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Your guide to retirement living & care since 2002

Home Care

Aging in place with the care you need


Find home care providers

Home care includes a wide range of services that support your needs in the areas of health, nutrition, transportation, companionship and care of your home and property. Home health care services allow people of all ages to continue to age in place, remaining connected to their community and defer the need for a move to more dedicated care. Here, we attempt to provide a clear, full overview of home care in Canada and advice for Canadians and families on how to find the best services.

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Government-supported home care is available in all jurisdictions across Canada, with some limitations. Home visits by nurses, physiotherapists, occupational therapists and social workers are typically available to cover an acute short-term need. This care may be available on a less frequent basis for those with longer-term chronic health conditions. It is assumed that family will still provide care and the publicly funded system supports this care. Anyone can request an assessment for eligibility from the government. When a senior requires more daily care and household operations a live-in caregiver can be hired through Human Resources and Skills Development Canada (HRSDC)'s Live-in Caregiver Program. Bear in mind, that regulation of home care workers is scattered (read more).

Be sure that you are taking advantage of all the free and subsidized home health care services available through your provincial government, other government services and local charities. There are many other services that are not free or may require your name on a waiting list, or other considerations. Some tasks you may be able to find help with include lawn and snow care, meal preparation or home cleaning. There are a variety of home care services provided by local communities and funded by a number of government levels and non-profits like the United Way.

Government-funded home care assistance offered in some jurisdictions may include the following:

You can learn more about these home care solutions and find government contacts in our senior care advisor, under Support Services.

Many of these community services rely on charitable donations in order to keep going and government funding of programs is always subject to change, as well.

As is widely reported, demand for home care frequently outpaces government resources available, and organisations like the CCAC are forced to restrict the hours of care provided per week or to place patients on waiting lists for care services.

Privately funded home health care providers are a perfect way to augment community-funded services. These companies come into the home and provide elderly community members with tactical help in areas that may not be covered by other services listed above. These companies offer outside help solutions for seniors that are accountable and professionally handled and are customized directly the individual senior’s needs. Services include regular companionship and visits that may include help with shopping and errands and even Alzheimer's Care, as well as dependable, reliable care in areas such as housekeeping, meal preparation and transportation.

These companies can also be used by people living in a retirement home who want to extend services they receive. Consult with the companies listed here to learn more about what they offer.

An Overview
Government-funded home care services are staffed with caring, professionally trained people. The volunteer-based Ontario Community Support Association provides essential-care services to 750,000 Ontarians yearly, and their community support services benefit those with chronic-care needs at half the cost of care in other facilities (the estimated value of this volunteer labour to the Canadian economy as early as 2003 was in the range of $20 to $30 billion). However, many people in both the private and public health care sectors admit that inconsistent funding undermines care provided. Government-funded services may also be subject to income testing and/or a co-pay depending on the jurisdiction, and there may be a variety of reasons for limits as to the amount of service that can be provided. Home care service providers are often contracted privately to deliver the additional hours that support and complement the publicly funded care. Even when there is strong family support close by, it can be extremely helpful to have a home care provider assisting with the caregiving responsibilities.

Private service providers offer a fuller suite of services, more accountability and a stronger guarantee of dedication when it comes to any form of senior care. For example, when it comes to long-term care homes, there are often waiting lists to get into the best care homes, and wait times to find the proper care can be one, two years, and even longer. Hiring a reputable, professional in-home care is one way of guaranteeing proper care for loved ones. As reported in Comfort Life as early as 2003, the 80-plus demographic is "the fastest-growing segment of the country's population" and is now well over 1 million people. As we reported then, government home-care spending has not kept up with the increase in population, holding steady at only four per cent of Ontario's health-care budget. In addition, only about 15 to 20 per cent of Ontario's health care funding goes to chronic geriatric home care. All of this means that the private home health care sector may be a safer bet, whose benefits you may need to consider.

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Caution against hiring private individuals
A survey of Canadian families in 2010 showed that more than half of respondents (65%) were unaware of the risks inherent in directly hiring a non-professional, non-certified, non-accredited individual to provide private home care. Some families hire personal care for an elderly family member, based on a personal job interview and a few references. Senior home care is difficult, challenging work and under many circumstances should never be undertaken by any untrained, unqualified people (this also includes family members, as well).

Accredited home care organizations that belong to an association such as the OHCA have a number of measures in place to ensure quality and professionalism.

