Patient advocates warn of deteriorating home care

System struggling as hospitals release people ‘quicker and sicker,’ group claims

Ontario’s home-care system is struggling as hospitals discharge patients “quicker and sicker” and as funding fails to keep pace with growing demands, a patient advocacy group charges.

“Everywhere across Ontario there is consensus that access to home care is poor, that people are left without needed care and are suffering. This violates peoples’ expectations of compassion and care,” said Natalie Mehra, executive director of the Ontario Health Coalition. She made her comments Tuesday following the release of a report from the coalition, titled The Care We Need. It says that per-client funding for home care was $3,396 last year, 3 per cent less than it was in 2002/03.

The funding situation is better than it was in 2008/09 when the provincial auditor found that per client funding had dropped to $3,003. But it’s still lower than 2002/03, when per client funding was $3,486, according to the report. Home care is being “severely rationed” and patients in need are increasingly forced to pay out-of-pocket for costly private care or do without, it warns.

The report was two years in the making and includes results of consultations with patients, families, nurses, personal support workers, community service provider agencies and other affected groups.

“Across the province, we heard about people discharged from hospi- tals without any care at all. Or people who are being cut off, even though their care needs have not changed, just because of arbitrary budgets,” Mehra said. “We heard about a woman who was left without being fed for two days or more. A film had grown all over her mouth. She was severely dehydrated. This is what inadequate home care can mean,” she added.

The report decries the growing involvement of the private sector in the delivery of home care and calls for a reformed system that uses non-profit community services.

It describes the home-care system as poorly co-ordinated, bureaucratic, top heavy and inequitable. It highlights concerns about early hospital discharges, inadequate PSW training and a lack of accountability.

NDP health critic France Gelinas said that despite years of promises, the government is failing many Ontarians who need home care.

“The government keeps saying they need to act but nothing yet. It’s longoverdue to apply the principles of medicare to home care and ensure patients have access to the publicly-delivered care they need to remain in their own homes,” she said.

In a written statement, Health Minister Eric Hoskins said his government is working to improve home and community care with the help of an expert group that recently submitted recommendations.

“Our government is committed to ensuring that Ontarians receive the care they need. That is why this year we have increased funding for home and community care $270 million and invested more than $4.3 billion in the community sector,” he said.