Hitting the Gas on Home Care Reform
The Globe has done a thorough job of highlighting the myriad of issues in delivering quality home care in Ontario in No place like home? Investigating Ontario’s home-care shortcomings. The system, like the people it serves, is complex, thorny and distinctive. There is no simple one-size-fits-all solution to delivering care in the community, but there are some basic bottom-line policies and programs that should be put in place.
The Ministry of Health recently introduced a roadmap to strengthen home and community care in response to recommendations tabled by a group of experts in the Bringing Care Home Report. It’s a great first step in setting out the desired destination but it’s still short on details on how we’ll get there.
Thankfully the government is beginning to hear the voices of clients and family caregivers. They are the ones we need to listen to more – they’ll tell us how to get there. After all, they know what they want and what they need to live as comfortably and with as much independence as possible. They want to live and die at home. And remarkably, what people want in terms of their care has been shown time and time again to be more cost-effective.
As the leader of a home-care organization and as a caregiver, I fully recognize the challenges of the complex web of services that make up our home-care system. I’ve experienced the “care by code” the article refers to firsthand in arranging care for both my parents (who lived out their last days in my home) and now for my in-laws who live in a different CCAC region. The discrepancies in what is available from one CCAC to the next speaks to the need for greater consistency across the board so there are no “have” and “have not” regions when it comes to home care. While standardization is vital, so too is built-in flexibility: we must be able to meet the unique needs of individuals without having to break through rigid rules or bureaucracy to do so.
Those we are here to serve can’t wait anymore for us to sort out the problems. We need to put their needs front and centre and knock down the barriers to accessing sufficient, high-quality care, when and where it’s needed. We need to look at the various home-care success stories like the House Calls program in Toronto that cares for seniors who are frail and home bound and then replicate these “wins” throughout the province—or work with them to increase capacity when people are waitlisted. Ultimately, we need to provide individuals and their families with the chance for more independence, more control and more choice in their care.
Reports and studies are important but we all know that actions speak louder than words. Now, more than ever, the Ontario government, Community Care Access Centres, home and community care provider organizations like our own, need to work together to “hit the gas” and figure out how best to implement this roadmap. Without a clear and pragmatic sense of how we’ll get there and the necessary investments to make it happen we risk getting lost in a dead end of good intentions and endless rhetoric.