Also known as home and community care (HCC) when provided by the health authorities.
The 3 types of service providers
Three kinds of groups provide home support services:
- Government-Subsidized (also known as Public)
- Non Profits (also known as Non Profit Societies, and Non Profit Organizations – NPO’s)
- Businesses (also known as For Profits, and Private)
Home Support services are designed to help seniors, those who are ill, and those with disabilities.
The three kinds of service providers offer different services at different prices, and are obtained in different ways:
Government-Subsidized (Public) Services
Wherever the person you care for lives in BC, the five regional health authorities (Fraser Health, Interior Health, Island Health, Northern Health, Vancouver Coastal Health) offer government-subsidized (public) Home and Community Care (HCC) Services to assist both the care recipient and the family caregiver. As explained at the BC government website: Publicly subsidized home and community care services provide a range of health care and support services for people who have acute, chronic, palliative or rehabilitative health care needs. Services include:
1) Case Management. Access to government-subsidized HCC services is through case managers who provide detailed assessments of individual clients. The health authority case managers coordinate care for people with complex health needs requiring extra, ongoing support to live at home independently. Their goal is to help people live at home safely and avoid unnecessary or premature admission to a hospital or care facility.
2) Home Support Services. These provide personal assistance with activities of daily living including bathing, dressing, medication administration, as well as support and relief (also called respite) for the primary caregiver. If home support assistance is recommended by your case manager, she/he will determine the assistance that will best suit your needs and will make the necessary arrangements for services to be delivered. If your care recipient is in the hospital, note that home support services are often provided to people after they have been discharged from hospital and this is arranged by a hospital coordinator called a Home Health Liaison or Quick Response Case Manager who understands how to match discharged patient needs to resources in the community. (Adapted from www.fraserhealth.ca)
Home Health Community Health Workers (CHW’s) provide home support services. They are trained, screened and insured and their services meet established standards. Some clients have unique care needs for which a worker’s gender, language or cultural awareness could make a significant difference. In such situations, efforts are made to consider those needs when scheduling a worker. Be certain to ask if an appropriate CHW is available for your loved one.
Home Health does not provide banking, companions, driving to appointments, foot care, grocery shopping, house cleaning, laundry, meal preparation, or rehab equipments/aids, but intake staff or the case manager can assist in locating these types of services in your community. Some of those services are listed in other sections of this website.
Get the brochure What is Home Support? in English, Chinese, and Punjabi.
3)Adult Day Centre Programs (ADPs). These provide a break/respite during the day for the caregiver, as well as social recreational therapeutic activity, a hot meal, and some personal assistance for the care receiver. Access is through a Home Health case manager who must assess the client and determine their need for this program. Programs generally run from 10am-2pm and eligible seniors are usually assessed to attend one day a week. There is usually a nominal daily charge to supplement the cost of meals, supplies, and for transportation (if supplied by the program provider or HandyDART).
4 )Caregiver Respite / Relief. A respite break can give the caregiver temporary relief from the emotional and physical demands of caring for a friend or family member. The case manager of the person you care for can help you arrange three different kinds of respite:
- Respite may be a few hours of service provided in the home of the care recipient while the caregiver takes a break to renew energy.
- Adult Day Centre Programs (item 3 above) also provide respite.
- Short-term admission to a Residential Care facility or hospice residence for a person with complex care needs is another respite service. This can give caregivers a temporary rest from between four and thirty days each year. Caregivers sometimes use this time to take a holiday; they even use this respite service to cover for them if they have to go into hospital. Caregivers wanting to use this respite service to cover their needs for vacation time are advised to give lots of notice to get the dates they need respite.
If you (the caregiver) are in need of respite, speak to the case manager of your care recipient; if the person you are caring for doesn’t have a case manager, contact the home and community care office in the health authority area where your care recipient lives. See also FAMILY & FRIEND (UNPAID) CAREGIVERS – RESPITE for more tips on how to achieve a break.
5) Choice in Supports for Independent Living (CSIL). This BC Ministry of Health self-managed care option for home support services is where funds are provided to eligible clients to purchase and manage their own home support services. CSIL clients, or a designated Representative or a client support group, receive funds directly for the purchase of home support services and assume full responsibility for arranging services, including recruiting, hiring, training, scheduling, disciplining, paying home support worker(s), and, if necessary, firing your own caregiver(s). You are the employer. You must follow Canada Revenue Agency, WorkSafeBC, and Employment Standards regulations. To quality for CSIL funding clients must:
- i) Be approved for Home Support services, and
- ii) Be living with physical disabilities and have high-intensity care needs requiring daily personal assistance, and
iii) Be medically and functionally stable, and
- iv) Be able to direct all aspects of your care, or have an alternate decision maker to do this for you, and
- v) Be able to direct and manage the CSIL contract obligations, or have an alternate decision maker to do this for you.
