Could B.C. reduce overall health care costs by providing home health care visits to seniors who may not need them yet? This sounds like a counter-intuitive solution, but it may be one way to help seniors age in place.
BCCPA’s most recent policy paper Health Begins at Home makes eight recommendations along four key themes: investments in funding, investments in seniors, fostering innovation and investments in quality. Included in the paper was the recommendation that the BC Ministry of Health funds or offers preventative home health care visits to people 75 and older on a proactive basis to prevent pre-mature frailty and ensure that seniors are provided with the necessary care as soon as possible. BCCPA also recommends that these visits should be paired with a public awareness campaign.
What is the thinking behind this recommendation?
Many seniors become connected to home health care supports when they (or a family member, or friend) contact their health authority and ask for services. From there, a case manager performs an assessment and determines what services are appropriate.
Yet, many seniors who would be eligible for home health care services do not reach out for help. Frequently it is because they are unaware that services are available or that they may be able to get services at low or no cost. Other times they fear the stigma which might accompany getting help. Marry this with families who do not want to be intrusive, or simply do not know how bad things are getting or where to go for support and it becomes easy to understand that by the time many seniors are receiving services their health has severely declined, sometimes irreversibly.
Integrating preventative, proactive home health visits into B.C.’s home health care system could help reduce social isolation, connect people with the services they need and make seniors more aware of what help is available to them. The available literature (as noted in Health Begins at Home) indicates that preventative home health care can help to:
- Initiate contact with seniors who may not request medical attention as expeditiously as they could.
- Help older people remain well and independent for as long as possible.
- Avoid or prevent functional decline.
- Identify safety issues in the home.
- Raise awareness of community services and programs.
- Facilitate adjustment of home care arrangements a needed.
Overall, these outcomes can help to support seniors to age in place, while supporting the government’s overarching direction to support people through home health services, compared to acute care or other costlier approaches.
There is also a strong precedent for success, as similar programs have been effective elsewhere, such as in Denmark. Denmark’s Ministry of Social Affairs passed a law in 1998 which obliged municipalities to offer professionally delivered home visits twice a year to all citizens 75 and older. Denmark found that these visits helped reduce hospital admissions by a whopping 19 per cent as well as reducing admissions to long term care homes by 31 per cent.[1]
For all these reasons BCCPA is recommending that B.C. establish similar guidelines which would encourage the health authorities to proactively offer free of charge home health care visits at least once a year to people aged 75 and older. As noted above, this would ideally include a public awareness campaign.
BCCPA expects that this would cost approximately $8 million per year, but should Denmark be an example there could be cost savings realized in other areas of the health care system, not to mention considerable effects on the quality of life for seniors.
[1] 60 Home Care in Canada: From the Margins to the Mainstream. Canadian Health Care Association. 2009. Accessed at http://www.healthcarecan.ca/wp-content/uploads/2012/11/Home_Care_in_Canada_From_the_Margins_to_the_Mainstream_web.pdf
