Home care

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Advocacy, Aging in place, Family, Home care, Legislation

Why helping families pay for home care makes sense

For seniors, aging-in-place at home is the most comfortable, safe, and affordable option.

That’s why Gaye Moffett is on the board of Home Care Ontario, to work closely with other home care advocates to keep their work top of mind with every level of government.

Here’s what they’re working on right now to get families more support:

Home care co-payments and tax credits

Right now, anyone admitted to a long-term care facility only pays part of the cost. The government subsidizes the rest. 

As an alternative to moving people to a long-term care facility,  Gaye is advocating for a co-pay option to support clients at home. It’s a good investment for the government to make. With less overhead, providing care at home is more cost-effective than at a facility.

Other government incentives are also on the table, such as enhancing tax credits like the Ontario Seniors Care at Home (OSCAH) tax credit, and exempting family-funded care from sales taxes like the HST.

Raising the reputation, visibility and awareness of family-funded home care

One of the biggest challenges home care providers face is the invisibility of the work they do.

When you drive past a hospital or long-term care facility, you know there are people being cared for within those walls. It’s easy to forget that care is also being provided in people’s private homes.

Gaye and her colleagues are raising awareness by advocating for accreditation for family-funded care providers, agency licensing, an authority to over see allied health, and stronger enforcement of labour standards in the grey market to protect people from unlicensed ‘caregivers’ advertising their services on Kijiji.

Contributing to health system transformation

With health system transformation underway due to the pandemic, Gaye wants people to know how family-funded care providers are contributing to those efforts.

That’s why they’re sending educational materials to Ontario Health Teams (OHTs) about their work. 

They’re also engaging the OHTs directly to explain why enhancing home care services is a better option than creating ‘add-on’ services via retirement homes, which come with overhead costs similar to long-term care facilities.

For Gaye and her fellow advocates, investing in home care just makes sense.

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Home care

When do I need a nurse vs. a personal support worker?

“I need a nurse,” is what Gaye Moffett often hears when she picks up the phone.

But a nurse may not be the level of care you or your loved one needs right now to live comfortably at home for as long as possible.

So how do you know you’re getting the right level of care? 

In Ontario, the first step is to call 310-2222 (no area code required) to find the Home and Community Care Support Service provider in your area.

They’ll assign a case manager to assess your situation and determine whether you need a nurse or personal support worker. Once that’s done you can top up your eligible hours with a family-funded provider like GEM.

Here’s what to expect from the professionals who will be helping you. 

When you need a nurse

As a rule, you don’t need a nurse unless you are acutely ill or injured, or have a chronic condition that requires ongoing nursing support, like having a peg tube that needs to be cleaned regularly to prevent infection.

While there are two types of nurses — registered nurses (RNs) and registered practical nurses (RPNs) — you can rest assured that they’re all registered with the College of Nurses of Ontario. 

For the most part they carry out the same duties, but RNs are typically responsible for planning and monitoring care, while RPNs carry the plan out. 

Care plans could include administering medications, wound care, changing dressings, monitoring blood pressure, administering oxygen therapy and collecting specimens. 

When you need personal support 

Personal support workers, home support workers, and companions are the people who help you live in your home independently, while lowering the risk of illness or injury that could land you in the hospital.

Personal support workers (PSWs) are college-trained, certified professionals who help people with their activities of daily living (ADLs) like bathing and dressing. Sounds simple, but knowing how to transfer someone safely in and out of the tub with a lift requires specific training.

Home support workers (HSWs) are also certified and trained in their field, and assist in all facets of home management, including meal preparation, light housekeeping, and assistance with shopping.

Companions who work for GEM must complete the company’s training course. Sitters ensure the safety and security of a client by assisting with all levels of companionship, emotional support and activity attendance. They are able to accompany a resident to and from appointments and record information as required.

In a world where it’s clear most people want to live at home, and delivering care at home is the most cost effective option for our health system, calling on GEM to make it possible could be the option for you and your family. Call (613) 761-7474 to learn more.

