A Dartmouth MLA says the province’s failure to provide enough home-care staff to look after Nova Scotia seniors can have catastrophic consequences.
“The strategy to keep Nova Scotians home instead of building on long-term care beds was one that would only work if there was sufficient home-care staffing in place to care for our seniors,” Tim Halman, the Progressive Conservative MLA for Dartmouth East, told the legislative public accounts meeting Wednesday.
“Nova Scotians have heard horror stories of seniors falling to the floor on a Friday and being found on a Monday morning because there was insufficient staff on the weekends,” Halman said.
Halman recounted a media report of a family suing a home-care company because their then 84-year-old father John Slaunwhite spent nearly two days on the floor of his Terence Bay home in September 2019 while two scheduled home-care visits were missed.
“At the same time as the number of seniors requiring home care have gone up each year, the number of home-care clients last year dropped from 31,688 in 2019 to 30,881,” Halman said.
Halman wanted to know what percentage of the time home-care companies cancel visits in the province.
Dr. Kevin Orrell, the deputy minister of the provincial health department, said the pandemic has presented a challenge in terms of managing people in their homes.
“There are a limited number of workers and hours,” Orrell said, adding that the department has increased the care provider subsidy, looked at home-care aids and implemented adult day programs.
“The stories that you hear that are very tragic are serious events that we will be looking into and investigating,” Orrell said. “With 17,000 people who receive home care in the province, there are thousands of people who are extremely happy with it.”
Vicki Elliott-Lopez, the department’s senior executive director of continuing care, said the authorized hours of home care have actually increased by about 23 per cent over the last five years.
“We’ve seen a continual climb of the number of clients served,” Elliott-Lopez said. “We try not to look at home support in a box. What we are trying to do is serve Nova Scotians with a variety of home and community services.
“We do know that … with COVID, people have cancelled home care because they are fearful of (other) people coming into their homes.”
Halman asked the department representatives to refocus and address his question about what percentage of the time do home-care companies cancel visits.
“Pre-COVID, the last report I would have seen, was between two and three per cent of visits were missed for a variety of reasons,” Elliott-Lopez said.
Halman asked “how much notice is given to families,” about cancelled visits and if there is a policy or a provincial standard on cancellations.
“Technically speaking, as much notice as possible is what we’d like families to receive,” Elliott-Lopez said. “If they are in a position where they feel that they have not received enough notice, we always encourage them to reach out to the agency.”
Beyond that, the family could take the complaint to the local care co-ordinator with the Nova Scotia Health Authority, she said.
“The strategy to keep Nova Scotians home instead of building on long-term care beds was one that would only work if there was sufficient home-care staffing in place to care for our seniors. Nova Scotians have heard horror stories of seniors falling to the floor on a Friday and being found on a Monday morning because there was insufficient staff on the weekends."
- MLA Tim Halman
“So what would you like to tell Nova Scotians when they call MLA offices and say that their home care was cancelled again and again and again,” Halman said. “It’s happening, I hear it all the time.”
Elliott-Lopez said there is a complaints process and repeated Orrell’s assertion of client satisfaction.
“We are hearing that most Nova Scotians are quite satisfied with their services and, as tragic as some of the issues are, they are a small percentage of what we see.”
Hallman also wanted to know why home care companies are accepting new clients “while it is clear and they are telling families on Day 1 that they do not have enough staff to provide the numbers and level and home care prescribed” for the senior population. Accepting new clients also decreases the number of hours that home-care companies can provide existing clients, Halman said.
Orrell said there has been an adjustment in the specific care provided since the pandemic began.
“During COVID, there have been refusals from clients to allow caregivers into their home,” Orrell said. “In fact, during the first wave it was necessary to support those providers so that they didn’t have to lay staff off, which would have been tragic. With the reduction because of client refusal there is an ability to deploy those people to new clients or clients who have been prioritized for a higher level of care.”
Susan Leblanc, the NDP representative for Dartmouth North, asked about wait times and when Nova Scotians might see regional wait times for home care on the department’s website.
Orrell could not commit to a time frame to make that happen but said the wait time has gone up over the past year.
“From January 2020 to January 2021, there has been approximately a 35 per cent increase in the wait time,” Orrell said. “In January 2021, there were 1,086 clients waiting for about 4,680 hours of home support. Since July of 2020, we have tried to mitigate that.”
He said the support of care funding doubled from $500 to $1,000, and a request to increase the caregiver benefit has been submitted.
The public accounts meeting agenda was revisititation of the auditor general’s taking the health department to task for not putting a process in place to verify the accuracy of reporting from home support providers regarding reported hours, performance indicators and statistics.
Orrell said the province invests more than $260 million in home-care programs and services and that work has begun to upgrade the accountability language in contracts for the 20 home-care agencies providing those services.
