Paid Companions for the Elderly: They're great, but why do we need them in BC?

My mom with Alice, a nurse and "paid companion" who has become a close family friend

I've just returned from a visit to see my Dad and family in Pennsylvania, and was once again touched and impressed by the care and affection of Dad's "paid companion" Mary. Although Dad is now in extended care, with a good staff to patient ratio, Mary provides the added personal attention and stimulation that makes Dad's life so much fuller each day. My brother and his wife also live nearby, and are there almost daily too, and are caring and attentive and do so much for Dad, and his other "kids" visit often, but we as a family have long ago realized the added dimension that private caregivers contribute, and also how lucky we are that Dad has been able to pay for this care, first for Mom (who passed away 4 years ago) and now for himself.

And yet, I can't help but worry about the increase in the numbers of paid companions over the last 20 years here in British Columbia, where we used to have far more home support services offered through our government health care system, but where now the aides and nurses are almost overwhelmed much of the time simply doing the necessities, with little time to sit and chat and have a personal interlude with any of their clients.
As I researched this topic with the help of Linda Outcalt, a project manager and research assistant at  the Centre on Aging at the University of Victoria, who wrote her master's thesis on paid companions and their elderly clients in BC, I realized that the reason for the huge increase in this job category in BC is because of the cutbacks to community care services which used to include many of the functions now being filled by privately paid companions, or caregivers. In other words, thanks to government cutbacks and a philosophy of "do it yourself...whether you can afford to or not" that is part of our political climate, the reality now is that those who can afford private care will pay for it and get better care, and those who can't, well....they just have to do without.

And yet, according to Linda, backed up by research done at the Centre on Aging, it is actually cheaper for the government to cover these community care costs and avoid institutionalization of the elderly than it is to offload the costs to the elderly and their families and make them pick up the tab for private care. If this is accurate, and I believe it is, then why does our government carry on with these cutbacks instead of the win win of reinstituting and even expanding community care and/or additional caregivers for our growing elderly population? Scandinavian countries do this very well, it seems. And the current vogue is to encourage people to "age in place"....which means, at this point, take on your own costs at home if you can. I'd like to see more publicity of this topic and more stats and a societal attitude in keeping with our Canadian belief in socialized medicine and health care for all.