opinion: team-based care is the relief canada’s healthcare system desperately needs
the key to alleviating demand on hospitals is helping older canadians age in place and providing, when appropriate, more at-home and community care.
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a recent survey by the canadian medical association and the national institute on ageing found that 96 per cent of canadians want to age at home, live independently for as long as possible, and do everything possible to avoid going into long-term care.
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more than a year after the unofficial end of the covid-19 pandemic, canada’s reeling healthcare system is still burdened by staffing and capacity shortages. it’s now evident to everyone the problem wasn’t just a surge in covid-19 patients. our hospitals are at a breaking point with increased demand due to a growing population, aging baby boomers and labour shortages not seen since the mid-90s.
decades of public policy failures and neglect by multiple governments have led to this outcome, and fixing the structural issues plaguing canada’s healthcare system is extremely difficult and complex. such an undertaking represents an immense public policy challenge for even the most seasoned governing parties.
our public healthcare system isn’t a bridge that can be torn down and rebuilt while traffic is rerouted. we need to fix healthcare within the boundaries of the existing system. the solution is to pivot from traditional care models to a team-based approach.
for too long, canada has approached patient care through the traditional primary care lens (doctors and nurses). this approach makes accessing at-home care challenging and creates barriers preventing older canadians from staying in their homes longer.
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but what if more care models took a team-based approach and included front-line health providers like occupational therapists (ots) and occupational therapist assistants (otas)? physicians would be supported by ots and otas, who can help people of all ages overcome challenges in completing everyday tasks or activities by assessing the safety of their home and cognitive function.
the outcome would be far-ranging, with older canadians, for example, being able to stay in their homes longer and age in place where appropriate. that’s what older canadians want: to stay in their homes. a recent survey by the canadian medical association and the national institute on ageing found that 96 per cent of canadians want to age at home, live independently for as long as possible, and do everything possible to avoid going into long-term care.
however, there are several significant barriers to making this a reality.
the first is the cost of at-home care and the lack of suitable private insurance benefits in even the most expansive insurance coverage plans. quite frankly, especially in a cost-of-living crisis, most canadians don’t have the insurance coverage or the money to access the support of ots and otas in the form of at-home care that would allow them to stay in their homes longer.
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the second barrier is the lack of financial support for canadians struggling with mobility issues who need to modify their homes to make these dwellings safer for at-home care. the government already has the policy tools to do this; we have given canadians tax incentives to modify their homes before for other purposes. all decision-makers need to do is adjust those same programs and policies to provide mobility home modification support with an eye to keeping as many people as possible in their homes longer.
finally, the underutilization of ots and otas in addressing mental health issues is the third barrier. with mental health service gaps occurring more frequently, mainly due to hospital wait times and shortages in outpatient services, more creative solutions are being explored to address these issues, including enhanced peer-to-peer support networks.
policymakers often overlook ots and otas as essential mental health service providers, especially in rural and remote areas, and more recognition of their work with those living with mental health concerns, including substance abuse, will help raise awareness of the availability of these services and further alleviate pressure on the system.
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utilizing the expertise of ots and otas represents an opportunity for decision-makers to relieve pressure on our healthcare system. however, that outcome is only possible if we change how we approach care models and move away from traditional models in favour of team-based care approaches.
either way, if canada does not find a way to address the cost of at-home care, the lack of financial support for home mobility modifications and the underutilization of ots and otas in addressing mental health issues, canada’s healthcare system will continue to struggle with demand.
hélène sabourin is the ceo of the canadian association of occupational therapists (caot). hélène has 40 years of experience working in canada’s healthcare system, including 25 years as a registered nurse in several settings such as acute care, community care, occupational health and safety, and correctional services.
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