The Complete Guide to Client Directed Home Care (CDHCI) in Alberta

Growing older isn't always what people expect.

Many Albertans picture themselves enjoying retirement, spending time with grandchildren, travelling, tending to their gardens, or simply relaxing in the comfort of the home they've worked so hard to build. Few imagine a future where getting dressed becomes difficult, preparing meals feels overwhelming, or recovering from surgery means depending on someone else for everyday tasks.

For family members, the journey often begins just as unexpectedly.

Sometimes it's a phone call after a fall.

Sometimes it's noticing unopened medication bottles on the kitchen counter.

Sometimes it's realizing Dad hasn't been grocery shopping in weeks, or Mom is struggling with tasks that once came so naturally.

These moments can bring uncertainty, worry, and countless questions.

• How much help do they need?
• Can they continue living safely at home?
• How do we pay for care?
• Where do we even begin?

The good news is that many Albertans may be eligible for publicly funded home care through Alberta Health Services (AHS). Even better, eligible families have the ability to choose their own approved home care provider through the Client Directed Home Care Invoicing (CDHCI) program.

For many families, this provides something incredibly valuable: choice.

Instead of simply accepting whichever agency best fits the system, CDHCI allows families to select an approved provider that best fits their loved one.

At Thrive at Home Care, we've guided families through this process across Edmonton and surrounding communities. We understand that navigating Alberta's home care system can feel confusing, especially when you're already caring for someone you love.

This guide was created to change that.

Whether you're just beginning to explore home care, have recently been approved for services, or are comparing different providers, this resource will walk you through everything you need to know — from eligibility and funding to choosing the right agency for your family's unique needs.

Before we talk about funding or paperwork, it's worth talking about why home care matters in the first place.

For most people, home represents far more than four walls and a roof.

• It's where birthdays were celebrated.
• Where children grew up.
• Where favourite meals were cooked.
• Where holiday traditions were created.
• Where memories live.

As occupational therapists often remind clients, independence isn't simply about completing a task without assistance. It's about continuing to participate in the routines, relationships, and activities that give life meaning.

For one person, independence might mean watering flowers every morning. For another, it means enjoying coffee on the front porch. For someone else, it simply means sleeping in their own bed each night.

Research consistently shows that remaining at home, when safe and appropriate, can contribute to better emotional well-being, greater life satisfaction, and a stronger sense of dignity. That's exactly what Alberta's home care system is designed to support.

Client Directed Home Care Invoicing — commonly called CDHCI — is one of Alberta's publicly funded home care options.

If you're approved for home care services through Alberta Health Services, you may be eligible to choose an approved private home care provider instead of receiving services through AHS-contracted providers.

Think of CDHCI as giving families more flexibility while still receiving publicly funded support.

Your AHS Case Manager continues to assess your needs and determine what services are medically appropriate. They decide the number of funded hours and develop your care plan based on your health needs.

The difference is that you decide which approved provider delivers those services.

This means families can choose an agency whose values, communication style, availability, and caregivers best fit their circumstances. For many people, that additional choice provides greater confidence and continuity throughout their care journey.

Healthcare has gradually shifted toward something called person-centred care.

Rather than designing services around the healthcare system, person-centred care focuses on designing services around the individual.

No two people age in exactly the same way.

Two people may both need assistance with bathing, yet have completely different routines, personalities, cultural backgrounds, communication preferences, and family dynamics.

• One client might enjoy chatting over breakfast before beginning personal care.
• Another may value quiet mornings and minimal conversation.
• One family may prefer daily updates.
• Another may only want communication if something changes.

The CDHCI program recognizes that families should have the opportunity to choose a provider who understands those preferences and can deliver care in a way that feels respectful, familiar, and individualized.

That additional flexibility often leads to stronger relationships between caregivers and clients, greater consistency, and care that feels more personal.

This is one of the questions families ask most often.

• Both options provide publicly funded home care.
• Both begin with an assessment by an AHS Case Manager.
• Both are designed to help Albertans remain safely at home.

The primary difference lies in how care is delivered.

Every family's reasons are different, but some common themes include:

• They want to choose the organization providing care.
• They value building long-term relationships with a smaller care team.
• They appreciate having one primary point of contact for questions and scheduling.
• They prefer an agency whose philosophy aligns with their family's values.
• They want greater flexibility in how approved services are delivered within their care plan.

For many families, it's less about changing the services they receive and more about choosing who provides them.

To receive publicly funded home care, you must be living in Alberta and have valid Alberta Health Care Insurance Plan (AHCIP) coverage.