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Aging in place, Family, Home care, Long term care

How to talk to your family about future planning

“The only way I’m leaving my home is in a pine box,” is what people often say when the topic of future planning is broached, no matter how sensitively or carefully.

Gaye Moffet’s response to that comment is, “Okay. Let’s plan for that.” 

Because the only way to truly safeguard our autonomy and independence as we age-in-place is to have a plan.

Fortunately there are tools we can use to make sure we’re taken care of the way we want. That said, it’s not an easy topic to broach with your family over dinner. 

Here are a few tips to be proactive when it’s time to start this difficult conversation.

Keep it practical: start with low hanging fruit

Before delving into any conversations about home care or long-term care, start by encouraging or helping your loved one choose their Powers of Attorney, including a Power of Attorney for Personal Care and a Continuing Power of Attorney for Property.

Designating a trusted person who will respect your wishes if you’re unable to make them yourself is the best way to prevent the government from stepping in and taking over. 

Inviting your loved ones to talk about Powers of Attorney can also open the door to completing other documents, like advance directives and a will.

What’s critical is keeping your loved one’s wishes at the heart of the conversation and emphasizing that writing them down will make it easier for someone else to know and respect what they want. 

Respond quickly during crucial moments

Often the first big loss of autonomy and independence comes when a doctor has to suspend a patient’s driver’s licence for safety reasons.

It’s a big blow, but it could be a chance for the family to come together to make sure their loved one will get what they need and stay engaged with the community.

It can also be the catalyst to talk about downsizing and moving closer to family, or possible to an easy-to-manage residence with the amenities they need.

And if the rest of your family isn’t engaged in future planning yet, moments like this can be a good time to pull them in so everyone is thinking about how they can help. 

Getting everyone involved will prevent caregiver burnout and possibly another crisis where your loved one’s choices are suddenly limited.

Continuing to emphasize that your loved one’s autonomy and independence is what’s most important. 

Connect and engage by listening first

While broaching the right topic at the right time is a good start, it can still be easy for emotions to get high. 

Gaye’s advice applies here as well: let’s plan for that.

Don’t forget that these are tough topics. The future we’re discussing is one where someone we love can’t live independently or worse, is no longer with us. Who wouldn’t get emotional? 

When feeling run high, we bring our own personality and ways of coping into the mix, whether it’s responding with anger, sadness, grief, or denial. These are just normal reactions to difficult situations, so don’t judge yourself or anyone else for how they’re reacting. 

Just know yourself and prepare, because what happens when we’re not grounded isn’t always pretty. We’re all capable of being patronizing, irritated, manipulative or dramatic. And it could lead us to call in reinforcements and make our loved one feel like we’re ganging up on them.

All that can be prevented by simply listening. 

Start by asking your loved one questions about what they want, then listen carefully and repeat back what was said so they know they’ve been heard before you weigh in with your own thoughts, opinions and needs. They’re important too, but your loved one needs to know they’re the one who’s in charge of what’s going to happen. You can show that by listening.

Other ways to keep the conversation constructive are:

  • using other people’s situation as an example
  • providing print materials so they have something to refer to while reflecting
  • writing down your concerns if having a conversation isn’t working
  • offering to help with research into their options
  • avoiding words like ‘a home’ or ‘nursing home’

Remember to ask for help if you need it

If you’ve tried everything and feel like you’ve hit a wall, it could be time to bring in a third-party expert who your loved one will trust to be neutral and provide straightforward, helpful information.

Gaye Moffett has been advising families with care planning for decades and has likely heard a story similar to yours.

You can get in touch with Gaye by calling 613-761-7474 in Ottawa or in 905-836-6999 in GTA.

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Advocacy, Home care, Legislation, Safety

Critical legislation changes just made home care safer in Ontario

Critical legislation changes just made home care safer in Ontario">

As the founder of GEM Health Care Services and member of the board for Home Care Ontario, Gaye Moffett does a lot of advocacy work for her clients behind the scenes.

After spending the past few years lobbying the provincial and federal governments about three key pieces of legislation to keep clients safe and lower the cost of care, she’s happy to report a recent victory.

