Health Care Coverage for Older People Canada

In most provinces, some home care (sometimes called community care) services are publicly funded up to a maximum capped amount. During the 1990s, the emphasis in home care programs shifted from that of supportive care for the chronically ill and disabled to substitution for acute care. This is particularly the case for home care programs in urban centers, where the pressure to offer "sub-acute" home care services intensified following hospital bed closures. Professional health services provided by registered nursesor rehabilitation disciplines continue to be subsidized; however, clients now pay out of pocket for services such as health supervision, personal care, and homemaking. Some programs no longer provide these services, leaving it up to clients and family members to locate and arrange for them.

The affordability and accessibility of home care remains problematic for people with chronic illness and disability in many parts of Canada. In at least one Canadian province it has been demonstrated that the impact of funding reductions in health and social programs affected older people disproportionately. Home care services have not traditionally operated around the clock and through the week, although this is beginning to change. Charges for supplies and medications, which would be covered by the universal health insurance plan if a person were in the hospital, must often be paid out of pocket once a person returns to the community. Such disincentives mitigate against the preferences and ability of older people to receive needed services in their homes.