Of course I can’t take the pandemic anymore, but you have to keep a global vision of health, and I’m talking about home support here. I can no longer hear all the political parties, without exception, that have exercised power in Quebec for thirty years talking about home care. We add a few million dollars a year and we make ourselves believe that we will solve the problem with a little money. The Clair Commission had nevertheless indicated and documented the fact that Quebec society was going to experience rapid aging, but no government took this into account.
Here are some thoughts forged from my 82 years of life and my experience as CLSC director for 16 years.
1. Instead of the term “maintenance at home”, I would prefer “assistance program to enable the elderly to remain at home”.
2. I ask that the Quebec State clearly state its position on the plan to help the elderly to remain in their living environment and to make it a priority. A law would be necessary to specify the objectives of such a program, the place we want to give it in the whole of the social environment and the health network, the responsibilities of each, the budgets we want to grant to it and the rights of Quebecers with regard to such a program.
3. I have a great deal of respect for Mr. Legault, and particularly for Mr. Dubé, but I disagree with the idea of investing billions of dollars in a new service called the Elders’ Centre. Investing so much money in the institutional seems to me a very questionable orientation. In my opinion, it would have cost less to upgrade the CHSLDs!
4. An aid program to enable people to stay at home is essentially a social issue, a societal choice. Making it a medical issue is the wrong direction. It is Quebec society, aided by the Quebec state, and not the medical world that decides on such an orientation. Of course, the medical world is an essential partner, but so are all the other important professionals in the pursuit of the program’s objectives.
5. An essentially social program presupposes that the social worker is a primary agent. He is the professional who best knows the social environment in which we want to help people stay at home. Obviously, the family doctor must be involved in this decision, but I believe that the social worker must remain in charge.
6. Any person supported by this program should be connected, by a telephone network, to a health information service, where a professional who provides follow-up would have access to the socio-medical file of the person calling, if necessary.
7. Such a program requires collaboration and concerted action by all social actors. The municipal world should play an important role in this program, as well as the community network. It should be understood that people who choose to stay at home may sometimes need material assistance (food, maintenance, travel, social contacts, etc.).
8. A resource such as day centers is important (physiotherapy, physical activities, social contacts, cultural activities, support for computer access, etc.). I remember that in Sweden in 1989, anyone receiving home care never lived more than 500 meters from a day centre.
I conclude by insisting on the fact that the home care program is first and foremost a choice for society, and not an alternative to the institutional system. I want the State of Quebec to recognize and affirm this choice.