Seven days a week, Margot Algie can’t get out of bed before noon. Not from choice. She has amyotrophic lateral sclerosis (ALS), a debilitating neurodegenerative disease, and needs a home care worker to help start her day.
But once someone arrives to shift her into a wheelchair, dress her and help with toileting, Algie often only has one hour — sometimes two — before another home care worker arrives to put her back to bed at 4 p.m.
“Being stuck in bed … isn’t great for my body, my skin or my psyche,” said the Toronto woman, who is gradually losing the ability to do all basic living activities.
But the home care company says “that’s all that’s available,” she said.
At least once a week, she gets a call to say no home care worker is available at all.
“I’m terrified when they say I can’t have help,” said Algie, 63, who says she’s fully dependent on the care she receives.
A home care worker helps Algie transfer to her wheelchair. (Norm Arnold/CBC)
Algie is not alone when it comes to complaints about substandard home care. A recent CBC Marketplace investigation sparked hundreds of stories from home care clients and their families across the country, complaining of missed visits, shortened visits and the inability to get visits at all.
Compounding problems, the number of people who rely on home care is expected to increase by more than 50 per cent in less than a decade, according to the Canadian Medical Association (CMA).
It estimated in a recent report that more than 1.1 million Canadians receive home care and that by 2031, that number will likely increase to 1.7 million. On top of that, the report estimates the annual cost for long-term care and home care in Canada will almost double during that period, from $29.7 billion to $58.5 billion.
“This problem is getting worse,” said CMA president Katharine Smart. “There is a real risk we will see our systems start collapsing over the next months and years.”
It’s a grim prediction that doesn’t have to materialize, said Dr. Samir Sinha, director of health policy research for the National Institute on Ageing and director of geriatrics at Sinai Health and the University Health Network in Toronto.
Geriatrician Dr. Samir Sinha says more investment in home care is needed to avert a financial long-term care crisis a decade from now. (Tiffany Foxcroft/CBC)
“The problem that we’ve had in Canada is this notion that if you can’t care for someone at home, they need to go live somewhere else,” said Sinha. “And so we have this real culture of institutionalizing people.”
Sinha said what’s needed isn’t rocket science. Provinces need to invest more in home care to help people age in place.
“Right now there are about 200,000 Canadians living in long-term care homes,” he said. “About a third of them — 60,000 or 70,000 people — could’ve actually stayed in their own homes, with proper home care support.”
Meantime, he said, at least 50,000 Canadians are waiting to get into a long-term care bed but there’s no room. Many have no option but to wait in hospitals for a spot to open up.
WATCH | The system this clinician says he’s up against:
‘That breaks my heart,’ says Canadian geriatrician
23 hours ago
Duration 0:30
Dr. Samir Sinha says Canada’s home care system often robs the dignity of his patients. 0:30
But Sinha said making a fundamental change to invest more in home care is a hard pitch to sell.
“Our politicians are living on four-year political life cycles and just trying to focus on getting re-elected — rather than figuring out how to create a sustainable health-care system for the future,” he said.
Smart says time to act is running out.
“I think there has never been a more urgent moment to shift our health-care system.
“This is a real example of where the government needs to get beyond politics and understand that Canadians need this system. It has to be functional. And right now it is not.”
Look to Denmark, geriatrician urges
The way forward is to take a page from Denmark, said Sinha, who has travelled to the Scandinavian country to study its long-term care strategy and returned last month with a CBC Marketplace crew.
In the late 1980s, Denmark — which, like Canada, has an aging population and publicly funded home care — slowed the growth of new nursing homes and instead used that money to heavily invest in home care.
In Ringsted, Denmark, elder dwellings with no stairs are available to rent. Here seniors receive home care and live independently. (Katie Pederson/CBC)
The funding means people in Denmark can get anywhere from 20 minutes to 10 hours of home care a day, depending on their needs.
When Danish people turn 80, they are automatically offered a home visit by a nurse to assess how things are going and whether they need any support to help keep them aging at home.
“We talk about if they have lost their husbands or wives, and how it is to be alone,” said Camilla Hove Lund, who manages the home care program in the municipality of Ringsted, 70 kilometres southwest of Copenhagen.
