COMMUNITY SUPPORT SERVICES FOR SENIORS

Research Highlights

• Community support services assist individuals in maintaining their maximum level of functioning at home and help prevent premature and inappropriate institutionalization.
• Demands on community support services have risen dramatically in recent years due to shorter hospital stays and the growth in the senior population.

Current Situation in Guelph-Wellington

• There is a shortage of community support services available.
• The community support services that are available are poorly funded.

What are Community Support Services?

Community Support is the term used to describe the range of services provided to seniors in their homes and in the community. The purpose of these services is to assist individuals in achieving and maintaining their maximum functioning level and to prevent premature and inappropriate institutionalization. They can also act as a safety net or early warning system to identify those in need of assistance before a crisis occurs.

Type of Services

The following is a description of the various types of community support services required by seniors. Not all of these services are currently available in Guelph and Wellington County.

• Adult Day Programs – Designed for individuals who live independently in the community but require a more therapeutic environment due to physical frailty, social isolation, mild memory loss or a specific identified medical diagnosis such as Parkinson’s, Depression or mild Dementia. They offer social, recreational, spiritual and physical activities in a group setting. The programs are designed to assist individuals in achieving and maintaining their maximum level of functioning, to prevent premature and inappropriate institutionalization, and to provide individual/family support counselling, education and respite. Participant fees may apply.
• Friendly Visiting – Volunteers regularly visit individuals at home to reduce social isolation and check on their well-being.
• Home Help and Homemaking – Refers to activities that help individuals maintain a safe and comfortable home. Services include menu planning and meal preparation, shopping, light housecleaning and laundry, and paying bills or banking.
• Home Maintenance and Repair – Refers to the range of activities that help individuals maintain their home, such as yard maintenance, snow shoveling, washing windows, or one-time repair jobs such as plumbing or electrical work. Community agencies may help to arrange ("broker") such services for frail seniors; typically, the consumer pays the worker or company directly.
• Hospice – Volunteers provide emotional support and physical help to support individuals who require palliative care and/or caregivers.
  
• Meals On Wheels – Volunteers deliver meals to individuals at home. Volunteers also provide social contact and an informal check on the health and safety of many home bound seniors.
• Wheels To Meals, Diner’s Club or Congregate Dining – These services reverse the Meals On Wheels concept. They transport clients from their home to a dining hall to join others for a nutritious meal.
• Security Checks – Volunteers contact individuals at home on a regular basis by phone or in person.
• Transportation – Volunteer drivers provide escorted transportation to medical appointments, shopping excursions as well as to various social activities for seniors who are unable to access public transportation, require escorted transportation and/or for those who live in rural communities. Drivers typically use their own vehicles to provide this service.

Community Support Services in Guelph and Wellington County

Case Management
The Community Care Access Centre of Wellington-Dufferin (CCAC) provides a single point of access for information on and referral to government funded home and community services and long-term care homes.  Case Managers work with clients and their families/caregivers. They assess clients’ needs and develop a plan of care, which may include:

• Coordinating and managing the delivery of homecare services.
• Helping clients apply for Adult Day Programs.
• Determining eligibility and managing the waiting list for admission to Long-Term Care Facilities (i.e. nursing homes and homes for the aged, not retirement homes).
• Arranging for caregiver relief (respite care).
   
  

Adult Day Programs
East Wellington Advisory Group for Family Services (EWAG) offers a Seniors’ Day Program for residents of East Wellington.

Evergreen Seniors Centre offers an Outreach Program for seniors who feel isolated and need help getting to the centre. Once a month a volunteer driver will pick participants up at their homes and drive them to the centre for lunch and group activities and entertainment.

St. Joseph’s Health Centre operates three adult day programs: two are located in Guelph at the centre - Out ’N About and the Alzheimer Day Centre; and the Seniors Day Away Program is located in Fergus (This program was previously operated by the Wellington Terrace).

Victorian Order of Nurses (VON) offers a Seniors Day Out Program in Mount Forest.

Friendly Visiting & Security Checks
EWAG offers a Telephone Check-Up Service. Volunteers provide a daily telephone call to seniors who may be frail, live alone or are in poor health, to check on their health and safety. As well, matches are arranged between seniors requiring assistance with housework and persons who will do this for a set fee. 
 
Guelph Wellington Seniors Association offers a Feeling Better Program. The purpose is to encourage community dwelling, home-bound older adults (55+) to maintain or increase their health and independence. This is accomplished by facilitating ten gentle yet progressive exercises (developed by the Canadian Centre for Activity and Aging) via weekly visits by a trained program volunteer.
 
Seniors Offering Support (SOS) has a pool of trained and caring volunteers who provide telephone support to fellow seniors dealing with loneliness, grief, separation, health concerns, mistreatment, and other difficult situations. They also assist individuals in accessing professional services, social service agencies and community support programs.
 