These include:

Even when hiring a professional caregiver, there are questions that will help you find the right care for your family and loved one.


What are tasks of daily living?

This phrase, used regularly in the care industry, covers daily activities as follows: eating, bathing, dressing, toileting, transferring (walking) and continence. When any of these become a problem, care services can be hired in to help. Seniors face a variety of hindrances due to aging, including a wide variety of ailments such as decreasing eyesight, failing memory and many other issues. For example, if you or your family member needs help with reading street signs (failing eyesight) or has troubles remembering the date or other common things, these are just a few cases where care support will help. Declining attention to personal care is another classic sign that home care services can help.



 

These structured programs benefit seniors and other adults with disabilities or other support requirements, offering them programs that facilitate community, interaction with others in a safe, supervised environment. Adults get out of the home and participate in any of a wide variety of activities. Elderly people in the community interact with their peers for a few hours daily, while remaining independent in the larger community, in their own homes or wherever they live. This provides an environment where caring people can keep in touch with seniors, and facilitates remaining independent, the ongoing wish of so many seniors.

Programs may be offered by municipalities or other public bodies, but privately run programs may meet more regularly; while privately run programs may require fees, they also have increased availability and reliability.

These day programs may offer therapeutic programs, assistance with personal needs, meals and refreshments, and a variety of other services that meet the needs of seniors who are otherwise living alone. There are programs that offer a wealth of activities that include board games, card games, bingo, puzzles, gardening, baking, cooking, pet visiting, crafts, fitness and exercise, movies and social interaction including reminiscing -- and making new memories. Adult day programs offered by community organizations are often staffed by volunteers, and these can — for the most part — be adequately run, engaging and a great outing.

In the case of seniors with dementias including Alzheimer's Disease (as well as Parkinsonian and/or Lewy Body dementias), this type of program can have a number of healthful benefits and presents an environment where professionals can monitor the dementia and its progress. For families worried about sundowning, late afternoon programs can improve your peace of mind.

We offer further information about program offerings, types of care, regulation and admissions, in a more extensive overview, adult day programs and services.

The value of the Gentle Persuasive Approach (GPA):

The Gentle Persuasive Approach is a professional training program that facilitates deeper understanding and patience between professional caregivers and those with dementia or other care requirements. It's another important component of training that separates professional care from all other caregiving.

This is care curriculum that takes a person-centred care approach. The program trains staff in a variety of health care verticals and sectors. The GPA Basics program is an 8 hour, one day course. Certified GPA coaches guide trainees through techniques of response. PSWs and other care workers with GPA training have been trained in understanding dementia and person-centered care, they have gone through case-based scenarios with their instructor and they have been given a solid understanding of dementias and their effects on people's behaviour. The course is designed to protect both the dementia sufferer and the care worker, and encourages self-protection and gentle redirection techniques for a variety of scenarios.

As of 2016, the home care industry is not duly regulated in Ontario, and only nominally so in other provinces including Alberta and British Columbia. For example, Alberta's Protection for Persons in Care Act focuses on care homes and facilities and includes a poorly defined provision for "any person designated by the regulations as a service provider." Private home care providers in the province of Ontario admit that the industry has little government regulation, except for what is provided for under other laws. The Home Care and Community Services Act in Ontario focuses on providing and promoting access to services, not so much on regulation of providers. It is also not regulated under the Canada Health Act5.

The Ontario Home Care Association (OHCA) is "the voice of home care in Ontario," a strong association "dedicated to promoting the growth and development of the home and community health care sector by helping to shape health care policy, supporting members to excel, and being a leading source of information on home and community care." OHCA members are typically concerned about practice standards and engaged in achieving excellence in all aspects of service. The majority of its members are accredited through Accreditation Canada, CARF Canada, and/or registered with the International Standards Association (ISO).

These accreditation bodies are a strong indication of credibility, but they do not legally regulate the industry. This lack of authoritative regulation may change as the industry grows, but in the meantime, seniors and families need to take great care in choosing a provider.

Notes
1Satistics Canada demographics
2http://pialberta.org/content/moms-private-care-costs-shock-family-action
3https://www.sunnet.sunlife.com/files/advisor/english/PDF/Completereport-LTC-Costs-AB.pdf
4http://novascotia.ca/dhw/ccs/FactSheets/Home-Care-Fee-Structure.pdf
5See The Canada Health Act


"When it's all over you want to be able to look back and say, 'I did the best that I could, I took care of my mom and dad as well as I could.'"



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