Our government has a key role to play in adapting policies and programs to support the needs of today’s growing seniors population.
Older adult care is an increasingly pressing issue and one that our country can no longer afford to ignore. In 2012, almost one in seven Canadians was a senior. But, by 2030, that number will jump to nearly one in four. Seniors are the fastest growing segment of the population, but gaps in Canada’s health and social policies are putting barriers in the way of their independence and their role in maintaining vibrant, healthy communities and economies.
Together with our national board, the Federal Retirees team has developed its advocacy position on long-term and home care. One of Federal Retirees’ key advocacy priorities is the implementation of a national seniors strategy. In its vision for a national seniors strategy, Federal Retirees advocates for quality and equitable health-care services for all older Canadians, and for policy, programs and services that will allow older adults to age with dignity, in the place of their choosing.
As you read through updates and articles from Federal Retirees, health organizations and other news sources, you may be seeing some new phrases and expressions. Let’s break down some of these key terms and, along the way, learn more about the current state of older adult care and Federal Retirees’ vision for the future.
Integrated continuum of care
The continuum of care refers to a comprehensive and coordinated system of care that guides and tracks patients over time through a wide range of health services. For patients with diseases, this covers all phases of illness from diagnosis to end-of-life care.
An integrated continuum of care emphasizes coordination and collaboration across health-care services resulting in a system that prioritizes patients.
One of the common criticisms of our current health-care system is its focus on episodic care, treating patients for conditions and ailments as they arise without building relationships between patients and providers or caring for the continuity of a patient’s care as they transition between services. An integrated continuum of care offers continuity by bringing together the various parts of the health-care system – hospitals, doctor’s offices, group practices, community agencies, private sector organizations, public health departments and others. This approach allows for better coordination of services, better collaboration among providers and, ultimately, better health care for Canadians.
Our country’s health-care system is complex and often difficult for patients, their families, and friends to navigate. Facilitating collaboration between service providers and integrating the continuum of care – or the span of health services that an individual will need in their lifetime – allows for seamless, patient-centred care.
Importantly, by connecting health-care providers to public health and related government agencies, the integrated continuum of care model enables the system to address the social factors that contribute to health outcomes – called the social determinants of health – to help improve and prevent poor health outcomes.
Social determinants of health
Social determinants of health are the social and economic factors that influence a person’s health. It may sound simple enough, but the implications for health care are complex and far-reaching. The conditions in which a person is born, grows, lives, works and ages all impact their health, both positively and negatively.
Some examples of social determinants of health are: income and income distribution, education, unemployment and job security, employment and working conditions, early childhood development, food insecurity, housing, social inclusion or exclusion, access to social supports, access to health services, aboriginal status, gender, race, disability and language spoken.
Not all Canadians have the same opportunities to be healthy. Research shows that social and economic factors play a huge role in our ability to lead a healthy life.
Social determinants of health have a major impact on health outcomes, especially for vulnerable populations. Research indicates that medical care accounts for only 10 to 20 per cent of the modifiable factors that contribute to health outcomes. The remaining 80 to 90 percent of a person’s health outcomes are driven by social determinants of health. This means that significantly reducing and preventing poor health outcomes will only be achieved by addressing the social determinants of health that negatively impact health.
Long-term care
Long-term care is a term we’re hearing a lot lately. In essence, long-term care involves a variety of services designed to meet a person’s health and personal care needs when they can no longer live independently due to a serious, ongoing health condition or disability.
Long-term care facilities provide living accommodation, care and services for individuals who require 24/7 supervised care, including professional health services, personal care and other services such as meals, housekeeping and laundry.
Long-term care services are not publicly insured through the Canada Health Act like hospital and physician services. Long-term care and the facilities that provide this care are governed provincially and territorially, so a different range of services and costs are covered across the country. This has resulted in troubling inconsistencies across Canada.
The way Canada’s long-term care system is currently organized has resulted in troubling inconsistencies across the country and even within the same province or territory.
The name used to refer to these facilities is also inconsistent. Common names include long-term care home, nursing home, personal care facility, residential continuing care facility, residential and long-term care centre and CHSLD.
Home and community care
Home and community care services help people receive care at home or in a community setting, instead of in a hospital or long-term care facility. This allows individuals to continue living at home and enables them to live as actively and independently as possible within their community.
Home and community care services allow Canadians to receive care in their homes or communities and these services cost less than long-term and hospital care.
Home and community care services can include nursing, physiotherapy, occupational therapy, social work, dietitian services, homemaking services, and personal care to assist with bathing, dressing and feeding. They can also include respite services, to provide caregivers with a break from demanding caregiving duties. Home and community care services are delivered by regulated health-care professionals such as nurses, non-regulated workers, volunteers as well as friend and family caregivers – also called informal caregivers.
If you’re wondering how these services are financed, you’re not alone. Home and community care services are not publicly insured through the Canada Health Act like hospital and physician services. Home and community care is delivered by provincial, territorial and municipal governments, so a different range of services and costs are covered across the country. This has resulted in inconsistencies across Canada – and sometimes even across the same province or territory!
Some funding for these services is provided by the federal government through health and social services transfer payments. The federal government is also responsible for providing home care to select populations – like members of the Canadian Armed Forces and RCMP, eligible veterans, and First Nations on-reserve and Inuit in designated communities.
Home and community care services are vital in helping people return to or continue living at home, remain as independent as possible, and improve or maintain their health status and quality of life. For caregivers and families, these services help in providing care, support and breaks when needed.
Overall, home and community care is less costly than long-term and hospital care, aligns with the wishes of older Canadians to remain at home, and leads to better health outcomes and quality of life.