In 2021, over 37 percent of individuals providing long-term care for loved ones in Canada were experiencing distress. This distress manifested in feelings of anger, depression, and an overall sense of being unable to cope. Shockingly, in the province of Ontario, the distress rate reached a staggering 42.2 percent. These alarming statistics shed light on a significant issue surrounding long-term care in the country. The current state of public home care services and long-term care homes is insufficient and in urgent need of a fundamental rethink.
The British Columbia Office of the Seniors Advocate recently revealed that the majority of home support clients do not receive daily service and only receive an hour or less of assistance on the days they do receive care. This lack of consistent and adequate care places a heavy burden on individuals providing care at home and contributes to the distress they experience.
Meanwhile, publicly funded long-term care homes, which receive the majority of government spending, have been deemed woefully inadequate by a 2020 report from the Royal Society of Canada. Obtaining a bed in such facilities can take months, and the quality of care once inside is inconsistent. These shortcomings have led to a growing waiting list for long-term care beds, with over 40,000 people in Ontario alone eagerly awaiting placement as of December 2020.
Though steps have been taken to address these issues, such as the introduction of LTC standards by the federal government and increased funding by provinces, these efforts are seen as marginal improvements at best. It is clear that a more significant and comprehensive solution is required to meet the growing demands of an aging population.
Looking ahead, the future of long-term care in Canada appears grim. As the baby boomer generation continues to age, the percentage of the population over 85 is projected to at least double in the next two decades. Despite advancements in healthcare allowing individuals to live longer, the number of years spent in poor health remains unchanged. Experts predict that the portion of Canadian GDP dedicated to financing long-term care will need to increase by nearly three percentage points to cover the escalating costs.
In light of these challenges, it is crucial to explore sustainable and equitable solutions for funding long-term care. One proposal is the implementation of a long-term care insurance model similar to Japan’s, where a special tax paid by individuals over 40 finances the insurance program. However, it is essential to strike a balance that does not burden younger generations with supporting older citizens solely.
While increased immigration can help mitigate the impact of population aging, it is not a panacea. Canada lacks the necessary infrastructure to accommodate the number of immigrants required to reverse the aging trend. Though more spending on home care is desirable, it is not a comprehensive solution. Additional home care hours may alleviate burdens for caregivers but will not significantly reduce the need for residential care or result in overall cost savings.
Ultimately, the best policy options are those that adequately and fairly fund long-term care, while maintaining transparency and neutrality between different care options. Adequate funding can be achieved by exploring alternative revenue sources. One possibility is to consider both assets and income when calculating an individual’s ability to contribute to the cost of their care. Another approach could involve raising broad-based taxes to ensure the burden is shared by all segments of the population, not just the younger generation.
Fairness is paramount in addressing these challenges without overburdening younger generations. If taxes are raised to finance long-term care, they should touch all age groups equally, such as property and estate taxes and, to a lesser extent, sales taxes. Alternatively, if the full cost of care cannot be accommodated, fair and transparent criteria should be established for allocating care funds. This approach would ensure that everyone in need receives their fair share, regardless of their care setting.
Difficult choices lie ahead, but the most crucial consideration is the well-being of our loved ones. Implementing meaningful and sustainable changes to the long-term care system is essential to provide the care and support our aging population deserves. By rethinking the way we pay for long-term care and finding new funding models, we can ensure a more equitable and compassionate approach that meets the evolving needs of our seniors while safeguarding the interests of future generations.
