There’s no place like home
John Amagoalik wants to stay in Nunavut. So what’s the problem?
Gov. Gen. Mary Simon, left, John Amagoalik, centre, and Simon’s husband Whit Fraser pose for a photo after Simon presented Amagoalik his Order of Canada medal in Iqaluit in 2024. (Photo courtesy of Sgt. Anis Assari/Rideau Hall)
Before John Amagoalik returned to Nunavut this summer, he said the first things on his mind would be the taste of Arctic clams and the kiss he would place on his wife’s cheek.
His arrival at Iqaluit’s airport on June 12 was a significant moment. Nunavut is a territory thanks in part to Amagoalik.
The 78-year-old had been living at Embassy West, a long-term care centre located in Ottawa, for 16 months when his loved ones came together earlier this year to help him spend the final days of his life in Nunavut.
They raised money for his move, procured at-home medical support and negotiated subsidized housing. But they warned they would need help from the Department of Health to fund his care in the long term.
Now, the department is saying it can only fund a fraction of the support he needs, meaning that, after all that work to bring him home, the man revered by many as the Father of Nunavut might have to return to Ottawa.
The territorial government recognizes the importance of providing elder care closer to home. It’s written all over its elders strategy, released in 2024.
It’s unclear how much the government was paying Embassy West to look after Amagoalik, but his friends and family used publicly available numbers to estimate it could have been in the area of $32,000 per month. The cost to provide his housing and care in Iqaluit is about half that, they say.
It doesn’t matter if it’s cheaper to stay in Iqaluit, say the top brass at the Department of Health.
“Privately contracted care services and independent housing arrangements remain separate from department-funded Home Care Services. Consequently, they cannot be provided or funded through the department’s Home Care Program,” wrote Heather Hair, assistant deputy minister of health, to Amagoalik and his representatives on Aug. 14.
“The department is not responsible for housing and is unable to transfer funds allocated to existing elder facility contracts to pay for private housing for individuals.”
This issue isn’t just about Amagoalik, and I would never suggest he is owed preferential treatment because of his career.
It is about hamstrung bureaucrats, unable to meet an individual on his own terms because policies prevent ingenuity.
How many elders across the territory are in the same situation as Amagoalik, for whom there is a feasible and economic way to provide in-territory care if somebody approved a tailor-made plan? If there is even one, that’s too many.
Does the Department of Health employ staff to work with elders and their families, to explore options to provide support in the territory? Are they allowed to think outside policies if it’s financially feasible and possibly better for an elder? If not, why not?
Everybody agrees it’s better for elders to age at home. In Amagoalik’s case at least, it appears it could be cheaper, too.
Amagoalik grew up governed by federal policies. He saw they didn’t work for Nunavut, so he upended them.
His situation today is a challenge to the government he helped create. If a policy isn’t working, it can be changed.
Health only has two program doors: home care capped at a few hours a week, or a facility placement where housing and care come bundled into one contract. There’s no third door for someone assessed at facility level who lives in a house. That is a missing program, a third door, to support self-directed elder home care.
BC, Ontario, Manitoba and Saskatchewan all fund self-directed home care as an option, with funding set by assessed need, arranged by the family, with eligibility published so anyone who qualifies can apply.
We should verify and break out how much of that $16,000 is housing and how much is care and build a self-directed program
option with a transparent application process.
Because housing access and home care are both needed for elders to “age in place”, we will need to bust down some departmental silos on this one. Dept of Health alone can’t solve this.
Our dysfunctional Nunavut government, the transient work force at the government that do not seem to know what is needed in Nunavut, the lack of leadership from our elected officials at the government, huge annual GN budget that seems to do very little.
There should be options such as more local support to keep family at home (various levels of care assessed from few hours a week to 24/7). Care-giving is a Full Time job, plus more. Additionally, buy a building in the south (NOT to contract Embassy, etc.) which can later be sold once Nunavut catches up with space and builds. Lastly, review OSHNI as there is a disconnect there causing so much more allocated funds to be ‘lost’. Btw, when was the RFP advertised for such a role as OSHNI? Those funds could be re-allocated to Local Caregivers.
While everyone wants to see John and other elders supported at home in Nunavut, this editorial offers a very surface-level look at an otherwise complex issue. Nunatsiaq News needs to do some real investigative reporting into the numbers and contracts rather than just repeating top-line estimates.
First, where does the $16,000/month Iqaluit estimate come from, and how is it broken down between rent/housing subsidies, groceries, utilities, and actual medical care? A facility like Embassy West in Ottawa which costs an estimated $32,000/month bundles 24/7 round-the-clock staffing, food service, liability insurance, facility maintenance, and specialized professional nursing. Comparing an all-inclusive, regulated institutional (with minimum staffing ratios) contract to an ad-hoc private arrangement in Iqaluit without examining line items is comparing apples to oranges.
Second, what exactly are the GN’s contractual obligations with Embassy West? Can beds or funding just be terminated and reallocated on an individual basis, or is the territory locked into block funding, bed minimums, or long-term operational guarantees?
Finally, looking at how other jurisdictions operate would bring much-needed context. In provinces like Ontario, public home care isn’t an open-ended voucher you can spend however you like. Under provincial regulations (e.g., Connecting Care Act / former O. Reg. 386/99), home care has strict service caps tied directly to professional qualifications:
Personal Support Workers (PSWs): Capped at 90 to 120 hours per 30-day period (roughly 2–4 hours a day), even for clients with high needs.
Registered Practical Nurses (RPNs) & RNs: Specific monthly ceilings on visits and direct clinical hours.
Even where provinces offer self-directed funding or family-managed care models, public health dollars cannot be used to pay unregulated family wages, food, utilities, or cover standard private rent; they are strictly audited, capped, and tied to credentialed, insured providers to ensure patient safety and public accountability.
