Provincial aging-at-home strategy fails many seniors

Provincial aging-at-home strategy fails many seniors; Much vaunted $1.1-billion plan has left thousands of Ontario seniors without adequate home care.

A 90-year-old Scarborough woman with dementia is told she does not qualify for home care.

A daughter in Stouffville , north of Toronto, begs to keep a few home care hours for her 86-year-old father who is paralyzed by a stroke.

In Aurora, a woman who cares for her chronically ill husband, was refused home care after she broke her back.

These are some of the faces of Ontario’s Aging at Home strategy, a four-year program that began in 2008 with great promise.

A Toronto Star investigation has found the $1.1-billion strategy is failing many seniors by not providing the care they need to continue living at home. Most of the money has been diverted to a provincial plan that provides home care for seniors discharged from hospital beds where the cost of a day’s care is more than three times what it costs for a day’s home care, and to provide care for very sick seniors so that they do not go to hospital emergency rooms.

Today, almost 5,000 seniors are stuck in Ontario hospitals though they no longer need hospital care. The cost of a day’s hospital care can be as high as nine times the cost of a day’s home care.

The problem: thousands of other aging seniors who do not receive home care are ending up in hospital or on waiting lists for scarce nursing home beds, two expensive prospects that cash-strapped Ontario cannot afford.

The solution: the province has to redistribute some money to community care access centres and community agencies that want to care for seniors who have stayed out of hospital and are trying to live at home.

Sou Ping Tsoi, 90, lives with her family in Scarborough. She has dementia but family members are determined that she will stay at home.

Her daughter, Angelina, called her local Community Care Access Centre, one of 14 provincially funded agencies whose job it is to co-ordinate home care services such as personal support, nursing, physiotherapy, and occupational and speech therapy. They serve 600,000 Ontario residents annually, more than half of them seniors.

“Somebody came to the house. They had a computer program to see if my mother was high urgency,” Angelina recalls. She asked for three hours of home care a day.

The Community Care Access Centre worker replied: “We can’t do anything. We have a long waiting list.”

Provincial Health Minister Deb Matthews defended her government’s actions in an interview, saying they have boosted funding to home care and as a result, she said, 50 per cent more people are being helped. She did acknowledge gaps.

“There is always more we can do, there is no question about that. When it comes to home care there is, I think, a high demand and a growing demand. Probably no government could ever satisfy the demands for service.”

Ontario’s population is aging. Waiting lists at provincially funded and regulated nursing homes are lengthy, with few new homes being built. Private retirement homes do provide options but a recent Star investigation revealed problems in care and with lack of oversight by the province.

Experts believe the best way to support the majority of seniors is in their homes and that led to the McGuinty government’s launch of its “Aging at Home strategy,” which vowed to transform community health care services “so that seniors can live healthy, independent lives in their own homes.”

Here’s how it was supposed to work: seniors needing government-paid help, their family members or health-care providers would contact a Community Care Access Centre, which assesses the need and dispatches people to do a variety of tasks, from helping a senior bathe to preparing food to providing nursing care.

But soon after it was announced, the province began pushing the home care funding to a plan called ER/ALC. The goal was and is to cut wait times in emergency rooms and to rid hospital of patients referred to as Alternative Level of Care patients. Almost one in five patients in Ontario hospitals doesn’t need to be there and costs taxpayers $450 a day, compared to as little as $50 a day for home care. A nursing home bed is $130 a day.

Advocates for more home care to support seniors who want to continue living at home recognize that the ER/ALC initiative is important. But increasingly, the ER/ALC plan is hijacking the Aging at Home plan. In the first year, an estimated 20 per cent of funding went to ER/ALC. By last year (the third year), almost all of it was focused on ER/ALC.

Last December, in a hard-hitting report by Ontario’s Auditor General, the province was slammed for only using $45 million of the $1.1 billion promised to deliver care through Community Care Access Centres to seniors living at home.

The demand for home care is so heavy that workers are swamped, says Margaret Mottershead, chief executive officer of the Ontario Association of Community Care Access Centres.

“I don’t think there’s enough money going to home care,” Mottershead said.

2011 Torstar Corporation

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