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Dec. 9, 2021 — Major investments and significant changes should be made in the long-term care sector, according to a new report from the C.D. Howe Institute. In “Ounce of Prevention is Worth a Pound of Cure: Seniors’ Care After COVID-19” author Rosalie Wyonch recommends expansions in both residential and homecare so Canadian seniors can receive care when they want it, where they want it. The report also recommends major investments in long-term care and retirement homes, to mitigate the risks of future infectious disease outbreak and improvement of quality-of-life needs for seniors.

Prior to the pandemic, Canada had long waitlists for long-term care homes and had fewer homecare providers than the international average. These existing shortfalls will be compounded by Canada’s ageing population as babyboomers surpass 80 years of age. Making necessary changes to improve the quality of long-term care—such as reducing occupancy per room, increasing staffing levels, supporting higher wages for care workers, constructing new facilities—would require nearly every new dollar of health spending be directed to seniors care, with annual costs projected to increase to 4.2% of GDP by 2040. This level of investment in seniors’ care is unprecedented and fiscally infeasible. Innovative approaches will be required.

Canada’s current system of seniors care exhibits several disadvantages —a lower proportion of the population receiving care, low investment in utilization of home and community care, and high barriers to access choice of care. Addressing these structural shortcomings will require a radical shift away from the institutionalization of the elderly. “Ensuring access to more appropriate levels of care and preventing people from occupying an acute care hospital bed or premature admission to long-term care homes has both cost and quality of life benefits,” writes Wyonch. “Innovation will be needed, in areas ranging from the provision of care to the funding and organization of the system.”

The international experience is instructive for innovative senior care policies:

  • Belgium uses a voucher-based model of subsidizing various homecare and other services to allow seniors to age in place, in addition to federal health insurance reimbursement for medical aspects of long-term care.
  • The German long-term care system prioritizes cost containment by enabling seniors to live independently for as long as possible and treating inpatient care as a last resort. Seniors can receive a care allowance (cash benefit supporting informal care), homecare services from a health professional (in-kind benefit) or residential care.
  • Denmark emphasizes user-centred preventative care with a focus on maintaining the skills to live independently. Individuals are assessed on a continuum of care and services are provided based on their specific needs.
  • Two-thirds of OECD countries provide cash benefits to family caregivers and/or a period of paid leave. Some countries also provide counselling, training services and recognized legal status (Germany) for informal care-givers. Nearly all seniors receiving homecare in Canada have an unpaid caregiver, normally a family member, and Canadian governments must do more to support these informal care providers.

Read the Full Report

For more information: Rosalie Wyonch, Senior Policy Analyst, C.D. Howe Institute; Lauren Malyk, Communications Officer, 416-865-1904 Ext. 0247, lmalyk@cdhowe.org