A few years ago Harold (not his real name) asked me to help him with his grocery shopping. Fiercely independent in his two-story stucco dwelling a heart condition kept him from attending to the leaky roof and tippy front steps. A beige wall-to-wall carpet covered a musty damp, dim interior while mice had scattered their droppings everywhere on the thick broadloom. Harold roared if I made the slightest suggestion of moving. An upstairs bedroom served as his headquarters so a loud knock instead of pushing the doorbell (it didn't work) would wake him. In a moment, his bearded face protruded from the window above, and eventually the front door opened to a grizzled bespectacled man in a frumpy grey housecoat. In detailed rhetoric and enthusiasm, he'd announce his grocery items but what he loved was to get out wheeling around the store hunched over his cart picking up so many of his favourite items. Then there was the embarrassment of not having enough money to pay for the goods. A few months of this and I finally offered to shop alone for him. He reluctantly agreed, and somewhat relieved, I'd buy what I could from his list; although he often stung me with criticism if I forgot his preferred brand. I kept the phone lines open with infrequent visits except when he'd call about something. Eventually, his heart gave out, and he died lonely and alone. Sadly, I'll always wonder if the right home care could have improved his situation.
Recently, I met Lori Flaxy at a meeting of people connected with Niagara's age-friendly initiative. Owner of Ontario Senior Services Ms Flaxy is a Certified Professional Consultant on Aging (CPCA). She is keenly aware that the inability to perform tasks such as housecleaning, shopping and meal preparation is a "tipping point" for admission to long-term care facilities (LTC). These factors are especially relevant if the client lives alone and is trying to manage a chronic condition. Universal, as it is Flaxy, believes in reaching out to help individuals for life by building strong relationships that can result in an independent future. However, many older adults still need personal attention from home care workers and family caregivers as well.
A 24/7 one-stop service, Ms Flaxy offers non-medical support and advocacy for seniors by promoting and assisting with the activities of daily living. She includes help with household management which encompasses homemaking and home maintenance for a safe and healthy environment. A quality value-added service regular interaction with the same familiar personal assistant, exercise and nutrition is promoted and monitored for general well-being. It is critical for continued mobility for seniors to navigate their environment, remain independent and enjoy familiar surroundings. These client relationships have proven to ease the distress of isolation and at times depression that can impact the quality of life for the maturing population. Besides, Niagara has one of the fastest growing seniors populations in Canada.
In Harold's case Ms Flaxy would have met with him to assess his needs and ensure his house was safe. She would remove tripping hazards and ensure functional smoke detectors including an emergency contact system were in place. To start she would act as an advocate and have regular communication with his physician for clarity re his heart condition and drive Harold to appointments. She would help Harold manage his daily activities of bathing, hygiene, dressing, laundry, housework, shopping, meal planning and preparation. Within the community, where possible, she would promote coordination with neighbours, family, pharmacists and friends to facilitate regular interaction to ease Harold's rage. Then working on his budget repairs to the roof, doorbell and front steps would begin with a regular indoor/outdoor household maintenance schedule. Issues such as the mice, moldy carpets and other difficult tasks like cleaning windows and yard work can all be done with daily, weekly or monthly visits depending on the level of need and client's budget. Ms Flaxy works with fully insured staff and licensed and trusted tradesmen sensitive to seniors' needs and coordinates work with multiple estimates.
The estimated cost is $450 per day for Alternate Level of Care (ALC). These are people who no longer need acute care but remain in a hospital waiting for placement to another facility such as an LTC home. ALC patients use up to 5200 beds in Canadian hospitals daily. The estimated cost for medical and basic non-medical home care is about $100 per day. Every 10% shift of ALC patients to home care can mean a saving of $35 million. Home care not only focuses on the client rather than the system; its integration with other areas of the health care system potentially makes it sensible and cost-effective.©