Recommendations for the Delivery
of Long Term Care
for an Aging Population in Canada
1 M-M Bernard,
MD., 2 Douglas E.
Angus, PhD., 3 Evelyn
Shore , 4 Liane
The purpose of this submission to the Romanow Commission is
to promote new and sustainable solutions for the delivery of long
term care for an aging population in Canada.
- In the context of Medicare, the Romanow Commission is planning
to "address the long-term sustainability of a high quality,
universally accessible and publicly administered health system".
- Roy Romanow (OECD, Nov.6, 2001) presented four perspectives
in dealing with the actual Medicare challenge: Financial funding
choices are prevalent in the first three, whereas the fourth
perspective takes into account a "new story" and "the
need for Medicare to be revitalized".
- At the Premiers' meeting on health in Winnipeg in August
2000, agreement was reached that access to health services is
of highest priority to all citizens, and the Premiers appealed
for Federal aid to health care.
1. The challenge for our governments is to balance health care
expenditures against other priorities in a context of changing
demographics and of new technologies.
2. Home bound seniors are the fastest growing population.
3. However, care in the home and community is identified as one
of the weak points of our current system. Already frail seniors
fall short of home care services and have fewer access to long
term care institutions. Over 10% of acute care beds are occupied
by seniors who wait for rooms in nursing homes.
4. The trend will soon be reinforced in the context of changing
demographics and aging baby boomers. The home care budget will
become unmanageable by public funding, unless it comprehends new
In fact, the delivery of services has already begun to change:
- Home care and community care are the fastest growing health
services in Canada.
- CST reports "there is now ample experience in Canada
and elsewhere that Telehealth can provide quality health care
for a great variety of medical conditions, involving all specialties
of medicine, nursing, and other health disciplines
- The provision of nursing services by tele-homecare using
video phones over ordinary telephone lines is now undergoing
extensive trials in Ontario, New Brunswick, the United States,
- A community of seniors, students, immigrants and health professionals
in the Ottawa region has been using PACE 2000's customized videoconferencing
since 1998 for regular social and health related services.
Recommendations for the delivery long term services to home
- The potential of the on-going tele-homecare strategies requires
broader implementation and evaluation projects are needed over
3-5 years to allow for sufficient time to take root, and for
the evaluation of short term and long term health related cost/
benefits to governments and to society at large.
- There are specific pre-requisites to the adoption of videoconferencing
by home bound seniors. These include: - non-intrusive, customized
videoconferencing for individuals with disabilities who need
no attending technician nor technical training - life size TV
images allowing for non-verbal communication and for interaction
In an aging population with increasing needs for home care, simplified
Video Conferencing stations for home users could become an indispensable
adjunct of supportive housing for seniors and of long term care
President, PACE 2000 International Foundation (Programmes for Autonomy and
for the Elderly)
2 Vice Dean and
Associate Dean (Academic), School of Management, University of
3 Member of the
"Coalition to Save Medicare" and of the "Ottawa
Seniors' Action Network" Board Director, PACE 2000 International
Foundation. Four years of home videoconferencing.
4 4th year student,
physiotherapy student, School of Rehabilitation, University of
Four years of Intergenerational coordination in the Intergenerational
Board Director, PACE 2000 International Foundation.
5 Report to Romanow
Commission, Canadian Society of Telehealth, Robert Filler, MD.