Social workers want home care services extended to support older adults aging in place

The following open letter was sent to New Brunswick’s Social Development Minister Bruce Fitch on April 12, 2022. 

We are social workers who work on a Healthy Seniors Pilot Project called the Mobile Seniors’ Wellness Network: Reaching Rural New Brunswickers. Our project aims to support older adults to age in place. We have foot care-trained RNs who provide six free foot care visits in the participants’ homes, and we as social workers also visit with them to see if there are any programs or services that we can connect them to, to support them to stay in their homes.

Our project has been very successful so far. We have surpassed our goal of 200 participants at the end of the two-year project and have now over 300 participants who have enrolled to date. This suggests that there is a definite need for this service. 

New Brunswick has the second highest aging demographic in Canada. As a province, we have identified aging-in-place as an important goal, because long-term care facilities are not enough to support our rapidly aging population. More importantly, it is where older adults want to grow older: in the comfort of their own homes, whatever that looks like for them.

We are advocating for a change in the eligibility criteria for home support services through the Department of Social Development. This is a service that we often support our participants to apply for. If an older person is experiencing challenges with activities of daily living such as meal preparation and housekeeping, they are not eligible for home care services. In order to be eligible, an older person must need more support, specifically with personal care such as bathing and toileting.

A recurring theme in our project so far has been that aging in place looks very different for each individual. However, most older adults in our project have expressed to us that they just need some extra help to keep their homes maintained. For example: changing light bulbs, sweeping and mopping the floors, laundry, small household repairs, a couple of meals a week, etc. When these things begin to accumulate, the idea of staying in the home becomes very overwhelming. We believe that a more proactive way to assist our older population to age in place is to provide this support early on, before it gets to a point where the person may have to consider the option of moving into long-term care. 

The first goal of the Aging Strategy released by the Government of New Brunswick in 2017 states a commitment to “enabling seniors to live independently. NB needs to move from a system focused on health care to one of prevention.” As well, the policy for Home Support Services from the Department of Social Development states among their objectives: “[1] to assist individuals and/or families to function as independently as possible, and [2] provide services to assist with what individuals and/or families cannot do independently, or with the help of other informal support services and volunteer groups.” 

We strongly urge you to reconsider a decision that focuses on personal care, to continue to provide home support services to include meal preparation, housekeeping, and companionship. Most of our participants are not eligible for this service under this criteria. We do not think it is favourable to have an “all-or-nothing” mentality when it comes to home support services. 

This mentality also applies when someone is assessed for home support services. The social worker from the Department of Social Development will decide how many hours of care per week the person requires. They will also provide an amount that the department will subsidize and present the co-pay to the older adult. Many times, they are unable to afford this co-pay. We believe that the person needing support should be able to make these decisions themselves. For example, if the person cannot afford two hours a day for five days a week at $359/month – would it be more beneficial if they could lower this to three hours a day for two days a week at a lower rate?

We recognize the important role that the Department of Social Development plays in supporting our aging population to age in place. We share a common goal. If these minor changes could be made, it would help a lot of older people to stay where they want to be – at home. We hope that this can be considered, and we are committed to working alongside the Department of Social Development to continue to advocate for the best path forward for older adults in New Brunswick.

Eve Baird, Shannon Good, Monnah Green and Lynsey Wilson Norrad are social workers with the Mobile Seniors’ Wellness Network.