Asking the Department of Health to simply “hand over” institutional funding to private arrangements without clear policy, credentialing, and regulatory limits isn’t just a matter of “hamstrung bureaucrats” it’s a massive legal, safety, and financial liability. NN should dig into the actual numbers, contractual terms, and interprovincial standards before framing this purely as bureaucratic inflexibility.
Complex. Excruciatingly boring and nerdy. So complex it likely excludes most families.
Sounds like a job for a bureaucrat.
The Dept should get down to work.
Meanwhile, fund John A.
Providing good care to elders is boring and nerdy? Crucially important, the mark of a caring society and an effective government is more like it. And it’s not a job for bureaucrats. It’s a job for elected politicians, who must move beyond empty words to making hard decisions about priorities, giving firm directions to bureaucrats to work out the details and hold them accountable for results. No it won’t happen overnight but without strong political commitment it will never happen.
The standard of living in Nunavut would be a lot higher than it is today if Nunavut had more nerds to depend on. Nerds run the world.
We absolutely need the best and brightest policy nerds out there to tackle policy issues that span multiple departments’ mandates and funding pockets, particularly in Nunavut’s unique programming environment. What we don’t need is bureaucracies turning policy challenges into policy excuses.
The original post demonstrates a deep understanding of these complexities, which I agree are glossed over far too simplistically in the editorial. It also reads like the perspective of someone who is exhausted by the many challenges involved, which is understandable.
But that deep knowledge of the issues also demonstrates the potential for Nunavut’s policy super heroes to find a clever path forward, if there is the political will to do so. I hope Nunavut’s elected leaders empower their best policy minds to work through this one. They clearly have the knowledge; now they need the mandate and support to put it to work.
For sure more funds should be allocated close to home. The quality and level of care differs, that’s not to say the care givers here are inferior to the south. The care givers here are stretched to their limits which diminishes their ability to get the rest they need to function at their full capacity. In other words we are asking too much for the problems we cause.
Inuuqatigiitsiarniq, respecting and caring for others is at the heart of this issue, and by the way, John Amagoalik is a special case. He received the Order of Canada, the Order of Nunavut, the Queen Elizabeth II Diamond Jubilee, Hon doctorate in Civil Law and the French Legion of Honour for his work to create a Nunavut homeland. He deserves better. Would Canada treat a former Prime Minister like this? Would a province or another territory treat a former premier so heartlessly? Nunavut owes John Amagoalik deep thanks for his service and that debt should extend to his care during his last remaining days. Shame on faceless bureaucrats who appear to be fixated on rules and regulations that in this case don’t make sense.
I have read the recent article and this editorial along with the comments. There is one thing that stands out. It is the comments regarding, “it’s a complex issue”, “it is not that easy to solve”, “the finances”, “the logistics” and others. You see it is actually about all those things and the FACT that the Nunavut Government (since its creation) has FAILED to address the need for appropriate elder care in the territory and appropriate care for ALL Nunavummiut.
Yes, John is a founder of Nunavut. One of a handful of others. In most places “Founders” are celebrated and recognized for what they did. For the enormous contributions they made to the people. Does this mean they deserve special treatment? Not necessarily. However, in John’s case; what is being demonstrated is NOT that he ALONE deserves special treatment but that the Government has failed to act to ensure ALL elders can receive the care they deserve and require and families can spend their remaining years close to them. Ensuring they are cared for. A system that ensures they can stay close to the place they created and lived in for decades and most importantly remain surrounded by the people they love. That is NOT a lot to ask and all the excuses and reasons in the world will not change that.
25+ years in, multiple Premiers, Minsters of Health (including the now Premier) Cabinets and MLA’s have neglected to take the necessary steps to build a Health Care system that takes care of people. Sure, some will say, “you know it’s only been 25 years”. Yes, it has. 25 years of doing what exactly? Look around. What exactly can anyone point to in the current Health Care systems and say, “we have done something to dramatically improve the lives of Nunavummiut”. The current status of Health Care and many other essential services failures experienced throughout Nunavut belong to the governments of the last 25 years and the politicians that did nothing to address them.
Oh, and if you think the Inuit Organizations (IOS) get a pass. WRONG. Those IOS that are supposed to SUPPORT and GROW Inuit quality of life. Where the HE___ have they been? (____ add the full word that I could not put because it would get the comment censored out). The IOS have a responsibility to ACT. To take steps, to act collaboratively with the GN, Hamlets and all other concerned entities to build a better Nunavut. What do we get instead? Vouchers to vote, the same recycled “so called leaders” spinning Nunavummiut around in a circle. Tens of Millions of dollars collecting interest in the bank and oh for good measure certain IOS suing the GN. Make that make sense. Until the day arrives where everyone puts their head together and money in the right place things will NOT move forward proportionally with what Nunavummiut need and deserve.
Founders usually create or build things because they had a vision that something could be better for the people. Believed something else could ensure a more prosperous future. To create something for future generations that would allow them to grow. Unfortunately, in this case, the very thing John and the others envisioned is failing. And all anyone wants to do is make excuses for why.
PSC
SHAMEFUL how we in Nunavut treat an elder statesperson,we all know here GOV Ministers don’t run their Depts,it’s the southern Beaurecrats, making up policy’s to make their jobs easier,this issue is getting National attention,3 Billion dollar Budget, and John knows all about Embassy suites.
The answer is blowing in the Wind…
The Department of Health’s Grants and Contributions Policy (and all the other GN policies) provides the answer in its final statemment, wich says:
“PREROGATIVE OF EXECUTIVE COUNCIL
Nothing in this Policy shall in any way be construed to limit the prerogative of the
Executive Council to make decisions or take action respecting Department of
Health grants and contributions outside the provisions of this Policy.”