Home care for seniors falls largely on friends, family

Nearly 180,000 Canadians aged 65 and older said their professional home-care needs were unmet, which could have increased their risk for injuries and hospitalization, a new report suggests.

More than half of people 65 and over received unpaid care

More than half of Canadians aged 65 and older who received home care in 2009 said they relied on family, friends and neighbours for the support, according to Statistics Canada.

In total, about one in four Canadian seniors, just over one million people, received home care such as housework and transportation that year, the federal agency said Wednesday in its Health Reports publication.

About 15 per cent of those receiving formal or informal home care used it for transportation like going shopping. (Thomas Kienzle/Associated Press)

Of those who received home care, 53 per cent turned to family, friends and neighbours exclusively for the help, and that figure could be underestimated, since seniors might not have reported informal care, such as from a spouse, if it was perceived as part of usual support from family.

"Home care can alleviate demands for hospitalization, it can reduce readmissions to the hospital and as well it can decrease the likelihood of institutionalization," said analyst Melanie Hoover, with Statistics Canada in Ottawa.

There is evidence that expanding home-care services and support for caregivers saves the health-care system money in the long term, agreed Prof. Wendy Young, Canada Research Chair in Healthy Aging at Memorial University of Newfoundland.

"How many people understand that granny getting her housework done actually saves the health-care system an incredible amount of money? If she can't get her housework done, then she ends up being admitted to a nursing home."

Young pointed to her father, who died last year at his home in the Ottawa Valley in his sleep at the age of 89 after receiving years of home-care services through Veterans Affairs. He received occupational therapy, physiotherapy and had access to a nutritionist in addition to round-the-clock informal care from his son.

Veterans Affairs set up the VIP program of additional care at home instead of trying to pay for more long-term care institutions, Young said.

Statistics Canada researchers asked people 65 and older about their use of formal or professional assistance like Meals on Wheels, and informal home care from family, friends or neighbours in the previous year.

Among those who had received home care, the most common types were:

  • Housework, including home maintenance: 18 per cent.
  • Transportation, including trips to the doctor or for shopping: 15 per cent.
  • Meal preparation: 10 per cent. 

Unmet needs for professional home care

For the close to 180,000 seniors who said they had at least one unmet need for professional home-care services, 63 per cent gave personal factors, 24 per cent cited lack of services and the remaining 13 per cent cited a combination of both.

Housework and personal care such as assistance with eating, dressing or bathing were the two most common unmet needs.

Among those with severe disability, about 10 per cent had unmet needs compared with one per cent among those with no or mild disability, Hoover said.

The findings were comparable to the last time Statistics Canada looked at unmet needs for home care in 2005, Hoover said.

A report earlier this year from the Conference Board of Canada noted over two million caregivers were over the age of 45 themselves, such as spouses, Young said.

Young gave two examples of the need to support caregivers. The Alzheimer's Society has called for more education for caregivers of individuals with dementia. And caregivers of those with chronic pain often experience higher rates of depression than the patients, she said.

Young called for objective measurements of formal needs for home care.

Statistics Canada conducted the survey from December 2008 through November 2009, when the population of those aged 65 and older was about 4.4 million.

With files from CBC's Amina Zafar