“We talk about their network — do you have some friends? Some family? Do you have activities you go to?” said Hove Lund. “And if we hear they need a little bit of help, we give that to them.”
Camilla Hove Lund runs the home care program in Denmark’s Ringsted municipality. She says focusing on prevention keeps aging people out of long-term care beds. (Katie Pederson/CBC)
It may sound like a warm and fuzzy approach, but don’t be fooled, said Sinha. “It’s actually a deliberate strategy to keep the overall health-care system sustainable.”
When Danes find themselves struggling physically — perhaps no longer able to bathe themselves — they’re registered in what’s called a “reablement” program.
“We offer them the bath,” said Hove Lund. “But we also offer training with our workers … to do the bath by themselves again.”
WATCH | Come inside a home in Denmark:
‘The goal is to strengthen his legs,’ says Danish PSW
23 hours ago
Duration 1:07
Johnny Olsen does rehab exercises with a trained personal support worker as part of Denmark’s ‘reablement’ program in home care. 1:07
It’s a much different approach than the home care most often provided in Canada, said Sinha.
“The little home care that we make available to Canadians is often what we call ‘reactive’ home care,” he said. “Someone falls, they need a bath, we send in people to help. Whereas [in Denmark] there is this idea of preventative home care.”
In Ringsted’s rural outskirts, 72-year-old Johnny Olsen, a former farmer, is struggling with Alzheimer’s disease.
He gets six home care visits a day, including physical therapy twice a week to strengthen his arms and back and try to prevent him from falling.
Johnny Olsen, who has from Alzheimer’s, pictured here with a regular home care worker, gets six home care visits every day in Ringsted, Denmark. (Katie Pederson/CBC)
“It’s working,” he said, as he diligently followed the prompts of his home care worker to raise and lower his legs.
In Denmark, all home care workers are trained to do preventative physio to try to keep people aging in place, whereas in Canada, it’s not standard practice for home care workers to get rehab training and physiotherapists are in high demand.
“We have a big group of elderly who need a lot less help if we give them rehabilitation,” said Hove Lund.
Those who do get rehab also have their progress tracked.
“The results are very important to us,” said Hove Lund. “We have to show our politicians that this works. You have to give money to this.”
Lonni Bensadon stands next to one of many electric vehicles provided to personal support workers in the Danish municipality of Ringsted so they can conduct home care visits. (Submitted by Samir Sinha)
It’s all a deliberate effort to help people age at home — and all a far cry from what’s being delivered back at home, said Sinha.
“We need to say that we don’t have a system that’s currently working as well as it could,” he said. “These aren’t pie in the sky ideas — we’re physically seeing them here in Denmark.”
Promises to invest more in home care
In 2018, Ontario’s Conservative government hired Sinha to develop a Senior Strategy — a long-term care plan for the province’s aging population.
He presented a report that called on the government to build fewer long-term care beds and invest more in home care.
But he said the Ford government basically shelved his report and instead committed to spending $6.4 billion to build 30,000 new long-term care beds by 2028. That’s on top of its annual $6-billion budget for long-term care and $3 billion for home care.
Ontario Premier Doug Ford talks on Feb. 1, 2022, about committing $6.4 billion to build 30,000 new long-term care beds by 2028. (CBC)
“They chose the solution that frankly is a lot more costly to taxpayers, but works really well for developers,” said Sinha.
“It really troubles me because we’re not getting the fundamentals right here. Nobody actually aspires to end up in a nursing home. But for the public, it’s being presented as, ‘We’re doing this big thing to take care of this big problem.'”
But earlier this week, in a surprise announcement, the Ontario government said it plans to invest an additional $1 billion over three years in home care if re-elected in June.
“This significant investment will ensure Ontarians can receive the care they need in the comfort of their own homes,” said Health Minister Christine Elliott.
It’s a step in the right direction, said Sinha. “This investment will help to fix fundamental problems [the Ontario government] created after four years of deliberately starving Ontario’s home care system.”
