Worries about home care and support services in Quebec

Quebec’s Health Commissioner says the home care and support services situation in the province is “worrying.”

“The home support system […] is no longer able to adequately meet the current needs of the population,” Joanne Castonguay said at a press conference on Tuesday. “Furthermore, it seems ill-equipped to face future demands.”

She presented the fourth and final volume of the Aging Well at Home series which was aimed at evaluating the performance of Quebec home care and support services.

“The projections for 2040 in this report are alarming. One observation is clear: our current model does not hold up,” she said.

This report offers strategic directions to improve home support, as well as 16 recommendations aimed at optimizing care and services and improving the working conditions of professionals.

According to Castonguay, some of these recommendations can be implemented now.

She emphasizes in her report that the cause of the problem is “not due to health professionals who are competent and committed, the difficulties come more from governance and the organization of work.”

“Faced with these findings, one thing is clear: a transformation is necessary,” declared Castonguay.

She recommends that the Ministry of Health develop a policy aimed at maintaining the autonomy of seniors, stating that “aging is not a disease.”

Modest expenses

With less than five per cent of health spending reserved for home support, Quebec has some of the lowest financial resources.

“Prioritizing home support would be a rational choice in terms of public financing of long-term care, due to the considerable costs of accommodation,” explained the commissioner.

For example, the average annual cost for a person receiving home support services was estimated at $13,900 in 2023. This will vary from $67,400 to $96,800 for a person in accommodation.

To cover these expenses, Castonguay suggests that the government should create a financing plan for the services. She also recommends imposing a financial contribution from home help users according to their means.

This patient contribution would be financed by public services and would only apply to domestic help and personal assistance.

This would not be applied for medical, nursing and professional services as well as post-hospital services and palliative services.

Increasing needs

“The current system is currently unsustainable. It faces a growing imbalance between the supply of home services and needs,” says Castonguay.

The number of people requiring long-term services will only increase in the coming years.

By 2040, it will be necessary to recruit 13,700 new nurses and 45,600 full-time workers in assisted care and support services to meet the needs, according to the report’s estimates.

In addition, she suggests that the Ministry of Health develop a strategy for attracting and retaining staff working in the home support sector.

Quebec will have to pay $8.9 billion more per year in 2040 for long-term care and services, for a total of $16.5 billion, and Castonguay urges the ministry to start planning for long-term car and services.

Support the regions

“Many Quebecers are unaware of home support programs because the information is hard to find, and people struggle to find their way around it,” she explained.

She suggests the creation of regional home support offices acting as entry points to home support and that one of these offices be intended for the Indigenous people.

Castonguay proposes that the government adjust the process for claiming the tax credit for home support for a senior, in order to make it fair, regardless of the person’s living environment.

Finally, she recommends that the government improve the financial support provided to caregivers by improving the eligibility conditions and the amount of tax credits intended for them.

–This report by La Presse Canadienne was translated by CityNews