The Cost of Staying Home: When Home Care Becomes Too Expensive to Stay Home
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- 1 day ago
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Susan and David's Story
Susan, 63, works full-time while caring for her husband, David, 71, who lives with multiple complex health conditions, including advanced heart failure, diabetes, mobility limitations, and cognitive decline. David requires daily assistance with personal care, medication management, meals, mobility, and ongoing monitoring of his health.
Like many British Columbians with high and complex care needs, David wants to remain at home, surrounded by familiar routines, neighbours, and the support of his wife.
"Home is where I want to be," says David. "It's where I feel safe and comfortable."
The Challenge
Susan's days are filled with caregiving responsibilities before work, during breaks, and late into the evening. She coordinates appointments, manages medications, prepares meals, assists with personal care, and responds to David's needs overnight.
Although David qualifies for publicly funded home support, the services available do not fully meet his needs. To remain safely at home, he requires additional support.
However, Susan and David face a significant financial barrier.
Because Susan continues to work full-time to cover their mortgage, household expenses, and rising cost of living, the family's income places them in a category that requires them to pay a substantial client contribution (co-pay) for home support services.
The result is a troubling reality:
They cannot afford the amount of home support David needs to remain safely at home.
A Difficult Choice
Susan is caught in an impossible situation.
If she cuts back her work hours, the family loses income they depend on. If she continues working full-time, she cannot meet all of David's growing care needs on her own. Paying for additional home support is simply beyond what they can afford.
Ironically, the option that may become financially feasible is moving David into long-term care.
"We want to stay together at home," says Susan. "But it feels like we're being pushed toward long-term care because that's the only option we may be able to afford."
Why This Matters
Susan and David's experience highlights a growing challenge facing family caregivers across British Columbia.
Many families are willing and able to support loved ones with high and complex care needs at home. Yet home support co-payments and limited service hours can create financial barriers that make it difficult—or impossible—to do so.
When families cannot access affordable home care, individuals may enter long-term care earlier than necessary, despite their preference to remain at home.
The Solution
A stronger home care system would help people like David remain where they want to be while supporting family caregivers like Susan.
This includes:
Increased home support hours for people with high and complex care needs.
Reduced financial barriers and co-pay fees for home care services.
Greater respite and caregiver supports.
Policies that recognize the realities of working family caregivers.
Key Message
No family should be forced into long-term care because home care has become unaffordable.
People with high and complex care needs deserve the opportunity to remain at home, and family caregivers deserve the support necessary to make that possible.
Home care should be based on need, not a family's ability to pay.
