Today’s answered question

Q.  Hello – I work with older adults with dementia and mental health issues in the community. “Home is Best” (HIB) is a daily theme in my work. I have some questions and/or concerns going forward with HIB:

• Home support services are not 24/7. If there is a client that is at home with full home supports during the day/ early evening, what happens OVERNIGHT? If there are no family/friends, and/or the family/friends cannot stay overnight with the Client, what is the alternative? Private caregivers throughout the night? I have 3 families struggling with this exact scenario right now. The Client cannot be left unattended overnight as it would be considered abuse/neglect under the Adult Guardianship Act.
• Does  “Home is Best”  provide domestic services that the client cannot do i.e.) laundry; cleaning; bed making; meal preparation? I find there is a huge discrepancy between what one HCW will do vs another HCW.

A.  As you know, ‘Home is Best’ is a philosophy that supports the belief that home is the best place for people to live as long as they are safely able to do so.

In order to support this philosophy, VCH has developed many Home First initiatives, including:

• QRT (Quick Response Team)
• EDicare
• Home First case conferences
• Integrated case conferences
• HomeVIVE

Following VCH guidelines re-established for the program in 2008 and based on Ministry of Health regulations, Home Support is another service that enables clients to remain at home.

With Home Support, the primary focus is on personal care with services that include:

• Bathing
• Dressing
• Toileting
• Mobility assistance
• Medication management
• Meal set-up

Home Support was created to provide supplementary services to promote the client’s maximum participation in care in order to optimize their level of independent function, but is not designed to meet all the clients’ needs.

Home Support is not intended to include hospitality services such as:  housekeeping, laundry and advanced meal preparation. There are community organizations who offer some of these services, such as the United Way’s Better at Home program. The service is also not able to provide 24 hour a day comprehensive monitoring or supervision on an ongoing basis. Family, friends or private care may also be options for clients to support all levels of care at home.

Of course, as you talked about with the needs of some of your clients for overnight care, in some cases if a client can’t safely be cared for at home, other options such as residential care or assisted living would need to be considered where the necessary supports for clients are already in place. We appreciate these are no doubt difficult situations for your families struggling with how to make it work at home right now for their loved ones. Thank you for your care and service to them.

We hope you will join us at the next All-Staff Forum (ASF) on June 10 where we will be discussing the topic of Home is Best in greater detail.

To find out more about the next ASF, check out today’s article: Home is where the heart is