In today’s noisy, contentious world, there’s a lot of concern about Canada’s healthcare system. Not surprising given we are the top spender on healthcare among the 38 OECD countries but rank 31st in healthcare outcomes. Policymakers and our fragmented healthcare system are hyper-aware there is a problem and are attempting to make changes, along with pronouncements.
But amidst the cacophony of news, politics, and system redefinition, we must ask ourselves: Are we truly listening to our seniors and those marginalized by medical issues or chronic conditions? Surveys and studies consistently provide feedback and show that people prefer to age gracefully or manage medical recovery at home. A study by the Canadian Medical Association and the National Institute on Ageing revealed that 96% of people would rather stay in their own homes as they age or deal with medical issues.
Despite this, 80% of elder care budgets go to institutionalized care, which is 18% higher than other OECD countries. In contrast, home care, where 96% of Canadians would prefer the budget to be spent, receives less than half the support compared to other OECD countries. Astoundingly, doubling the home care budget from $15 billion to $30 billion would only make us average among OECD countries.
So, what’s holding us back? Are we truly listening and making necessary changes?
Our healthcare system is a complex ecosystem. Imagine it as a “galaxy” that individuals must navigate, moving from one siloed provider (a planet unto their own!) to another—doctors, ER, hospitals, specialists—reiterating their medical and family history at each stop. Most of our time during this journey is spent at home, yet the foundational role of the home in any medical journey is often overlooked.
Policymakers also find it challenging to navigate this ecosystem and make decisions. Primary care is isolated, and institutions like federal and provincial policymakers, academia, media, analysts, hospital networks, and technology providers orbit around it, exerting powerful “gravitational” forces. Technology offers many opportunities for improvement, but the fragmented ecosystem is slow to adopt it or does so only in isolated pockets.
How do we solve this?
We must recognize the foundational role of our homes in any healthcare journey—the place where we feel safest and have the best chance at recovery. Redefining the home care experience for both clients and caregivers is essential. This involves several initiatives:
- Health Care Navigators: Trained nursing staff who act as advocates and navigators of the healthcare ecosystem, helping clients access appropriate resources and providing guidance.
- Recognition of Caregivers: PSWs and home care nurses are paid less than their counterparts in hospitals or long-term care. We need to redefine their roles, provide better training and support, and recognize their contributions to attract more talented staff.
- Embrace Technology: Utilize various technologies to support comprehensive home healthcare, including:
- AI Navigator support for Health Care Navigators;
- Remote monitoring of vitals for early detection and issue prediction;
- Virtual wards to provide home care at the same level as hospital or LTC care;
- Centralized, comprehensive medical records owned by the client and shared only with their consent.
- Increased Government Focus and Funding: Progress is being made with increased funding to home care and initiatives like the National Research Council of Canada’s “Aging in Place Challenge Program,” which funds new ideas and technologies for home care.
Achieving comprehensive healthcare at home leads to several benefits:
- Familiarity: Seniors prefer home care because their home is familiar, making them feel safe and comfortable. Nursing homes, despite efforts to be comfortable, are entirely new environments that can increase stress for seniors.
- Independence: Aging at home allows seniors to maintain their freedom and make their own decisions about daily activities, meals, and visits from friends and family, unlike the restrictive environment of nursing homes.
- Social Relationships: Home care helps seniors preserve their important social relationships, leading to happier lives and a positive outlook. Nursing homes, on the other hand, often isolate seniors from their lifelong connections.
- Improved Health: Living at home can lead to better physical and mental health, supported by multiple studies and analyses. This isn’t just a nice-to-have; it drives better health outcomes.
Our world won’t become quieter or simpler. However, if we listen—both broadly and at the individual level—it’s clear that our home must become a much more integrated and recognized foundation of healthcare. As the classic quote goes: “Sometimes the questions are complicated, and the answers are simple.”
This is my perspective, and I hope you will join us in making Comprehensive Healthcare at Home a reality.
Sincerely,
Robert Stanley, CEO of CHAH.
