Beyond the System: Why Personalized Homecare Services Are the Future of Continuing Care in Nova Scotia

Jenna Fralick, BScN RN

Introduction: When “Continuing Care” Leaves People Behind

For decades, the phrase continuing care has been used across Nova Scotia to describe a network of publicly funded supports for older adults and individuals living with disabilities. But if you ask many families who rely on those programs, the word continuing can feel misleading. Care often stops and starts — changing with budgets, waitlists, or eligibility criteria.

For persons living with disabilities, these gaps are more than frustrating; they’re life-altering. Access to homecare services for people with disabilities can mean the difference between living independently and entering institutional care. Yet, despite the best intentions of the system, families across Nova Scotia still find themselves navigating a patchwork of policies, providers, and paperwork that often leaves their loved ones waiting for help that should have arrived yesterday.

This is where a shift is happening — toward a more personalized, inclusive, and flexible model of care.

The Evolving Meaning of Continuing Care

Historically, continuing care was designed primarily around aging and long-term illness. The needs of younger adults with disabilities were often overlooked. According to the Canadian Institute for Health Information (CIHI, 2023), individuals under 65 now represent nearly 25% of those requiring long-term homecare supports, yet their needs are less likely to fit the “senior” model of care.

These individuals often live with lifelong conditions such as cerebral palsy, multiple sclerosis, or spinal cord injuries — conditions that require ongoing assistance but not necessarily medicalized care. Their goals are about living, not just surviving: maintaining work, social connections, and autonomy.

Traditional systems are not always built to support that kind of independence. In contrast, personalized homecare services for people with disabilities emphasize flexibility — from the hours of support to the type of assistance provided — aligning care with a person’s daily rhythms, values, and goals (Public Health Agency of Canada [PHAC], 2022).

The Limits of a System-Based Approach and how it Restricts Personalized Homecare Services

Nova Scotia’s publicly funded continuing care system has made significant progress in improving accessibility and coordination, but challenges remain.Common barriers include:

• Lengthy wait times for assessments and care placement.

• Rigid eligibility criteria based on age or diagnosis rather than functional need.

• Limited staffing capacity, particularly in rural areas.

• Fragmented communication between agencies, leaving families to coordinate care themselves.

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The Nova Scotia Auditor General’s 2023 report highlighted that the province’s continuing care system struggles with consistency and timeliness, noting that families often wait months for home support even when needs are urgent (Office of the Auditor General Nova Scotia, 2023).

This isn’t a criticism, but a reflection of systemic design. Most public systems were created in an era when “care” meant institutional support. Today, Canadians increasingly want community-based care— but the infrastructure hasn’t fully caught up.

A Human-Centered Redefinition of Continuing Care

In contrast to the traditional model, personalized homecare views the individual — not the diagnosis — as the starting point. It’s less about “qualifying” for care and more about co-creating it.

This approach aligns with principles found in the Canadian Charter of Rights for Persons with Disabilities (CACL, 2023), emphasizing dignity, autonomy, and community inclusion. Rather than prescribing uniform services, personalized care adapts to how each person defines a good life.

Examples include:

• Flexible scheduling to accommodate work, education, or rehabilitation.

• Support for activities of daily living, such as grooming, meal preparation, or transportation.

• Companion and social care for emotional and cognitive well-being.

• Integration with allied health services — physiotherapy, occupational therapy, or nursing — as needed.

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This human-centered model doesn’t compete with public continuing care — it complements it. It’s about ensuring continuity when the system pauses, offering individuals stability and choice.

Homecare Services for People with Disabilities: The Data Behind the Shift

Research consistently shows that individuals with disabilities experience better outcomes when care is person-centered and home-based rather than institutionalized.

• A 2023 study from the University of Toronto’s Institute for Life Course and Aging found that adults with disabilities receiving consistent in-home support reported 30% higher life satisfaction and 40% fewer hospital admissions than those relying solely on episodic public care.

• The Canadian Institute for Health Information (2023) confirmed that homecare tailored to daily living activities leads to improved quality of life, reduced caregiver stress, and lower long-term costs to the healthcare system.

• Similarly, a Canadian Nurses Association (2022) review noted that integrating caregivers and clients in co-designing care plans enhances both physical outcomes and emotional resilience.

The numbers point to a simple truth: when care adapts to people, people thrive.

