This is exactly why I think we have to be really careful about looking at it as a continuum of care with multiple options and about making sure we're making the decision that provides the right care for the person in their circumstances. If the person has the kinds of needs that are easily met by the services available, then they're going to be able to be kept in the home longer. But once you start to get into the mental health issues and the dementia issues and so on, there may not be readily available professional assistance in the existing home care service roster to provide the care that's needed.
The human resource issue on the health care professional side is a big problem, in terms of adequately servicing home care clients, absolutely. That's why you also have to be careful, in your assessment process, to make sure you're taking a very broad-based look at assessing need. It's not purely function—what you can do under the ideal circumstances—it's a question of what's really available to you and the kind of support you are going to need.
It's also a question of recognizing that people don't necessarily go into long-term care as a one-time thing, whereby they go in and never come out. There's a quite a revolving door for long-term care as well. People may need to be in long-term-care beds for a while and then are able to go back to the community at different stages of their life, depending on what resources are available to them.
I think we need to become much more flexible in how we think about all the different options along their care continuum and how these can intersect and work together to meet different needs at different times.