Alberta Health promises a 'building year' to reform seniors care at home and in facilities

Thursday's budget included only a small increase to home care, but Health Minister Jason Copping says there's much more to come.

Alberta Health intends to spend $856 million per year by 2024-25 on the health care aides and others who assist seniors to age in place. That's up from $750 million budgeted for this year, and $731 million budgeted for last.

And that doesn't yet include non-health care support — snow shovelling, house keeping and meals — which families say can be just as important. 

"There's no additional funding for (non-medical support) in this budget," Copping said in an interview. "We know that's going to be one of the reasons why people come in to care homes — not because they actually need a higher level of medical care, per se, but they just can't stay at home because of those practical issues in terms of snow clearing.

"We need to be able to deliver on that."

Alberta has been funding a group of non-profit leaders to figure out how to co-ordinate non-medical care better. The chair of that committee, Karen McDonald, previously said she expects to see funding for improvements next year, in budget 2023-24.

Throughout CBC's focus on family caregivers this month, many adult children and spouses pointed to this help as critical.

Alberta is expecting a wave of aging seniors needing care will stress the continuing care system in the next decade. Figures in the budget suggest nearly one in five Albertans will be 65 or older by 2030.

Last year, an expert panel told Alberta Health it should prepare for that by increasing the quality of care at home, which is less expensive. They said it must also fund more long-term care spaces, and they recommended an increase to staffing ratios in the existing facilities.

That's not addressed yet either.

Copping said they believe roughly 20 per cent of the people in long-term and other continuing care facilities would not be there yet if sufficient support was available in the community.

"As a government, we're working through the proposals and putting together the plan," he said, adding that includes introducing legislation this spring.

"This year is a building year in terms of finalizing our plans, starting the process. But really, moving into future years to implement and go harder on providing the support so people can stay at home longer."

Copping said the change for home care is not just increased funding. This year, they're also giving more flexibility to home care companies, hoping that will lead to more full-time positions and more continuity in staffing. He said the government will explore various models for delivery.

Many families have told CBC that home care staff are often stretched; they rush from place to place and are often only allowed to take on very specific tasks. Some families report home care is short-staffed, which means help can be cancelled at the last minute, or the staff turn over so quickly families feel they are constantly having to reorient newcomers.

Investing in these people is key, says Cindy McCaffery, who was part of a group of family caregivers who shared their stories with CBC News. Her husband was diagnosed with dementia at 48.

"They are golden people because it takes the worry away. And worry is one of the most prevalent feelings I have as a caregiver. I can't keep my eye on him all the time, and I want to make sure he's enjoying a good quality of life, too."

When asked about the budget, she said she'd like to see home-care staff paid enough with good training and job conditions so they know they are valued and will keep doing this work long term.

Here are a few other items in Thursday's budget on the continuing care file:

• Part of the capital budget includes money for renovations, including to start turning two-person rooms into single rooms. The practice of rooming patients together is commonly seen as a key factor in the rapid spread of COVID-19 during outbreaks.
• Families of dementia patients have been lobbying for small-scale care homes. Copping said that will likely be a focus for the province in later years.
• A shortage of care homes in Indigenous communities has meant many elders are forced to leave their communities in their final years. Copping said funding for new elders' lodges has been approved. The exact amount depends on which projects are approved.