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Home care: “I don’t know how we’re going to succeed”

Aboard his small car, in which we take a seat to go to the apartment of one of his patients, Dr. Patrick Bernier admits to us that he is trying to relax a little.

I try to take it easy; I drive more “cowboy” than usual! confides the family doctor specializing in psychogeriatrics.

Dr. Bernier goes to a private residence for seniors in the Lebourgneuf district of Quebec. He cares for patients with cognitive problems often accompanied by mental health disorders.

At home, they will be less anxious, more in their elementhe explains.

The objective is for these patients to stay at home as long as possible, despite their state of health, far from emergencies and CHSLD. The doctor assesses them at home so that, depending on their condition, the beneficiary attendants and nurses who provide support adapt their care.

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It takes a lot of time for doctors who make house calls, like Dr. Patrick Bernier, to travel, which means they necessarily see fewer patients than in the office.

Photo : - / Jean-Michel Cloutier

The scale of the exponential problem

In Quebec, nearly 20,000 people are waiting for a first home support service. Successive governments have promised a shift towards home care for years, but they have never fully delivered on their commitments.

In response to a rapidly aging population and a tightening of finances in the health network, stakeholders, including Dr. Bernier, are expressing their concerns.

I don’t think we’re necessarily moving in the right direction when it comes to access to care.

A quote from Dr Patrick Bernier, family doctor specializing in psychogeriatrics

The government is seeking to reduce spending by $1.5 billion in the health system. On November 29, the Minister of Health, Christian Dubé, recognized that there could be repercussions for patients.

I don’t know how we’re going to succeed. […] I think teams like ours deserve to be developed and more widespread toobelieves Dr. Bernier.

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Dr. Patrick Bernier in the offices of the Christ-Roi establishment of the CIUSSS de la Capitale-Nationale

Photo: - / Pierre-Alexandre Bolduc

Its small team of five doctors works closely with nurses, beneficiary attendants, occupational therapists and several other professionals who serve the areas of Quebec, Côte-de-Beaupré and Portneuf.

It is sure that it is less costs; we will not hide it. It’s easier for the health system if people are at homeargues the doctor.

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Dr. Leila Mekki Berrada is part of a team of five doctors specializing in geriatrics who make home visits in the Capitale-Nationale region. They try to help patients with neurocognitive disorders.

Photo: - / Pierre-Alexandre Bolduc

Patrick Bernier also admits that he has difficulty seeing how Santé Québec, the new single employer in the health network, will improve the situation. The one who says he has lived several mergers in the network rather advocate decentralization and a model where people talk to each other rather than send each other papers.

We have a certain drift towards structures, he notes. As a clinician, I don’t see many benefits.

A plan too late for the challenge ahead?

In 2031, 1 in 4 Quebecers will be over 65. In 2061, this will be nearly 1 in 3 Quebecers. The need for home care will therefore grow exponentially.

In an interview at her office in the National Assembly, the Minister responsible for Seniors, Sonia Bélanger, says she is keeping calm, even if the pressure risks being enormous. She announced at the end of November that she would present a new national home support policy within a year, but organizations say it is already too late.

This year, we aim to reach 400,000 people with home support. This is 10,000 more than last yearunderlines the minister.

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The Minister responsible for Seniors, Sonia Bélanger, defends her government’s record on home care. She maintains that the objectives she set for herself have been achieved and that she is continuing the work.

Photo : - / Jean-Michel Cloutier

At any given time, the Ministry of Health cannot take 100% of the budget available to the government. It is very important to respect the budget.

A quote from Sonia Bélanger, Minister responsible for Seniors

Even though she maintains that the government has increased funding for home care, the number of hours of service and the number of positions, critics accuse the Coalition Avenir Québec (CAQ) of relying on the model of seniors’ homes. The implementation of this flagship promise of the Legault government cost on average $825,000 per unit.

It is truly utopian to think that all people who are aging in Quebec will be able to stay in their homes, explains Ms. Bélanger. And seniors’ homes, we are in the process of transforming the housing model in Quebec with that. It’s extraordinary what’s happening there. I am very proud of it.

Caregivers at the end of their tether

I have seven phones since this morning, then everyone goes to the waiting listdeplores the person responsible for respite at the Association of Caregivers of the Capitale-Nationale, Claude Bergeron.

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The team from the Association of Caregivers of the Capitale-Nationale discusses waiting lists to provide assistance to caregivers.

Photo : - / Jean-Michel Cloutier

Mines are very low in the organization’s offices. Funding is slow and the waiting list for help is growing by the day.

The organization can count on only 15 care workers to provide 4-hour blocks of respite to caregivers who are caring for a person as best they can at home.

Currently, it is a disaster; we don’t want to be sicksupports the President and CEO of the Association, Suzanne Girard.

She emphasizes that when caregivers are older, often there are two sick people in the house. And several die before the person being cared for, due to exhaustion.

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The CEO of the Association of Caregivers of the Capitale-Nationale, Suzanne Girard, is discouraged by her organization’s long waiting list. She struggles to be able to offer respite services to all caregivers who request them.

Photo: - / Pierre-Alexandre Bolduc

Everyone has their eyes rolling towards the Ministry of Health, waiting for budgets to receive the respitesaid Ms. Girard, sighing.

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