Obvious need, obvious challenge: experts make the case for an aging at home benefit in Canada

Ottawa is being encouraged to help move seniors away from “institutionalized care” after the pandemic exposed widespread failures in the long-term care system. “Upfront” investments to give Canada’s aging population options in their final years will be worth it in the long run, according to one expert.

Before Prime Minister Justin Trudeau’s summer cabinet shuffle, the Seniors and Health ministers were mandated to set up an expert panel “to provide recommendations for establishing an Aging at Home Benefit,” as promised by the Liberals during the 2021 campaign. The panel was struck last fall and its consultations closed in April with the National Seniors Council now mulling the possibility of bringing in a benefit.

Fresh mandate letters for the relevant ministers — Health Minister Mark Holland and Seniors Minister Seamus O’Regan — are expected to drop soon, and advocates will be watching to see whether realizing the benefit remains a priority in the revamped marching orders.

Rosalie Wyonch, a senior policy analyst at the C.D. Howe Institute who studies health and tax policy, said there is ample need for the measure given Canada’s aging population, a shortage of care workers and underinvestment in long-term care homes — a reality the pandemic made grimly apparent.

Wyonch said Ottawa is likely to view the benefit as a “priority” but may balk at the “complicated challenge” standing it up will be, since seniors care mainly falls within the realm of health care, which is the provinces’ purview.

“Canada fared really poorly during Covid in terms of protecting our seniors, particularly those in institutional care, and that really is the basis of the current motivation to drive towards home  and community care and aging in place,” she said.

Given “the level of attention that Canada’s failures in seniors care got during the pandemic,” Wyonch is cautiously optimistic the Grits will implement the promised policy but acknowledged they may instead “decide it is a large and expensive challenge that they don’t want to focus on.”

“It’s hard to call whether the obvious need or obvious challenge will win out,” she said.

B.C. seniors advocate Isobel Mackenzie believes the Liberals are poised to usher in a benefit, once the council’s recommendations are out.

“If they weren’t intending to [create a benefit], this train would not have gotten out of the station and down the track as far as it has,” Mackenzie said, adding there is “absolutely” a need for it as most seniors want to age in their homes “for as long as possible” — a desire that is contingent on accessing adequate support.

Mackenzie said her team has found it is typically lower-income people who end up in long-term care homes as a result of not being able to cover costs related to remaining at home.

She said a national benefit available to seniors in all jurisdictions will “provide a greater equalization” across the country.

“People need to have resources to access what they need, and resources is the polite word for saying they need the money. They either need the things provided to them, free of charge, or they need the money to buy it,” Mackenzie said.

Canada’s care system is “set up to drive [seniors] toward institutional care,” according to Wyonch, who said the feds could take lessons from Germany, which does a better job of preventing older people from moving from their homes into institutional care facilities.

That superior performance is thanks in part to a long-term care insurance program created in 1995, which requires Germans to pay into a system designed to cover expenses likely to come up due to old age, illness or accident.

In Canada, Wyonch believes a similar system would be easier to administer at the provincial and territorial level, given jurisdictional divides — though she noted ushering in a benefit would require participation from premiers anyways.

If Ottawa opts to make the benefit a tax measure, Wyonch said there could be a lot of “variation” in how the cash is spent, depending on the senior’s living situation. “The true benefit of cash is it allows for individual choices and it’s not a one-size-fits-all solution,” she added.

In Germany, she said seniors can be linked with social or health-care workers who help refer them to the most suitable services, which also helps provide “oversight” of the government aid being doled out. Flexibility needs to be baked into the system so money can be used depending on individual needs, Wyonch said, “encouraging that autonomy and maintaining quality of life and health.”

A spokesperson for O’Regan’s office outlined the need for the benefit but was mum on details of its possible design, noting the council is expected to issue its recommendations to the minister “this fall.”