Guest Editorial - Home Care in Canada: Housing Matters

Abstract

It was a pleasure to work with Laurie Gottlieb to produce Volume 33 No. 2 of the Canadian Journal of Nursing Research. To the best of our knowledge, this is the first time a nursing journal has devoted an entire issue to home care. We hope that readers will share our pleasure in the result! The focus is very timely because, after more than a decade of dramatic "restructuring," most health care currently is provided in the homes of Canadians. The articles featured draw on an array of disciplines and perspectives, hence this collection contributes significantly to the growing body of knowledge pertaining to the reconfiguration of health-care systems that has occurred in many industrialized countries. Although the contributors address very different issues associated with the provision of home care, each one highlights actual and/or potential inequities and tensions that have arisen. These inequities clearly revolve around axes of discrimination such as gender, disability, age, socio-economic status, ethnicity, and geographical location. Anderson poignantly asks us to grapple with the knowledge that increasing numbers of homeless Canadians are literally and metaphorically left "out in the cold" because they largely are excluded from home-care programs. By way of evaluating a telephone support intervention for family caregivers, Ploeg and her colleagues reveal that loneliness and isolation may characterize home-care experiences. These findings raise the possibility that under the rubric of community integration for citizens with disabilities, a paradoxical but unconscionable pattern of dispersed segregation has been created. Ward-Griffin describes the complex relationships and tensions that develop between nurses and family caregivers who provide care to frail elders, and Angus, by describing the particular predicaments women experience as they recover from heart surgery in their homes, illustrates how meanings of home are deeply gendered. Coyte and McKeever review home-care service utilization and financing in various provinces and conclude that national standards should be developed to increase the likelihood