Two nations, one challenge

Australia and Canada share similar health care systems characterised by their provision of publicly funded health care. As their populations continue to age, both countries are navigating the complexities of providing high-quality care and support to their growing ageing demographics, with a significantly growing proportion of their older adults requiring health care and aged care support.

This demographic shift presents challenges such as an increased demand for services, strain on existing care infrastructure and workforces and the need to address increasingly diverse needs and preferences among their ageing populations, including those from culturally and linguistically diverse backgrounds.

At the same time, Australia and Canada face similar issues related to aged care delivery, such as chronic staffing shortages, quality-of-care concerns, and the need for more innovative solutions to meet the evolving needs of their populations. As a result, both Australia and Canada face similar challenges and at the same time, opportunities in providing adequate and responsive care for their ageing populations.

The provision of aged care services is a relatively recent addition to the broader health care landscapes in both Canada and Australia. Traditionally, publicly-funded healthcare services mainly centered around hospital care and physician services.

However, societal changes such as longer life expectancies, an increase in chronic health conditions, functional and social issues, and evolving family structures have created a greater demand for aged care services. These services can be provided either in people’s homes, in community-based settings, or in specialised facilities like nursing homes – known as residential aged care facilities in Australia.

Both countries are actively investing in providing more home-based aged care services to address these challenges

Both Australia and Canada have responded to the challenges associated with their ageing populations by developing and offering publicly-funded aged care services – but their organisation, administration and funding differ.

In Canada, healthcare and aged care services are administered by provincial and territorial governments, leading to variations in aged care accessibility, standards and quality of care across provinces. By contrast, Australia has a unified national aged care system that is regulated and funded primarily by the federal government, providing more nationally consistent aged care services when compared to Canada.

In both Canada and Australia, there is a growing demand for aged care services, but how these are accessed varies between the two countries. In Canada, there is no national universal point of access, with each province and territory having its own system navigation and assessment processes.

Australia, on the other hand, has created a single point of access through its My Aged Care platform, which provides accessible information about services, eligibility and assessment links online, via telephone and in person for all of its aged care services. The MAC platform offers benefits such as streamlined access to various care options, standardised assessment processes, and information about costs and government subsidies to provide some degree of financial transparency.

Canada lacks a similar nationwide system due to its decentralised healthcare administration, resulting in provincial variations in aged care access, assessment methods, funding mechanisms and quality standards.

Despite these differences, both Canada and Australia face similar challenges in meeting the growing demand for aged care services, with current shortages of home-based aged care services and extended wait times to access them.

Both countries are actively investing in providing more home-based aged care services to address these challenges and support older adults to remain in their homes for as long as possible. Barriers to improving home-based care in Australia include challenges related to current funding levels, chronic workforce shortages, and disparities in service availability across geographical regions.

Australia could consider adopting Canada’s robust methods of aged care needs assessments and data collection

Additionally, limited awareness of available services and difficulties in navigating the current care system contribute to limiting access to and utilisation of home care services by older adults who need them. Policy reforms to address these issues could involve strategies such as increased funding, workforce development, making information on services more widely available, regional equity, collaboration and coordination between the healthcare and aged care sectors.

Learnings for Australia

While Canada still has a long way to go to improving care for its older adults, there are aspects of Canadian approaches that Australia could consider incorporating into its system.

First, Australia could consider adopting Canada’s robust methods of aged care needs assessments and data collection. Tools like the interRAI assessment systems used in Canada and several other countries around the world, including New Zealand, could greatly benefit Australia’s aged care sector by providing standardised data collection methods and facilitating quality improvement efforts.

The interRAI assessment system is a standardised tool used in Canada and New Zealand to support comprehensive assessment, care planning and data collection in its aged care sector and facilitates the evaluation of individual health and social needs to support evidence-informed care planning. With consistent measurement and cohesive data, it becomes possible to identify and address aged care issues more effectively. Implementing integrated and multi-purpose systems like interRAI in Australia could streamline the assessment process and provide valuable data for improving overall care quality across the continuum.

Australia could also benefit from adopting Canada’s model of Home-Based Primary Care – HBPC – provision, which has been successful in increasing healthcare satisfaction, reducing hospitalisations and improving quality of life for homebound older adults. In Canada, HBPC is a health care service model where medical care typically provided in a clinic setting is delivered directly to patients in their homes. This approach involves the support of a multidisciplinary team led by a primary care provider (usually a general practitioner) who conducts regular home visits, coordinates care with other healthcare professionals, and provides on-call support outside of regular working hours.

HBPC aims to improve care satisfaction and quality of life for homebound patients and their caregivers. This model reduces hospitalisations and admissions to residential aged care facilities and alleviates strain on the healthcare system by offering timely and accessible primary healthcare services to individuals who are homebound or have difficulty accessing traditional clinic-based care.

By implementing appropriately funded and supported HBPC systems, Australia could enhance the healthcare experience for the growing number of homebound older adults and better support their ability to age in place.

As Canada and Australia both navigate the complexities of better caring for their ageing populations and evolving healthcare landscapes, they can learn valuable lessons from each other. By embracing innovative approaches like robust assessment, care planning and data collection methods – and better integrating the provision of home-based primary care services, and fostering more collaborative learning – both countries can forge ahead in enhancing the quality of care and support for their ageing populations.

For more information about Canada and Australia’s aged care systems and what these countries can learn from each other, please see our report:
Enhancing Care for Older Adults in Canada and Down Under: What Canadian and Australian Long-Term Care Systems Can Learn from Each Other

Dr Kristina Kokorelias and Dr Anna Grosse are associate fellows at the National Institute on Ageing – a Canadian public policy thinktank on ageing

NIA executive director Alyssa Brierley and the institute’s director of health policy research Dr Samir Sinha contributed to this article

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