The Government of Ontario has passed legislation requiring Temporary Help Agencies to be licensed to continue their operations. 

The eligibility criteria to be licensed is stringent to protect both employees and clients, as well as preventing the loss of tax dollars. 

“We’re certainly in favour of this legislation,” said Moffett. “It stops people from putting up a ‘fly-by-night’ temp agency on Kijiji without any oversight or regulation.”

How do you get a licence?

The bar for a Temporary Help Agency to meet the licensing criteria includes:

  • CRA business number
  • WSIB certificate
  • Liability insurance and indemnification
  • Third party quality control, eg. ISO or other relevant certification
  • Criminal background and vulnerable population checks for all staff
  • Putting $25,000 in escrow to cover wages in the event of bankruptcy
  • Application fee of $750

How does this legislation help?

While the legislation protects temporary employees from unfair wages and exploitation in any industry or sector, it’s especially important for home care staffing agencies.

“Our clients are vulnerable and working conditions for our employees can be precarious due to the unpredictable nature of the work,” said Moffett. “They need a staffing agency that knows how to conduct a care assessment so that clients are getting what they need, and staff are being matched to the right clients on a consistent basis.”

Some online home care staffing agencies that call themselves a “matching platform” claim to lower costs by “avoiding overhead” (such as care assessment conducted by a licensed health care practitioner). 

These outfits will also need to apply for a licence before January 1, 2024 and meet the same criteria or face stiff penalties. The government started accepting applications in July, 2023.

“While temporary help agencies are vital to Ontario’s businesses and jobseekers looking to get their foot in the door, for too long they have operated in a grey zone that allows criminals to prey on vulnerable workers,” said Monte McNaughton, Minister of Labour, Immigration, Training and Skills Development. “Our government’s licensing system will ensure law-abiding businesses can have confidence in the THAs and recruiters they work with and that those who abuse workers face the harshest fines in Canada and are banned from operating in our province.”

How will it be enforced?

Penalties for contravening the act will be stiff, ranging from $15,000 for a first offense, to $25,000 for a second offense within three years of the first, and $50,000 for a third offense within the same three year period.

Officers will be looking for these contraventions:

  • operating as a temporary help agency without a licence
  • acting as a recruiter without a licence
  • clients knowingly using an unlicensed temporary help agency, or
  • employers, prospective employers or other recruiters knowingly engaging or using the services of an unlicensed recruiter

And if you’re wondering whether the staffing agency that’s sending your home care worker is licensed, you’ll be able to check with an online search of the government’s database.

Check out our other “Buyer Beware” posts for more tips on screening your caregivers for safety and security, as well as their qualifications.

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Home care, Safety, Security

Four safety and security questions to ask before welcoming a home care professional into your home

Four safety and security questions to ask before welcoming a home care professional into your home">

We’re continuing our “buyer beware” series to talk about another critical topic: safety and security. 

Any credible home care provider conducts a thorough background check on every service provider they hire, but there are other details to consider. The four questions below will cover those bases.

As always, look for concrete answers in addition to noting the tone and tenor of their response, because anyone who sounds defensive or offended by questions about safety and security is also waving that big red “buyer beware” flag. 

1.Are your home care workers contractors or employees?

This is one of the most important questions to ask, because it potentially affects clients in two ways.

The first is financial. Employers are required by law to deduct taxes, EI and CPP from their staff’s salary. But contractors are responsible for handling these details themselves. 

If the CRA audits a contract worker and finds they haven’t declared all their income, they could target the client to recoup any taxes owing.

The second is liability. Contract workers should carry their own malpractice and workplace insurance, but many don’t due to the cost. Employers on the other hand are mandated to carry this insurance.

If you’re using an online matching service to find home care workers at a lower cost, be sure to ask if their staff are contractors or employees. 

2.If the caregiver I’m assigned isn’t a good fit or I’m mistreated, how will you find a better match?

What online matching services may fail to mention is that when you hire one of their home care workers, you have technically become an employer. 

