Manitobans who manage own home care squeezed by rising expenses, worker shortages

It’s getting harder for Vishno Gupta to hire the home-care workers he needs as a quadriplegic living at home. 

The 82-year-old, who needs help with everything from getting out of bed in the morning to bathing and eating due to a spinal cord injury, is one of about 1,000 people in Winnipeg who manage their own home care.

As costs rise, the money they get from the province isn’t going as far as it used to, he says.

“With the gas prices … [if] somebody has to spend $10 just to come here and go back, how am I going to pay $20 an hour for two hours?”

Manitoba’s self- and family-managed care program, available through regional health authorities, allows people who need home care to act as managers and hire their own workers. The intent is to give them more control over who comes through their door. 

The province has set rates for hiring workers through the program — $21.40 per hour for health-care aides, $14.50 for home support workers. Those rates haven’t changed since 2012.

They also don’t translate directly to hourly wages. People who manage their own care are responsible for paying administration costs — like Canada Pension Plan and workers’ compensation deductions.

People who use the program say the money available to them has been inadequate for years. Now, with decades-high inflation driving up costs and a shortage of health-care workers, it’s getting harder to hire qualified people.

“It’s a shame that we are trying to shortchange the very people who want to make a difference,” said Gupta, who has been using home care for six years.

‘Embarrassing’ wage

After deductions, people who use the self-managed program are left with about $14 an hour, on average, to pay their staff, said the Independent Living Resource Centre’s Doug Lockhart.

“It’s almost that they feel disrespected in having to offer that type of wage to individuals — the same wage they’ve been offering for the last 10 years — and it’s frankly quite embarrassing for people,” he said.

Doug Lockhart with the Independent Living Resource Centre says the rate for self- and family-managed care has to cover administration costs as well as paying the home-care worker. That leaves about $14 an hour, on average, to pay staff. (Holly Caruk/CBC)

The centre helps people navigate self- and family managed-care, and runs a program to help people with disabilities train their workers.

“I was at a job fair [recently], and the first question everyone is asking is, ‘What is the starting wage?’ And when you have to say $14 an hour, it really is not very appetizing for a lot of people,” said Lockhart.

Qualified home-care workers are also hard to come by.

The Winnipeg Regional Health Authority says about 17 per cent of its total home-care related positions are currently vacant. The Interlake-Eastern and Southern health authorities both reported  a vacancy rate of more than 20 per cent.

CBC has also requested vacancy rates from Northern Health and Prairie Mountain Health.

Manitoba Health Minister Audrey Gordon did not provide a comment when asked whether she would consider increasing the rate program clients get.

A government spokesperson said the province is in the process of reviewing the self- and family-managed care program, and “looking at the broad continuum of seniors care, not just about personal care homes.”

That includes community-based care, supported housing and caregiver supports, the spokesperson said in an emailed response.

Vishno Gupta says he’s lucky to have help from family and the ability to cover the difference between the rate the province gives him to hire workers and what he actually has to pay. (Holly Caruk/CBC)

Like many people who use the self-managed care program, Gupta hires his three regular workers through an agency. It charges more than the $21.40 an hour he’s given, so he pays the difference. He also gets help from his son and daughter in-law, with whom he lives.

That makes him lucky, he said.

“There are so many other people who don’t have families. How are they coping?” he said.

Gupta’s son, Sean, said $21.40 may have been enough a decade ago, but now his dad is left covering rising costs.

“We’re talking about caring for people. This is a grandma, a dad, an aunt or an uncle. And to expect somebody to care for them at a high level and pay them 14 or $15 an hour is not reasonable,” he said.

Invest in home care: advocate

The province’s failure to do more to help people to stay in their homes is short-sighted, said Vishno Gupta, since it would cost the health-care system far more to care for him in a hospital or long-term facility.

He also knows he gets more one-on-one care at home than he’d likely get living in a personal care home. 

“Long-term care is there just for the people to die — it’s not for the people to live,” he said. “I am determined to live, but the circumstances are so challenging.”

With the baby boomer generation aging, more needs to be done to keep them out of long-term care, said Gupta.

Laura Tamblyn Watts agrees.

The chief executive officer of the seniors’ advocacy organization CanAge says with an aging population and a shortage of workers, the health-care system is headed for trouble.

“Right now the Manitoba system is almost at the breaking point,” said Tamblyn Watts.

“We need to robustly invest in home care.… That means better jobs, full-time wages, that means pensions and benefits, and also supports to get training.”

She said people are leaving health-care professions because of low wages, and too few are entering the sector to keep up with the increased demand.

“We know that many people could work at McDonald’s or Starbucks and make much more money than they are going to get paid … being a health-care aide in Manitoba,” she said.

Earlier this month, the province of Manitoba announced a plan to spend $16 million to to recruit and hire 350 health-care aides and 72 nurses in personal care homes.

Tamblyn Watts says government needs to do more.

“By focusing our attention only on personal care homes, we are going to be starving staffing from home care,” she said. 

“It needs to be a whole aging-in-place solution, not just pulling from one sector to the other.”

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By Jon Doe