Who Needs Home Care and What Is It?

by Audrey Miller on April 18, 2012

in Elder Care, Home Care

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April 18, 2012: Allaboutestates blog:
We may all need it, at some time or another. The Health Council of Canada (2012) has recently published: Seniors in need, caregivers in distress: What are the home care priorities for seniors in Canada?
It is an excellent paper that explores the growing issue of home care in Canada. The report takes a deeper look at the seniors who are receiving home care, the family caregivers that are lending support, as well as the challenges of home care in Canada. The government has heard this before so let’s hope that these findings do not fall on deaf ears.

The Health Council of Canada reports the following:
“Home care has many faces. It is used to provide care after hospitalization or when someone is dying, to help vulnerable seniors stay in their homes independently, and to manage chronic conditions, disabilities, and mental illness. Home care programs are also linked with community support services such as food delivery, house cleaning, and transportation, which are often provided to the client at additional cost.
The Canadian Home Care Association defines home care as “an array of services for people of all ages, provided in the home and community setting, that encompasses health promotion and teaching, curative intervention, end-of-life care, rehabilitation, support and maintenance, social adaptation and integration, and support for the informal (family) caregiver.” Home care, defined as an “extended health service,” is not an insured health service under the Canada Health Act. Each province and territory administers its own publicly funded home care programs and services, but these vary in terms of levels of coverage, eligibility criteria, and funding schemes.”
The report kindly includes a list of terms and definitions; given the importance of understanding the subject matter, it is reprinted below. My next blog will review some of the report’s key findings. Terms used in the report and generally agreed upon, include:
Home care – publicly funded and administered services received in the home.
Senior – a person age 65 and older.
Client or care recipient – the person who is receiving home care services.
Caregiver – family members, friends, or others who are providing unpaid care.
Provider – any paid professional or worker who provides home care services.
Personal support worker (PSW) – an unregulated worker who provides support for personal care, such as bathing, toileting, and homemaking functions. Personal support workers are employed in home care, long-term care, and hospital settings. This role is known by different names, such as home support worker or health care aide.
Long-term care – care received in an institution such as a nursing home.
Continuing care – a general term used to encompass home care, assisted living, and long-term care facilities where the sectors are not clearly separated, but seen as part of a continuum.
Assisted living – a type of residential living that provides supportive services, such as housekeeping, communal dining, and in some cases personal care assistance to seniors who require some help with daily living.
Community supports (or community support services) – services provided in or through the community, such as transportation, shopping, house cleaning, and yard maintenance.
Vulnerable senior – someone who has some challenges with independent living due to health limitations and who may be at risk for further disability or complications. The word “frail” senior is often used to describe this population, but frailty is considered a pre-disability state. As many seniors receiving home care services already have disabilities, in our report we will refer to this group as “vulnerable.”
Alternate Level of Care (ALC) patients – people who no longer need acute care, but who still require a lower level of care as they cannot manage independently. These patients must remain in hospital while waiting for space to become available in another facility (such as a rehabilitation hospital or long-term care facility), or for home care supports to be put in place.
IADL – instrumental activities of daily living, such as cleaning, cooking, grocery shopping, and home maintenance.
ADL – activities of daily living, such as bathing, eating, and toileting.
Note: Abellan Van Kan, G., Rolland, Y., Bergman, H., Morley, J.E., Kritchevsky, S.B. & Vellas, B. (2008). The I.A.N.A. task force on frailty assessment of older people in clinical practice. The Journal of Nutrition, Health and Aging, 12(1), 29-37.
Until next time.- Audrey Miller

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