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Older Ontarians prefer living at home to long-term care

Older Ontarians prefer living at home to long-term care

James Meloche says, ‘Why is the government ignoring this wish?’

You may know the riddle: if a tree falls in the forest and no one hears it, does it make a sound? It seems to be a predicament of the home and community services sector as of late. Despite all the evidence demonstrating our effectiveness — the testimony of clients and public recognition of our COVID-19 response — the government doesn’t seem to be hearing us, let alone showing up with the chequebook.

A recent research poll indicated that zero per cent of Ontarians 55 years and older currently living at home said they planned to live in a long-term-care home. Zero. When asked if they would prefer to live at home with additional supports as they got older, 91 per cent said yes and only two per cent said no. Ontarians want to live at home, accepting some of the burdens this may require. They are willing to take that responsibility to live where and how they wish. So why is the government ignoring this wish — or, more specifically, those community organizations whose goal is to help make this wish come true?

At Community Care Durham (CCD), we serve more than 240 assisted living clients living in their own homes rather than long-term care. Through a combination of our in-home and community supports, we assist people to remain at home for as little as $39 per day. Considering the average care expense in a long-term-care home ($201/day) or hospital ($730/day), this represents considerable savings. In fact, if our 240 assisted living clients were in long-term care, it would cost taxpayers an estimated $5.5 million more than our model.

The lack of publicly funded home and community care forces people to more costly, less safe institutional care sooner than they wish. Whether it’s the preventable deterioration of health and well-being or the financial burden due to supplementing formal and informal care — families are reaching breaking points. So have we.

To balance our budget this year, CCD needs to reduce our assisted living capacity by 16 per cent. Already we have 57 clients waiting for service. And our wait list continues to grow as the lack of basic inflationary funding adjustments means our capacity to deliver care is eroded every year, at a time when more people require it.

A lack of fair funding and inflationary adjustments is also driving out the home and community care workforce to higher-paid positions in hospitals and long-term care. Hospital personal support staff earn 20 per cent more than our support staff, while long-term-care staff earn nine per cent more. These front-line workers, often women and visible minorities who are already facing an equity challenge, deserve a modest cost-of-living adjustment. By not keeping pace with inflation, we are outpaced by hospitals and long-term care where care is more expensive, not necessarily better, could have been avoided and is not where people want to be.

We are not looking to compete or take dollars away from hospitals or long-term care. We know, however, there is an alternative to what is presently an unsustainable trend toward institutional care that serves neither the public nor the government well. A strategic investment in home and community care leverages and supports the efforts of caregivers, volunteers and communities to do what we can do best — support each other with dignity and independence at home. In-home and community care provides better health, client experience and workplace satisfaction — all at a lower cost.

It isn’t hard to understand. My fear is that, if unattended, the forest will be gone before we know it.

The Metroland Media Group first published this column on November 8, 2021.