Ontario is on the verge of home-care crisis
Strain will put pressure on long-term-care homes, rest of health-care system
Last week’s announcement by the Ontario government of $270 million in new funding to increase staff in long-term-care homes is welcome news, but it didn’t go nearly far enough.
There was no mention of the need for similar support for home care, which allows more than 440,000 Ontario seniors to live independently and in dignity at home and is essential in delivering needed care for patients discharged from hospital after surgery or other treatment.
Demand for home care is expected only to increase. A recent poll by Home Care Ontario found 96 per cent of Ontarians over 55 said they plan to stay in their homes as long as possible.
But despite growing demand, and the many painful lessons the COVID-19 pandemic has taught us over the past year and a half, there is still too little recognition by decision-makers of the critical role home care plays in reducing the pressure on our long-term-care homes and keeping people, mostly seniors, out of hospital.
Sadly, the health-care system, our seniors and patients across Ontario will soon pay the price of this neglect and lack of recognition. The nurses, personal support workers (PSWs) and other professionals on whom home care depends are leaving the sector in droves. According to a report by the Ontario Science Table released last week, increased health-care provider burnout is likely to lead to these individuals seeking jobs outside of direct patient care. In the spring of 2021, 30 per cent of nurses in a Toronto hospital reported considering leaving their jobs because of moral distress. We are seeing a similar trend in home care. Because of staffing shortages, the sector has gone from being able to fill 9.5 visits of every 10 requested pre-pandemic, to just four visits of 10 as of last August.
What people do not seem to recognize is that increased strain on the home-care sector will put an already burdened long-term-care sector under more pressure and will add to hospital capacity concerns resulting in more hallway health care than we see today.
Home care is not glamorous. It’s demanding work involving travel throughout the day and caring for patients with all types of diagnoses and health outcomes. And even with a recent temporary pay increase of $3 an hour for our home-care PSWs, there continues to be a significant disparity in pay with similar work performed in hospitals or in long-term-care homes.
Home-care workers are often the only support for our frail seniors. They typically work alone and often suffer, or succeed, in silence. There is also an ever-present worry that if they are unable to visit a senior at home, there may be no one else — a family member, friend or health-care worker — available to check in on an individual who needs care.
No wonder it’s hard to recruit into this sector and that nurses and PSWs are giving up on it. It takes a special kind of person to thrive among these headwinds.
But there are potential solutions that the system can put in place to alleviate the crisis unfolding in the home-care sector in Ontario today:
› Permanently increase the wages of our home-care workers so they are paid the same rate as those working in hospitals and long-term care. In a recent poll by Home Care Ontario, 97 per cent of seniors said it was very important or somewhat important the government increase funding to the home-care system and the majority supported wage equity for PSWs regardless of where they work. Those providing care to our most vulnerable seniors deserve a living wage so they can provide for themselves and continue to serve others. We see these investments in hospitals and long-term care across the province. Why not in home care?
› Leverage alternative approaches or non-traditional resources to relieve some of the pressure on the sector. There are models that have proven successful, such as the Seniors for Seniors program we introduced at Spectrum Health where we match younger seniors in their 60s and 70s to provide care for older seniors. Resources like this provide respite and overnight relief to burned-out family members. They can also provide for basic care needs, freeing up precious PSW capacity. Programs like this should be celebrated and expanded.
› Accelerate immigration and nursing licence bridging programs, which are significant obstacles to the many internationally trained nurses working as PSWs trying to get through this process. There are many hard-working, educated and skilled individuals arriving in Canada ready to care for others. While always keeping quality of care and qualifications at the forefront, we need to reduce barriers to allow these individuals to advance in their careers in home care.
We need to celebrate our home-care providers. It is time to recognize the critical role of home care in our health-care system. We need to give home care and the people working tirelessly to provide care to our most vulnerable citizens the profile and thanks they deserve. Home care is a critical pillar of our health-care system. We are the ones keeping our seniors at home, where more than 90 per cent of them want to stay. We need to make changes to attract new nurses and PSWs as well as keep those already working in the sector so that this most recent health human resources crisis does not collapse the whole system.
We have all seen the results of decades of neglect in the longterm-care sector. We can’t allow the same thing to happen in home care.