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Citizen Watch Continuing Care in Alberta and the Seniors' Action and Liaison Team www.continuingcarewatch.com
September 1, 2008 Subject: MLA Bulletin 3, The Senate Report on Aging and Home Care Issues Our last Bulletin was on the subject of home care, and provided some background to the Alberta program and some conclusions from Donna Wilson's recent study of publicly funded home care services for seniors in Alberta. In March of this year, the Senate Special Committee on Aging released its Interim Report on "Issues and Options for an Aging Population". This second report focused on key public policy issues, including the challenges faced by seniors who experience income insecurity, social exclusion and isolation, ill health and loss of independence. This is particularly timely for Albertans, as the Government is currently working on a follow-up to the 2002 framework for the aging population. Fundamental issues of the aging population and seniors' care and services are concerns for seniors, their families and communities, across Canada. It is heartening to know that the Senate is giving these matters some serious study and thought. We'd like to bring some of the Committee's "Proposed Options" concerning home care, respite care, and palliative care to your attention. Although the Senate Committee is, of course, concerned primarily about programs within federal jurisdiction, there are issues and proposals (including coordination of standards and funding responsibility) which could be cost-shared with provincial and territorial governments. The final phase of the Senate Committee's work will be further expert witness testimony and public hearings over the next year in order to develop their final recommendations. The reports, the testimony of the expert witnesses and the Committee Proceedings are available from the website of the Senate Special Committee on Aging, at http://www.parl.gc.ca/common/committee_Senhome.asp?Language=E&parl=39&S es=2&comm_id=600 We look forward to your questions and views. If you'd like to provide a response for posting on the website in the MLA Bulletin section, please let us know. Sincerely, Carol Wodak On behalf of Citizen Watch and SALT
(780)417-1705; cwodak@techwcs.com
MLA Bulletin 3, Summer 2008
from Citizen Watch on Continuing Care and SALT
The Senate Report on Issues and Options for an Aging Population* and Home Care Issues www.continuingcarewatch.com
Among the 84 Proposed Options which conclude this second report on the aging population are several which parallel concerns about Alberta's home care program. National Home Care Program (page 39, option #60) "The Canada Health Act makes reference to home care under its definition of extended health care services. Since the 2004 First Ministers' Accord on Health Care Renewal, however, short-term home care has been recognized as a part of the acute care system. Some have suggested that this focus on acute care home care has had the unintended negative consequence of reducing the availability of longerterm care." A National Home Care Program would be similar to other initiatives with national policy co-ordination and federal funding to support delivery of programs in provincial and territorial jurisdiction. 1 Among the evidence presented to the Committee was the need for a system of integrated care to target the diverse range of health and social care needs of frail seniors, incorporating both professional and supportive services, which would enable a large group of seniors to remain safely in their own homes. Other witness spoke about the deterioration in health status which results when home care services are delayed or inadequate. The Veterans Independence Program (page 43, option #70) VIP is a very successful home care program established in 1981 by Veterans Affairs Canada to help eligible veterans remain in their own homes or communities. 2 The program provides housekeeping and maintenance assistance, transportation costs, home adaptations, access to other health and support services, and family caregiver supports which complement existing services, enabling more seniors to stay well and independent as long as possible. National Respite Care program (page 41, option #64) In its discussion of home care, the Committee noted that informal caregivers provide about 80% of all home care to seniors living in the community. "Being a caregiver presents physical, mental, emotional,
Proceedings of the Special Senate Committee on Aging Dec 10 2007 http://www.parl.gc.ca/39/2/parlbus/commbus/senate/Com-e/agei-e/02evbe.htm?Language=E&Parl=39&Ses=2&comm_id=600 2 Veterans Independence Program, Veterans Affairs Canada, http://www.vacacc.gc.ca/clients/sub.cfm?source=services/vip
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and financial challenges to caregivers, particularly for those who balance caregiving and paid employment." Financial support, better information and resources for informal caregivers, and a National Respite Care program, to help caregivers get the physical and emotional rest they need to provide care, were among the recommendations to support these caregivers. National Policy Initiative for Integrated Care (page 42 , option #68) Throughout the Committee discussions and the expert testimony, there was concern about the need for integration and coordination of the wide range of services needed by frail and chronically ill persons. Much like other initiatives to coordinate and provide additional funding for specific health care goals, the proposal is for a federal funding initiative to provide easier access to needed services to maintain independent living, and portability between provinces. 3 Drs. Rockwood, MacKnight and Martell spoke eloquently on a similar theme: the need for comprehensive health care services, with service delivery planning which considers all the needs of those with multiple and complex health needs. Hospice Palliative and End-of-Life Care (page 32, option #42) "There are many disparities in the delivery of palliative care across Canada, and it is estimated that only 25% of Canadians requiring hospice palliative and end-of-life care services are able to access these services. Considerable evidence exists that older people suffer unnecessarily due to widespread under-assessment and undertreatment of their problems as well as lack of access to hospice palliative care." The Senate Committee heard evidence of a need for increased training, education and implementation of the national norms of practice for hospice palliative care in all settings of care, palliative care standards in all accredited health settings, 4 and training and incentives for geriatric and palliative care physicians and other health care professionals 5 . Prepared by Carol Wodak for Citizen Watch and SALT, June 2008
Proceedings of the Special Senate Committee on Aging Dec 10 2007 http://www.parl.gc.ca/39/2/parlbus/commbus/senate/Com-e/agei-e/02evbe.htm?Language=E&Parl=39&Ses=2&comm_id=600 and April 7 2008 http://www.parl.gc.ca/39/2/parlbus/commbus/senate/Com-e/agei-e/05evbe.htm?Language=E&Parl=39&Ses=2&comm_id=600
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Proceedings of the Special Senate Committee on Aging April 7 2008 http://www.parl.gc.ca/39/2/parlbus/commbus/senate/Com-e/agei-e/05evbe.htm?Language=E&Parl=39&Ses=2&comm_id=600 5 Proceedings of the Special Senate Committee on Aging, May 12, 2008 http://www.parl.gc.ca/39/2/parlbus/commbus/senate/Com-e/agei-e/45394e.htm?Language=E&Parl=39&Ses=2&comm_id=600
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MLA Bulletin 3, Senate Report Issues and Options for an Aging Population Page 2