PERENNIAL POLICY ISSUES IN DIRECTLY-FUNDED HOME CARE IN CANADA: AN INTERSECTIONAL, QUALITATIVE STUDY TO ENHANCE SOCIAL AND HEALTH OUTCOMES
AUTHOR(S) & CREDENTIALS: Dr. Christine Kelly, PhD, Department of Community health Sciences at the University of Manitoba and Cassy Hemphill, Communications and Engagement Coordinator at the APPTA hub and AGE-WELL NCE.
CO-INVESTIGATORS: Dr. K Aubrecht–St Francis Xavier University, L Dansereau–University of Manitoba, Dr. M FitzGerald–University of Saskatchewan, Dr. Y Lee–University of Calgary, and Dr. A Williams– McMaster University. We also wish to acknowledge support from project partners across the country, including representatives of provincial health departments, home care service organizations, and advocacy organizations for older adults, disabled people, and caregivers.
AFFILIATED INSTITUTION(S): AGE-WELL National Innovation Hub: APPTA
ACKNOWLEDGEMENTS: This project is funded by the Canadian Institutes of Health Research.
CAN YOU TELL US A BIT ABOUT YOURSELF?
Christine Kelly, PhD, is an Associate Professor in Community Health Sciences and a research affiliate with the Centre on Aging at the University of Manitoba, in Winnipeg, Manitoba, Canada. Dr. Kelly is health policy researcher with expertise in home and community care services and studies directly-funded home care across Canada.
WHAT INSPIRED YOU TO BEGIN WORKING ON THIS PROJECT? AND CAN YOU DESCRIBE THE MAIN ISSUE OR CHALLENGE YOU INTENDED TO ADDRESS WITH IT?
Home care programs across the country are facing increasing challenges such as equity in access, inadequacy of support for clients and caregivers, and labour conditions for home care workers. The primary focus of Dr. Christine Kelly’s research project was directly funded home care, which is where families and clients are given funds to organize their own home care services. Interest in direct funding is growing based on various factors, including dissatisfaction with ‘regular’ home care services and pressures of an aging population. Dr. Kelly’s project asks how directly funded home care programs across Canada may be designed to better enhance social and health outcomes for all parties involved, including clients, caregivers and other unpaid supports, and paid workers.
CAN YOU TELL ME A BIT MORE ABOUT YOUR PROJECT?
“Perennial Policy Issues in Directly-Funded Home Care in Canada: An Intersectional, Qualitative Study to Enhance Social and Health Outcomes” is a project that focused on three key policy issues that vary depending on which province you live in, and which may present challenges to equitable and fair access. 1) the role of private home care agencies, 2) direct funding as a small program focused on specific population groups or as a mainstream program open to all home care clients, and 3) the role of direct funding in rural areas. To learn more about these issues Dr. Christine Kelly talked with those directly involved in providing or receiving care in the home—clients, families, and workers. Kelly has been conducting interviews and focus groups in areas of Alberta, Manitoba, and Newfoundland. Dr. Christine Kelly chose these provinces as research sites because they have different approaches to providing services to rural clients, have varying levels of infrastructure for public services versus reliance on private home care agencies, and each province has unique challenges attracting and retaining workers.
WHY DO YOU THINK RESEARCH IN THIS AREA IS IMPORTANT?
When asked why research in this area is of particular importance, Dr. Kelly stated the following: “COVID-19 has shown that we need high quality care options outside of residential care facilities. Directly funded (DF) home care is one potential solution to some of the issues surrounding aging and care in Canada. But research in this area has shown that policies for directly funded home care are not the same across the country, and that there are still many challenges and unknowns.”
Dr. Kelly believes her research is vitally important because it reveals the value of directly funded home care as an option and its great potential for enhancing quality of life and improving health outcomes. Her work also shows the potential challenges and inequities presented by DF, such as unequal working conditions, differences in access depending on where you live, or clients burdened by expectations to organize their own care services without sufficient supports. Research in this area helps provide evidence for policy makers and governments for improving home and community care across the country.
IF APPLICABLE, IDENTIFY ANY IMPORTANT POLICY IMPLICATIONS THIS PROJECT MAY HAVE.
Home care and caring for aging populations is an important topic right now in Canada. Especially with residential care facilities dealing with challenges that were exacerbated during the pandemic. Aging and care are on the minds of Canadians. Dr. Kelly’s research has clear policy implications by answering key questions about directly funded home care. Her research shows that DF may create barriers for low-income individuals, those with limited social support, and clients with limited English. Which reveals that there are potential equity issues with DF home care when scaled up. In short, Dr. Kelly’s research implications in policy offers a potential solution to the care deficit and crisis in Canada, while also cautioning and showing the potential roadblocks and challenges in that solution.