Care of Seniors in Canada

An important advantage of the Swedish eldercare system is that many older people with health issues can continue to live in their own homes. The staff of the hemtjänst and the care homes possess a wide range of competencies covering home help, physiotherapy, occupational therapy, and nursing care. Nowadays, elderly hospital patients are able to return home the same day that they are discharged following treatment. Close coordination between the hospitals and the hemtjänst has resulted in a drastic reduction in the number of occupied hospital beds and care home places.

The standard of eldercare in Sweden has gradually improved during the last hundred years. Work is still ongoing to make further improvements, and there is lots more to do. One problem is the shortage of doctors. In terms of GDP, Sweden spends more – approximately 4 percent – on eldercare than any other OECD member state. This outlay is expected to increase further due to the aging population.

By Laurel Anderson-McCallum

Private for-profit homes are a growing industry aiming to serve thousands of seniors on waiting lists. Photo: Dominik Lange/unsplash.com

In 1961, Canada adopted Universal Health Care devised by Premier Tommy Douglas of Saskatchewan. Today, Medicare covers 70 percent of all Canadians’ health care needs; the remaining 30 percent – prescriptions, glasses, dental care – may be covered by private insurance plans which not all citizens have. Of the total spending on pharmaceuticals in Canada, seniors spend 55.3 percent.

Care of seniors is offered at home, in long-term care (LTC) facilities or as palliative service. In 2018, 17 percent of Canadians were over age 65. Care is challenging for marginalized seniors and those in rural or remote communities. Admission for long-term care is processed by regional health authorities. Eligibility, wait times and ability to pay accommodation costs affect admissibility, although subsidies are available. Private service providers fill the gaps in the public sector. Private for-profit homes (54 percent of LTC homes) are a growing industry aiming to serve thousands of seniors on waiting lists.

There are three types of homes: publicly government funded, private for-profit homes, and private non-profit homes. LTC homes are regulated by the Ministry of Health provincially and are inspected annually. Paying for care is a “mixed model,” different among provinces and territories. Provinces pay for a basic portion of care; the benchmark is 4.1 hours per 24-hour day per resident but varies widely in regional implementation down to as low as 2.4 hours per day. Residents in homes pay for private rooms and extras such as telephone, TV, and hairdressing. Forty-six percent of LTC homes are publicly funded. Research shows reduced safety and care quality in for-profit homes, as well as fewer nursing and aide hours per resident than in government-run facilities in Manitoba, B.C., Quebec, and Ontario. Some seniors may not need nursing home facilities. Inhome care services are used by 20,000 Canadians and are regulated provincially. Advantages of home care have been recognized: independence, dignity, social relations, and autonomy over care needs. Access to home care is complex; more staffing, specialized training and improved government oversight are required to meet home care demands. Currently 6 percent of seniors receive publicly funded home care.

Palliative care relies on community level service providers. However, Bill C-277, 2017 – an act providing for the development of a framework of palliative care in Canada – is to be finalized in December, 2022 by Health Canada.

Many Canadians have espoused the idea that a major step in furthering seamless health care for seniors is to have Beds in residential long-term care facilities per 1,000 population aged 65 years old and over (2016 and 2018)

N/A

SWE: 65 beds/1,000 (In 2018: 70.3)

CAN: 57.6 beds/1,000 (In 2018 54.4)

US: 33.4 beds/1,000 (In 2018 data N/A)

Source: OECD (https://stats.oecd.org/)