursing homes, because they can’t access the home care support they need.
What’s clear from both studies is this: the Ontario government cannot have it both ways. It can’t cut the extraordinary cost of keeping patients in hospital simply by pushing them out the door as quickly as possible without providing sufficient home care on the other end to ensure they don’t end up returning in worse shape, requiring more expensive care, than when they left.
And it can’t prevent elderly patients from accessing expensive long-term nursing home beds if it doesn’t provide the care they need at home.
The government has been warned for decades about the need to coordinate and support home care to accommodate:
The fast-growing number of Ontarians with Alzheimer’s and related dementia. There were 181,000 of them in 2011, and that number is expected to grow by 40 per cent before 2021.
The 13,042 people currently on wait lists for home care services. (This does not include those cut from the lists because Community Care Access Centres had to tighten eligibility because of a lack of funding.)
The increasing need for home care to help seniors retain their independence.
But instead of properly supporting and funding home care — to save money, never mind provide compassionate care — the current $2.4 billion budget for home care provides less per patient than in 2002/03, according to the health coalition’s calculations.
This year the Ontario government topped up the entire $4.9-billion budget for both home and community care (which includes community health centres) by $270 million and plans to increase that gradually to $750 million over the next couple of years.
Still, the Ontario Health Coalition is recommending:
- Patient advocates or an ombudsman to help people access timely, sufficient home care.
- Increased funding to ensure those in need are cared for.
- More controversially, an end to the current mix of private and public health care services. (It argues the home care system should be a public, not-for-profit service)
Their report is a well-researched, well-thought-out eye-opener – backed up on many issues by the government-commissioned report. Health Minister Eric Hoskins should act on both immediately. The most vulnerable of patients – those waiting for help at home – depend on it.
March 15, 2015