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Monday, April 16, 2012

Caregivers to seniors need more help, report says...

Canadians attempting to care for seniors at home are having trouble coping and not receiving the support they need from the health system, concludes a new report from the Health Council of Canada.
The report found that those seniors with the most complex health needs – such as those with both dementia and medical problems – are not getting enough support. They often receive only slightly more publicly-funded home care a week than those with more fewer needs, the report found.

Not only does that put ailing seniors at risk, the stress also risks the health of their home-based caregivers, who are usually family members and often seniors themselves.

The demand for home-based care has grown significantly in recent years, with the number of home care recipients rising by 51 per cent in the last decade. This report is the first cross-Canada look at how the home care system is adapting to this shift.

It found that one-third of seniors receiving home care have complex health needs, often involving both a physical disability and cognitive impairment. But close to half of those seniors with the most complex health needs have "distressed" caregivers.

These caregivers report feelings of stress, anger, and depression. And many say they are finding it difficult to continue to provide care.

"Those caring for seniors with dementia are suffering most of all, reporting the highest levels of stress, social isolation, depression, and chronic health problems," the report notes.
The report authors note that "burned-out" caregivers cannot help their loved one if they end up in hospital themselves or become unable to function.

"Many family caregivers of high-needs seniors are at a breaking point. Both the caregiver and vulnerable senior are at risk in these situations," the report authors write.

"…Family caregivers are the backbone of the home care system; they need to be adequately supported for the system to work."

According to the report authors, there were 2.7 million Canadians over the age of 45 acting as caregivers to family members. Most of these family caregivers -- 60 per cent -- were women, and one-quarter were seniors themselves.
The more care these family members provided, the higher their levels of stress, the report found.
Caregivers who provided more than 21 hours per week of care reported higher levels of distress, as did those who were caring for people with depression, cognitive deficits, or behavioural problems.

The report notes that while home care co-ordinators often fully assess the needs of the patients requiring care, there is often no system for ensuring that caregivers have what they need too.

"Caregivers have various needs, including a need for information, a need to be involved in decision-making, a need for breaks (respite) from caregiving duties, and help with navigating the health system," the report says.
"However, assessments of potential home care clients usually do not include comprehensive caregiver assessments, which means that their needs go unnoticed."

The report offers a number of suggestions for easing the stress. It notes that since hospitals are the main source of referrals to home care, home care should be more integrated in the health-care system, the report advises. To that end, a client's family physician should be included as part of the home care team, the authors suggest.

As well, the report suggests shifting more funding into home care, noting that Canada spends considerably more on long-term care facilities than on home care, even though polls suggest most Canadian seniors live at home and want to stay there as long as possible.

The report advises that governments and the health system should:
  • recognize that home care has become a cornerstone of the health care system
  • provide ongoing support for family caregivers and immediate relief for those in distress
  • adapt or expand the programs that are working
  • consider new home care options before new investments in long-term care facilities

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