'Home care has long been the Cinderella of the health-care system, underfunded and undervalued, yet it is of increasing importance.' Readers, print and digital, assess a system that's more often seen as a pumpkin than a coach
The failings of Ontario's Community Care Access Centres' services is, in part, a reflection of our ailing health-care system.
The unsung heroes in many of these scenarios are the patients' family members, who go to great lengths and personal sacrifice to provide care to patients where CCAC has failed them. But they, too, are human and can only endure so much. I routinely encounter patients and family members who are in crisis and can no longer cope at home after being abandoned by our system.
Is this the way an advanced society such as ours treats our more disadvantaged members?
Anne-Marie Humniski, staff emergency department physician, Credit Valley Hospital, Mississauga
CCAC workers cared for my mom – some were nice and helpful, many just sat on the couch gossiping with her about other clients. Never bathed her, rarely lifted a finger. Just checked their texts and chatted for a half hour.
My mom was on a wait list for a facility for almost three years (we live far away, so we could do only occasional visits). She weighed 72 pounds, had no short-term memory and was on oxygen 24/7, but wasn't considered a priority.
Finally, she got into a care facility, where if it weren't for my nephew, she would have been sitting in a shared room with almost no interaction from the staff.
She was there for a month before she caught the flu and died. Staff never returned our many phone calls or responded to our e-mails.
This system has to change. It's a disgrace on all levels, both home care and facility care.
Julie Cameron, Vancouver
When the Ontario government cut acute-care beds in the 1990s, adequate home care was not put in place first, reflecting the head-in-the-sand approach of successive governments to an aging society.
Home care has long been the Cinderella of the health-care system, underfunded and undervalued, yet it is of increasing importance.
Preventative support to keep seniors independent in the community has markedly decreased, because resources are concentrated on the acute needs of patients discharged from hospitals. This leads to unnecessary early institutionalization.
The burden is increasingly born by patients and their informal caregivers. These caregivers are often frail and vulnerable themselves or, if they are the patient's children, there is the economic impact of taking them away from their work.
Inevitably, there is a two-tier system, where the wealthy are able to obtain necessary support, while the rest are on waiting lists, receiving less than adequate care. With an aging society, the problem will become worse.
It is time to review the whole community care system and, learning from other jurisdictions, put in place a comprehensive, transparent and properly funded home-care system.
Rory Fisher, professor emeritus, medicine, University of Toronto
My wife has advanced multiple sclerosis. Two years ago, she got a cut on her foot, which became infected. She was seen at a local hospital, where it was determined she would need intravenous antibiotic every eight hours. With the first treatment at 1 p.m., every third treatment was at 5 a.m. After the fourth visit, a nurse at the hospital asked why we were not getting these treatments through home care. We did not know it was an option.
She picked up the phone and by the time we returned home, we had a message from the Champlain CCAC to schedule a nursing visit for the treatment.
Within 48 hours, my wife was assessed and services assigned that exceeded our expectations in quality and oversight of her condition. Over a two-year period, she has received regular reassessment, with treatment plans adjusted according to her needs.
There is no doubt in my mind that home care is not only more cost-effective, but allows treatment to be delivered in a more comfortable setting without travel and waiting room purgatory. There is also no doubt that the government planning process has failed this system miserably.
We are an hour from Ottawa, which may have something to do with it, but I cannot believe we are the only people in Ontario who have been this fortunate.
Ken Duff, Vankleek Hill, Ont.
I used to "warn" my patients' families that the first thing CCAC tries to do is to get the family to take over care, even though they "promise" home care while in hospital (to get them out of the hospital). Then, CCAC cuts back on the hours until they "decide" that they must not need home care, because they are only getting four or five hours per week (instead of the 15 or 20 they were originally promised!). It is not the doctors and nurses trying to "get rid of patients," it is administration because of bed times (days in hospital).
Linda Steele, Grand Bend, Ont.
Government needs to put this on speed dial.
April Nairne, Vancouver
Let's not paint the home-care system with one brush. My husband had excellent, timely and compassionate care through the last weeks of his life which allowed him to die at home, as was our wish. Nurses, personal support workers and supervisors were kind and empathetic. We could never thank them enough.
Ann A. Estill, Guelph, Ont.
Caregivers are frustrated and burning out. One in five Ontarians is a caregiver and they are not receiving the support they need to keep their loved ones at home – be it aging and/or ill parents, spouses or children.
Ontario has acknowledged the need for caregiver supports and more home care. That is great – but where is the change, instead of just lip service?
In the meantime, families increasingly abandon their loved ones at hospital emergency departments, more caregivers fall into depression, and care recipients end up in hospital or long-term care when they could have stayed home.
We are ready for improvements to home care – any time now.
Lisa Levin, chair, Ontario Caregiver Coalition
Anyone wondering why we baby boomers are demanding the right to assisted suicide should read Kelly Grant and Elizabeth Church's excellent coverage of the Ontario home-care situation to learn the reasons.
Brian Caines, Ottawa
ON REFLECTION Letters to the editor
Deficits? That's all parties
Re A Cautionary Fiscal Lesson For Mulcair (July 17): In recessions, government revenues fall faster than cuts can or should be made. Deficits, en route to balance, are universal. NDP governments in Nova Scotia and Manitoba had deficits similar to other contemporary governments. Jeffrey Simpson should have said: "Thomas Mulcair leads a party whose provincial wings balance budgets in good times but run deficits in bad times. So does Stephen Harper. So does Justin Trudeau."
If such a column sounds pointless, that's my point.
Kelly Lamrock, Fredericton
It's about expansion
Re Wall Decries Green Bent In Energy Strategy (July 17): The rhetoric around pipelines is getting increasingly frustrating – new pipelines are not about maintaining the oil and gas industry, but about expanding it. Investments into the energy sector need to be directed at clean alternatives.
One way to ensure that is to incorporate the external costs of carbon pollution into the price we pay. A revenue-neutral price on carbon (i.e. fee and dividend) would do just that, and encourage transitioning to a clean energy economy.
Jack Morton, Toronto
More cash won't fix all
When Health Care Becomes Unnecessary Care (July 14) mirrors my views after 22 years in medicine. We don't need more money for health care, we need to spend it better. Inefficiencies because of care and service-provider self-interest, increasingly unrealistic patient expectations, poor institutional accountability and cost control have led to wasted capital and poor infrastructure/system design. Al-ways seeking a quick cash fix for problems obvious in hindsight: We can draw comparisons between our health-care system and Greece's predicament.
P.D. McNeely, MD, Surrey, B.C.
Cricket's eternal hold
Re Hope Rises From The Ashes, But The English Still Worry (Sports, July 15): Cathal Kelly quotes Shaw's opinion concerning the raison d'être for cricket: "The English are not a very spiritual people, so they invented cricket to give them some idea of eternity."
Maybe, but The Almighty has tended to treat the English with kid gloves: It's been said that the sun has never really set on the British Empire because God simply can't bring Himself (or Herself, of course) to trust an Englishman in the dark.
Gerard Ponsford, White Rock, B.C.
Letters to the Editor should be exclusive to The Globe and Mail. Include your name, address and daytime phone number. Try to keep letters to fewer than 150 words. Letters may be edited for length and clarity. To submit a letter by e-mail, click here: firstname.lastname@example.org