Joyce Hudson, a seniors' advocate from Hopewell Cape, chats with Cecile Cassista, executive director of the Coalition for Seniors and Nursing Home Residents Rights, at Lakeview Tower yesterday during a seniors' recognition party. 

High marks for care program
Survey of patients by N.B. Health Council indicates high satisfaction rate for in-home care



New Brunswick's Extra-Mural Program, which provides in-home health care to patients of all ages, has received a glowing endorsement in a survey by the New Brunswick Health Council.

However, those involved in the programs say there is always room for improvement.

The Health Council yesterday published the results of its first survey on home health care in New Brunswick, with the hope that it will serve as a benchmark for decision-makers to find ways to make it better.

According to the survey, 97 per cent of respondents were satisfied with the Extra-Mural Program, and 88 per cent indicated they were satisfied with services received from home care agencies or home support workers. The satisfaction rate exceeds the rates seen in the NBHC's previous surveys, which varied from 50 per cent to 90 per cent, depending on the type of service provided. The survey targeted citizens across all communities who have received home care services between the months of February and April 2012, with the cost being entirely or partially covered by government. The New Brunswick Home Care Survey has resulted in a sample of 4,246 completed surveys.

'The survey results show us that the coordination and providing and sharing information between home care providers and the citizen and his or her caregivers can be improved,' said Stéphane Robichaud, CEO of the NBHC. 'When someone receives care from different providers, it's imperative to have open communication lines to ensure the citizen can manage his or her health in the best way possible, and therefore stay at home as long as
Extra-mural program praised in health care survey

possible.' The survey results also show some existing barriers to home care. Some respondents indicated that more could have been done to help them stay at home, and reported difficulties with respect to the duration of services or the number of hours available. The limited scope of home support services was also cited as a barrier and can vary greatly from one community to the next.

Terry Morrissey, director of Extra-Mural programs for the Moncton region, said the mandate is to prevent hospital admissions and make it possible for people to live at home and be independent as long as possible. The program recently celebrated its 30-year anniversary in New Brunswick and has received national recognition. In New Brunswick, the Extra-Mural programs serve about 40,000 people, or roughly five per cent of the provincial population. 

In the Moncton region, there are about 12,000 patients receiving home-based health care services from Extra-Mural programs administered by the Vitalite and Horizon health networks. Morrissey said the programs serve patients of all ages but the majority are people over 65. For Horizon, Morrissey said there are about 100 professionals making the rounds to provide in-home health care. The professionals include Registered Nurses, Licensed Practical Nurses, occupational therapists, speech therapists, respiratory therapists, rehabilitation therapist and physicians. 

There is also a network of other agencies who provide a host of other services that include meal preparation, housecleaning, grooming and specialized care. There are also agencies like Hospice Greater Moncton, a volunteer agency that provides support to terminally ill patients and their families. The Extra-Mural system also works with the departments of social development and education.

'Ultimately, people want to remain in their own homes as long as possible,' said Morrissey. She said the survey of patients is very positive and more analysis of the responses will allow them to find ways to tweak the system and look for ways where it can be improved.

'The extra-mural people are so nice and so friendly, I don't know what I would do without them,' says Ruth Degan, who lives in the Kinsmen Residence on Runnymeade Road in Riverview. Degan, who is '76 and going strong' returned to New Brunswick from Ontario to live out her golden years. She describes herself as very independent but has professionals visit her a few times a week to care for her legs, which need to be wrapped as part of her ulcer treatment.

Degan said many seniors are able to look after themselves and stay in their own homes or apartments, but need help that can be provided in-home. But she said having the city buses grounded by the Codiac Transpo labour dispute has left many seniors without any form of transportation. Fortunately, the Red Cross has mobilized a team of volunteer drivers to help them get their errands done.

Joyce Hudson, a seniors' advocate from Hopewell Cape, said many seniors who aren't able to drive anymore and don't have family members to rely on are really missing the bus service these days. But she said the Extra-Mural Programs have been well-received by seniors in both rural and urban areas who are able to look after themselves.

'As long as your health is reasonably good, you can stay at home and get some help.' Hudson was in Riverview yesterday for a seniors' recognition party at Lakeview Tower, a retirement residence on Crystal Drive.

Cecile Cassista, executive-director of the Coalition for Seniors and Nursing Home Residents Rights, said apartment complexes like Lakeview Tower and People's Park Tower in Moncton are ideal for seniors who are making the transition from a house to special care home or nursing home. Cassista, who also serves as a Riverview town councillor, said the Health Council report released yesterday is very positive but there is obviously more that can be done to help seniors who want to stay in their own home as long as possible.

'These are excellent models that the government could be looking at. The government could build more of these affordable homes where people live independently and look after each other,' Cassista said yesterday as seniors sat in the common room listening to live accordion and fiddle music. 

'Some are in walkers, some are on oxygen, but they have 24-hour alert and there is staff here to care for them.' People living in such apartments, special care homes and nursing homes are eligible to receive services from the Extra-Mural program, but any medical treatments must be approved by the individual's physician. Cassista says this often results in the staff of the homes simply calling an ambulance to take the person to the hospital if there is a problem. Her suggestion is that the Extra-Mural program be given more powers of diagnosis and treatment, so they could decide a better course of action.

Cassista believes this would be more cost-effective and cut down on the number of ambulance calls to these homes. It would also reduce the stress of seniors being carted off to the hospital every time they have a problem. She says there are still hundreds of seniors and other patients in hospitals waiting for a spot in a special care or nursing home.

The Home Care Survey showed that 66 per cent of the respondents had three or more chronic conditions, representing a very vulnerable group of citizens.

The New Brunswick Health Council said the survey reveals gaps when it comes to collaboration and communication between government departments and between service providers, since the majority of respondents are receiving care from the Extra-Mural Program after a visit to a hospital or rehabilitation centre.

Those responding to the survey also said it was important to share information with the family members and friends of patients. They also said they needed better information about taking care of themselves.

This could mean spending more time explaining what medications are for, or better explaining how to make one's home more accessible or safe.

The NBHC was established as an independent organization that measures, monitors and evaluates New Brunswick's health care system performance, population health and to engage citizens in the improvement of health service quality.