CMA wants seniors’ care on federal agenda

With regard to the CMA article dated August 18, 2014, entitled "CMA wants seniors' care on federal agenda", written by Barbara Sibbald, I'd like to make the following comments: Although I applaud your medical association for highlighting the needs of seniors and their families and for your call for a national strategy, at least one of the cost of care figures cited by the CMA seems highly questionable. We are a specialist service and research organization that, among other activities, conducts an annual fee survey of more than 1,500 non-profit and commercial home care and residential care providers for seniors in all 10 provinces across Canada. The resulting cost figures from our survey for home care are quite different from the one cited in your article.

Specifically, your citation of home care costs of $55 for one day seems quite misleading. Based on our annual survey, home personal care in Canada in 2013 typically cost from a low of about $19 per hour to a high of $37 per hour, depending mostly on location and the agency supplying the care. Median national cost of charges for one hour of companionship/supervision/attendant care is $22.36. Accordingly, a "day" of home care or 8 hours of care typically costs about $168, not the $55 cited by CMA. Furthermore, if a "day" is defined as 24 hours of care, to enable a fair comparison to hospital care or long term care in a nursing home, the daily cost is double or triple that $168 cost. Finally, our data show that in 2013 the national median cost of skilled nursing delivered via home care was $51.64 per hour. If even one hour of skilled nursing per day is also included in the "one day" of home care, then the total cost per day is even higher.

I suppose that the only way one could even muse about a home care cost of $55 a day would be to assume that the provider was an untrained, unsupervised and unregulated live-in "nanny" or "maid" who is also receiving room and board. There are too many complications to even begin to fully discuss why this form of care is usually an unrealistic and inadequate alternative to nursing home or hospital care. But suffice it to say that caring for frail, chronically ill and often disabled and/or demented patients is a job that requires more than a $6.88 an hour nanny or cleaning lady.

While the logic of your argument about shifting chronic care seniors out of acute care beds and hospitals remains very valid, it is important in making your case to government and to the public to work with real data and realistic cost savings estimates. Sincerely, Mark Frankel, Ph.D., C.Psych. President and CEO LifestageCare Inc.

Conflict of Interest:

None declared