No Longer Home Alone? Home Care and the Canada Health Act

Abstract

In this paper, I argue that addressing the medical needs of older persons warrants expanding the array of insured services as described by the Canada Health Act (CHA) to include home care. The growing importance of chronic care supports my call for federally regulated home care services as the nature of disease management has changed significantly in the last decades. In addition, if the values of equity, fairness and solidarity, which are the keystone values of the CHA, are to be upheld within the current social and demographic context, then Canada's health care system should adapt accordingly. I focus my argument on the services provided to older persons for two main reasons. First, the changing nature of disease management is best seen in this population. If it is to be successfully argued that the transformations in medicine warrant an expansion of insured services covered by the CHA, it will be best illustrated by looking at the needs of older persons. Second, with the demographic shift looming large in the policy agenda, an exploration of this issue is not only crucial but timely.

Utilization of Formal and Informal Home Care: How Do Older Canadians’ Experiences Vary by Care Arrangements?

“…With population aging and higher rates of chronic health conditions and disabilities, the demand for home care services is increasing. Yet, within the Canada Health Act that guarantees equitable access to some forms of health care, home care is considered an "extended" rather than a "medically necessary" service, and is provided at the discretion of each province or territory (Lanoix, 2017). Older and disabled people are typically eligible for some publicly funded home care, but there is wide variation in the availability and quality of services between jurisdictions.…”

Beyond Private? Dementia, Family Caregiving and Public Health

“…The reluctance to integrate family caregiving for persons living with ADRD as a question relevant to public health also comes in part because it blurs the boundaries between health care and unpaid care taking place at home. 6 However, that boundary is permeable, as many policies, for example those on home-care, illustrate (38). My point is that the proposal to add caregiving for persons living with ADRD does not expand public health's overall focus, as another service is simply included within its scope.…”