Montreal — The COVID-19 pandemic has laid bare major gaps in Canada’s long-term care (LTC) system and raised questions about our heavy reliance on institutional care. A new study from the Institute for Research on Public Policy concludes that cash-for-care benefits could give Canadians more autonomy in choosing the care they receive, while reducing unwanted admissions to LTC institutions. Such benefits are widely used in other OECD countries to ensure that LTC services are more readily provided where most people want to receive them: at home.

Provincial and territorial governments must move quickly to enhance the full spectrum of long-term care services. “Canada’s long-term care system needs an overhaul. In order to address the system’s failings, governments have to do more than reform institutional care — they need to also increase funding for formal home care and bolster supports for informal caregivers such as family and friends,” says the lead author, University of Ottawa professor Colleen M. Flood.

Over half of OECD countries have cash-for-care schemes, which are cash transfers to LTC recipients that give them more autonomy over the organization of their care and help them address unmet care needs. In Germany and the Netherlands, for example, these benefits are an important part of integrated public insurance plans that cover the full range of LTC services. But these countries’ experiences show that Canadian policy-makers should proceed with caution: public spending on LTC surged when cash benefits were implemented, and there were concerns about the quality of care as informal caregivers undertook tasks that required health care training.

Policy-makers also need to take into account the potential consequences of cash-for-care benefits for informal caregivers. The benefits could encourage these caregivers — mostly women — to reduce their participation in the labour market in favour of more caregiving, which could undermine their longer-term employment prospects and financial security. Implementing cash-for-care benefits should therefore be accompanied by measures to mitigate these effects, such as strengthening job-protected leave legislation and supplementing public pension plan (CPP/QPP) contributions for informal caregivers.

“Ultimately, cash-for-care benefits should be part of a suite of initiatives that includes investing in the quality and safety of LTC institutions, improving access to formal home care, and better supporting informal home care. Policy-makers need to find the sweet spot for these benefits to help maximize care recipients’ autonomy and address their unmet LTC needs, while minimizing the potential disadvantages for informal caregivers,” says Flood.

Assessing Cash-for-Care Benefits to Support Aging at Home in Canada, by Colleen M. Flood, Deirdre DeJean, Lorraine Frisina Doetter, Amélie Quesnel-Vallée and Erik Schut, can be downloaded from the IRPP’s website (irpp.org).

The Institute for Research on Public Policy is an independent, national, bilingual, not-for-profit organization based in Montreal. To receive updates from the IRPP, please subscribe to our e‑mail list.

Media contact: Cléa Desjardins, tel. 514-245-2139 cdesjardins@nullirpp.org