Able-bodied folks rarely sweat the small stuff. Making dinner, grocery shopping, and having a shower are the kinds of daily tasks that are easily taken for granted when you have no trouble doing them.

Add to that list household chores like vacuuming, dusting, scrubbing bathtubs, and wiping down countertops. And when you’re unable physically or mentally to clean your house, your health suffers, according to a leading Vancouver disability advocate.

Jill Weiss, chair of the City of Vancouver’s persons with disabilities advisory committee, wants the provincial government to reinstate housework on the list of services provided to those who qualify for home care.

“It [housework] is not, strictly speaking, a health service, but it’s essential for people to be healthy and to be able to function,” Weiss says in a phone interview. “If you can’t move your arms and your legs, how are you supposed to do the housework?

“Imagine yourself: what if you have no clean clothes? What if you’re living in a place full of dust and dirt and there are no clean dishes? What happens to you is eventually you’re going to get sick. Imagine if your bed wasn’t changed for months. It affects both physical and mental health.”

People who are eligible for publicly subsidized home- and community-care services are those with acute, chronic, palliative, or rehabilitative health-care needs, including seniors, according to the B.C. government website. Home-support services are provided by community health workers to clients who need personal assistance with nutrition, lifts and transfers, bathing, cueing (providing prompts to assist with the completion of tasks), grooming, and toileting.

Housework was included in home-support services until about the mid-1990s, when it was cut. Weiss argues that withholding housework costs the government more money than providing it to people in need: poor health that results from living in unkempt surroundings puts more strain on the public system.

“What they [the provincial government] have now is very narrow; it only provides what they call personal care, things like feeding people, bathing them, helping them get dressed,” Weiss says. “But one of the main problems with the system is…it doesn’t cover what a person needs in order to be fully functioning.

“By cutting out housework…people get sicker and end up in hospital more, which ends up costing the health-care system significantly more,” she adds. “If you cut housework, it will reduce the budget in one area but then it increases hospital costs. Or it ends up increasing home-support costs because people deteriorate and need more support than they did previously. So it doesn’t seem like anyone is looking at the overall costs.”

According to Health Ministry spokesperson Kristy Anderson, the ministry is not proposing to include housework as a home-support service.

“The ministry expects to spend over $2.5 billion on home and community care this year,” Anderson told the Straight, noting that the provincial Choice in Supports for Independent Living (CSIL) is an option for clients who can direct their own home-support services. It allows people with a significant physical disability to have control and flexibility in managing their home-support services. (In some cases, CSIL can involve a daily fee paid as a monthly “contribution”.)

A 2001 report for Health Canada by Victoria’s Hollander Analytic Services, called Evaluation of the Maintenance and Preventive Function of Home Care, looked at the effects of cuts to home care. It found that cuts in service to home-care clients represented “an offloading of support from the state to individuals and their families”.

“It appears from both the quantitative and qualitative data in this report that ignoring the maintenance and preventive aspects of home care may not only lead to increased costs in the overall health system, but may also lead to suffering and emotional distress for a significant portion of the people who are cut from care,” the report stated.
Research backs up Weiss’s assertion that a dirty home has negative health effects.

Clothing, linens, and cleaning cloths, like any other surface in a home, can become contaminated with potentially harmful bacteria, viruses, and fungi during normal daily wear and use, according to the nonprofit, U.K.–based International Scientific Forum on Home Hygiene.

Infectious agents that can spread via clothing, cleaning cloths, and other fabrics include: enteric bacteria such as salmonella, shigella, campylobacter, Escherichia coli (including E. coli O157 and O104), and Clostridium difficile; and enteric viral strains such as norovirus, rotavirus, and rhinovirus. Food particles from plates left to soak or rinsed from dishes on their way to the dishwasher can act as a breeding ground for illness-causing bacteria, including E. coli and salmonella. Staphylococcus bacteria can live in bathtubs that aren’t regularly well cleaned.

Carpets can collect mould spores and allergens and can be reservoirs of bacteria or viruses, including norovirus, salmonella, and campylobacter.

House dust is another source of bacteria. According to a 2012 study published in Environmental Science and Technology, older, cheaper vacuum cleaners release more bacteria and dust than newer, more expensive ones. And airborne and settled dust, as well as dust mites and mould, can cause or exacerbate asthma.

Jane Dyson, executive director of the B.C. Coalition of People With Disabilities, says having housework included in home care would be a boon to the organization’s clients.

“If you can’t keep your house clean, it’s a health issue,” Dyson says. “Unless you’re fortunate enough to have money to pay someone to do it—and most people with disabilities are not in that position—it’s very, very challenging. If you don’t have any family members or friends who can help, it’s a really big issue. If you don’t have a clean house, it’s terrible for your physical health and your mental health.

“I don’t think people ever think about this stuff, but it’s a huge issue,” she adds. “This tends to get pushed off to the side.”