Home care services are intended to support Albertans living in the community, whether that's:

• Your own home
• A condominium or apartment
• A family member's home
• A seniors' lodge or other community living setting

The goal is to help people remain safely in their community for as long as possible when appropriate.

This is the most important step.

No website, agency, or family member can determine whether someone qualifies for publicly funded home care. That decision is made through an assessment completed by Alberta Health Services.

Many families worry before this assessment:

• "What if we don't qualify?"
• "What if we ask for too much?"
• "What if they think Mom is doing better than she actually is?"

These concerns are completely understandable.

Remember that the purpose of the assessment isn't to judge anyone or test whether you're "managing well enough." It's a conversation designed to understand how your health is affecting your ability to safely complete everyday activities.

Your Case Manager will look at the whole picture, not just a diagnosis. Someone doesn't qualify for home care simply because they have arthritis, Parkinson's disease, dementia, or have recently had surgery.

Instead, the assessment focuses on how those conditions affect everyday life:

• Are you able to safely bathe yourself?
• Can you prepare nutritious meals?
• Are you able to dress independently?
• Is getting in and out of bed becoming difficult?
• Have you experienced falls?
• Are medications being taken safely?
• Is a family caregiver becoming overwhelmed?

These everyday challenges often provide a much clearer picture than a medical diagnosis alone.

Home care isn't designed to replace every task someone can no longer do. Instead, it's intended to provide support that helps people remain as safe and independent as possible at home.

Depending on your approved care plan, funded services may include assistance with:

One thing many families don't realize is that home care isn't simply a checklist of services. It's about helping someone continue living safely and meaningfully at home.

For example, someone may technically be able to prepare breakfast, but if standing at the stove leaves them exhausted and increases their risk of falling, receiving assistance may actually help preserve their energy for activities they enjoy later in the day.

Likewise, someone living with mild dementia may still be physically capable of showering independently, yet require supervision because they're forgetting important safety steps.

These are the kinds of real-life situations your Case Manager considers when developing your care plan.

Families often imagine the assessment as a formal test they need to "pass."

In reality, it's much more like a conversation.

Your Case Manager wants to understand what everyday life actually looks like. They'll ask questions about your health, your daily routine, your mobility, your support network, and the challenges you're experiencing.

You may be asked about things like:

• How you move around your home.
• Whether you've fallen recently.
• How you manage bathing and dressing.
• Who helps you now.
• Whether family members are experiencing caregiver fatigue.
• Your medications.
• Your medical history.
• Any concerns you have about remaining at home safely.

In some cases, they may also observe how you complete certain everyday activities to better understand your abilities and where support may be beneficial.

One of the hardest parts of an assessment is that many people instinctively say they're "doing fine."

It's human nature.

No one wants to feel like they're complaining or losing their independence.

The assessment isn't about proving what you can do on your very best day. It's about understanding what everyday life actually looks like so that appropriate support can be put in place.

If you believe you or your loved one may benefit from home care, the first step is to contact Alberta Health Services Continuing Care. There are several ways to do this:

Once Alberta Health Services receives your referral, a Continuing Care Case Manager will contact you to arrange an assessment. Depending on your circumstances, this assessment may take place:

• In your home
• In the hospital before discharge
• Occasionally by telephone for initial screening
• In another healthcare setting if appropriate

The exact timeline varies depending on urgency, your location, and current demand within Alberta Health Services.

Many families hear the term "case manager" without really knowing what that means.

Think of your Case Manager as the healthcare professional responsible for coordinating your publicly funded home care services. Depending on your situation, your Case Manager may be a Registered Nurse, Registered Psychiatric Nurse, Occupational Therapist, Social Worker, or another qualified healthcare professional within Alberta Health Services.

Their role isn't simply to approve or deny services. They're there to understand your situation, assess your needs, develop an appropriate care plan, and help connect you with services that support your health, safety, and independence.

Throughout your home care journey, your Case Manager continues to be an important point of contact if your needs change over time.

Many people worry they're about to be "tested."

Fortunately, that's not what happens.

The assessment is simply a conversation about your everyday life. Your Case Manager wants to understand how you're managing at home — not just medically, but functionally.

They may ask questions such as:

• Can you safely get out of bed on your own?
• Are stairs becoming difficult?
• Have you fallen recently?
• How do you manage bathing?
• Can you prepare meals?
• Are medications being taken correctly?
• Are you forgetting appointments?
• Do you have family nearby?
• Who currently helps you?
• How is your caregiver coping?

They'll also discuss your medical history, current diagnoses, medications, mobility, cognitive function, home environment, and personal goals.

