Seniors do not have adequate, publicly funded home care allowing them to age in place affordably, or at all. Home care must be profoundly reformed to provide a meaningful quantity of appropriate, high-calibre care to allow seniors to age in place. Home care workers must be paid a living wage with appropriate benefits to ensure both current workforce sustainability and to attract new workers to the home care field.

Recommendation #91: Transform the Current “Home Care Worker” Model, with an Integrated Multi-disciplinary Team Model of “Care at Home”

Instead of having only personal support home care workers provide the bulk of home care assistance, transform the model to integrated Care at Home. Invest in expanding geriatric multi-disciplinary team hubs, which provide in-home visits and robust integrated home supports. Bring the care teams to the house of the community-dwelling senior. Add significantly more Care at Home supports, both in terms of hours and type of care provided.

Recommendation #92: Increased Quantity, Quality, and Types of Care at Home

Invest in providing increased quantity and quality of Care at Home, which is equitable across Canada, and not dependent on postal code or one’s ability to privately pay. Establish Care at Home as the primary model of care for aging in place, covering medical, social, and personal care needs. Adopt the Nordic Model for Care at Home.

Recommendation #93: Directed Federal Funding Transfers Tied to Outcomes

Directed funding from the federal government to provinces in the area of home care should have specific reportable metrics and spending priorities. While the 2017 federal budget included funding to the provinces of $11 billion over 10 years, beginning in fiscal year 2017‑2018, divided between home care and mental health initiatives, little measurable improvement has occurred. This and any future direct federal funding for home care investment must be targeted, measured, and have reportable indicators, to avoid being subsumed in general provincial revenues.