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Ontario's system of Community Care Access Centres (CCACs) and their basket of home- and community-care services are an alternative to retirement homes and a worthwhile option for senior care in this province. If your mother can no longer safely get in and out of the tub or your neighbour seems unable to cook for himself since his stroke or your own recent hip surgery has made stairs difficult, Community Care Access Centres may be an answer to your concerns.
Ontario’s CCACs and their importance to senior care in Ontario
"The name, to start with, is an odd one for people to grasp," says Graham Bird, chair of the Ottawa CCAC, one of 42 in the province and Ontario's largest. "People may not know what CCAC stands for but they sure know what home care is."
Established by the Ontario government in 1996 to co-ordinate both home care and long-term care, CCACs aim to help seniors (or Ontarians of any age) stay in the comfort of their homes despite mounting health concerns. If necessary, a CCAC will help find an appropriate long-term care facility or retirement residence.
Canadians over the age of 65 now make up almost 13 per cent of the population and the numbers will continue to climb. "CCACs have been growing by leaps and bounds as more and more of our population needs their services and as the recognition grows throughout health care that we're likely to recover more quickly at home," Bird explains.
According to the Ontario Association of Community Care Access Centres (OACCAC), funding for home care and placement services has grown from $750 million in 1994-95 to more than $1.16 billion in 2002-03. Last year, the community care agencies helped in more than 533,000 cases, provided 6.9 million nursing visits, more than 18 million hours of personal support and homemaking, plus 1.4 million therapy visits. While home care seems costly, institutional care costs the province much more.
CCACs do not charge people for their help, but like anything else in health care, their services are not without limit. Eligibility is based on need, determined by an assessment. While one client may need daily nursing help with wound care, another may simply need the number of her local Meals on Wheels. Not only do CCACs arrange for care from their basket of services, but they also can direct clients to other services that exist in the community, some of which are volunteer-based and others which charge clients a fee. "We have a responsibility that if the client has needs that cannot be met solely by our services, we link them to other community services," says Bob MacWhirter, the care coordinator for the Toronto CCAC.
As coordinator of client services at the Scarborough CCAC in Toronto, Rowena Fowler may, in a matter of hours, have to think about everything from foot care to food preparation, from speech therapy to palliative care. "It might be an adult child or caregiver or a senior himself who calls with concerns," she says.
After meeting with the client, Fowler may determine that what's needed are the services of an occupational therapist, who can make subtle but significant changes in the client's home "a bathtub safety bar, for instance, or a ramp for wheelchairs.
"What we can do is make it easier for people to be in their own homes," Fowler says.
At the central Toronto location, MacWhirter describes the association as a navigation service. "The government originally set it up as a kind of one-stop shopping. I do believe in that philosophy," he says. "It's less confusing for seniors if they have one number to call and then be guided where to go from there. We can be the initial point of contact."
Some CCACs may have more community services to draw on than others, but Dr. Jim Armstrong, the CEO of the OACCAC, says there's a concerted effort to address the disparity between urban and rural areas.
"CCACs are working with the provincial government to ensure that the services are more consistent across the province," Armstrong says. He adds that since the launch of the centres, the range and scope of services has increased; for instance, mental health services are now included.
What's most important is to respect a client's wishes, MacWhirter says. "I've seen caregivers get frustrated because the client won't do what they want them to do. Unfortunately there is a tendency to 'infantilize' older people. That only sets up a bad dynamic. CCACs help people to maintain their independence from Ontario’s retirement homes."
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