A snapshot of government-provided care

How many paid hours of care you can expect from the government differs dramatically depending on where you live and even who assesses your needs. Here’s an idea of what to expect:

In Alberta, “clients with a dementia are typically considered ‘long term supportive’ clients,” says Cheryl Knight, executive director of community and seniors’ health at Alberta Health Services.

“These clients can get a maximum of 10 hours per week of direct professional service, 35 hours per week of personal support service and 26 hours per week of respite services.” If your needs exceed that ceiling, “there’s an opportunity to have the services considered for extraordinary funding.”

In Ontario, says Audrey Miller, owner of geriatric care manager Elder Caring Inc.  “the maximum I’ve seen is 56 hours and that was for palliative care.” If you need help bathing, you might get one to two hours a week, enabling you to bathe twice, she says.

In British Columbia, by contrast, you could get a maximum of 28 hours of care a week, according to Peter Silin, owner of Diamond Geriatrics in Vancouver. But that would be rare, he says. “Generally, the maximum you’ll get is two hours a day.”

A social worker by training, Silin is one of the new breed of geriatric care managers, like Audrey Miller, who offer services geared to the overworked caregiver. He has accompanied elderly people to doctor’s appointments, intervened with the local health authority to get them more in-home care and watched over them in hospitals and nursing homes.

He start withs a care management assessment to identify issues, such as night wandering. Then he works inside and outside the public health care system to put supports in place that enable people to stay in their homes as long as possible. As Silin told one busy real estate agent recently: “I’ll be the caregiver so you can be the son.”

To find a care manager, check out the Senior Service Directory listings.

Consider hiring a private patient navigator. For more on how they work, read Gift of Guidance: The Role of Patient Care Navigators.

How to get extra help

It is possible to negotiate for more hours of government-paid care, says  Silin. He suggests documenting all the things you do as a caregiver on a day-to-day basis, from bathing to feeding and notifying the CCAC when the person you’re caring for loses abilities and has new symptoms.

It helps to know how to phrase your request for more care, adds Miller. She suggests saying something like “my parent is at risk of a fall – I think she needs help with bathing.” The government is well aware that it is far more expensive to provide hospital care for a broken hip, than to provide care at home, she says. “Be assertive. Ask what else you can get – what else is available? The squeaky wheel gets the grease.”

Blyth suggests making sure you’re part of the process. “It’s really important to be there when the case worker is doing an assessment,” she says. “I think if family members are involved, they feel as if they’re a little more under the microscope and they’re more willing to deal.”

Case workers are also a good source of info about other services you may be eligible for, she points out. “Because my dad was a veteran, we had a little more help. We could have someone come in to clean the house, cut the grass, clean the eavestroughs and remove the snow.”

Other people may have access to resources through workplace benefits or pension plans, a private insurer, or Aboriginal Affairs, says Angelakis.

Finally, don’t be shy about asking for help from family, friends, church groups and others. Angelakis suggests making a list of the things you are currently doing and how much time is required to meet that need on a sign-up sheet.

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Camilla Cornell

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