LiveWell Pathway is a proud Canadian home health care company dedicated to enhancing the quality of life of seniors and those living with temporary, progressive, or chronic illnesses and diseases. We spoke with Pauline Smiley, the Director of Administration, about homecare services and what we need to know about initiating them. 

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What is homecare? 

Homecare is having a health care worker provide one-to-one support in a person’s home or any place of residence, to people who are sick, injured, or too frail to care for themselves due to aging. Care at home includes, but is not limited to, assisting with bathing, oral care, grooming, medication reminders, meal preparation, mental stimulation, going for walks, and much more. The level of care depends on the needs of the person.   

In Ontario, where our services are located, you can initiate an assessment with Home and Community Care Support Services. Every province and territory will have their own provincial home care service organization. For a list of health care resources in your province or territory, please visit Dying With Dignity Canada’s Local Directory page. 

What are the main services or categories of homecare we should understand? 

Some services provided: 

• Personal Care: Assisting with day-to-day activities 
• Respite Care: Short-term or temporary relief for a primary caregiver 
• Companionship: Mostly non-medical support such as light housekeeping, meal prep, medication reminders, running errands, assisting with medical appointments, etc. 
• Palliative/Hospice Care: Compassionate comfort care provided to an individual to manage their symptoms and enhance their quality of life due to life-limiting or end-stage illnesses. This is also known as end-of-life care.  

What professions are involved in homecare, and what services do they provide? 

Care at home may involve the following professionals: a Social Worker, an Occupational Therapist, a Physiotherapist, a Personal Support Worker, a Registered Nurse, and much more. The illness dictates the level of care. For example, a client recovering from a stroke would be cared for by all the above, and possibly a Speech Therapist. A client with a wound may only be a nurse and a Personal Support Worker.      

A Social Worker is at the heart of a patient’s care. The Social Worker works alongside the medication practitioners such as the doctor and Occupational Therapist to identify areas of need and coordinate care accordingly.    

What does a homecare assessment look like? 

A homecare assessment is generally performed by a health care worker such as a nurse. A report is prepared which is comprised of the following: 

• Client’s current age, sex, and current health status
• Current medications 
• Client’s care needs 
• Recommended care plan that is agreed to with the input of the primary caregiver/family and or client. The care plan tells the worker how to care for the client daily. It may include some light mental and physical exercise routines like walking and playing games/puzzles. A care plan will also list things not to do based on the client’s health condition. It will also state the client’s wishes regarding resuscitation/DNR form and who to contact in case of emergency. Care plans will change as the client’s care needs change. 

How do we know if a person needs homecare or if it’s too early to arrange it? 

Some signs that additional care is needed: 

• The person is at risk of falling. 
• The person struggles with basic daily care such as bathing, grooming, hygiene, etc. 
• The person is not eating properly or struggling with preparing meals. 
• It seems unsafe for the person to cook or interact with fire. 
• There are obvious gaps in memory and or coherency.  
• The person is unable to care for their home and surrounding. 
• The person seems depressed or lonely. 

Some of these gaps can be filled by family or friends, so your regional home and community care service is not always the first phone call. For seniors, it is good practice to allow the regional home and community care service to determine if it’s too early. Too late would be overlooking the signs that care is needed which could lead to death. This sometimes happens in the case of a serious fall.   

How can a person access homecare covered by provincial or territorial health care and when we might want to “top up” with private homecare services? 

When a senior or an ailing person appears to need assistance, it is always safe to engage your regional home and community care service for an assessment. Anyone can make that phone call. It could be a family member, a friend, or a neighbor. They will determine if the individual qualifies for support and how much. If the individual or family concludes that the support provided by the provincial/territorial services is not sufficient, they can engage private care for additional hours/support if they have the means; this is called top-up care.