Ask the question around you: when they consider their old age, do people see themselves spending the last years of their life in a CHSLD, or do they rather dream of ending their days “at home”?
The vast majority (83%) choose the second option, as revealed by a Léger survey in 2021. Provided, of course, that they have access to adequate care.
However, in Quebec, home care does not meet the needs.
This is what emerges from the most recent report of the Commissioner for Health and Welfare (CSBE), which offers a quantitative analysis of the performance of home support services.
“The level of resources granted for home care services (SAD) in Quebec would be among the lowest in Canada”, can we read in the report by Commissioner Joanne Castonguay, which specifies that “Quebec stands out unfavorably in the alignment with the needs of users and caregivers. »
Not surprising when you know that along with Ontario, Alberta and New Brunswick, Quebec is the province where spending on home care and community services was the lowest per capita in 2021-2022. These expenditures have gone from 4% of all health expenditures in 2003 to 4.8% in 2021-2022. It’s so little.
Result: “only a minority of SAD users benefit from a satisfactory rate of response to their needs,” reads the report. It’s serious.
And this time, we can’t blame the pandemic: accessibility to home care services was already an issue before the pandemic. The situation deteriorated thereafter.
This seems to be a truth from La Palice, but the commissioner notes that the best results are obtained when the organization of care is thought out according to the objective of maintaining people at home. An objective which, it should be remembered, was the cornerstone of the policy of the Ministry of Health in… 2003. “At home, the first choice”, they said at the time. Twenty years later, this is still not the case.
This situation is all the more difficult to conceive since the Quebec population is among the most aging on the planet. However, its health system seems unable to listen to its beneficiaries. As if, in Quebec, we blocked our ears when the old people spoke and expressed their needs.
Unsurprisingly, the weakness of our home care system has an impact on the possibility of ending one’s life at home. Once again, the figures speak for themselves: only 17% of Quebecers have had the privilege of breathing their last breath between the reassuring walls of their house or apartment. In general, in the last months of life, there are more trips back and forth between home and hospital. A situation that could be avoided, according to the commissioner, if the needs of home care recipients were adequately met.
The DD Geneviève Dechêne, a pioneer in home care in Quebec, told us well during an interview last February: the Quebec health care system is too centered on the hospital and our doctors are “hospitalists”.
The shortcomings of our home care are not new and the DD Dechêne is not the only one to denounce the situation. Think of the Dr Réjean Hébert who has already proposed “autonomy insurance”. Think of the Institut du Québec which, under the pen of the former journalist Alain Dubuc, tabled a report in 2021 entitled “Home care: the status quo will no longer be possible”. Finally, let us think of the FADOQ, an organization that represents more than half a million Quebecers over the age of 50, which is campaigning for a serious overhaul in home care. It feels like all these voices are talking in a vacuum.
Commissioner Castonguay must table her recommendations in six months, next December. Until then, why not listen to the first people concerned, the elders? They don’t ask for the moon. They just want to end their days in dignity… at home. Not in a seniors’ home or a CHSLD.
Is it too much to ask?