In the early 1900’s, large rural families often looked after their aging parents. However not every family had the capacity to do so. Some religious and ethnic groups sponsored the first long term care services which were restricted to residential care. During the past 100 years there have been many influences on society which have had an impact on how we care for our aging family members.
We have seen increased access to education, mobility of workers, smaller family size, the shift from rural to urban living, growing strength of the economy, technological advances, greater levels of public funding and the persistence of a value to provide care and safeguards for the more vulnerable people in society.
There has been an evolution in the methods of care and legislation over the years, as new knowledge was acquired about care-giving; as limitations with old methods became apparent, as more public funding became available and as successive governments took a greater role in establishing public policy and legislation related to care of older adults.
From its simple beginnings, the long term care system has grown to a comprehensive continuum of support and service delivered by charitable organizations, municipal governments and private corporations. Services include those provided in one’s own home to maintain quality of life as well as a variety of residential options when living at home is leading to diminishing quality of life. The focus is on supporting people to live as independently as possible.
Support programs may include adult day care, home health care, hospice care, respite care and community support services such as transportation, friendly visiting, security checks, home maintenance, foot care, health promotion, medication education, meals on wheels, wheels to meals, information and referral services. The vast majority of older adults receive support from the long term care sector so they can remain at home.
In addition to these support programs there are also other social, recreation and support services operated by elderly persons centre, by seniors’ clubs and municipal recreation departments in communities across Ontario. Community support services are often available through elderly person’s centres.
Today, 43 Community Care Access Centres (CCAC’s) in Ontario coordinate services provided by 1200 local agencies. Each local CCAC is the entry point for access to residential care facilities in their area. There are over 600 facilities in Ontario providing long-term residential care. About 52% of these facilities are owned and operated on a for-profit basis by large and small corporations. The remainder are not-for-profit organizations owned and operated by charitable organizations or by municipalities. These facilities provide care for 76,000 people.
While the forms of support to older adults have expanded and matured, the underlying values remain consistent. In the event that shared values are not enough in all situations, social policy continues to move in the direction of seeking the best way to safeguard against domination, exploitation and abuse of older adults. The current dialogue among service providers, planners and legislators is filled with reference to principles of living with dignity, independence, participation, fairness, security and quality of life.
Participants in the Ontario Partnership find that the developmental service system shares very similar values to the long term care system and it is on this foundation that the dialogue between the sectors takes place.