Inadequate funding for home care threatens older Ontarians

Be afraid. Be very afraid, especially if you or someone you love may someday need help to live at home instead of ending up in a long-term-care home.

The failures of Ontario’s LTC system during COVID-19 should scare all of us, especially anyone who would rather live at home for as long as possible and really doesn’t want to be institutionalized.

“People’s psyche has been scarred by this, but it sure as hell should scare those of us who might be 20 years away from what is happening here,” HomeCare Ontario CEO Sue VanderBent said in an interview.

“If we don’t get a better home and community care system, we will then move to institutionalize everybody, and that’s not what you want.”

The pandemic highlighted the weaknesses of an LTC system that institutionalizes people, and made clear the lack of options for seniors who need help with basic chores such as bathing and preparing meals, people who could live at home for many years with proper support.

After nearly 4,000 COVID-19 deaths in LTC homes, the government finally announced plans to hire 27,000 more staff and offer pay raises for personal support workers and nurses, but ignored the home-care sector.

The pay raises for LTC workers drew staff away from home care, at a time when both are suffering critical personnel shortages, an entirely predictable outcome that put more strain on an already weakened system.

HomeCare Ontario and the Victorian Order of Nurses want wage parity for staff in LTC, hospitals, and home and community care, along with increased access to home-care services.

Institutionalizing people is also the worst option financially, something you’d expect the Progressive Conservative government would be concerned about. The cost of home-care services is infinitesimal compared with long-term care, or an even more expensive hospital bed, and staying home is much safer than institutional settings where exposure to infectious diseases is possible.

Even before the pandemic, people were getting only a “tiny, tiny” portion of the home-care support they need, even though over 90 per cent of those polled want to live at home for as long as possible.

“There is a fear, and I think an even heightened fear right now, about institutions in general,” said VanderBent. “We do not want to be institutionalized, but we give them so little home care at the expense of institutional care.”

Canada spends 87 per cent of its longterm-care funding on institutional settings and only 13 per cent on home-care services, compared with Denmark, which spends 36 per cent on LTC homes and 64 per cent on home care.

Sadly, the growing number of people with Alzheimer’s and other forms of dementia will eventually have to be in some sort of facility, and hopefully we start designing better ones for them, but many seniors could actually stay in their own home until they die, with the support of a home-care worker.

Why is there such a disconnect between everyone’s desire to live at home for as long as possible, and the government’s decisions to offer millions in bonuses to developers to build tens of thousands more LTC beds in large facilities, while flatlining the home-care budget?

We shouldn’t have to fear being put into an institution as we get older when we could live comfortably at home with a little help and support from professional caregivers.

Adequate home care shouldn’t be a dream, and the alternative for seniors shouldn’t be a nightmare.