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Will Quebec’s ‘massive shift’ toward home care actually work?

WATCH: In its major health-care reform plan announced earlier this week, the government made more promises to seniors than perhaps anyone else. If Quebec honours its many commitments, there will be a dramatic shift toward caring for people at home instead of in hospitals or residences. But is that realistic? Global’s Dan Spector reports – Mar 31, 2022

If Quebec honours the many commitments made in its sweeping health-care reform plan this week, there will be a dramatic shift toward caring for people at home instead of hospitals or residences.

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Seniors advocates, however, have several questions about the shift to home care.

Dr. José Morais, the director of the geriatric medicine division at McGill University, said both the Liberals and Parti Québécois promised better health care in recent mandates, but never fully honoured the commitment.

He says minor investments won’t get the job done.

“Because the ageing of the population goes at such a rapid pace that even by improving the services, we would never end up meeting the real needs of people,” he told Global News.

Quebec’s population is aging quickly. According to statistics cited in the new health plan, more than 20 per cent of Quebecers will be over 70 by 2035.

The challenge will be enormous for a health system emerging from the pandemic battered and bruised.

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Morais says keeping people at home is far cheaper for the state than bringing them to residences or hospitals.

He believes part of the solution should be to give subsidies to families, so they can then use the money to manage care for their loved ones.

“They just need the monetary support to take care of these aspects. This would liberate quite a lot the responsibility of the government,” said Morais.

Medical malpractice lawyer Patrick Martin-Menard agrees with the need for a big investment in home care. He said he regularly hears from people having issues with insufficient home care.

“It’s either because those key services are being cut or because they have significant difficulty in having access to even basic services staying at home,” Martin-Menard said.

Advocates are concerned that the health reform proposal provides few details.

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“The plan must actually lead to concrete actions, like right away,” said Danis Prud’homme, executive director of FADOQ.

“We know what we need to do. Instead of putting most of our budget toward hospital-centric care, we need to be decentralizing the care, and sending people  home.”

Martin-Menard said for home care to work well, there also needs to be a rethinking of management.

“CLSCs need to be much better equipped to do more, and the home care teams have to be better managed as well to make sure that services are being given in an efficient way and in a respectful way,” he said.

The reform also promises improvements at seniors homes ranging from new buildings to improved evaluation systems and better food.

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“The patient experience has to be at the centre of this structure. The patients, the families, the people who actually receive the care, not the perspective of the manager who added up from some external performance indicator,” said Martin-Menard.

Morais says reform in seniors homes and the system in general, is essential.

“It will take a few more years to have this implemented, but it’s a must. There is no other way. Otherwise, the health-care system will not survive,” he said.

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