COVID-19 restrictions have made Canadians anxious to get out, to go to work, to school, for a walk. Yet the population most impacted by COVID-19, our senior citizens, has only ever wanted to stay in their homes. The heartbreaking news reports from long-term care homes demand that we re-examine the role of home and community care for seniors.
Every day healthcare professionals arrive at clients’ home and care for those who require post-surgical care, tracheotomy care, ventilator care, advanced wound care, cancer care, palliative care, chronic disease management, pain and symptom management, home infusion services, intravenous therapy and those living with dementia and Alzheimer’s.
Bayshore HealthCare’s homecare team consists of 11,000 healthcare support workers, nurses, pharmacists, social workers, occupational therapists, physiotherapists and speech language pathologists across the country who visit more than 35,000 people every single day in their homes.
You would expect that COVID-19 would have taken a toll on in-home client/patient care. Yet the data from our organization shows 0.36 per cent of our homecare clients have had COVID-19 and, thankfully, only 0.1 per cent of our homecare employees (or eight staff members) have acquired COVID-19. This is a stark comparison to more than 5,000 COVID-19 deaths in Canada’s long-term care homes.
The priority of home care has always been the safety of clients and staff. Since the end of January, with little to no warning, we stepped up to ensure our staff and clients were safe, including limiting the number of healthcare providers in any one client’s home. We moved quickly, developed strict pre-screening processes, COVID-19 infection and prevention practices and more importantly, we did it early.
Enhanced safety measures and additional training and education have made a significant difference in containing and preventing both the spread of COVID-19 across our client/patient population and among our staff and have made them feel safe. In a survey of Bayshore’s home-care providers, 93 per cent felt they received enough information about COVID-19 for themselves and their clients; 92 per cent felt supported by their managers to provide care safely; and 98 per cent knew when to use PPE and how to properly don and doff PPE.
Further advancements of digital health have enabled healthcare providers to securely and conveniently connect with clients and their families to provide advice, support and guidance to help them better manage their condition or simply get answers to questions. Through telepractice, we can now remind seniors to take their medication on time or to visually assess an injury to determine if additional in-person care is needed. Virtual counselling is available to support oncology patients, mental health and rehab therapy to keep patients motivated and on track to reach their health care goal.
Our healthcare system has been built around institutionalized care but now more than ever we need it to be built around home and community care. Canada’s 2017 census revealed that for the first time our seniors outnumber children in Canada. There are now 5.9 million seniors compared to 5.8 million Canadians aged 14 years and under. It is more important now than it has ever been to have enabling policies at the federal and provincial level to enable seniors to stay in their own home and receive the care they need and deserve.
A report released Thursday based on 2018-19 data from eight provinces and territories reveals that one in nine newly admitted residents of long-term care facilities could have remained at home with proper support. The report says more than 5,000 long-term care spots would have been freed up.
“Most of us want to age in place. Most of us don’t really want to go to an institution,” Tracy Johnson, a director of research and analysis at Canadian Institute for Health Information, the country’s health care statistics agency, told The Globe and Mail.
The quadruple aim of healthcare is focused on improving the patient and provider experience to enhance the quality of care that individuals receive. It is about delivering the best possible care and achieving the best possible outcomes for individuals. Evidence indicates that people want to remain at home for as long as possible and if given a choice would prefer early discharge from hospital followed by provision of home care. Patient satisfaction levels were also found to be greatest for those receiving care in their own homes.
COVID-19 has exposed flaws in our healthcare system and starkly illustrated that we must re-examine the access to in-home care for seniors and for all people in need.