Home-care system fails 4 in 10 New Brunwickers who need it

A new report from the New Brunswick Health Council has found that home-care services in the province are failing to meet the needs of more than 40 per cent of people who require support.

The study said publicly funded home care is more important than ever with an aging population and a need to reduce the number of citizens "waiting in hospitals for appropriate care" such as nursing or special care homes.

"A huge proportion of people are saying we need more help in order to stay at home," said Stéphane Robichaud, CEO of the New Brunswick Health Council.

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The report takes a closer look at home care, which falls into two different categories and is paid for by two provincial departments.

Extramural medical services provided by Medavie Health Services are paid for by the Department of Health, while home support services such as bathing, meal preparation and housekeeping are paid for entirely or partially by the Department of Social Development.

Robichaud said those responsible for delivering home care need to do a review of their current "scope of services" to ensure they are helping people who could remain in their homes, rather than end up in hospital.

He said services have not "evolved" with shifts in demographics.

"This really speaks to needing to do that, and with an aging population it's a challenge that's just going to grow."

'It's pretty alarming'

Haley Flaro, executive director of the non-profit organization Ability New Brunswick, which supports disabled people, said the results of the survey sadden but don't surprise her.

"It's certainly reflective of the trends we're seeing at our organization with people with a mobility disability," she said. "Our systems are taxed."

Flaro said a shortage of home-support workers has been worsening for years and that, combined with an aging population, is creating a huge problem.

"New Brunswick has the second-highest rate of disability in Canada, at 26.7 per cent of the population, and mobility is among the most common disability types."

Flaro said that in may rural areas, there aren't any workers to provide basic care and support and that keeps her up at night. 

"We're going to have individuals that are going to go in [to hospital] for a level of care that they could get in the community if it was available."

Personal care biggest 'unmet need'

According to the report, an estimated 38,000 New Brunswickers require some type of home-care services but 12,500 of them receive none at all, while another 3,500 only have some of their needs met.

"Home support services are non-medical and include personal care such as bathing, housekeeping and meal preparation," the study said.

Transportation, shopping and yard maintenance were also identified as common needs that weren't being met.

Robichaud believes part of the problem is that in many cases people don't know where to turn for help.

"Let's face it … they didn't plan this," he said. "This survey just tells us, wow, there's a significant amount of people who are saying, 'If we had more services, we could probably stay home longer."

The study backs up Flaro's assertion that the need for home support services has large variations depending on geography, and demographics.

Robichaud said it's "not a surprise" that the survey found people who live in more urban areas, such as Moncton, Fredericton and Saint John, are more likely to have their needs met, while those who live in Bathurst, the Acadian Peninsula, Madawaska and Restigouche are less likely.

Indigenous people, people who prefer services in French, low-income people and those with a disability are also more likely to not have their needs met.

Call for change

The report calls on the provincial government to move to a "citizen-centred approach" that is accountable to New Brunwickers rather than expect people to adapt to what is being offered.

"What is required is a comprehensive, co-ordinated and integrated plan designed to meet the home care needs of New Brunswickers." 

Right now, the New Brunswick Health Council said services are not consistent nor equitable, and home-support and extramural services are "often just one standalone piece of a disconnected system."

Flaro agreed with the recommendation but said many government departments and community organizations will have to work together to improve the situation.

"Seniors we work with [who have] a mobility disability — they want to live at home as long as possible with the right supports and it's becoming harder to find that, so I'm really worried about the effect on our health care system overall."