Home care is a group of health care services provided to a person in his or her home. Homebased services aim to enable people with health problems (e.g. acute illnesses, long term disabilities, and/or people who are recovering from illness or surgery) to live as well and as independently as possible, in their own homes and communities.
These services include care provided by health care providers (e.g. home support workers, nursing care, physiotherapy, occupational therapy, lab technicians, etc.) and respite care, as well as care focusing on personal hygiene and/or activities of daily living.
VIHA Home and Community Care program provides community-based health services intended to support people with acute or chronic illness or a physical disability to remain at home, as independently as possible. Home-based health teams provide the services.
Through this program, homecare nurses provide:
- health promotion
- teaching of self-care
- coordination of multi-disciplinary services, treatments and supports
The homecare nurse will work with the person receiving care to address his or her goals for:
- emotional support and coping
- pain control
Home support services offer personal assistance with daily activities such as:
- hygiene and toileting
- assistance in getting up and/or going to bed
- assistance with medications
Home support services help with various household tasks such as laundry, meal preparation, and so
forth. Home support services are provided by workers with home support training; however, they are
not generally registered nurses.
Anyone can make a referral to the Home and Community Care program at 388-2273 or 1-888-533-
What happens when you call the Home and Community Care Program?
When you call you will be connected with Central Intake. The Central Intake staff will ask a series of
questions over the phone to determine the priority level of the person in need of assistance/care.
The priority assigned is determined by reviewing care needs, current supports, and immediate
risks. Risk to the individual if service is not provided immediately is considered, especially if there is a
risk of illness or injury and/or if family caregiver stress/breakdown is evident.
If, as a result of Central Intake telephone screening, the person is determined to be high or medium
priority, a Case Manager is assigned and will make a home visit to further assess whether the person
is eligible for subsidized home support service and other home-based care programs offered through
Community Health Programs. The level of risk/need also determines the number of hours of home
support that an individual may receive. Subsidies for home support are based on a sliding scale in
relation to the person’s income.
If, as a result of Central Intake telephone screening, the person is determined to be low priority, yet
home support or other home-based care services are still desired by the individual or their family,
services can be arranged privately. In these situations the home support service will be not subsidized.
The person requiring assistance or his/her family caregivers can contact the Home Support Agency of
their choice. This also holds true for individuals who are receiving some subsidized home support but
want additional hours.
Case Managers work with care receivers and their families to help meet individuals’ health care goals.
Following a referral from Central Intake, a Case Manager will arrange a home visit with the care
receiver (and family caregiver) to:
- discuss the person’s health care needs
- jointly develop a care plan
- provide information about available resources in the community
- assess eligibility for subsidized services such as home support, adult day centers or facility care,
- and authorize payment for these resources if appropriate
- jointly decide how to monitor the care plan
- communicate with other service providers to make sure the care receiver and family obtain the
- help needed
Since a financial assessment will be completed to determine the care receiver’s costs for Home
Support (assuming that home support services are required), it is important that the most recent
income tax returns are handy.
In the CRD certain home support agencies are affiliated with VIHA and participate in an ongoing quality
assurance program. Call the Central Intake line at 388-2273 for a list of these services or check the
VIHA website at www.viha.ca. If following your assessment by a Case Manager, you are eligible for
subsidized home support, you will likely receive service from the home support agency above,
designated for your neighbourhood or community. The Case Manager arranges for the subsidized
home support service. If additional non-subsidized home support and/or other home-based care
services are required, these arrangements need to be made by the care receiver or family and paid for
There are several home support agencies that are privately owned and operated. Some offer a wide
range of services including:
- case coordination by a registered nurse
- personal care by licensed practical nurses or home support workers
- assistance with housekeeping and laundry
- meal preparation
- handyman services
- shopping services
- companion services
- transportation services
- respite services
Not all agencies necessarily provide this full array of services, so it is important to discuss what the
agency offers when you make enquiries. In arranging privately for home care, it may be helpful to ask
particular questions of the agencies you are considering. Some important questions include:
- What services does the agency provide?
- How long has the agency been in business?
- Is the agency insured or bonded? Are the workers bonded?
- Does the agency supply references for itself and its employees?
- What type of training is required of employees?
- Will the same person come to the home each time?
- Will a supervisor oversee the quality of care that is being received?
- Does the agency perform an in-home assessment and create a care plan based on this
- What are the fees? Is there a sliding scale? Are there payment plan options?
- How does the agency deal with emergencies, holidays, and sick days?
An alternative to arranging home support service with an agency is to hire an individual to provide
home support services. If you are considering this option, some questions that you may want to ask
of the applicant include:
- Why are you interested in providing home care?
- What are some of your past experiences with home care?
- What training do you have in home care?
