Long Distance Caregiver
How to Care: Home Care
A group of services that help people receive care at home when they
are ill, disabled, recovering from illness or surgery, or dying.
care, home care, home support, palliative care, respite care, supportive
care, telehealth, tele-home care
Home care is a group of services that allows people with health problems
to live as well and as independently as possible, in their own homes
and communities. Home care designed to give caregivers a break is
called respite care. Palliative care offers nursing care, home support
and/or respite for people with a terminal illness and their families.
The care provided at home can come from a number of sources
family members, friends, neighbours, community volunteers, health
professionals, paid care workers, government-run and volunteer-run
community health and social services agencies and private care agencies.
A new and growing source of home care is tele-home care or telehealth,
which uses information and communication technologies to deliver
patient care at home.
Most home care services are publicly funded but a growing proportion
is paid for by private insurance plans, charitable organizations
and by individuals out of their own pockets. Patients and families
also bear the indirect costs of lost employment opportunities, lost
wages, unpaid family labour as well as the psychological, social,
physical and economic burdens.
Successful home care:
- delays or eliminates the need for care in a hospital or long-term
- provides preventive medicine
- assists in relieving caregiver stress
- encourages a high degree of participation by the person receiving
- depends on an informal network of family and friend caregivers
Types of Home Care Services
Professional Nursing and Therapeutic Services
Clinical or specific care provided by registered health care professionals
- nursing care
- occupational therapy
- speech therapy
- social work
- nutrition counselling
Personal Care Services
- intravenous antibiotic therapy
- home chemotherapy
- life support systems
- ventilator assistance
- tube feeding
One-on-one care provided by family members, home care workers, community volunteers
- assistance with activities of daily living
- assistance with personal hygiene
A wide range of homemaking and personal support services provided by family members, friends, neighbours, government
agencies, community agencies and organizations, private agencies and individuals.
- companionship services
- volunteer visiting
- meal programs delivered to the home
- community dining
- home maintenance
- respite care
- in-home respite including overnight care
- adult day programs care away from home during working hours
- institutional respite the ill person stays for a weekend, a week or longer
- Palliative care: home care for someone with a progressive, life-threatening illness
Care in Canada
demand for home care has skyrocketed, now that health care has moved
from the hospital back into the home.
- Seniors the main recipients of home care are living
longer with chronic illnesses, disabilities and dementia. The
current trend is for seniors to receive care at home instead of
being placed in long-term care or chronic care institutions.
- More and more people are receiving at home the kinds of care
that used to be provided in hospitals.
- acute care for acute illness and recovery from surgery
- chronic care for chronic physical illness and functional disabilities
- outpatient services physiotherapy, occupational therapy, counselling
- palliative care for the terminally ill and dying
- specialized medical services chemotherapy, antibiotic intravenous therapy
- technology-dependent care home oxygen therapy, dialysis, respiratory therapy
a result of governments' health and social services restructuring
which has resulted in fewer hospital beds, shorter hospital stays,
outpatient surgery and care as well as the release of chronically
and mentally ill people into the community.
Finding good home care is a challenge.
- Families that traditionally provided care and assistance with
the activities of daily living are now expected to provide a more
sophisticated level of care and manage the various care services
provided at home to family members.
- Extra caregiving demands are being placed on families at a time
when fewer women the traditional family caregivers
are at home full-time to provide care.
- Long-distance caregiving has become more prevalent now that
family members live at greater distances from each other.
- There is no uniformity of service
Home care is not covered under the Canada Health Act. Home care
in Canada is a patchwork quilt of programs and services managed
by provincial and territorial governments and delivered by local,
regional and municipal authorities. Each has its own definition
of home care, its own menu of home care services, its own set
of eligibility criteria and its own built-in time limits and/or
funding limits for the provision of services.
- The quality of care varies widely
There are no national standards for home care. Professional services
delivered by doctors, nurses and other health care professionals
are covered under the Canada Health Act and these professionals
are governed by their regulatory bodies. However, personal care
services which used to be supplied by trained nurses, are now
handled by a variety of home care aides, attendants and home support
workers who may have little or no formal training in health or
home care work. Also, imposed time restraints can prevent care
workers from fully attending to their clients' needs.
- Good help is hard to keep
Many home care workers earn little more than minimum wage, work
irregular hours, often under difficult conditions and do not qualify
for benefits. Yet they are being asked to perform increasingly
complex tasks. Many workers leave home care for more lucrative
employment in hospitals and long-term care institutions.
"Home care is underfunded, undervalued
and overstressed." Putting A Face on Home Care, CARP's Report on Home Care in Canada, 1999)