Abstract

It was challenging to receive so many thoughtful responses to my paper on home care. Given the space limitations, I cannot respond to everything the commentators mentioned, but I can highlight the key issues. Almost everyone agreed that home care ought to be covered by the principles of the Canada Health Act. Thompson felt that socially necessary home care (i.e., home support services) does not fall within the purview of the Act. However, he agrees with me (and others) that we do not know enough about supportive home care to establish whether or not it meets its goals. I am not sure that supportive home care is only a social service. In the absence of conclusive analysis, I would rather include it as part of a total home-care approach, because it is so critical to the quality of life of the frail elderly and their caregivers, a point made by Chappell and Shapiro.