The model of home care and support services in Quebec must be reviewed. This is the observation of the Commissioner for Health and Well-being, Joanne Castonguay, who considers the situation “worrying”.
“The home support system […] no longer manages to adequately meet the current needs of the population. Moreover, it seems ill-equipped to deal with future demands,” said Mr.me Castonguay during a press conference Tuesday morning.
The commissioner presented on Tuesday the fourth and final volume of the Aging Well at Home series, 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,” we can read in its most recent report.
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. Some of these recommendations can be implemented now, says the commissioner.
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 Mr.me Castonguay. She first recommends that the Ministry of Health develop a policy aimed at maintaining the autonomy of seniors. “Aging is not a disease,” she says, adding that we need to rethink how we perceive aging.
Modest expenses
With less than 5% of health spending reserved for home support, Quebec is among the Canadian provinces with 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,” notes the commissioner.
For example, the average annual cost for a person receiving home support services is estimated at $13,900 in 2023. This cost varies from $67,400 to $96,800 for a person in accommodation.
To cover the expenses of home help, the commissioner suggests that the government define a financing plan for services. It also recommends imposing a financial contribution from home help users according to their means.
This patient contribution would only apply to domestic help and personal assistance. This contribution would not be applied for medical, nursing and professional services as well as post-hospital services and palliative services.
The needs are increasing
“The current system is currently unsustainable. It faces a growing imbalance between the supply of home services and needs,” says M.me Castonguay. And the number of people requiring long-term services will continue to increase in the coming years.
By 2040, it will be necessary to recruit 13,700 new nurses and 45,600 full-time assisted care and support services workers to meet the needs of users, according to the report’s estimates.
The commissioner therefore suggests that the Ministry of Health develop a strategy for attracting and retaining staff working in the home support sector.
Quebec will also have to pay $8.9 billion more per year in 2040 for long-term care and services, for a total of $16.5 billion. Mme Castonguay therefore recommends that the ministry begin strategic planning for long-term care and services based on reliable forecasts.
Support the regions
To this day, many Quebecers are unaware of home support programs. This is because information is difficult to obtain, and users struggle to find their way around it, underlines the commissioner.
She therefore suggests the creation of regional home support offices acting as entry points to home support, including one intended for the indigenous population. These offices should be set up now, she believes.
The commissioner also proposes that the government adjust the process for claiming the tax credit for home support for a senior, in order to make it uniform, regardless of the person’s living environment. Finally, she suggests that the government improve the financial support provided to caregivers by improving the eligibility conditions and the amount of tax credits intended for them.