Home care: do we have the wrong model?

Home care: do we have the wrong model?
Home care: do we have the wrong model?

There will be more money for home care, we learned yesterday. Should we rejoice?

In any case, the amount announced yesterday by the Legault government is impressive: $ 750 million over 5 years.

It’s a bit inevitable: on the planet, Quebec society is among those that are aging the fastest. (This amount also includes amounts for young patients.)

Something must be done to respect the first choice of the elderly, which is to be able to stay at home as long as possible.

That’s good

The announcement was timely. The debate on the living conditions of seniors has been revived by the current pandemic and the devastation it has wrought.

A documentary titled The last house, by cultural columnist and host Annie-Soleil Proteau, will be presented on June 6 on TVA.

In anticipation of this broadcast, Mme Proteau made a remarkable outing at Everybody talks about it recently, deploring the lack of emphasis placed by Quebec on home care, compared to accommodation.

In other countries grappling with accelerated aging, such as Denmark, the proportion of budgets devoted to home support (73%) is much greater than that going to accommodation (27%), she said. argued. In Quebec, the proportion would be the opposite, which Minister Marguerite Blais did not contradict when I submitted the data to her, recently, during an interview in Qub.

Tax credit

Home care has long been the poor relation of our system. Quebec governments have often developed home care through tax credits. Moreover, in the Legault government’s announcement yesterday, there were still several increases in refundable tax credits, in particular “for caregivers” and “for home support for the elderly”.

In an interview with Qub, Marguerite Blais declared that “never has a government put so much money into elder care. “

Spend better?

Maybe, but are we spending it well? Are the tax credits adequate?

The geriatrician and former minister Réjean Hébert does not believe it. “Tax credits are not a measure of social solidarity, they are a measure to stimulate the economy,” he railed in an interview he gave me in 2018.

Among the elderly who claim the tax credit for home-support services, some 80% live in private seniors’ residences (RPA), he has already stressed. However, these residences help “their” seniors to claim this tax credit; which, subsequently, take this amount into account in the cost of the rent. As if the state were indirectly subsidizing RPAs! A better formula would be, according to Mr. Hébert, to create an “autonomy insurance” allowing the elderly to choose their care and to make their claim according to where they live. In 2013, he tabled a bill providing for the creation of this insurance. This would have represented a real shift in these matters in Quebec. Maybe it is time to reconsider this option? Coupled with contemporary technological possibilities for attendants to monitor the health of their patient at home (scenario mentioned by Université Laval professor Philippe Voyer at LCN yesterday), we could undoubtedly develop a less expensive and more efficient model. than traditional tax credits.

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