Home care could save health system millions: new report

Hector Cormier is 80 years old and still lives at home in Moncton. He’s in good shape and plans on living at the house he bought in 1984 for as long as possible. That’s why he said he’s calling on the provincial government to ramp up its support for home care. PHOTO: SARAH SEELEY/TIMES & TRANSCRIPT
Hector Cormier is 80 years old and still wants to see the world.
But when his travels are all said and done, he says there’s only one place he wants to come back to: his home in Moncton that he’s owned since 1984.
“At 80 years of age, I am fearful of going into a [nursing] home,” he said in an interview with the Telegraph-Journal.“I want to stay in my own home.”
Cormier’s concern comes as a new report from the Canadian Institute for Health Information found more than 20 per cent of seniors admitted to residential care might have been able to stay in their own homes if they had the proper level of support. It would also be dramatically cheaper for the provincial government to finds ways for Cormier and other aging New Brunswickers to stay out of hospitals and nursing homes, according to advocates.
“To help ensure that health systems can continue to meet the needs of seniors, it will be essential to expand efforts so they can remain in their homes for as long as possible,” reads the report.“If we assume that health services will be provided in the future as they have been in the past, health systems would need to double existing residential care capacity over the next 20 years to keep up with population growth.
“Clearly, this is not a feasible or appropriate option.”
Department of Social Development data states that there were 598 patients on the wait list for nursing homes in New Brunswick in June, and 375 of them were waiting in a hospital.
Meanwhile, it costs $800 a day to keep a patient in a hospital bed in Canada, but it only costs $45 to care for them at home. That averages out to $300,000 a day to keep these patients in the hospital. In comparison, it would only cost $16,875 if they were all kept at home.
That’s a difference of $283,125 a day, or a total $103,340,625 for the year if numbers stayed exactly the same.
The provincial government said in an email to the Telegraph-Journal that they are fully supportive of a home care system, and are in the process of strengthening key initiatives meant to keep people in their homes.
“The provincial government is committed to ensuring New Brunswick offers a positive aging experience for our seniors,” said Anne Mooers, spokeswoman for the Department of Social Development.“It named a minister of Seniors and Long-term Care in June 2016 and also created the New Brunswick Council on Aging.”
The council on aging submitted a report to the government this year, with short and long-term goals to specifically help seniors stay healthy and independent as long as possible. And that means keeping them in their homes, Mooers said.
A governance structure is currently being developed to implement the report.
But is the government there yet? Not according to one expert who has more than 50 years of experience in the health-care profession over three provinces.
“While [New Brunswick] has had a wonderful extramural hospital system that has been one of the crown jewels of the [New Brunswick] health system for years, all the elements that support a person in remaining safely at home often do not come together in orderly fashion,” said Ken McGeorge, who recently served on the board of directors of Atlantic Institute on Aging.
He points to patients with dementia as a prime example, who he says need their symptoms recognized and supported much earlier than what is usually the case.
“Elders with dementia and their caregivers eventually get to crisis point and resort to the emergency departments and acute care hospitals for help,” he said. “Absolutely the wrong place for persons with dementia or frailty.”
Cecile Cassista, the executive director of New Brunswick’s Coalition for Seniors and Nursing Home Residents’ Rights, is calling on the government to do more.
The province is expected to spend $2.7 billion on health care for this fiscal year as per the 2017/18 provincial budget.
Cassista said caregivers are currently only making $13.40 an hour, which she says is just simply not enough. It leads to a high turnover rate, she said, and it is not enough for many of the workers to live on.
“If you take a look at the Government NB website for seniors it’s promoting institutional care,” she said in an email Tuesday.“In NB we continue to study and study with no action.”
In response, Mooers said to simply look at the website. It currently advertises Home First at the top of its page, a program created in 2014 to help seniors stay in their homes longer. She said there are also links for the Aging Council and other recent programs.
But there is still a ways to go.
As Cormier points out, there are other things to consider past the actual medical care.
There is cleaning, yard work and snow removal, to start.
“I can’t do the lawn anymore. So I have to hire someone to do the yard,” said Cormier.
“In the winter, I can find someone to do my driveway, but I can’t find anybody to do my walkway. So I have to hire somebody. That means from now on I have to hire people but I can afford it, not everybody can.”
The retired teacher still exercises every day. He’s cut out almost all of his daily pills, and is in the works of filling out paperwork for a new passport.
He maintains his independence, and said he plans on keeping it that way.
He’s not quite at the point where he needs a daily nurse, but he knows the time will eventually come. That’s why he’s calling on the government to start seriously pushing for home care.
“It is costly to live in a home or an apartment.
“But if it costs [the hospital] $800 or more to stay in a hospital setting – which is not a setting for seniors – I think the government should look at [home care] very seriously and very closely and see how they can help these seniors that would like to stay in their home.”