That means any issues that may arise, whether it’s just a bad fit personally, discovering their skills aren’t up to snuff, or if you’re outright abused, is a problem you’ll have to solve on your own. 

So the answer to this question reveals whether they hold themselves accountable for the staff on their roster.  If you find yourself left in the lurch you’ll have to do all the work to handle the problem as well as starting at square one to find someone new.

Licensed home care agencies that employ full-time staff are less likely to hire problem staff in the first place because they’re accountable if a problem arises and they have a management team in place to respond.

3.Does your company conduct criminal record and vulnerable sector background checks for all the staff on your roster? 

The biggest safety risk is of course knowing your worker is who they say they are and hasn’t committed a crime.

There are many kinds of background checks that find this information. Ask your provider if they conduct vulnerable sector background checks on all their staff. 

4.Are your caregivers vaccinated?

While the worst of the pandemic is over, contracting COVID or some other virus will always be a concern for those with a vulnerable health status. 

If you believe you’ll be at risk, you have every right to ask this question to ensure your safety. GEM requires three COVID vaccinations for all their staff.

In addition to these questions, starting with a care plan assessment conducted by a nurse or care coordinator is a preventative measure. 

There’s nothing less safe than missing a service that could prevent a fall, fire, or some other accident that makes it impossible to stay where you’re most comfortable: at home.

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Home care, Quality, Safety

Buyer beware! Four questions to ask about qualifications before welcoming a home care worker into your home

Buyer beware! Four questions to ask about qualifications before welcoming a home care worker into your home">

For seniors and other folks who need support to live at home, finding the right mix of home care services can mean the difference between autonomy and dependence.

That’s why it’s so important to choose the highest quality people to support you.

But how can the average person screen highly-trained health professionals, especially in a world with “disruptors” entering the home care space? 

The good news is that no one can stop you from asking questions, and any agency that doesn’t provide thorough answers is waving a red flag saying “buyer beware”.

Two areas in particular where you need trustworthy information are around qualifications and safety & security. We’re publishing posts that cover each topic, starting with qualifications.

Asking about qualifications isn’t just about understanding an agency’s basic standards. It’s also an opportunity to ask about specialized skills that meet your particular needs. 

Here are four questions we think you should ask:

1.What are the minimum requirements you require to add home care staff to your roster?

The answer to this question will give you a baseline regarding their post-secondary education and licensing requirements. 

You can also use this information to see if the rest of the answers are consistent with their baseline.

2.How does your company verify credentials? 

Look for employers who require their staff to provide proof of their diploma or degree, as well as any specialized certificates they’ve earned. 

They should also be confirming the credential was granted by an accredited institution. 

3.What training requirements do you have for your home care staff?

Here you’re looking for basics like CPR and First Aid., as well as skills that are specific to your particular needs, like mobility assistance.

You’re also looking for in-house training that ensures staff are familiar with internal policies and procedures as well as relevant legislation.

And don’t forget to consider management training. The tone of their responses will show how much experience they have operating within a complex health-care system.

Do they come across as an agency that will take responsibility for problems that may arise, or the kind that passes the buck and blames their staff? 

4.Do you provide professional development and training for the staff on your roster?

A commitment to providing professional development that ensures their skills are up-to-date is another answer to look for. It shows an understanding that investing in their staff is necessary to provide continuous quality care.

It also gives you the opportunity to let a home care agency know they could be missing a particular skill set that a prospective client needs.

There are no cookie-cutter solutions

So consider the answers to these questions to be a starting point. 

Any successful home care plan starts with a thorough assessment from a licensed health-care professional who will link you to the right mix of services to help you stay at home for as long as possible. 

Because the last thing you want is a home care provider who doesn’t know what they don’t know.

* Stay tuned for our next “buyer beware” post about safety and security.

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Home care

How to get the right mix of home care services with the resources you have

How to get the right mix of home care services with the resources you have">

When the benefits of helping seniors stay at home are so clear, maximizing the home care services you can get with the resources you have makes perfect sense. 

