Shaping the future of care closer to home for older adults
As part of its five-year strategic plan where everyone in Canada has safe and high-quality health care, Healthcare Excellence Canada (HEC) is committed to reimagining care with — and for — older adults. The COURAGE team asked HEC to share insights from its pan-Canadian focus groups.
“My mother has always been very independent, and she worked hard for many years to be at a point where she was content with her life. In the past year, my mother went from being on her own to living in long-term care. I know my mother really loved her home and wanted to stay there. Since moving, she feels completely dependent and that she’s lost everything she ever worked for. I often think about what could have been done to help her stay at home and what could have been.” — Essential care partner
Stories like this inspired the team at Healthcare Excellence Canada (HEC) to start a national conversation about aging in place and to explore how older adults can be supported to live safely and independently at home or in the community for as long as they wish and are able.
Over several months, we engaged older adults living at home and in the community, those providing care to older adults and family and essential care partners who provide physical, psychological and emotional support. By listening to people with lived experience, we were able to identify opportunities and challenges, learn what matters and start reimagining the future of care closer to home for older adults.
What we heard
Some key themes emerged in these conversations:
Person-centred care: Older adults told us they want to be empowered to take charge of their health in the home or community with care that is responsive to their holistic needs and preferences, offers them greater choice and respects their autonomy.
“Just because I get old shouldn’t mean that I lose the right to make choices that other people might not think are good for me. When I was young, I could speed and that was taking a risk. How come now that I’m old I can’t live at home alone.” — Older adult
People told us that appropriate use of technology can promote person-centred care and enhance access to care and services for older adults. AGE-WELL, a Canadian network for technology and aging, recently released a report titled Technology and Aging at Home: The Future of Aging in Place, which details opportunities to meet the needs of community-dwelling older adults through technology.
Home care and community support: People with lived experience emphasized the need to improve and strengthen current models of formal home care and community support services to reduce barriers to accessing support closer to home and enable aging in place.
“There are a lot of obstacles to receiving care. One of them is that if you don’t need assistance for bathing, you can’t qualify for home care at all. We need to address these restrictions so we can get people the basic things that would support them. Right now, we have fragments but nothing that covers even half of what people need to stay at home.” — A home care worker
Essential care partners: Older adults told us that essential care partners empower them to live in the home and community and called for health systems to acknowledge their role in supporting care and to prioritize their well-being. While these calls to action may seem daunting, we can expand and learn from existing innovations like the University of Alberta’s Care for Caregivers program and HEC’s Essential Together initiative to empower essential care partners right now.
“We have a huge network of compassionate, caring family members. I recognize that at times those family members can be spectacular caregivers, but our rigid systems and rules don’t allow any financial support to families for that. I dream of a day where we can recognize a role that families might play in caregiving in a way that is beneficial to them.” — Health care worker
System navigation: People with lived experience told us about confusing and frustrating attempts to navigate the different health and social systems across Canada. They stressed the need to simplify and centralize complex health system information to improve understanding and access. Additional suggestions were made for increased access to services like NAV-CARE or ServUS Health, which connect older adults, families and essential care partners to skilled system navigators.
“It would be really helpful to have a navigator, a multi-skilled navigator that can help you with practical supports navigation but also that could link you with emotional and spiritual support that can link you with health system navigation. It's really a difficult and disconnected health system that we have. This multi-skilled person can help link you with the supports you need.” — Essential care partner
Equity: We heard loud and clear that the choice to age in place should be available to all older adults. Those with lived experience told us that barriers such as ageism and inequity stemming from socio-economic status, cultural identity and other personal factors must be addressed to provide safe and quality care for older adults.
“Ageism is one of the biggest barriers to enabling adults to stay safe at home. Inequitable access to care in a country where we are more rural than we are urban, and yet, the remote are very vulnerable. Even if you are in urban centres, the ageism that is prevalent in policies and funding, they are not supporting it.” — Older adult
The future is now
The conversation does not end here. Our hope is that what we heard will inspire others to reimagine the care of older adults in their work and to join HEC and our partners in this ongoing conversation. HEC will use these findings to work alongside people across Canada to find, promote and spread innovations that effect change in the care of older adults accessing high-quality and safe care closer to home.
Download the Shaping the Future of Care Closer to Home for Older Adults Environmental Scan and Consultation Executive Summary.
Olivia Sellner is a Program Intern at HEC, working as a member of the Programs and System Transformation team with Vice President Maryanne D’Arpino, Director Gina De Souza, Senior Program Leads Kathryn Graves and Shelly Crick and Program Leads Megan Taylor and Jessica Crawford.
This important work would not have been possible without the contribution of other pan-Canadian health organizations, home care providers and people with lived experience who shared their insights and stories.
Healthcare Excellence Canada (HEC) works with partners to spread innovation, build capability and catalyze policy change so that everyone in Canada has safe and high-quality health care. Through collaboration with patients, caregivers and people working in health care, we turn proven innovations into lasting improvements in all dimensions of healthcare excellence. Launched in 2021, HEC brings together the Canadian Patient Safety Institute and Canadian Foundation for Healthcare Improvement.