Defining Home Care in Canada

Home care is defined by the Federal/Provincial/Territorial Working Group on Home Care as the:

array of services which enable consumers incapacitated in whole or in part to remain in their own homes, often with the effect of preventing, delaying or substituting for long term services… It may address needs specifically associated with a medical diagnosis, and/or may compensate for functional deficits in the activities of daily living… To be effective [home care] may have to provide services which in other contexts might be defined as social or educational services (e.g., home maintenance, volunteer visits)… Home care may be appropriate for people with minor health problems and disabilities, and for those who are acutely ill requiring intensive and sophisticated services and equipment. There are no upper or lower age limits at which home care may be required, although as in other segments of the health care system utilization trends to increase with age” (Canadian Home Care Sector Corporation, 2003a)

Although each province has organized care differently there are some common features: entry to all home care services is by way of provincially designated public or quasi-public agency, eligibility for home care services is based on need as determined by a provincially uniform assessment and care planning process, a case management service and each feature above has a single regional or provincial administrative structure (MacAdam, 2004). Currently, all provinces provide three types of home care—post-acute, supportive care for the chronically disabled and end-of-life care—within one umbrella program. Professional services (nursing, rehabilitation, and case management), pharmaceuticals and medical equipment/supplies, support for essential personal care needs, and assessment and case management are offered at no cost to clients (Hollander and Walker 1998; MacAdams, 2004). Access to other home support services vary from province to province by eligibility, costs, and coverage. In Ontario, for example, home support services are provided up to a maximum number of 40 hours per month, but only to clients who require personal care. Often there is a maximum upper limit to care based on comparable nursing home costs.