The personal lesson many of us have learned from the pandemic: we want to spend the last weeks and months of our lives in our own homes, not in a hospital or in long-term care or in a retirement home. But it won’t be easy unless there are some significant changes, in which the city can play a major role.
Toronto already has one of the most successful programs in the country for keeping seniors happy in their own homes: SPRINT, Senior Peoples’ Resources in North Toronto, founded in 1980 with the help of the late councillor Anne Johnston. SPRINT provides the kind of care seniors need on a daily basis: personal care such as bathing and dressing, medical care, transportation — care that depends on day-to-day needs, maybe 20 minutes today and three hours tomorrow.
The SPRINT personal support workers are constants in the lives of their clients. The seniors served by SPRINT live in several buildings where rents are subsidized depending on income. It’s a combination of low-cost housing and community care.
What’s good about this kind of home care is that hospitalization and emergency room visits are considerably less than for those not receiving this kind of support. And seniors are happier and less lonely than seniors in the community at large.
Sadly, the funding of the kind of program run by SPRINT is not straightforward. The city subsidizes the cost of housing, the Ministry of Health provides funding for personal care, the Ontario Ministry of Long-Term Care provides funding for dementia patients, and funds are kicked in by United Way and local charities for other services.
The contrast with long-term care institutions is considerable. Many studies have shown that the care there is more industrial than personal; staffing is inadequate; many seniors live four to a room; and as we have learned tragically in the pandemic, infection control is poor. The cost to the client is considerable, upwards of $2,000 a month, on top of which there is a subsidy from the provincial government of about $180 a day per person. The province also provides a subsidy for the construction of long-term care institutions.
There are serious questions to ask about spending such amounts of public money on long-term care. Seniors for Social Action (Ontario) has asked the provincial auditor general to do a value-for-money audit into “whether the current funding arrangement with the long term care sector represents the best use of public funds, or whether these funds would be better redirected to not-for-profit community residential options other than for-profit and not-for-profit large institutions.”
Long-term care became big business in Ontario when Premier Mike Harris privatized it 20 years ago. He now chairs one of the largest private long-term home care institutions in Canada, to his considerable personal profit. In the recent provincial budget, Premier Ford opted to put government funds only into expanding long-term care and did not put a new cent into home care.
Council could take the lead on home care. It already houses some 30,000 seniors in affordable units and is introducing an integrated service model to address some health needs.
Pushing for full health care for these residents should be a key demand by the city. Of course, there is not nearly enough affordable housing for seniors.
Council could provide seed money to establish more groups like SPRINT. It could ask the provincial government to convert the new funding for home care. It could ask the provincial and federal government to create a home care tax credit as recommended by Home Care Ontario.
With the pandemic still in sight and with all of us getting older, now is the time for the city to push for a change that is widely popular and needed.