Grant: Foundation Grant

Most Canadians wish to stay at home in their old age, but to still have access to healthcare. With new medical technologies (such as alarm bracelets), more and more seniors can stay at home for longer and receive care from home care teams. But seniors living at home often face difficult decisions, such as "Who will look after me when I can't look after myself any more, or if I have dementia?" or "Should I move to a nursing home, or stay here?" For the caregiver, the decision may be "Can I continue to care for my loved one at home?" When more than one option is possible, home care teams can help seniors and their families who are making these hard decisions by giving them the information they need and asking about their values and preferences. This way, seniors and their caregivers can know more about their choices and choose options that reflect what is important to them. We call this 'shared decision making', and it has been shown to improve patient experiences (less disappointment, anxiety or regret) and better use of healthcare dollars. More and more, seniors will be making such decisions in consultation with their home care teams. Over the years we have developed tools and training programs to help home care teams support seniors and their caregivers in making the decision about whether a senior who is no longer independent should stay at home with more help, or move to a nursing home. However, most of our research has been at the regional level. Too many pilot projects that could benefit far more people stay hidden at the local level. So we plan to scale up the tools, programs and systems that seem to work well for one decision and one region. We will adapt and apply them to home care in other places across Canada and to other difficult decisions, so that more seniors and their caregivers benefit from shared decision making and can make decisions together that are better for their health, their pocket, and their quality of life.