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Issues and Opportunities in Home and Community Care

In 2020-2021, more than 700,000 Ontarians were served by community support services.(1) With the substantial baby boomer generation now aging into their mid-70’s, it is anticipated that the demand for home care will increase by over 50% in the next 10 years, with estimates suggesting close to 1.8 million Canadians will be seeking home care in 2031.(2) 


Following are evidence-based sources that describe some of the current issues and opportunities in the Home and Community Care (HCC) sector, as it approaches this surge in demand.

Key Issues

HR Capacity

Increased demand for services will require additional staff to deliver and manage those services. 


Currently, organizations in the HCC sector say they are at a disadvantage when competing with higher pay rates in other areas of the healthcare system, and report that current staff are facing burnout following the COVID-19 pandemic.(3)

Research 

It is reported that a lack of research makes it challenging for policy makers, service providers, and front-line workers to make the informed decisions that help equip the sector to perform optimally.(4) 


More sector-specific studies would help to find effective, efficient solutions to the increasing need for care,(5) while helping the sector and stakeholders better understand HCC and address challenges and gaps.

Funding

At present, Canadians over the age of 65 represent less than 20% of the population, but account for more than 40% of public-sector healthcare spending.(6) As boomers move into their senior years, they’ll represent a greater percentage of the population, causing these costs to grow. 


For the year 2019, just under $30 billion was spent on home and long-term care. Reports indicate that, with population change, $58.5 billion will be needed annually to meet the demand from 2021-2031.(2)

Opportunities

Technology

The sector reports that advances in communications are making it more accessible for family caregivers to coordinate care and receive training and support.(7) 


Researchers believe tools, such as interRAI, could make it easier for hospitals, primary care providers, specialists, and caregivers to efficiently share information and coordinate care, particularly for patients with complex needs.(8)

Care Equity

A systems-based approach to sharing medical information can help to coordinate care and ensure that patients receive the supports they need, according to researchers.(8) 


They predict this will not only help prevent older patients from prematurely moving into long-term care,(9) but will also better improve access to care for patients experiencing added barriers, such as income, race, or location.(10)

Increased Use of HCC

A study estimates that around 1 in 10 Canadians entering into long-term care in 2020-2021 likely could have had their immediate needs met through HCC.(11) 


A recent survey indicates nearly all older Canadians want to age at home,(12) which researchers say can improve quality of life.(13) HCC supports could help Canadians age in their homes as long as possible, which researchers estimate could save over $2 billion a year.(2)

References


  1. Home and Community Care Support Services. Consolidated Local Health Integration Network Annual Report 2020/21. Ontario: Home and Community Care Support Services; 2021. 86 p. Report No. 7. Accessed January 18, 2023. https://healthcareathome.ca/document/2020-21-consolidated-lhin-annual-report/
  2. Deloitte. Canada’s Elder Care Crisis: Addressing the doubling demand. Canadian Medical Association; 2021. Accessed January 18, 2023. https://www.cma.ca/sites/default/files/pdf/health-advocacy/activity/CMA-LTC-Deloitte-Report-EN.pdf
  3. Evans C, Waddell K, Lavis JN. Rapid Synthesis: Examining Intersections Between Ontario Health Teams and Home and Community Care. McMaster Health Forum; 2022. Accessed January 18, 2023. https://www.mcmasterforum.org/docs/default-source/product-documents/rapid-responses/examining-intersections-between-ontario-health-teams-and-home-and-community-care.pdf?sfvrsn=7a2e9d07_5
  4. Decade of Healthy Ageing: Plan of Action. World Health Organization; 2020. 26 p. Accessed January 18, 2023. https://www.who.int/publications/m/item/decade-of-healthy-ageing-plan-of-action
  5. Government of Canada. Importance of Science and Research. Government of Canada; Updated December 8, 2011. Accessed January 18, 2023. https://www.canada.ca/en/health-canada/services/science-research/about-science-research/importance-science-research.html
  6. Canadian Institute for Health Information. National Health Expenditure Trends, 2021 — Snapshot. Canadian Institute for Health Information; 2023. Accessed January 18, 2023. https://www.cihi.ca/en/national-health-expenditure-trends-2021-snapshot
  7. Lindeman DA, Kim KK, Gladstone C, Apesoa-Varano EC. Technology and Caregiving: Emerging Interventions and Directions for Research. The Gerontologist. 2020; 60(Supplement_1):S41–S49.  https://doi.org/10.1093/geront/gnz178
  8. What Have We Learned About CSS Clients? ‘Not Just Tea and Cookies’ with John P. Hirdes. Virtual Community Connect, OCSA Speaker Series. October 20, 2022. https://www.youtube.com/watch?v=WgYb1uDHn6Q 
  9. Iciaszczyk N, Arulnamby A, Brydges M, et al. Ageing in the Right Place: Supporting Older Canadians to Live Where They Want. National Institute on Ageing; 2022. Accessed January 18, 2023. https://www.nia-ryerson.ca/airp
  10. Exploring the Opportunities for Home Support. AGE-WELL National Innovation Hub APPTA Inc.; 2019. Accessed January 18, 2023. https://agewell-nih-appta.ca/wp-content/uploads/2020/01/Policy-Innovation-Lab-Report-APPTA-Hub-2.pdf
  11. Canadian Institute for Health Information. 1 in 9 new long-term care residents potentially could have been cared for at home [story]. Canadian Institute for Health Information; August 6, 2020. Accessed January 18, 2023. https://www.cihi.ca/en/1-in-9-new-long-term-care-residents-potentially-could-have-been-cared-for-at-home
  12. National Institute on Ageing. Pandemic Perspectives on Long-Term Care: Insights from Canadians in Light of COVID-19. Canadian Medical Association; 2021. Accessed January 19, 2023.https://static1.squarespace.com/static/5c2fa7b03917eed9b5a436d8/t/60428c8d3c118d6237a6ac11/1614974093703/English+NIA+CMA+Report.pdf 
  13. Giosa J, Saari M, Holyoke P, Hirdes J, Heckman G. Long-term LIFE care at home: the future of aging-focused care in Canada. The SE Research Centre; 2021. Accessed January 18, 2023. https://research.sehc.com/SEHCResearch/media/Research_Centre/pdfs/2021_06_02-MCD-417-ROTR_LTC@Home.pdf
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