Saturday, March 14, 2015

Ontario's Home Care System –what is really wrong with it?

Yet another report.
My experiences, volunteering in two different LHINs, in two different CCAC
regions, with over two dozen clients, as well as family members, have given me some insight. Families expect much, but the government cannot meet their wishes. It all boils down to a finite pot of budget money.
The other issues is that people are confounding healthcare with home care.
Do we, as citizens, condone paying people to go into someone's home to do laundry and housecleaning and bathing, while people in hospital require beds and extreme nursing care 24/7?
The two budgets must be separate.
While it is laudable to keep someone independent in their own home, how much are taxpayers prepared to subsidize a 90-year-old who has the funds to maintain her own home, but is not prepared to pay someone to do her vacuuming, or help her have a bath?
There is a difference between Healthcare: changing bandages, emptying catheter bags, and Home Care: helping some one have a bath, or vacuuming in a private retirement home.

What is the reality about home care?

  1. Seniors and those with debilitating illnesses, insist on living at home, with a wide range of abilities.
  2. Many prefer to die at home, which is a whole different set of needs. 
  3. Family members are urged by CCAC Charge Nurses to provide care.
  4. Hospitals discharge patients, suggesting that family recruit family members and friends to provide care.
  5. There is a limited pot of money, with specific budget lines for home care services.
  6. We are short Home Care nurses and personal support workers (PSWs).
  7. Since home care working conditions and pay scales are different than working in a large, unionized institution, for example, hard-working home care staff are often called to the 12-hour, regular shifts in hospitals and long-term care.
  8. Even if we had a large pot of money, which we don't (Ontario is in debt big time), we couldn't find enough people to deliver the services that families demand and expect form Home Care. 
  9. Robbing hospital budgets, to deliver services at home, isn't the right thing to do, either.
  10. Charge Nurses, who determine the levels of care a family receives have different mandates, depending upon the region and the LHIN from which they draw money. Perhaps we need a provincial standard, with money to back up a certain number of hours per client.
  11. CCACs, who control the purse in their region, outsource to for-profits, who have their own set of rules, regulations, bottoms lines. They are agencies, such as Bayshore Home Health (huge profits across Canada), Red Cross (issues with working conditions for PSWs: mileage, working hours), VON, and other profits and non-profits, bid on a RFP for each CCAC. There is no continuity across regions and LHINS. 

Until taxpayers are prepared to pay more in healthcare through their taxes, we will not see changes. There simply isn't enough money for all those who want home care 24/7, despite what they need. It is less expensive to put clients into an institution, but none want to be there.  The provincial governments are in the red, and all politicians run on a 'no tax increase' plank, their platforms are intended to gain votes, not ensure that needs are met.

A much-anticipated report suggests ways to make the system more accountable,...

Ontario’s home and community care system is failing patients and their families and needs “urgent attention,” says an expert panel tasked by the province to take a hard look at services and suggest fixes. The report says clients and families are confused about the availability of publicly covered services, including support from visiting nurses and personal support workers, rehabilitation, transportation, home help and meals.

1 comment:

Jennifer A. Jilks said...

I cannot imagine how a woman in a retirement home would think she should have home care services, while others deserve less. She is in the wrong type of institution to get this kind of care.