You must also complete an orientation before you sign a CSIL agreement which outlines what you are required to do. The amount of funding you will get depends. Your Case Manager will work with you to determine the amount of money you will receive based on your personal care needs. Funding is based on the current hourly CSIL rate and the number of hours of personal care you need. CSIL funds cover the costs of managing your home supports (such as wages, advertising, bookkeeping, etc.). You must submit regular financial reports to show how you have spent the funds.
If you think your care recipient might be eligible for CSIL, visit this website and talk with the case manager of your care receiver.
6) Government-Subsidized (Public) Assisted Living and Residential Care. When independent living in the community is no longer possible, a senior might be eligible for publicly funded Assisted Living (a housing arrangement that consists of a private housing unit with a lockable door, hospitality services and personal care services), or Residental Care, also called Long-term Care, Complex Care, Continuing Care, Facility Care and Nursing Homes. Residential Care refers to facilities that provide 24-hour professional nursing care and supervision in a protective, supportive environment for people who have complex care needs and can no longer be looked after in their homes.
See the Housing parts of this website to learn about the three levels of care in seniors housing – Supportive Housing, Assisted Living and Residential Care. You will also find an explanation of the three types of housing providers –government-subsidized (public), non-profit societies, and businesses (private for-profits).
7) End-of-Life Care. End-of-life care is supportive and compassionate care that improves the quality of life for people and their families who are facing the end stages of a terminal or chronic illness or preparing for death. It addresses physical, psychological, and spiritual concerns and focuses on comfort, respect for decisions, and support for the family. It is provided wherever the client is living, whether in their home, in hospice, an Assisted Living residence or a Residential Care facility. Note that end-of-life care is supportive and compassionate care provided during the remaining days, weeks or months of a person’s life; it DOES NOT hasten death. To learn more about these services, and caring for a dying person, see the END OF LIFE sections of this website.
8) New Models of Care for Frail Adults. Since we are living longer, the caregiving journey is lasting longer. The longer our care recipients live, the frailer they will likely become, and the more services will be required to help frail elders ‘age in place’ and remain in their homes, as many wish to do. The BC Ministry of Health is working with the health authorities to develop revised and enhanced Models of Care. These new Models of Care aim to improve integration of care with physicians and other health care providers, and community organizations to realign services. This integrated Primary and Community Care (PCC) is meant to improve patient and family experience of care in community based settings with timely access to quality hospital (acute) services when needed. The new care models are slowly being introduced across BC. All are designed to provide caregivers with more assistance and support, in addition to providing more comprehensive care to their adult care recipients.
Fraser Health Authority (FH) Home & Community Care (HCC) Services
serves residents from Burnaby to Hope to Boston Bar. Specifically: Abbotsford, Anmore, Belcarra, Burnaby, Chilliwack, Coquitlam (Tri-Cities), Delta, Hope, Langley, Langley City, Langley Township, Mission New Westminster, Maple Ridge, Pitt Meadows, Port Coquitlam (Tri-Cities), Port Moody (Tri-Cities) South Surrey, Surrey, and White Rock.
If the person you are caring for lives in the FH area and needs access to HCC services, call the Fraser Health HCC Central Intake line Toll-free 1-855-412-2121 to access services such as case management, home care nursing, community occupational and physical therapy, community nutrition, home support, acquired brain injury supports, hospice palliative care, adult day programs, caregiver support, convalescent care, assisted living and residential care.
For more information about Fraser Health Home & Community Care Services: 604-587-4600, or toll-free outside the Lower Mainland: 1-877-935-5669
Interior Health Authority (IH) Home & Community Care (HCC) Services
Serves residents in the East Kootenay, Kootenay Boundary, Okanagan and Thompson Cariboo Shuswap areas. Specifically: 100 Mile House, Anahim Lake, Armstrong, Aschroft, Barriere, Canal Flats, Castelgar, Chase, Clearwater, Clinton, Coldstream, Cranbrook, Crawford Bay, Creston, Elkford, Enderby, Fernie, Golden, Grand Forks, Greenwood, Invermere, Kamloops, Kaslo, Kelowna, Keremeos, Kimberley, Lillooet, Logan Lake, Lumby, Lytton, Merritt, Midway, Montrose, Nakusp, Nelson, New Denver, Oliver, Osoyoos, Peachland, Penticton, Princeton, Radium Hot Springs, Revelstoke, Rossland, Rutland, Salmo, Salmon Arm, Shuswap, Sicamous, Silverton, South Cariboo, South Similkameen, Sparwood, Spallumcheen, Summerland, Tatla Lake, Trail, Vernon, Westbank, West Kelowna, Williams Lake, Windemere.
