Is seniors' care based on a false premise?

from helphealthcare

The headlines du jour are about the stress and waitlists for home care.

http://www.cbc.ca/news/canada/nova-scotia/nova-scotia-home-care-1.3518830

The conversation is about the demographic tsunami. But the question remains: why didn’t anyone plan for it? As I’ve written before, generations of Nova Scotians didn’t suddenly get old overnight. If we could build the schools to accommodate the birth boom why couldn’t we foresee that those generations would also grow old?

If the baby boom wasn’t enough of a hint, then a reading of demographer’s David Foot’s 1996 best-seller, Boom, Bust & Echo should have informed their thinking and planning. Except that public sector thinking is less driven by future needs than immediate career advancement.

According to current reports, the western health region (basically SW Nova) has 361 people waiting for home care. That is a 50 percent increase. I was surprised to learn that the VON, which oversees home care in Western Zone, handles 60,000 home visits a year! They also manage the Meals on Wheels program. A health care worker not involved with the VON tells me the organization needs another 126 home care workers for the Western region! That’s a shocking number. Where are they going to find that many care givers? That’s not a need which can be filled in a few months or years. So what happens, do we abandon those in need or warehouse them in hospital acute care beds waiting for enough others to die to open a space in the schedule? That’s costly and cruel. Costly to the system, cruel to the person whose life is in limbo, stuck waiting with no quality of life.

The number of caregivers required suggests that the current plan for keeping people at home may not be practical for those in care and those who deliver the care.

It seems that a lot of a caregiver’s day is spent in travel between clients. Some may also be taking time to handle household chores for their clients.

I understand people wanting to stay in their homes. But that may not be practical. Even those who are capable of caring for themselves “downsize”. They shed material possessions to live comfortably in smaller accommodations that require less work and maintenance. We should be looking for alternative accommodation opportunities in local communities. It might be more practical for clients and caregivers if we also invested in renovating existing community infrastructure, like abandoned schools and hospitals, into self-catering or cooperative housing for the elderly. Clustering small numbers of people together – each with their own space – in one location provides greater opportunity to socialize, thereby eliminating or at least reducing loneliness, isolation and vulnerability some might feel, but are too proud to admit.

We used to build seniors’ housing, but when was the last time that happened? And what kind of waiting lists do they have? We assume that people want to stay in their homes. But do we know how devoted they, and their families, are to that? Is the real desire to stay in that physical building or avoid a nursing home? Has anyone asked whether the real motivation to stay in their own home is because alternatives don’t exist or are too grim? Are we building a system on a false premise?

A type of clustering for independent or semi-independent people would also be more practical in terms of care delivery. Caregivers could spend less time on the road, dealing with poor weather and dangerous road conditions, and be able to spend more of their shift actually assisting their clients.

It would seem kinder and cheaper than the alternatives that exist now.

 From helphealthcare