Aging & Society: Eighth Interdisciplinary Conference

Abstract

Home care systems in Ontario, Canada have undergone major transformation in the last ten years, including a shift towards “patient-centred care,” the standardization of Personal Support Worker training, and recent efforts to move all home care to the public sector. Amid these changes, direct funding (DF), where individuals receive cash transfers to arrange their own services, is under consideration as a policy mechanism that is key to “transforming” the current organization of home care systems and facilitate “aging in place.” DF is championed for improving autonomy, cultural sensitivity, cost-effectiveness, and health outcomes. Yet, it is also an example of neoliberal downshifting and contributes to precarious forms of work. While DF emerged from legacies of disability activism (Kelly 2016), efforts to expand DF programs in the United Kingdom and Australia have fallen short of their promise of equity, autonomy, and choice (Slaberg et al. 2014/15, Ottman et al. 2013). In this paper, we question whether DF can be mainstreamed in Ontario and beyond. We introduce the findings of a textual analysis of forty-nine media and grey literature sources about DF home care in Ontario between 2012 and 2017. We find DF is represented in three main ways, as a solution to a home care crisis, as a form of privatization, and as a mechanism for social transformation. We offer a social justice lens for caring for older people, arguing that the aging “home care crisis” in Ontario requires a complex political and social response