Celebrating 50 years of Home Care
2024 marks the 50th anniversary of Manitoba's home care program. Established in 1974, home care services in Manitoba are the oldest comprehensive, province-wide, universal services in Canada. Today, the Home Care program the Winnipeg health region includes approximately 3600 staff and completes 450,000 visits per month, providing excellent, much-needed services that contribute to the health and well-being of our community.
A day in the life of a health care aide
What is it like to be a health care aide? We followed Dean Hofer on a typical work day to learn more about the important work health care aides do for our clients.
When Linda Dando started in home care as a VON (Victorian Order of Nurses) visiting nurse, there were no cellphones, no computers, no electronic medical records. Her nursing bag contained surgical instruments that were boiled on the stove at each home, if a dressing change was required.
Home care started in Manitoba in 1974. In fact, our province is the birth place of the first comprehensive home care program in the country. Evelyn Shapiro, a researcher and professor at the University of Manitoba, is long-recognized as the "mother" of publicly-funded home care. She passed away in 2010, but her idea - to help people who want to stay in their homes remain independent as long as possible with appropriate supports, continues to live on - 50 years later. "Even half a century later, that premise of being able to provide care in people's homes to help them stay there as long as they are able is still what we strive to do," says Luba Bereza, Director of Health Services, Centralized Home Care and Regional Palliative Care for the Winnipeg Health Region.
For Linda Dando, working in home care was about developing a more collaborative relationship with clients. "You are in people's homes. There's a closeness and comfort level for clients that you don't have working in a hospital. You are able to involve family members in the care plan to better meet each client's needs."
Dando remembers caring for a middle aged woman who lived with her husband , two teenaged children and her mother. She visited the woman, who was palliative, for several weeks. Years later, during a call with Seven Oaks Hospital, the operator recognized Linda's name and thanked her for the care she provided her mom at the end of her life and her support to the family. "It's those kinds of connections that you remember and make the job so special."
Dando, who finished her career as a director in home care, says to work in the field you have to want to make a difference in someone's daily life. "It's a privilege to go into people's homes, to provide care, to see what they and their families are coping with and develop a care plan to meet their needs."
Home care largely serves senior populations, people with developmental disabilities, those with chronic conditions, and children with special needs. Services offered with home care include personal care, nursing care, providing medications, meal prep, respite care, therapy services such as physiotherapy and occupational therapy, and more. There is no fee for home care, regardless of income, and it has stayed that way here in Manitoba right since the start in 1974. Manitoba's model has also been adopted by other provinces in Canada.
With a growing population in Winnipeg, and adults 65 and over making up more than 17 per cent of people in the health region, home care continues to be a vital service, which has seen numerous changes and additions over the years.
Some of those changes include the Self and Family Managed Care program, which allows clients and their caregivers to manage their own care. The home care program also includes home dialysis and ostomy, as well as community IV therapy, and other specialty services such as community stroke care, and the children's and palliative care programs.
In 2023, the WRHA home care program relaunched the Uncertified Home Care Attendant training program, to boost the number of home care attendants in the workforce - contributing to a reduction in the visit cancellation rate from more than 5% to just over 1% in just one year's time
In summer 2024, home care staff started using a new app, making it easier to deliver visits in a timely manner. Mobile Procura eliminates the need for paper files, allows for real-time scheduling and enhances communication among home care teams.
"The changes over the years in communication and technology have really improved service and coordination," says Dando.
Regardless of the changes and additions over the past 5 decades, home care remains an important service that many people, including Linda Dando, have come to rely on. Now retired, she had her own experience with home care earlier this year when her husband needed care. "The home care staff were reliable, compassionate, caring and knowledgeable," says Dando. "They even went out of their way to drop off supplies that we needed."
According to Bereza, that's what providing home care is all about. "At the end of the day, we want our clients and their families to feel supported in the most caring, considerate manner possible."
We asked current and former home care staff from across the region to share their stories about working in the program, and how it makes a difference to those we serve. You can read their stories below.
Jennifer Myers, P3 Scheduling Clerk, Downtown/Point Douglas
I have only worked in Home Care Scheduling for 3 years, but there was a reason I was drawn to it. In 1979, my maternal Grandma Polly found herself a young widow at the age of 49. She had spent most of her married life at home raising children and suddenly found herself needing to look for employment. She took a night class and was hired as a Home Care HCA in the mid-1980s. She worked in an apartment block in Winnipeg's west end and one story she told I'll always remember. She was doing her run one day and visiting an elderly female client. The client was having trouble communicating and seemed frustrated because she could not understand English. My grandma picked up a few queues and spoke to the client in her first language, Ukrainian. The client was so happy to communicate and be understood that she cried tears of joy. My grandma was proud of the connections she made with her clients and knew the importance of her work. Eventually, my Grandma Polly would come to rely on the HCAs herself, and when she passed away in April of 2009, her long time HCA attended the funeral, a gesture that meant so much to my family.