Sometimes they'll observe you completing simple tasks, such as standing from a chair or walking through your home. This isn't a test — it's simply another way of understanding how you move safely in your own environment.

This may be the most important advice we can give.

Many older adults have spent their entire lives being independent.

They're proud of what they can still do.

So when someone asks, "How are you managing?" the automatic response is often, "I'm doing okay." Even when they're struggling.

Unfortunately, minimizing difficulties can sometimes result in your Case Manager not seeing the full picture. Remember, they're not looking for perfection — they're looking for an honest understanding of what daily life is really like.

Instead of describing your best day, describe your typical day.

Those details matter. Home care isn't just about whether you can complete a task — it's also about whether you can complete it safely, consistently, and without placing yourself or your caregiver at unnecessary risk.

There's no need to prepare extensively, but having a few things readily available can make the visit smoother.

Helpful information may include:

• A list of current medications
• Contact information for your family physician
• Recent hospital discharge information (if applicable)
• A list of questions you'd like to ask
• Information about any mobility equipment you use, such as walkers or wheelchairs
• Family members or caregivers who help regularly (if they'd like to participate)

If a family member is heavily involved in your care, it's often helpful for them to attend the assessment as well. They may notice challenges that you've become accustomed to or forgotten to mention.

One thing we've learned from working with families across Alberta is that many people wait too long before asking for help.

• Sometimes they don't want to be a burden.
• Sometimes they think someone else needs home care more than they do.
• Sometimes they assume they're "not bad enough yet."

The reality is that home care isn't only for people who are completely dependent on others. In fact, receiving support earlier can often help people remain independent for longer — by preventing falls, reducing caregiver burnout, maintaining routines, and addressing small challenges before they become much bigger ones.

The first time most families search for a home care provider, they're not experts.

They're sons and daughters. Spouses. Friends. Neighbours.

They're often trying to make an important decision during one of the most stressful seasons of their lives.

• Maybe Dad was recently discharged from the hospital.
• Maybe Mom was diagnosed with dementia.
• Maybe your spouse is recovering from surgery.
• Or perhaps you've quietly reached a point where you simply can't do everything on your own anymore.

Whatever brought you here, you're probably asking yourself the same question hundreds of Alberta families ask every year:

"How do I know which home care agency is right for us?"

Open ten different agency websites and you'll notice something interesting. Almost every one says the same thing.

• "Compassionate caregivers."
• "Personalized care."
• "Treating clients like family."

Those things matter. But they're also what every agency says.

The questions that truly determine whether a home care experience is positive often aren't mentioned at all.

This guide was written to help you ask the questions that matter most, so you can make a decision with confidence — whether you choose Thrive at Home Care or another provider.

One of the biggest mistakes people make when looking for home care is searching for the "best" agency.

The truth is, there isn't one agency that's right for everyone.

The best provider is the one that fits your family's needs.

• Someone recovering from knee replacement surgery has very different needs than someone living with advanced dementia.
• A client living alone in downtown Edmonton has different challenges than someone living on an acreage outside Peace River.
• A spouse providing care twenty-four hours a day needs something entirely different from an adult daughter who visits every evening after work.

That's why choosing an agency should never start with the question, "Who's the biggest?" It should start with, "What does my loved one actually need?"

Before making phone calls or reading reviews, spend a few minutes thinking about everyday life.

Ask yourself:

• What tasks have become difficult?
• What worries us the most?
• What would make the biggest difference day to day?
• Are we trying to prevent a crisis or recover from one?
• Is our family caregiver becoming exhausted?
• Does our loved one value conversation and companionship as much as physical assistance?
• Do we need short-term support or ongoing care?

The clearer you are about your needs, the easier it becomes to evaluate whether an agency is truly the right fit.

Not every agency will be the right fit.

Consider asking more questions if you notice:

• Pressure to sign immediately.
• Difficulty reaching someone by phone.
• Vague answers to important questions.
• Little interest in learning about your loved one.
• No discussion about communication.
• Promises that sound too good to be true.

Choosing home care is too important to rush.

Every family who contacts us has a different story.

• Some are navigating a new diagnosis.
• Some are balancing careers while caring for aging parents.
• Some are trying to honour a loved one's wish to remain at home.
• Others simply need someone they can trust.

We've learned that excellent home care isn't built on doing extraordinary things once. It's built on doing the ordinary things exceptionally well — showing up consistently, listening carefully, communicating openly, respecting dignity, and treating every client as an individual.

Whether you ultimately choose Thrive at Home Care or another provider, we hope this guide helps you ask better questions, feel more confident in your decision, and find the support your family deserves.