Grant: Project Grant

Most older adults prefer to remain at home as they age, and home care can help make that possible. Home care includes paid services from nurses or personal support workers, as well as unpaid help from family and friends. Although governments have increased funding for home and community care, it is still unclear which combinations of paid and unpaid care best support older adults, reduce avoidable hospital use, delay transition to long-term care, and make good use of public resources. Since provinces organize home care differently, what works well in one setting may not work as well in another. This study will follow older adults from the Canadian Longitudinal Study on Aging and securely link their survey responses to provincial health records in British Columbia, Ontario, and New Brunswick. We will examine how people use formal and informal home care and identify common care patterns, such as frail older adults relying mainly on family support. We will then assess how these patterns are associated with later outcomes, including emergency department visits, hospital stays, transitions to long-term care, and overall health system costs. We will also examine whether these patterns and outcomes differ by rural or urban residence, sex, gender, and other socioeconomic factors. Finally, we will model home care planning scenarios, such as increasing formal home care for people with high frailty and limited formal support, to estimate the likely health benefits and value for money. Our goal is to generate evidence that helps provinces better target home care investments so more older adults can remain safely at home with appropriate support, caregivers are better supported, and the health system can avoid preventable and costly hospital and long-term care use. Findings will be shared with patients, caregivers, and policy-makers to support better planning decisions.