There is no question that British Columbia’s healthcare system is creaking under the weight of population growth, demographic pressures, and both federal and provincial government balance sheet constraints. These pressures are replicated across many countries like Australia, the UK, and New Zealand. There is no place where this is felt more acutely than in the home care sector. Traditionally, this was the sole domain of Health Authorities. In decades past, services like personal care (washing, bathing, dressing), as well as homemaking (light cleaning) and meal preparation, were guaranteed for those who needed them. Sadly, this is no longer the case. Below is an occupational therapy perspective on home care in Kelowna and BC.
Reduced Service Scope
For years, Health Authorities have quietly reduced the scope of home support services. This is a product of increased demand for services not being matched by proportionally increased funding, and the difficulty of finding qualified staff. Services are essentially rationed; clients are provided 2-3 hour possible service windows, limited-service time, and canceled care due to staffing shortages is common. Additionally, the actual care aide can be different each visit. As you can imagine, having a stranger shower you each day can be disconcerting. Of note, home support (non-nursing) services are limited to personal care help.
Accessing Services
Health Authority Services can be accessed by contacting a community health center and making a self-referral, a physician referral, or a referral from another Health Authority clinician. In Kelowna, this is Home and Community Care at 250-469-7070.
Assessment of Eligibility
Once a referral is made, typically, a community nurse will complete a needs assessment that looks at how a person functions. These are broadly called activities of daily living. They will also consider the client's cognitive status and general mobility (risk of falls). Once eligible, a person is then either scheduled for care or put on a waitlist.
Health Authority Home Support Costs
Costs are calculated as part of an eligibility assessment. Read more here.
Other Care Options
Given the limited nature of publicly subsidized care, many people turn to private care providers to either supplement Health Authority care or provide complete services. This can come with its own set of challenges, and there are a few things to consider when taking this step:
Is the private care provider a reputable actor in the industry? Do they hire trained care staff? Do they pay them fair wages? Do they complete criminal record checks?
Will you have a consistent care aide each visit?
Is there a clear method of communication with the care coordinator and a clear care plan?
For reference, private care rates range from $35-55 per hour.
New Options
Interestingly, there are new online platforms designed to connect caregivers with people requiring services. One local BC company, Gravitii Care, offers a great platform for doing just this.
Keys to Remember
Advocate strongly for your needs. Unfortunately, this means following up regularly and being armed with information around needs and entitlements.
Ask for a care plan and ensure this meets your needs.
Regularly follow up with your care manager and report any issues as they emerge.
Other Considerations
Is the home environment set up for safe functioning? See associated blog.
In addition to home care, do you or your loved one need home safety equipment or a mobility aid?
Do you or your loved one need a regular at-home rehabilitation program aimed at maintaining and improving functioning? This can be great for maintaining safety and independence.
Do you need help arranging and monitoring care? Consider hiring an Occupational Therapist to provide case management support.
If we can help at all, please reach out.
Comments