The Ontario government said this week that it plans to invest an additional $1 billion over three years in home care if re-elected in June. (David Donnelly/CBC)
Meanwhile, the Ontario Liberal Party said that if elected, it would invest a further $2 billion in home care over four years and end for-profit long-term care by 2028.
The provincial NDP said it would invest up to $1 billion in home care if elected and would also end for-profit long-term care.
A survey by the National Institute on Ageing found that almost 100 per cent of people said they hope to age at home, as opposed to moving to a long-term care facility.
Figures obtained by Ontario’s Ministry of Health show that providing home care is also half the price of a long-term care bed — roughly $100/day compared to $200/day — and far less costly than a hospital bed that costs approximately $700/day.
Home care clients in Canada receive, on average, 4.9 hours of care a week. According to the CMA, even if that number was increased to 22.2 hours per week, to reflect higher need clients, it would still be cheaper than institutionalized care.
Algie has amyotrophic lateral sclerosis, a debilitating neurodegenerative disease, and needs a home care worker to help start her day. (Tiffany Foxcroft/CBC)
“When you’re delivering care in a long-term care home, you’ve got to buy a piece of land, you’ve got to erect a building, you have to heat and cool it,” said Sinha.
“You don’t have to be a mathematician to realize that the care that most people actually want is the most cost-effective for the taxpayer and more in line with what everybody hopes for.”
Stuck in bed for most of the day, Algie said she’s tired of struggling with a broken home care system that’s in desperate need of better funding.
“It really gets my goat,” she said. “Everybody knows it. And yet, we’re still in this pickle of being underfunded. I just don’t get it.”
EDMONTON – The legendary k.d. lang got the band back together at the Canadian Country Music Association awards show.
Lang teamed up with the Reclines for the first time in 35 years to belt out “Big Boned Gal” from their last album together in 1989.
Clad in a blue and green western-style dress, lang strut across the stage in Edmonton to embody the “big boned gal from southern Alberta.”
The awards show saw Alberta’s MacKenzie Porter and Ontario’s Josh Ross take home hardware for being best female and male artists of the year.
Ross also won entertainer of the year and single of the year for “Trouble.”
Ontario artist Jade Eagleson won album of the year for “Do It Anyway.”
The James Barker Band from Woodville, Ont., won fans’ choice and group of the year.
During their acceptance speech, frontman Barker hinted at new music and a possible tour in 2025.
Ross says he and his band play roughly 150 shows every year and are never home, but says taking home entertainer of the year made the hard work worth it.
Porter won for female artist of the year and top video for “Chasing Tornadoes.”
The female artist win ends the five-year streak of Tenille Townes being awarded the coveted hardware.
Porter had been nominated seven times previously for the award in the past decade but hadn’t won until now.
The artist from Medicine Hat, Alta., says it takes a lot of hard work and hustle to succeed as a female in the country music industry and gave a shout out to her fellow singers and her newborn daughter.
Joining the two artists in the winners’ circle was Ontario singer-songwriter Owen Riegling, who won for breakthrough artist of the year.
The show began with American artist and co-host Thomas Rhett being dubbed an honorary Canadian by Edmonton Oilers players Corey Perry and Leon Draisaitl.
Rhett donned an Oilers jersey that was gifted to him by the pair.
This report by The Canadian Press was first published Sept. 14, 2024.
EDMONTON – Ontario country artist Jade Eagleson has won album of the year at the 2024 Canadian Country Music Association Awards in Edmonton.
The singer from Bailieboro, Ont., was up for six awards alongside Alberta’s MacKenzie Porter.
Eagleson took home album of the year for “Do It Anyway” and says he’s thankful to his wife and management team for helping him reach the level he’s at.
The James Barker Band from Woodville, Ont., also won fans’ choice and group of the year at the award show, held in Edmonton.
During their acceptance speech, frontman Barker hinted at new music and a possible tour in 2025.
Another Ontario crooner, Josh Ross, has taken home a trio of awards, receiving entertainer of the year, male artist of the year and single of the year.
He says he and his band play roughly 150 shows every year and are never home, but says taking home entertainer of the year makes the hard work worth it.