- Are you currently providing care for others?
- Why did you leave your last position?
- Are there any duties that you are unwilling or unable to do?
- What will you do if there is an emergency?
- Have you handled an emergency situation before? What happened?
- How would you deal with someone who may resist your care?
- What will you do if you are sick and cannot come in
Other Home-based Care Services
The purposes of the Quick Response Team (QRT) are:
- To prevent avoidable hospital admission;
- To provide crisis intervention at home; and
- To facilitate early hospital discharge
Quick Responses Team’s services include urgent assessment, treatment and consultation through a
multi-disciplinary team including physiotherapists, occupational therapists, social workers, nurses and
home support workers. Referrals to the QRT come from health care providers only. QRT services are
provided free of charge (with the exception of QRT home support, for which care receivers may pay in
keeping with LTC home support provisions).
Community Rehabilitation Services: aim to provide a variety of home-based physiotherapy and
occupational therapy services, in order to help enable a person’s capability to remain living at home
safely. The focus of these services is on non-urgent rehabilitation in order to:
- promote independence
- pain management
- pre- and post surgical care
- palliative care
- environmental adaptation
- home safety
Anyone can refer to the program, though treatment needs to be authorized by a doctor. There are no
direct costs to the person receiving care, although individuals are responsible for the cost and
provision of supplies.
Adult day centers provide opportunities to get out and keep in touch with other people in the
community. These centers are located throughout the region; some in long-term care facilities, stand
alone, in apartment buildings and within seniors’ centers. Participants can join in the:
- exercise programs
- discussion groups
- arts and crafts
- information programs
- community outings
All this while the family caregiver has the chance to rest or run errands. There are also health
professionals to talk to for both caregivers and the participants. Individuals are welcome to attend
adult day centers if they qualify for VIHA’s long-term care services. Some centers also accept private
clients or those referred from the community.
Overnight facility stays
After attending day centre activities care receivers can stay overnight at the facility then enjoy another
full day at the centre before returning home. Overnight facility stays can provide much needed breaks
for family members.
Community Bathing Programs assist people who cannot bathe safely in their own homes. For a
small fee, they can bathe in specially equipped bathtubs, with the assistance of trained staff, at several
facilities in the greater Victoria area. Community bathing programs are open to anyone having difficulty
bathing safely at home.
For those people not requiring or not eligible for the health authority’s programs,
community agencies are adding to their existing programs:
Direct Volunteer Service Agencies
Certain agencies will provide a Community Service Coordinator to support connection to and coordination of community-based services for individuals who have difficulty accessing these services
because of frailty or disability.
The Coordinator will link seniors to other community services and programs that encourage selfreliance and improve physical and emotional well-being. Contact: Lynn at Saanich Volunteer Services
Society at 595-8008 for more information.
Silver Threads provides various different services. For information about any of the Silver Threads
Programs the general information line at 388-4268.
Nutrition services aim to provide a variety of nutrition services to order to help enable a person to
maintain optimal nutritional health while living at home. Clinical nutritionists provide assessment,
consultation and education to people with compromised nutritional status. Services are provided in
the home. Anyone can refer to the program and there are no direct costs to the person receiving care.
Respite is the break that caregivers get by allowing someone else to temporarily take over some of
their caregiving duties. Used on a regular basis, respite care helps prevent caregiver burnout, by
relieving some of the caregiver’s workload and stress.
Respite care usually takes one of three forms:
- arrangements can be made for someone to come into the home to look after or sit with the care
- receiver (even if the caregiver is at home)
- the care receiver can attend an adult day program.
- the care receiver can have a short stay (overnight, weekend, a week or more) in a long-term care or
- other facility
The first step in obtaining respite is to call your Case Manager for an updated assessment. All Long
Term Care respite is arranged through the Case Manager. She will discuss your respite requirements
with you and suggest one or more of the following options:
- Urgent Respite
- If need is immediate and urgent, the Case Manager will suggest that a home support worker come into your home to care for the family member. Care may be provided for up to 24 hours per day to a maximum of 10 days. There is a sliding scale cost for this service. The amount of home support hours authorized is dependent on the care needs of the individual. An important consideration is safety and whether the person can be left alone.
- Ongoing Respite
- It could be that a family caregiver wants to attend a regular class or engage in some sort of fitness activity once a week. In this case your Case Manager may set up regular, ongoing home support hours.
- Adult Day Programs
- See information above about Adult Day Programs
- Facility Respite
- Numerous care facilities provide short-term admission beds that can be booked for respite use.
Adapted and compiled from:
Resource Guide for Family Caregivers, published by the Family Caregivers’ Network Society, March
“Update from the Day Programs”, by Vicki McNulty, Network News, September and November 2003,
Family Caregivers’ Network Society.