Caring for an aging parent or chronically ill spouse or friend is a challenge most Canadians are facing with too little support
Home care is a group of services that allows people with health problems to live as well and as independently as possible, in their own homes and communities. Home care designed to give caregivers a break is called respite care. Palliative care offers nursing care, home support and/or respite for people with a terminal illness and their families.
The care provided at home can come from a number of sources family members, friends, neighbours, community volunteers, health professionals, paid care workers, government-run and volunteer-run community health and social services agencies and private care agencies. A new and growing source of home care is tele-home care or telehealth, which uses information and communication technologies to deliver patient care at home.
Most home care services are publicly funded but a growing proportion is paid for by private insurance plans, charitable organizations and by individuals out of their own pockets. Patients and families also bear the indirect costs of lost employment opportunities, lost wages, unpaid family labour as well as the psychological, social, physical and economic burdens.
Successful home care:
 | Seniors the main recipients of home care are living longer with chronic illnesses, disabilities and dementia. The current trend is for seniors to receive care at home instead of being placed in long-term care or chronic care institutions.
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| More and more people are receiving at home the kinds of care that used to be provided in hospitals.
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| acute care for acute illness and recovery from surgery
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| chronic care for chronic physical illness and functional disabilities |
| outpatient services physiotherapy, occupational therapy, counselling |
| outpatient services physiotherapy, occupational therapy, counselling |
| specialized medical services chemotherapy, antibiotic intravenous therapy
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| technology-dependent care home oxygen therapy, dialysis, respiratory therapy
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| There is no uniformity of service
Home care is not covered under the Canada Health Act. Home care in Canada is a patchwork quilt of programs and services managed by provincial and territorial governments and delivered by local, regional and municipal authorities. Each has its own definition of home care, its own menu of home care services, its own set of eligibility criteria and its own built-in time limits and/or funding limits for the provision of services. |
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| The quality of care varies widely
There are no national standards for home care. Professional services delivered by doctors, nurses and other health care professionals are covered under the Canada Health Act and these professionals are governed by their regulatory bodies. However, personal care services which used to be supplied by trained nurses are now handled by a variety of home care aides, attendants and home support workers who may have little or no formal training in health or home care work. Also, imposed time restraints can prevent care workers from fully attending to their clients' needs. |
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| Good help is hard to keep
Many home care workers earn little more than minimum wage, work irregular hours, often under difficult conditions and do not qualify for benefits. Yet they are being asked to perform increasingly complex tasks. Many workers leave home care for more lucrative employment in hospitals and long-term care institutions. |
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| the care recipient's needs for independence and familiarity with friends and community |
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| your past relationship with the care recipient |
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| your needs and your family's needs |
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| lifestyle differences |
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| the home environment space, privacy, safety |
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| the availability of proper health care |
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| the availability of publicly funded community resources to help the care recipient |
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| your emotional, physical and financial capability to deal with the person's care needs |
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| cost of associated care if this is not available or accessible from the publicly funded system |
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| the impact on your job |
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| How long you expect the arrangement to last |
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| the effect of an out-of-province or out-of-country move on eligibility for health-care and other services |
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| Is the care recipient receiving proper medical care? |
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| If not, what can be done to improve medical care? |
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| Can the care recipient |
| Manage his/her/their own personal care? | |
| Handle house-keeping and home maintenance duties? | |
| Move freely and safely in and out of the house? | |
| Drive or have easy access to transportation? | |
| Manage his/her/their own finances? | |
| Make sound decisions? | |
| Continue living at home? If, what housing options exist? |
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| Are there family members, friends and neighbors who can help? |
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| What publicly funded professional, community and commercial resources are available? Are there co-payments for these services? |
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| What services are privately available? What are the associated costs? |
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| How will the care be financed if publicly funded services are not available? |
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| Who will be responsible for what? |
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| How will you manage care at a distance? |
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| Should you consider relocation? |
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| If relocating, who is going to move? |
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| Make a thorough assessment of the situation |
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| Arrange for a medical assessment, including a cognitive assessment by a family physician or specialist if necessary |
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| Determine what care services are needed |
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| Find out about available community resources |
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| Seek help from local health departments and community agencies or private care managers |
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| Find out who is available to provide help family members, friends and acquaintances |
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| Identify areas where you may need professional assistance |
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| Draw up a list of care options |
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| Discuss the pros and cons associated with each option |
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| Develop a care plan |
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| Discuss the care plan with the care recipient, family members, and the health care team, as necessary |
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| If publicly funded services are not available, assistance from private care managers may also be available for a fee. Be sure to research associated costs. |
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| Determine who will provide which service, how often, for how long |
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| Adjust the care plan, as circumstances change |
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| Investigate housing and relocation options |
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| Learn at-home coping strategies to manage care at a distance. |
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| Learn about helpful products and devices |
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| Contact health associations and organizations that offer information, advice, and support for long-distance care giving |
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| Notes and observations on the care recipient's health status, e.g., medical information such as health conditions, medications, recent injuries, accidents, etc. |
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| contact names, numbers and addresses of the professional care providers |
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| list of relevant community resources |
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| contact names, numbers and addresses of the informal network of friends, family members and others providing care |
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| travel information |
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| legal, financial, insurance information |
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| any other relevant documents |
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| Discuss the care plan with family members. Explore ways to share care giving responsibilities |
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| Adjust the care plan, as circumstances change |
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| Introduce yourself to the professional care providers family physician, home care worker, nursing home staff, and others |
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| Develop an informal care network. Ask relatives, friends and neighbors to look in on the care recipient on a regular basis and call you collect if they notice problems |
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| Keep in touch with the formal and informal caregivers. Make sure they know how to reach you, in case of emergency |
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| Look for savings plans and discounts for long-distance telephone and travel |
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| Prepare for emergencies. Be ready to travel at a moment's notice have car in good repair; valid driver's license and auto insurance; current bus, train, airline schedules; passport and travel documents in good order |
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| Plan for the future. Discuss and make legal and financial arrangements. |
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| Be realistic about the care recipient's care requirements |
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| Be realistic about how much care you can provide |
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| Look for ways to balance your long distance care giving responsibilities against your other obligations, such as your health, family and work |
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| Develop a support group of friends, fellow caregivers and, if necessary, professional counselors to whom you can turn |
