Home Care for Older Adults During the COVID‑19 Pandemic: Lessons from the Netherlands, Denmark, and Germany to strengthen and expand home care in Canada

This Issue Note summarizes our understanding of how the pandemic has affected the home care sector in Canada compared to three countries with well-developed home care services: the Netherlands, Denmark, and Germany. Lessons for Canada draw from both the published literature and consultations with experts.​

The main insight about home care in the Netherlands, Denmark, and Germany is that sooner or later everyone sits down to a banquet of consequences. Prior to the pandemic, these comparator countries had invested heavily in a robust, comprehensive, and integrated home care infrastructure for those choosing to ‘age in place.’ This meant that many older adults were supported at home rather than in congregate care facilities. Yet, even with this strong foundation, the pandemic has exposed vulnerabilities in their home care systems, as it has in Canada. ​

We conclude that improving access to home care would allow more Canadians to ‘age in place’ and is, thus, an important part of ‘building back better’ from the COVID‑19 pandemic. The main lessons for Canada are that we ought to urgently reconceptualize care for older adults to move away from a binary approach to aging, where many Canadians either struggle on their own to live at home, sometimes supported by unpaid family/friend caregivers because they don’t qualify for publicly-funded support (or for a sufficient amount), or they move to a long-term care facility where they do qualify for paid support. This would involve building up and professionalizing the home care labour force so that more care can be deinstitutionalized, designing, and implementing national home care standards supported by enabling legislation, and redistributing (and possibly increasing) funding to provide more supports to more older adults so that we can remain at home as long as possible as we age. ​