The Importance of Respite Home Care Services for Caregivers in Ontario

Caregivers need a break from caregiving from time to time. This is where respite services come in.

These are home and community services that allow a family caregiver to take some time off or vacation. They include the in-home presence of a paid homemaker to provide care; facility-based respite such as a short term stay in a long-term care home and day programs for persons receiving care.

In-Home Care

Home care workers can help your loved one with activities of daily living and basic medical needs. They can also complete household tasks and run errands. Some can even provide transportation to your loved one’s appointments.

This study examines publicly-funded respite programs offered by jurisdictions across Canada including in-home care (home support worker comes to the home and performs services such as bathing and meal preparation); facility-based respite where the patient stays at a residential care facility or, less commonly, a hospital for a predetermined period; and day programs. It looks at user profiles and eligibility criteria, cost to the family caregiver (where applicable), and level of demand relative to service availability.

The majority of in-home care services are provided free of charge to clients whose assessed needs are up to the monthly allowed limit ($3875/month). In Newfoundland and Labrador, there is an income threshold of $3000 or less for a single person or $5500 or less for a couple above which a client must purchase their own respite service.

Adult Day Programs

Adult day programs can help caregivers get a much-needed break from the stress of caregiving by offering in-home assistance with activities of daily living as well as onsite services such as foot care and hairdressing. Many of these programs also provide transportation to and from the program.

The cost of respite services varies widely across the country, but is often covered by provincial or territorial home care plans for clients assessed at risk and whose income is below a threshold (for example, $3000 in liquid assets/single or $10,000 in liquid assets for a couple in Newfoundland and Labrador). Many families that exceed this threshold either hire private service providers directly or use community or regional agencies to act as brokers between them and accredited paid home support workers.

The number of adult day programs is limited, however, and demand for such services is high relative to availability. More funding for these programs could help to alleviate this problem.

Short-Term Stays in a Long-Term Care Facility

Caring for a family member with health care needs can be stressful and exhausting. Respite home care services can allow caregivers to rest and recharge for a short period of time, so they can return to their caring duties with a renewed sense of purpose.

In some jurisdictions (Ontario, Manitoba, Yukon, Northwest Territories, Nunavut, First Nations and Inuit Health Branch programs, Veterans Affairs Canada programs) there are no direct costs to families for respite services. In others (Newfoundland and Labrador, Nova Scotia, New Brunswick, Prince Edward Island, Quebec, Saskatchewan, Alberta, British Columbia) a case worker assesses financial capability and determines the portion of costs to be borne by the family.

There are limited facility-based respite spaces available, and demand is high. It is important that families plan for respite well in advance so they can schedule the right service at the most convenient times.

Personalized Care

The individualized care that respite workers provide allows family caregivers to take a break from their caregiving responsibilities while knowing their loved ones are being well taken care of. These caregivers provide assistance with activities of daily living, medication reminders, physical activity, meals, and transportation services. Some also offer basic health care services, such as wound care and wound dressing.

Most jurisdictions have programs that offer facility-based respite services, but the availability of these programs is dependent on available funding and staffing levels. There are also gaps in the availability of respite services for Canadians living in rural and remote areas.

In general, public officials interviewed had a strong commitment to providing family caregivers with the best home care services possible within their existing financial and human resources constraints. This includes a desire to reduce income barriers for families and improve access to services such as home care and day programs. The attached tables provide information on the types of publicly-funded respite care offered in each province and territory, as well as user profiles, program details, eligibility criteria, cost to the user, and special features if available.