Grant: Cat Gr.: Policy Research for HST - IHSPR - Health Care Policy Res./Systems Res.

There are increasing numbers of older and seriously ill people unable to access health and social care that addresses their unique needs. These might include declining health, increasing disability, loneliness, difficulty remaining in their home, coming to terms with end of life, and grief from losing loved ones. The medical care system is not well equipped to handle many of these issues. Social care programs can help, but they are often disconnected from each other and from formal health care. Both these types of care are needed for 'holistic health' (e.g. physical, emotional, social). Holistic health and wellness community programs can be part of the solution. An example of this type of program is where people use assessments to map out their needs and goals and volunteers help them create a fluid circle of care in their community that addresses their needs. This information can be shared with medical providers to help them understand the person's situation and reduce risk. These programs show potential to improve outcomes without increasing costs. However, they are difficult to organize on a large scale because they do not fit into the regular systems that organize and pay for health care. This study aims to create options for policy changes that will overcome the current challenges of mainstreaming community programs for holistic care as a routine part of serious illness and elder care delivery. We will compare selected programs in Canada and other countries that have experience connecting community programs into the health system. We will summarize how they work and their challenges and successes by looking at reports. Next, we will interview leaders in various roles who have experience with these issues to understand the range of policy issues that support and hinder these programs from becoming mainstream. Finally, we will analyze these policy issues and propose three options for funding and organizing, with pros and cons, to policy makers in Canada