Porter took home female artist of the year, ending the five-year streak of Tenille Townes being awarded the coveted hardware.
Porter had been nominated seven times previously for the award in the past decade but hadn’t won until tonight.
The artist from Medicine Hat, Alta., says it takes a lot of hard work and hustle to succeed as a female in the country music industry and gave a shout out to her fellow singers and her newborn daughter.
Joining the two artists in the winners’ circle was Ontario singer-songwriter Owen Riegling, who won for breakthrough artist of the year.
The show began with American artist and co-host Thomas Rhett being dubbed an honorary Canadian by Edmonton Oilers players Corey Perry and Leon Draisaitl.
Rhett donned an Oilers jersey that was gifted to him by the pair.
The return of k.d. lang and the Reclines was expected to be a highlight of the show.
The appearance will mark the first time the Alberta songstress has teamed up with the band in 35 years and is tied to lang’s induction into the Canadian Country Music Hall of Fame.
The awards show is back in Alberta’s capital for the first time since 2014. It was held in Hamilton last year and in Calgary in 2022.
This report by The Canadian Press was first published Sept. 14, 2024.
VANDERHOOF, B.C. – British Columbia Conservatives are promising changes they say will bring more stability to the province’s struggling forest industry.
Leader John Rustad announced his plan for the sector a week before the official launch of the provincial election campaign, saying a Conservative government would do away with stumpage fees paid when timber is harvested and instead put a tax on the final products that are produced.
Rustad said Saturday that under a provincial Conservative government, a small fee may be charged upfront, but the bulk would come at the end of the process, depending on what type of product is created.
He also promised to review how wildfires are managed, as well as streamline the permit process and review what he calls the province’s “uncompetitive cost structure.”
“British Columbia is by far the highest cost producers of any jurisdiction in North America. We need to be able to drive down those costs, so that our forest sector can actually be able to do the reinvestment, to be able to create the jobs and make sure that they’re still there to be able to support our communities,” he said.
The governing New Democrats meanwhile, say eliminating stumpage fees would inflame the softwood lumber dispute with the United States and hurt forestry workers.
In a statement issued by the NDP, Andrew Mercier, the party’s candidate in Langley-Willowbrook, said Rustad failed to support the industry when he was in government under the former BC Liberals.
“Not only will Rustad’s old thinking and recycled ideas fail to deliver, his proposal to eliminate stumpage would inflame the softwood lumber dispute — punishing forestry workers and communities,” Mercier said, accusing Rustad of ignoring the complexity of the challenges facing the industry.
The softwood lumber dispute between the U.S. and Canada stretches back decades. In August, the U.S. Department of Commerce nearly doubled duties on softwood lumber.
International Trade Minister Mary Ng has said Canada has taken steps to launch two legal challenges under the Canada-United States-Mexico Agreement.
Rustad said a provincial Conservative government would push hard to get a deal with the United States over the ongoing dispute “whether it’s with the rest of Canada or by itself.”
He said his party’s proposed changes are in the name of bringing “stability” and “hope” to the industry that has seen multiple closures of mills in rural communities over the last several years.
Most recently, Canfor Corp. decided to shutter two northern British Columbia sawmills earlier this month, leaving hundreds of workers unemployed by the end of the year.
According to the United Steelworkers union, Canfor has closed 10 mills in the province since November 2011, including nine in northern B.C.
Jeff Bromley, chair of the United Steelworkers wood council, said Saturday the idea of changes in favour of taxing the final product has been floated in the past.
He said the finer details of the Conservative plan will be important, but that the system needs to be improved and “new ideas are certainly something I’d be willing to entertain.”
“Something needs to happen, or the industry is just going to bleed and wither away and be a shadow of its former self,” Bromley said.
“Politics aside, if (Rustad) can come up with a policy that enables my members to work, then I would be supportive of that. But then I’m supportive of any government that would come up with policies and fibre for our mills to run. Period.”
When Canfor announced its latest closures, Forests Minister Bruce Ralston said the sector was a “foundational part” of the province and the current NDP government would work to support both local jobs and wood manufacturing operations.
This report by The Canadian Press was first published Sept. 14, 2024