If the person you are caring for needs access to services such as case management, home care nursing, community occupational and physical therapy, community nutrition, home support, acquired brain injury supports, hospice palliative care, adult day programs, caregiver support, convalescent care, assisted living and residential care:
100 Mile House (250) 395-7676; Armstrong (250) 546-4752; Ashcroft (250) 453-1939; Barriere (250) 672-9707; Castlegar (250) 365-4333; Chase (250) 679-1416; Clearwater (250) 674-3141; Clinton (250) 453-1939; Cranbrook (250) 421-8912; Crawford Bay (250) 227-9019; Creston (250) 428-3600; Elkford (250) 865-2247; Enderby (250) 546-4752; Fernie (250) 423-8288; Golden (250) 344-3005; Grand Forks (250) 443-2100; Invermere (250) 342-2360; Kamloops (250) 851-7900; Kaslo & East Shore (250) 352-1401; Kelowna (250) 980-1400; Keremeos (250) 499-3029;
Kimberley (250) 427-2215; Lillooet (250) 256-1326; Logan Lake (250) 523-9414; Lytton (250) 455-2221 ext. 4; Merritt (250) 378-3408; Midway (250) 449-2887; Nakusp, Nelson and New Denver (250) 352-1401;
Oliver (250) 498-5080; Osoyoos (250) 495-6433 ext. 0; Penticton (250) 770-3477; Princeton (250) 295-4442; Revelstoke (250) 814-2267; Rutland (250) 980-1400; Salmo (250) 352-1401; Salmon Arm (250) 832-6643; South Similkameen (250) 499-3029; Sparwood (250) 425-2064; Summerland (250) 404-8060; Tatla Lake (250) 476-1114;
Trail (250) 364-6230; Vernon (250) 541-2200; West Kelowna (250) 980-1400; Williams Lake (250) 302-3244.
For more information about Interior Home & Community Care Services: www.interiorhealth.ca/YourCare/HomeCommunityCare/Pages/default.aspx or www.interiorhealth.ca/AboutUs/ContactUs/Pages/default.aspx
Island Health Authority (IH) Home & Community Care (HCC) Services
Serves Vancouver Island, the islands of the Georgia Strait, and in the mainland communities north of Powell River and south of Rivers Inlet. Specifically the areas of: Alberni, Campbell River, Courtney, Cowichan, Greater Victoria, Gulf Islands, Lake Cowichan, Ladysmith, Nanaimo, Qualicum, Saanich, Sooke, Vancouver Island North, Vancouver Island West.
If the person you are caring for lives in the IH area and needs access to HCC services, contact the Central Intake HCC office closest to where your care receiver lives to access services such as case management, home care nursing, community occupational and physical therapy, community nutrition, home support, acquired brain injury supports, hospice palliative care, adult day programs, caregiver respite and support, convalescent care, assisted living and residential care:
South Island (All communities south of Mill Bay, including Greater Victoria, the Southern Gulf Islands and west to Port Renfrew) 250-388-2273, toll-free: 1-888-533-2273
Central Island (All communities from Mill Bay to Deep Bay, included. Toll-free: 1-877-734-4101
North Island (All communities north of Deep Bay including the Mt- Waddington Regional District and the mainland area adjacent to it) 250-331-8570 toll-free: 1-866-928-4988
For more information about Island Home & Community Care Services: www.viha.ca/hcc or 250-370-8699 toll-free: 1-877-370-8699
Northern Health Authority (NH) Home & Community Care (HCC) Services
Serves residents in Atlin, Burns Lake, Chetwynd, Dawson Creek, Dease Lake, Fort Babine, Fort Nelson, Fort St. James, Fort St. John, Fraser Lake, Granisle, Haida Gwaii (formerly Queen Charlotte Islands), Hazelton, Houston, Hudson’s Hope, Kitimat, Mackenzie, Masset, McBride, Nechako, Nisga’a, Peace River, Prince George, Prince Rupert, Queen Charlotte City, Quesnel, Smithers, Snow Country, Stewart, Stikine, Tellegraph Creek, Terrace, Tumbler Ridge, Upper Skeena, Valemount, Vanderhood, Village of Queen Charlotte.
If the person you are caring for lives in the NH area and needs access to HCC services, contact the Central Intake HCC office closest to where your care receiver lives to access services such as case management, home care nursing, community occupational and physical therapy, community nutrition, home support, acquired brain injury supports, hospice palliative care, adult day programs, caregiver respite and support, convalescent care, assisted living and residential care. Get the list of NH HCC Central Intake Line phone numbers.
