Staffing shortages prompting some Manitoba families to hire their own home-care help
Manitoba’s regional health authorities also using agency staff to maintain services
Joanne Brown hired her own home-care attendants when she felt she could no longer rely on the visits her parents were eligible to get through the Interlake-Eastern Regional Health Authority (IERHA).
Brown, of St. Andrews, Man., moved her elderly parents to an assisted living complex in nearby Selkirk, Man. from Winnipeg so they could be closer to her.
However, she says frequent cancellations and the limited time home-care staff were given to spend with her parents prompted her to change how their care was delivered.
"The home care started getting worse," Brown said. "My mother has dementia and then my father went deaf … I had an incredible problem with constant cancellations, people not showing up."
In Manitoba, regional health authorities (RHAs) are responsible for delivering home-care services with RHA staff members visiting eligible clients. Home-care staff help individuals regardless of age with daily tasks and health supports to help people stay in their own homes longer.
But RHAs across the province are dealing with home-care staffing vacancies that have families such as Brown's seeking care outside the public system. Each of Manitoba's five RHAs use, to some extent, contracted agency home-care attendants to maintain their services in some communities.
"Home-care services are provided in 13 community offices throughout Interlake-Eastern Regional Health Authority," Tricia Tyerman, the IERHA's director of health services, home care, said a statement. "Presently, only the Selkirk office has contracted agency home-care attendants due to staffing vacancies.
"Agency staff are contracted when we need to maintain service delivery."
As vacancies are filled, Tyerman says, home-care teams modify schedules to address the needs of their clients.
The regional vacancy rate in the region for health-care aides who deliver the majority of home-care services in the region is 17 per cent, according to Kate Hodgson, regional lead for health services in the community and continuing care.
"Vacancy rates vary significantly among the offices that co-ordinate home care service delivery in the region," Hodgson said.
Home-care clients and their families can also manage their own care. Funding is provided to families based on an assessment of needs, but clients or family members have to recruit, hire, schedule, manage staff and do payroll-related tasks.
Family-managed home care an option
About 1,500 Manitobans were registered for self- and family-managed care as of Oct.1, a provincial spokesperson said. Home-care services cannot exceed 55 hours of service per week, and the cost of services shouldn't exceed the average cost of a personal-care home bed, according to the province.
When Brown learned that was an option, she signed on to manage her parents' care.
"Once I had private [care] it was much better," Brown said.
Before making the change there were times her father's catheter bag was left open and he was sitting in urine, she said, adding at times staff were only allotted 20 minutes per visit to help both her parents.
Brown doesn't blame staff, she sees it as a system-wide issue.
"It's because of how much stuff, how much staff they have, to do what they have to do," Brown said.
The IERHA said there has been an increase in people registering for self- and family-managed care but couldn't link it directly to staffing in the region, Hodgson said.
Other health regions are also hiring home-care attendants from private agencies to provide care when in-house staff aren't available.
A spokesperson for the Winnipeg Regional Health Authority said it's responsible for 15,000 home care visits daily. When it's short-staffed, the home-care program uses back-up agencies to ensure scheduled visits can be completed and provide continuity of care.
"Recent data shows between two to five per cent of overall volume of home-care visits are completed by agency staff," the WRHA said.
Agencies used only in 'select communities'
A spokesperson for Prairie Mountain Health, which is responsible for the delivery of home-care services in southwest Manitoba, said the region only uses agencies in "select communities" to help with attendant vacancies.
"Hours are minimal and areas fluctuate as needs and resources fluctuate," the region said.
The Northern Health Region also said its use of agency home-care attendants fluctuates depending on demand and vacancies
Southern Health-Santé Sud said in an email it uses agency home-care attendants to provide support in communities with staffing vacancies.
The Manitoba Government and General Employees Union represents home care workers who work for the the Interlake-Eastern Regional Health Authority and Prairie Mountain Health.
MGEU president Kyle Ross said, "there's so much work and not enough people."
He said MGEU members are doing their best with the time they're allotted to help home-care clients.
"It's been difficult for many years now and we're hoping with this new government's commitment to rebuild health care and rebuild home care, we're really hoping they'll put some investments in … so people can age at home like they want to," Ross said.
Health Minister Uzoma Asagwara says home-care workers took part in a meeting with Premier Wab Kinew and health-care workers at Grace Hospital on Friday
Asagwara says they heard wages have been among the issues that have prompted some home-care workers to leave their jobs.
The minister says they want to hear from health-care workers about how to improve service delivery.
"Our priority has to be about relationships," Asagwara said Friday. "It has to be about strengthening and repairing relationships with home-care workers, reassuring them that they have a government that's going to work with them to ensure that they can provide care that they know is meaningful and sustainable."
Brown, whose father died Nov.10, says she couldn't wait for the traditional delivery of home care to improve. Her mother is waiting for placement in a personal-care home.
While managing their care has meant more work for her, she says it's been worth it.
"At least you have control over your home care," she said.
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