Editorial: Home support is a growing challenge

Beacon Community Services is transferring all of its home-support program to Island Health. The move will affect 850 staff, each of whom has been guaranteed that jobs and salary scales will be preserved.

Home support is intended to help elderly or infirm clients retain their independence, by providing various forms of personal assistance such as help with dressing, bathing and other daily activities.

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However, there have been difficulties recruiting and retaining staff due to the relatively low wages these workers earn, coupled with the high cost of housing in Greater Victoria.

As well, 70 per cent of Beacon’s home-support staff are employed on a casual basis, meaning many take a second job to make ends meet. While this is understandable, it creates scheduling difficulties, as many clients need support both early in the morning and late in the day.

Part of the intent behind the changeover is to offer more secure employment. However, the principal benefit is that home-support staff in the region will now work in close conjunction with other care providers, such as physiotherapists, pharmacists and social workers.

This team-based approach has been shown to be far superior to older models, where health professions tended to work in isolation. There is also the reality that modern care for the elderly has grown far more complex.

To help co-ordinate delivery, Island Health has set up 14 neighbourhood teams in the capital region. Family physicians are being given contact numbers through which they can guide team members to patients they know need help.

That’s important, because in the past, identification of people requiring assistance was often a major obstacle. GPs might see that one of their patients needed home support, but had no easy way of making the necessary contacts.

And that led to a further problem. Some patients were being admitted to hospital who could have remained in their homes had more co-ordinated assistance been available.

It’s believed 10 per cent or more of hospital beds are occupied by patients who do not require acute care, but who do need some form of help.

That problem is not confined to Victoria. It is a serious concern elsewhere in B.C. and across Canada, particularly in high-demand periods such as flu season.

However, matters are made worse because hospitals in the capital region regularly operate at more than full capacity. Moreover, there are insufficient long-term care facilities to offer an alternative. By far the best solution is to transfer patients back home with the support services they need.

Elin Bjarnason, Island Health’s vice-president for clinical service delivery, made clear these difficulties were no fault of Beacon’s: “Island Health has been partners with Beacon Community Services for 15 years, and they have served the community well.”

But as the population ages, “there is a growing need for better integration between community health workers and the rest of the community care team. That requires us to take a different approach to care delivery than we have in the past.”

Let us hope this transfer will result in more co-ordinated and reliable care that will benefit both clients and the already thinly stretched hospital system.

It’s a regrettable fact that many of us will need some form of support as old age approaches. In times gone by, our health-care system was primarily geared toward a younger population.

But those days are rapidly coming to an end. In 1970, only seven per cent of Canadians were 65 or older. That figure has already doubled, and by 2030, nearly one in five of us will be seniors.

Providing home support in a humane and organized manner is perhaps the biggest challenge we will face in the years ahead.

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