For more information about Northern Health Home & Community Care Services: https://northernhealth.ca/YourHealth/HomeandCommunityCare.aspx or https://northernhealth.ca/ContactUs.aspx
Vancouver Coastal Health Authority (VCH) Home & Community Care (HCC) Services
Serves residents in Vancouver, Richmond, The North Shore and Coast Garibaldi, Sea-to-Sky Highway, Sunshine Coast, Bella Bella, Bella Coola, the Central Coast and the surrounding areas. Specifically: Bella Bella, Bella Coola, Bowen Island, Britannia Beach, Brackendale, Coast Garibaldi, Darcy, Earl’s Cover, Egmont, Garden Bay, Gilles Bay, Gibsons, Halfmoon Bay, Lions Bay, Madeira Park, Mount Currie, North Vancouver, Pemberton, Pender Harbour, Port Mellon, Powell River, Richmond, Roberts Creek, Sechelt, Secret Cover, Squamish, Vancouver, West Vancouver, and Whistler.
If the person you are caring for lives in the VCH area and needs access to HCC services, call the Central Intake HCC office closest to where your care receiver lives to access services such as case management, home care nursing, community occupational and physical therapy, community nutrition, home support, acquired brain injury supports, hospice palliative care, adult day programs, caregiver respite and support, convalescent care, assisted living and residential care:
Gibsons HCC Central Intake Line 604-741-0276
North Shore HCC Central Intake Line 604-986-7111
Pemberton HCC Central Intake Line 604-894-6939
Pender Harbour HCC Central Intak Line 604-741-0276
Powell River HCC Central Intake Line 604-485-3310
Richmond HCC Central Intake Line 604-278-3361
Sechelt HCC Central Intake Line 604-741-0276
Squamish HCC Central Intake Line 1-877-892-2231
Vancouver HCC Central Intake Line 604-263-7377
Whistler HCC Central Intake Line 604-932-4911
For more information about Vancouver Coastal Health Home & Community Care Services: www.vch.ca/your-health/health-topics/home-and-community-care/ or 604-736-2033; Toll-free for residents outside of the Lower Mainland 1-866-884-0888
N.B. The Office of the Seniors Advocate September 2015 report Caregivers in Distress: More Respite Needed expressed deep concern about the need for more home support hours and services to help relieve the strain on unpaid caregivers who enhance the ability of those they care for to continue to live in their homes. The report noted the level of carer distress rises with the number of hours of care they provide. The Advocate emphasized that home support services have not kept pace with the rapidly growing seniors’ population, and that family caregivers are becoming increasingly distressed. “If we cannot find a way to support these caregivers, especially those who are in distress, we will find that demand will increase on residential care and acute care as seniors can no longer be supported at home.”
There is also a call by the BC Seniors Advocate to have more than the typical one day a week Adult Day Program (ADP) service available to clients, to have ADP’s open on weekends, and also have a second shift, later in the day for an additional group of clients. The advocate also recommends ADP’s be funded to support a second type of client – one with care needs that are more complex than the prevailing system allows. These changes, i.e. the provision of more ADP services to frail elders, would reduce the number of visits to hospital emergency departments and reduce hospital admissions.
The advocate is also calling for a simpler, less bureaucratic way to be able to use the CSIL option.
Home Support: Non-Profit Societies
Better at Home Only a very small number of non-profits offer home support services. The biggest is the Better at Home program that helps seniors 65+ with simple day-to-day tasks so that they can continue to live independently in their own homes and remain connected to their communities. The BC Ministry of Health funds the program, United Way of the Lower Mainland manages it, and local non-profit organizations in 60 communities across BC provide a range of non-medical home support services. The services, which are income based so as to accommodate the needs of low-cost seniors, vary from community to community. They are designed to complement existing services and are based on the unique needs of local seniors. Examples include:
- Friendly visiting
- Light yard work
- Minor home repairs
- Light housekeeping
- Grocery shopping
- Snow shoveling
Seniors living in Better at Home communities can contact a local organization to find out more and to apply for services. The local service provider will help determine which services are most appropriate for an individual’s circumstances.
Home Support: Private, For-Profit Businesses
Private business agencies offer home support and home health care services on an hourly basis for companionship, home cleaning, meal preparation, accompaniment to places outside the home, personal care (bathing, dressing, grooming, toileting), assistance with medications, foot care, assistance with needs related to conditions such as dementia, MS, Parkinson’s, post-surgical help, nursing (wound dressings, IV therapy, ventilator care), palliative care and live-in companions. Hourly rates tend to begin at $25 per hour plus tax and rise with the level of care needed. Each agency has its own requirement for a minimum number of hours per visit. Some agencies provide all services, others only some. See HOME SUPPORT SERVICES in your Yellow Pages for a list of agencies.
Note: There are no regulating bodies for home support agencies in BC, so when hiring an agency, ask if the care staff are bonded, screened (criminal record check, past employment references checked), insured, trained, and supervised. If you or your care recipient will be transported by a staff person from a home support agency, ask if the agency runs their staff through ICBC driver record checks.