St. John’s Ambulance in Fergus and Guelph offer Therapy Dog Programs. Volunteers and their dogs visit facilities such as hospitals, palliative care units, seniors’ residences, etc.
 
VON offers a Volunteer Visiting program. Volunteers visit seniors who are ill or socially isolated providing one-to-one support. Volunteers and clients are matched for suitability based on common interests, background and special requests. Generally visits occur once a week for several hours.  Volunteers are trained in communication skills, and refer clients to other community programs where appropriate. VON also has a Telephone Reassurance program which offers a daily call to seniors or adults with disabilities. Many calls are to remind clients to eat or take their medication. VON has recently been joined by SOS. SOS volunteers will now be assisting VON with the voluntary Telephone Reassurance Program.
 
Home Help
The Community Care Access Centre of Wellington-Dufferin (CCAC) administers Home Help/Homemaking for Wellington County. The service is accessed through a toll-free number and includes light housekeeping, shopping, meal preparation and laundry. The program is intended to support adults who wish to continue to live independently, but need extra assistance. Four Wellington County community support service agencies provide the services by matching a homemaker to a client. A small fee ($12/hour) is associated with the service.
 
This program was initiated in June 2006. It is too early to determine the value of the Home Help service, but it is expected that this program will help fill a gap in community support service provision in Guelph and Wellington.  
 
Meal Programs
Meals-on-Wheels is run through the Canadian Red Cross in Guelph, Puslinch and Rockwood, and by VON in centre and North Wellington.
 
The Garden Fresh Box is a non-profit alternative food distribution service operated by and for the community with the purpose of providing fresh, affordable produce in an effort to build a healthy community. Volunteers help weigh and pack the produce that goes into the boxes. The boxes are then delivered throughout Guelph and Wellington to 12 different site locations, including the Evergreen Seniors Centre.
 
Evergreen Seniors Centre offers nutrition counselling, a Diabetes support group, cooking groups for men, and education workshops on food and nutrition topics. As well, the Centre’s dining room offers meals at a reasonable cost.
 
Palliative Care
Hospice Wellington provides compassionate care to individuals and their families facing a life-threatening illness, extending through bereavement. They offer weekly Day Hospice Wellness Programs in Guelph and Fergus. Programs vary from relaxation and support to walking, working with clay art and horticulture therapy, scrap booking, watercolour painting, and monthly luncheons. Within the next two years Hospice Wellington will be opening up a residential palliative facility to better serve their clients.
 
VON has recently partnered with Hospice Wellington to provide Hospice Programs to residents of North Wellington. The program is administered through Hospice Wellington and delivered by VON staff.
 
Of the above mentioned services, the United Way of Guelph & Wellington funds Evergreen Seniors Centre (Guelph Wellington Seniors Association), Hospice Wellington, Meals on Wheels (Red Cross), Seniors Offering Support (SOS), Therapy Dog Programs (St. John’s Ambulance), and Volunteer Visiting (VON).

What are the Social Service Issues in Guelph and Wellington?

Lack of Social Support Services
Local providers and residents report a shortage of social support services for seniors in Guelph and Wellington. The service gap is difficult to quantify as there is limited documentation, and waiting list information is not available for many services.
 
The former Waterloo Region Wellington Dufferin District Health Council attempted to document the need by conducting a one-day survey of long-term care community services on September 24, 2003 ¹. On this day, community agencies in Waterloo provided 1,481 units of service to seniors – a rate of 28.6 services per 1,000 population aged 65 and older. In Guelph-Wellington-Dufferin, however, 271 units of service were provided – a rate of 9.2 per 1,000 population aged 65 and over. While this could mean that Waterloo is over-serviced, it is unlikely given the known demand for these services throughout the province. What is more likely is that the number and type of social support services available for seniors living in Guelph and Wellington is extremely inadequate.

In recent years, demands on social support services have risen dramatically due to shorter hospital stays. Frail seniors must now compete with growing numbers of discharged inpatients and day surgery patients for home care services. Limited home care funding and legislated limits on the amount of care that can be received are further reducing access to care.
 
Local providers report that the biggest gaps are for homemaking, personal support and home maintenance services. Seniors must either purchase the extra care they need or, if they cannot afford to and do not have family to help, must do without. Often it is the lack of these services that leads to premature and inappropriate institutionalization.    
 
With a growing and aging population, demand will only continue to rise unless there is a major investment in social support services.
 
Lack of Palliative Care Beds
Although Guelph and Wellington is served by a volunteer Hospice Program, there are no palliative care beds available in the community. Hospice Wellington is working to remedy this situation, and has recently acquired land to build a hospice facility.

1. Waterloo Region Wellington Dufferin District Health Council (2004). A Day in the Life of Community Long-Term Care Services:  Results of a One-Day Census in Waterloo Region and Wellington-Dufferin Counties. Waterloo, Ontario: Region of Waterloo.