Home Care in an Age-Friendly City

Building an age-friendly Hamilton requires that older people receive the support and care they need to live and thrive in their communities. Strong home care services are therefore a key pillar of age-friendly cities. What makes for good home care services, and what do older people need and want from home care?

Home care services range from help with cooking and cleaning, to personal care such as bathing, to nursing care and occupational and physical therapy. Increasingly, physicians are becoming a part of the home care system by visiting those who may find it difficult to get to a doctor. Transportation services such as DARTS, meal delivery services like Meal on Wheels, and friendly visiting programs also play an important role in supporting older people in their homes. To access publicly funded home care, provided through Community Care Access Centres (CCACs), those in need of care must undergo an assessment. Those with the financial means may also choose to pay privately for home care.

 As a graduate student researcher in the Department of Sociology at McMaster University, I have conducted interviews with older people using home care to gain a better understanding of their experiences and expectations of home care services. The participants in my study, living in Hamilton and Toronto, shared important insights on the things they value in home care and on the ways we might improve these services to enable older people to live happily and safely in their own homes for as long as they wish. In this blog entry, I will share some of these findings with you.

Although participants in my study received home care for help with a variety of activities, they often emphasized that it was important to continue caring for themselves as much as possible. Participants expressed a desire for home services that supported their capacity to take care of themselves in ways that were personally meaningful and that contributed to their well-being. For example, some participants who had trouble walking wanted home care workers to accompany them on short walks. Such support enabled them to stay active without worrying about their safety if they were to fall while walking alone. Providing home care services that meet older people’s desire to care for themselves can support their long-term well-being.

In many cases, participants who were receiving home care also received support from family members and friends. Participants often expressed that their family and friends played an important role in caring for them and in enabling them to live in their own homes. Yet, participants were often reluctant to ask their families and friends for more help, and expressed feelings of guilt about “burdening” family, especially adult children. Participants often voiced a need for more public home care services so that they would not have to turn to family in times of need. There were also some participants who had very few family members or friends available to help, for diverse reasons. Some of these participants had migrated to Canada and left family behind, while others had cut ties with family due to experiences of abuse and conflict. Providing sufficient home care for all—including those with very little support from family and friends—is necessary to build an inclusive age-friendly city.

Finally, participants expressed a desire for greater control and flexibility in accessing home care. In some cases, participants complained that the home care they received disrupted their schedules when care providers visited at inconvenient times. For example, having to wait for help with a shower sometimes meant that participants missed social activities and appointments. In other cases, participants felt that they did not receive help where it was most needed. For example, some participants expressed a need for help with cleaning, rather than bathing, but were only allotted home care for bathing. Providing flexible services, which respond to individual needs and desires, is essential to enabling people to live well and to participate in their communities.

Rachel Barken is a PhD Candidate in the Department of Sociology at McMaster University, and a student member of the Gilbrea Centre for Studies in Aging. You can follow her on Twitter @RachelBarken.