Susan Williams, Supervisor, Provincial HR Shared Services
I worked for Home Care many, many years ago. I had what they called a bath run: my entire job was driving from client to client and assisting them with their baths.
All the clients were always so happy when I arrived, we would chat away as I set up their baths and assisted them. They loved knowing about any tidbit I would share of my life and were happy to be clean and having the company.
Home Care made it so they could remain in their homes where they were most comfortable, giving them a feeling of still being in charge of their lives. The unfortunate part of getting older is losing your sense of control over your life due to illness or fragility. Having a home care attendant assist them and be directed by them gave that sense of control back.
I loved listening to the stories of their lives, and also when leaving how happy they were.
Though I have not worked for home care for a very long time, I still talk fondly of my years working for home care. This is a much-needed program in Manitoba and should always be treated with the respect it deserves, and its impacts on people never overlooked.
I applaud all the home visitors, home care attendants and all who work in home care. These are not easy positions, and they deserve this recognition for all the years this program has run and the thousands and thousands of people they have helped.
Congratulations on 40 years!
Diane Sluis, RN, WRHA CIVP Homecare, Downtown/Point Douglas
I love my job and the people I have met along the way!
I have worked more than half of my life with home care in Winnipeg as an RN. I started in 1996 and am still currently working with the CIVP (community intravenous therapy program) in the downtown area.
I enjoy making a difference in people's lives, but I also enjoy how they make a difference in my life!
I was lucky enough to have met my husband through home care (who is now in his 30th year as an RN in the downtown area) and we now have a daughter who is also working as a home-care nurse in Winnipeg's downtown.
We seem to have a thing for home care in the downtown area as we all work there and love what we do!
Leanne Newman, Home Care Visiting Nurse
I have worked in Home Care for over 20 years. Years ago, nurses received pagers and a daily print out of clients we were assigned to visit. In the beginning, we had no cell phones and were told to call the next client from our previously client's landline, and press *67 to block the number. Home Care Nurses worked out of a centralized office on Portage Avenue; we would would pick up our assignment and drive to the many community areas around Winnipeg. Later, Home Care decentralized into multiple community area offices. Over the years, Home Care has expanded to include wound care and IV clinics, as well as other specialty programs. Home Care Nurses are privileged to work with clients long term, and can help individuals achieve their best possible health outcomes. I recall one client who had multiple challenges--Home Care Nurses did wound care for this client's chronic lower leg wounds for 20 plus years. Unfortunately, the client's wounds deteriorated, and they needed to have their leg amputated. Home Care Nurses saw the client through this process, from attending the surgical consult, to supporting the client before and after surgery. They were supported with a caring team of health care professionals who helped them transition back home. I have been fortunate to be part of excellent Home Care nursing teams who truly care, and this is just one example.
I am writing to you, on behalf of my siblings, Heather (Doucet), Barry (McLeod) and Debbie (Zammit) and especially our Mom Grace McLeod (Gracie as she is affectionately known), to acknowledge the exceptional care that she receives from Home Care nurse Cora Tabios.
Our Mom has been a resident of Sturgeon I in St James for almost 6 years. She moved to Sturgeon in March 2019 as a healthy active senior who would typically walk 5 to 7 km per day and was very active at the residence. As you know, the Pandemic lock downs and isolation basically halted her physical activity and interaction with other seniors. As a result, in addition to natural aging, we have seen a continued decline in her physical and mental health. She now is 94 and despite her age she remains largely independent with only limited support from Home Care.
Home Care nurse Cora, (or as mom calls her affectionately - "Cruella") has been with Mom since she moved in. She visits Mom in the morning to provide her medications which means waking her up - hence the nickname my mother gave her . . . "Cruella". We have all seen Cora in action with Mom and there is an amazing bond. What Cora does is beyond just doing her job, she is truly caring, compassionate, upbeat and attentive to moms needs as they have changed over the years. Cora is truly a "hero in the home" to us and gives us great comfort that Mom is so well looked after and cared for.
On a recent visit in October, I was looking for opportunities to recognize Cora's excellence through some formal WRHA recognition program for Home Care providers. I was unable to find one so thought I would just send this letter to you in the hope that she could be recognized in some special way by the WRHA.
As you know, what most of us hear about in health care is not always positive. We wanted you, and the Home Care team, to know that you have an absolute star in nurse Cora Tabios who models all the very best in care in the home.
Sincerely,
J Scott McLeod