Seniors who age-in-place hold onto their autonomy and independence longer because they’re in a familiar environment and maintain ties to their community. With the appropriate support, seniors can downsize at their own pace rather than being forced to move due to a crisis.

But navigating Ontario’s home care system isn’t as simple as picking up the phone and asking for help. That’s why Gaye Moffett, owner and operator of GEM Health Care Services, often hears from people who are just trying to figure out where to start. 

“This morning someone called and said her father is on a limited income, but needs help doing his housekeeping and laundry,” said Moffett. “I pointed her to the City of Ottawa’s Home Support Services so they can determine if he was eligible for the services they offer.”

Navigating a complex system to get the right mix of services

Moffett has been working in the home care sector long enough to know the ins and outs of navigating a complex system that’s always changing.

Whether you start in the public system or with family-funded home care services, you’ll probably need a bit of help to make sure you’ve got the right mix of services at the right time.

Moffett’s experience running GEM Health Care Services — which currently has a contract with the Ontario government to provide publicly funded, privately delivered services — is why she’s a master at this. 

“I often get people started with family-funded nursing care,” said Moffett. “But if they become eligible for public services, we can adjust their hours to make sure they have the right mix.”

Moffett leverages her nursing background to help her clients maximize their resources. “I once helped a client’s mother get her nursing care covered by writing their insurer a letter,” she said. “Her coverage said the services had to be medically necessary — as a nurse I was able to explain that a PSW can’t manage tube feeding and other care needs that she had.” 

So where should you start if you or your loved one needs home care to “age-in-place”? 

Asking yourself these questions will help point you in the right direction

  1. Are you eligible for publicly funded home-care services? Call Home and community services with the Ontario government to find out.
  2. Do your benefits cover homemaking, nursing or both? You need to ask your insurer how they define “medically necessary.” 
  3. How many family–funded hours do you really to supplement your public services? Talk to a veteran health professional like Moffett to find the right balance, and explain the difference between what’s medically necessary and what isn’t.

Whether you’re on a fixed income, have some benefits for private nursing through your employer, or have enough resources for family-funded nursing care, talking to someone who knows the system like Moffett can give you the confidence that you’re accessing the services you really need with the resources you have.

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Advocacy, Home care

Why community PSW’s deserve better compensation

Why community PSW’s deserve better compensation">

People who receive home care services love their personal support workers (PSWs). 

And why wouldn’t they? PSWs provide the personal care seniors, people with disabilities and other vulnerable populations need to stay in their homes — like bathing, providing medication, meal prep and light housekeeping.

Community PSWs spend more time with home care clients than any other home care worker and become an important presence in their lives. They play a critical role in our healthcare system by significantly improving quality of life for their clients in a cost effective manner — most of the dollars spent on PSWs goes to care rather than on operating an institution. 

So why are community PSWs paid a lot less than PSWs who work in the hospital or long term care? 

Before the pandemic, home care PSWs were paid an average of $16 – $17 per hour. Those who worked in a hospital or long term care facility made $25 to $30 per hour. While the government did increase pay for community PSWs, it’s still falling short by an average of $5 per hour.  

This doesn’t make sense. PSWs in the community need the same skill set and perform the same tasks as those who work in institutions. If anything, home care PSWs have a tougher job because they work alone and in more challenging conditions.

We hire a lot of PSWs and send them everywhere — sometimes almost all the way to Kingston —  but we can’t guarantee them a 9-5 schedule because our clients’ care plans vary and people’s needs are always changing. It’s just the reality of the homecare sector. That’s why a lot of PSWs must work for more than one agency. Understandably, they’ll take whoever can give them the most hours and the best shifts.

The government could help solve this by giving care provider agencies more funds to compensate our PSWs’ for their travel time. We pay a flat rate between shifts, but there’s no incentive for us to pay more for their travel time because we won’t get paid for it. Every time our PSWs need to travel, providers like GEM lose money. 

That’s why we want the Ontario government to invest more in this critical service, so care providers like ours don’t have PSWs leaving us to work for minimum wage jobs that give them steadier work.

The important role PSWs play in our health system has been neglected for long enough.