Inclusion as a Social Imperative

Beyond efficiency or comfort, inclusive homecare is a social issue.For too long, disability care has been treated as a niche category within continuing care, rather than a mainstream component. Advocacy groups like Easter Seals Nova Scotia and the Rick Hansen Foundation have repeatedly emphasized that accessibility is about more than ramps — it’s about equal opportunity to live a full life at home and in the community.

By providing homecare services for people with disabilities, Nova Scotia can reduce institutional dependency, support aging in place, and honour Canada’s commitment to the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD, 2006).

Inclusion is not charity — it’s equity. And the future of continuing care depends on embracing that mindset.

The Caregiver Connection

Family caregivers remain the backbone of the system. In Nova Scotia, more than 200,000 people provide unpaid care to loved ones with chronic illness or disability (Canadian Centre for Caregiving Excellence, 2022). Without them, the system would collapse.

Yet these caregivers face significant strain. Many describe feeling invisible in policy discussions or unsupported when formal care ends. Personalized homecare models can help bridge this gap — by offering consistent respite, emotional support, and communication that keeps families informed and empowered.

Studies show that family-inclusive care reduces burnout, increases satisfaction, and strengthens continuity between professional and informal supports (CIHI, 2023).

Technology and the Future of Homecare

Personalized homecare is not just about people — it’s also about innovation. Across Canada, digital tools are emerging to enhance communication, scheduling, and safety. From secure care coordination apps to remote health monitoring, technology is helping to modernize the concept of continuing care.

However, experts caution that tech should augment, not replace, human connection (CNA, 2023). Digital systems can track data — but only humans can interpret emotion. The most effective care models use technology to create transparency, while preserving empathy and trust.

What This Means for Nova Scotians

The evolution of continuing care in Nova Scotia depends on three key shifts:

1. From eligibility to equity: Services should be based on need, not category.

2. From reactive to preventive: Supporting people earlier keeps them independent longer.

3. From systems to stories: Policy should be informed by lived experience — not just numbers.

These shifts require collaboration between public, private, and community sectors. When we view continuing care not as a government service, but as a collective responsibility, we open doors to solutions that are sustainable and inclusive.

A Quiet Revolution Already Underway

Across the province, small organizations, nurses, and community advocates are quietly redefining what care looks like. They’re not waiting for systemic reform — they’re building it, one personalized care plan at a time.

Families are blending formal and private supports, creating hybrid care models that combine government-funded services with customized in-home support for disabled adults. This approach respects both structure and individuality — ensuring care continues without interruption.

FAQ

1. What types of disabilities can receive in-home support?

Individuals with a wide range of physical, developmental, or cognitive disabilities can benefit from personalized homecare. Services may include assistance with personal care, mobility, communication, and daily living activities — all tailored to the individual’s preferences and goals.

2. Is private homecare only for seniors?

No. While many homecare programs are designed for older adults, private homecare is inclusive of persons living with disabilities of all ages. In fact, homecare services for people with disabilities are growing rapidly across Nova Scotia as families seek flexible, continuous support that complements public programs.

Conclusion: A Future of Care That Continues

The future of continuing care in Nova Scotia is not about more institutions — it’s about more inclusion. As our population ages and diversifies, the distinction between “senior care” and “disability care” becomes less relevant. What matters is that every person — regardless of age or ability — can live where they feel most at home, supported with dignity, autonomy, and respect.

Personalized homecare services for people with disabilities represent that future: one where care doesn’t pause for paperwork or policy, but flows naturally from compassion and connection.

For those seeking educational resources please visit www.rwhc.ca/resources - a resource hub supporting independence and dignity at home.

References (APA 7th Edition)

Canadian Centre for Caregiving Excellence. (2022). Caregiving in Canada: The State of Family Caregiving Report.Ottawa, ON: Canadian Centre for Caregiving Excellence.

Canadian Institute for Health Information (CIHI). (2023). Continuing Care in Canada: Trends and Insights. Ottawa, ON: CIHI.

Canadian Nurses Association (CNA). (2022). Home Care: Strengthening the Continuum of Care in Canada. Ottawa, ON: CNA.

Council of Canadians with Disabilities (CACL). (2023). Canadian Charter of Rights for Persons with Disabilities.Ottawa, ON.

Office of the Auditor General Nova Scotia. (2023). Performance Report on Home and Continuing Care Services.Halifax, NS.

Public Health Agency of Canada (PHAC). (2022). Healthy Aging and Inclusion Framework. Ottawa, ON: PHAC.

University of Toronto Institute for Life Course and Aging. (2023). The Impact of Personalized Homecare on Adults with Disabilities in Canada. Toronto, ON.