Towards a Shared Understanding A Forum for Dialogue and Learning

Working Definition – Continuing Care is… An integrated mix of health, social and support services offered on a prolonged basis, either intermittently or continuously, to individuals whose functional capacities are at risk of impairment, temporarily impaired or chronically impaired. The objective of continuing care is to maintain, and when possible, improve the functional independence and quality of life of these individuals. The continuing care network is composed of a continuum of services available for individuals and their families according to needs (CHA, 1993).

Working Definition Most people (85%) agreed, in general, with the definition Several people recommended improvements… –Should reflect role of families –Should include social and mental well-being as well as functional impairment –Wording seen as “cumbersome”

Principles Should follow the principles of the Canada Health Act (comprehensive, portable, universal, publicly administered, accessible) Versus Needs more principles… accountability, equity, sustainability, person-centred, culturally appropriate Should NOT add sustainability

Core Elements Broad conception that encompasses all that’s needed to ensure a continuum of care and smooth transitions Versus Define a “basket” of services and eligibility criteria

Populations Universal/non-exclusive Versus Focus on key sub-groups… vulnerable, frail, disabled, low income, chronically ill, injured, post-acute, those with severe persistent mental illness

Challenges Funding for a comprehensive model – and wide- ranging views on how a program should be funded Need for a common voice – there is a good deal of disagreement on the “execution” Political will – there is fear of what this might commit governments to Ongoing lack of integration across the continuum – and the silos are entrenched Differing views on the legislative frame for a program

Where there is agreement… 1. we need action on a continuing care program for Canada And this continuing care program needs to: 2. adopt a person-centred approach to improve the patient experience 3. improve the experience of continuing care providers 4. focus on prevention and health promotion

Where there is agreement… 5. ensure access to more and better continuing care services 6. be governed by the principles of the Canada Health Act 7. be governed by important additional principles…

Our Challenge Today… To work from our areas of agreement, to drill down into these, to identify the actions we need to take to make progress

Think from the perspective of the person… Dennis is an 18 year old with multiple disabilities, including: cerebral palsy; epilepsy; autism spectrum disorder; and cortical visual impairment. His seizure disorder is controlled with oral medication administered twice daily. He is non-verbal, is not toilet trained, and has mobility restrictions which require the use of orthotics and a wheelchair. He needs constant supervision and assistance with all aspects of daily living.

Who is your Dennis?