What the world can teach us about home care

Image: What the world can teach us about home care

Spectrum's CEO Sandra Ketchen on what we can learn from countries all over the world about home care solutions.

According to the report titled “Enabling the Future of Long-Term Care in Canada”, over 430,000 adult Canadians were recently estimated to have unmet home care needs with 40,000 of them on wait lists for nursing homes.

In a recent report issued by the Canadian Institute for Health Information, one in nine newly admitted residents of long-term care facilities could have remained at home with proper supports.

It’s a fact that our population is aging faster than we can build facilities. But why build them at all? What if we could provide quality care in people’s homes, where many Canadians want to age? And what if we could do this at reduced costs to Canadian taxpayers?

Countries around the world have successfully piloted and implemented home care-first strategies as a solution to long term care challenges. Think about what we can learn from these examples:

Three decades ago Denmark adopted a home-care first approach, shifting its investment from nursing homes to home care, leading to a 12% reduction in overall long-term care spending. By adopting a home-care first approach Denmark was able to avoid building any new nursing homes for close to 20 years. Today the country spends only 36% of its long-term care funding on care in facilities, while spending 64% on home and community-based care. This is opposite the OECD average where countries spend 65% of long-term care funding on care in facility settings like nursing homes and only 35% on home and community-based care.

Canada doesn’t even hit the OECD home care average though, spending 87% of its long-term care dollars on facility care and only 13% on home and community-based care.

England piloted a similar program with successful results – the Community Matron system was established in 2004. Skilled nurses conduct regular home visits and use case management techniques focused on individuals with complex needs. This approach led not only to a more positive patient experience but delivered cost savings resulting from a 41% reduction in emergency hospital admissions.

In 2006, the Netherlands implemented a Buurtzorg nurse-led home care model which has grown to provide home-based care for over 90,000 clients. In this model nurses lead teams of medical support staff in local catchment areas. They conduct qualified initial assessments and then transition patients to ongoing support that helps individuals develop independence in their homes and stay connected with other services in the community.

These home-first institutional frameworks have demonstrated that high-quality care can be provided in homes at a reduced cost to governments and taxpayers. In addition, we know that 83% of seniors want to age at home as long as possible with the right support. With demand continuing to surge as our population ages, the time is now to prioritize investments in caring for our elderly loved ones in their own home, wherever that may be.