Canadians are living longer, and advances in health care along with greater awareness on healthy living is largely behind a growing senior population. If given a choice, most seniors across Canada choose to live at home and not move to assisted living, retirement communities, or long-term care. However, even with living at home, there will be a need for help and care. Home care services are the best option for any senior choosing to age in place. Typically, family members are the caregivers, but this often leads to caregiver burn out because the care becomes too much to manage.
Across the country, home care is offered through provincially subsidizes programs and private-sector home care providers. Home care is one of the best choices for seniors requiring personalized care but can live in the familiar comforts of their home. Home care provides various services and could involve short-term or long-term services and even live-in home care. Generally, home care for seniors in Canada encourages them to take responsibility for their own care and allows them to maintain independence. However, the circumstance is different for each person, as are the reasons someone needs home care services.
Home and community care services help people receive care at home rather than in a hospital or long-term facility. According to the government of Canada, home care services are not publicly insured through the Canada Health Act. Most home care services in Canada are delivered by provincial, territorial, and some municipal governments. The goal of home care is to help maintain or improve the health status of seniors. It is also there to assist seniors in remaining as independent as possible, supporting families providing care, and helping seniors with personal care and health care.
Common Services Provided in the Home for Seniors
Home care services provided in the home help seniors with minor health problems and disabilities. Also, home care helps those seniors who need intensive and sophisticated services and equipment. Typical home care services include:
- Respite Care
- Dietitian Services
- Occupational Therapy
- Physiotherapy and
- Personal Care, such as bathing, dressing, feeding, transportation
Home Care Providers in Canada and a Growing Industry
The population in Canada is aging, with an increasing percentage of adults aged 65 and older. Canada's elderly population is growing faster than the national population growth rate. In addition, the country has been shifting from institutionalized care to more home care options. The pandemic of 2020 demonstrated how vulnerable seniors are living in assisted living or long-term care homes. Home care options become a viable solution for monitoring the health and safety of aging Canadians. Moreover, the elderly generally have higher disposable income levels and can pay out of pocket, which helps sustain a growing home care industry.
Home care providers in Canada are private and subsidized—every province provides different home and community care services. According to the University of British Columbia, adults aged 65 and older currently account for more than 46% of national healthcare spending in Canada. Also, approximately 70% to 80% of Canada's home care services were provided by unregulated healthcare workers. More seniors in Canada are opting to stay home for as long as possible. However, this does place more responsibility on family caregivers. In 2016, 1.2% of Canadians lived in nursing homes or residences of senior care.
However, more Canadians are shifting to home care as the total expenditure rose by an annualized rate of 3.1% over the previous five years, reflecting the high demand for home health care services. The industry is becoming bigger, and after the pandemic of 2020, the industry may see a rapid spike in home care demand. Per the report issued by UBC, between 2018 and 2023, industry revenue is expected to grow to an annualized rate of 3% to 4.8 billion. Industry wages are expected to grow to an annualized rate of 3.5%. More private home care providers are going to be needed as many seniors will likely choose aging in place over long-term care or assisted living.
Additionally, Canada's elderly population is expected to grow annually by 3.4%, and 20% of the population in Canada will consist of adults aged 65 and older by 2023/24. In 2018 approximately 5.9% of care was homemaker and personal services, while 13.7% was home therapy services. Also, 53.5% of care was traditional home health and nursing care, and 21.9% was home hospice care. About 1.2 million Canadian adults needed home care services, and 26% had their needs unmet, while 10% had their needs partially met.
The report by UBC points out that the top barriers to obtaining home care are the availability of services, personal characteristics, cost, and ineligibility. However, over the next few years, the availability may increase, and more doctors will recognize the need for home care, due in part to the number of seniors that died in long-term care during the pandemic. The cost of home care may increase due to the increase in demand, but this is still uncertain. Approximately 52% of services are paid for by the government, and 27% were paid out of pocket.
Additionally, 8% were paid for at least in part by government and or insurance, 7% was paid solely by insurance, and 6% was paid for by other sources. There may be a shift in how home care is paid as demand increases—insurance may begin to cover more of the cost, or more responsibility is going to be placed on the taxpayer.
Home Care and Meeting the Needs of Aging Adults
Home care is an essential part of an integrated health system providing seamless patient and family-centered care and supports for older adults. According to a National Action plan, the number one challenge identified by all provincial, territorial, and federal home care programs is the impact of hour aging population on home care demand and service complexity. The damage done by the COVID-19 pandemic, for example, placed a significant strain on an outdated system of care that was not originally designed to manage acute care patients.
Much of the responsibility with home care is on the government, but this may shift and allow the private sector to grow and provide more services. Older statistics from 2012 reported by Statistics Canada indicated that almost 147% of the Canadian population aged 15 years and older had a disability that limited daily activities. Approximately 43% of Canadians fell within this demographic, and 33% were aged 65 and older.
Accountable care is provided within the private sector that focuses on increasing capacity and improving performance. However, the future of home care in Canada relies on accessibility and having enough care providers to meet the need of a growing and aging population.