Services to those vulnerable people in our society who need care, especially seniors, have been receiving much publicity lately. Media attention has focused on subsidies and fee increases to residents of long-term care facilities (nursing homes) and the impact of these costs on families. A recent report by Care Watch Toronto "House Bound: The Voices of Full-Time Family Caregivers" confirmed and re-stated not only the financial costs of caregiving but also the physical and emotional toll. Caregivers in Muskoka participated in one of the focus groups held last October in Gravenhurst and contributed valuable insights about the rural experience. Other focus group discussions were held throughout the Toronto area. Care Watch, looking beyond the impacts and asking caregivers to reflect on their needs reported, "In our focus groups we asked the caregivers to open their minds to imagine a better system or other services, and gave them unlimited imaginary funding and policy scope. They were, of course, not used to being asked what they wanted, in a system that they felt generally defined their needs for them, based on arbitrary and unevenly defined eligibility criteria. Especially after the recent cutbacks in home care services, they saw the system as fiscally constrained and likely to remain so. They could not readily be lured into what seemed to them to be fantasizing about an ideal system. Nonetheless some interesting ideas emerged from this exercise: Offer caregivers a "bank" of respite days, which they can draw on at their discretion, for an evening or a day at a time or even for an out-of-town holiday. The number of days available annually should be based on the needs of the caregiver and care recipient with a certain minimum number of days, for example 52, guaranteed." Other suggestions included designating a family member's income taxes to cover the cost of care, and providing extra care where an elderly family member is caring for an elderly spouse or sibling.

The most pressing need that emerged from this wish list is RESPITE. Some innovative models of out-of-home respite were found. For example, operations similar to a ‘‘care hotel' or holiday camp give the caregiver time away and the care recipient a change of location in a home-like setting. Respite services are provided by fully trained, experienced care professionals who not only look after the physical needs of the care recipient, but also attend to their need for appropriate activities and companionship. Such a publicly funded, user-centred system that serves and is accountable to both care recipients and caregivers would allow the family caregiver the confidence to leave their loved one for the three R's - much needed rest, renewal and recreation. (Adapted from House Bound: the Voices of Full Time Family Caregivers by Care Watch Toronto, March 2002)

Caregiver Meetings: