Direct Funding and Health Equity in Dementia Care: Evaluating a New Direction in Service Delivery

Before COVID-19 health systems were strained and people living with dementia on continuing care waitlists and their caregivers were in crisis. This crisis was intensified with the pandemic. In July 2020, the Government of Nova Scotia expanded the Supportive Care Program as part of its pandemic response and to support people living with dementia to remain at home rather than in hospital as they waited for home care or long-term care. The program provides people living with dementia who have a caregiver that helps them with decision making and who are on the waitlist money to purchase personal care, respite, housekeeping and meal preparation. In giving people who are in a vulnerable situation money to purchase their own services, the program offers an innovative approach to continuing care service delivery. By supporting care at home, it has potential to enhance the quality of care of people living with dementia and improve the health and well-being of people living with dementia and their caregivers, as well as relieve some of the strains on the system that can drive costs, and influence the working conditions of care providers. While there is potential, evidence is still lacking. We do not know much about the program from the perspectives of people living with dementia, their caregivers and home care providers. We also do not have a strong understanding of whether there are differences in how people learn about, access and experience the program. In this project we will talk with people who are using, providing, planning, and sharing information about the Supportive Care Program to better understand its real and potential value. In doing so we will create new knowledge and share what we learn with the public, providers and policy makers to support better care and a stronger health system.