Thursday, September 24, 2015

Issues for Seniors in Canada

Aging seniors and their families are faced by the complexity of issues facing the elderly. Not only do older people have to contend with declining income, increased debt and poor investment returns, but they have to deal with declining health, medical crises, complex insurance programs, long term care challenges, who-gets-what decisions, end-of-life, where to live in their final years and a whole range of other difficult situations requiring hard decisions.

The Government of Canada and the Canadian Retired Teachers Umbrella organization have identified the following issues as important to Canadians. They may disagree on their solutions, but the problems identified are of concern to both groups.

1.       Health Care including Dementia and other cognitive impairments; lack of Doctors, Social Workers and others trained in how to treat or deal with Geriatricians; Health Accord Funding, and the lack of a National Phamacare programme; the sustainability of medicare, and the issue of end of life care.
2.       Poverty among Seniors, including Seniors Housing, and Pension Reform

The biggest challenges any  community faces with regard to caring for the aging are (1) the lack of awareness and connection to existing systems and supports; (2) the lack of coordination among many existing programs and resources; and (3) the fact that we tend to age differently based on our demographics, environment, formative experiences, and lifestyle.

Our structural orientation towards aging can assign resources in ways that do not always address the highest need. Aging is a process, not a number. Age is as much social as it is biological, and how we age affects our relationships and the ways we think about ourselves and how we think about our place in society.

As we age, the realities of our changing ability to engage the social and physical world affect us all. There is a need for investments to address seniors’ access to places, assistance, and resources. This includes improving how older adults learn about and approach the existing network of support and how they are thereby able to access physically services and amenities throughout the community. Connecting more seniors to the resources that are already available will make an immediate quality of life impact within the community, and will help reduce long-term crisis intervention and chronic illness costs.

At the local and provincial level, agencies and groups working with seniors could provide new and more efficient ways to help seniors and their caregivers navigate through existing programs and resources. This would make a distinct impact for seniors almost immediately.

Community investments can improve how senior advocates and stakeholders coordinate and collaborate across domains and providers. Streamlining the provision of services and the interaction among service providers could make a tremendous long-term holistic impact, leading to a reduction in costs associated with crisis intervention.

One way many seniors can be involved in the community is by volunteering.  A large percentage of seniors want to be active and engaged in their community. In Canada, thirty-six percent of seniors perform volunteer work, with volunteers over 65 contributing about 223 hours a year, compared to the national average of 156 hours. In fact, in 2012, baby boomers and senior adults contributed more than 1 billion volunteer hours. Governments at all levels and community groups should be working together to  support programs and initiatives to encourage and recognize volunteer work by seniors.

The most significant issue facing geriatric medicine right now is that we have an inadequate supply of clinicians who are trained to meet the demands of the aging baby boomers. We do not train nearly enough geriatricians to care for this growing aging population. This is an issue because seniors are living longer and healthier lives than previous generations. Between 2014 and 2036, the average life expectancy for a 65-year-old  in Canada is projected to increase by 1.8 years for women (to 88.8 years) and by 1.9 years for men (to 86.5 years).

Despite this increased longevity, recent statistics tell us that 90 percent of Canadians aged 65 and over live with at least one chronic disease or condition, such as cardiovascular disease, cancer, respiratory conditions, diabetes, dementia, arthritis, or obesity. Chronic health conditions require more focus than ever before to ensure effective health care support and good health management. In fact, the Alzheimer Society of Canada has estimated that, in 2011, as many as 747 000 Canadians were living with Alzheimer's or related dementias, and that by 2031, this figure could increase to 1.4 million.
There is an issue of ageism. We all have innate prejudices, and we are surrounded by negative stereotypes of the elderly in the media. Many people think of old people as being crippled in nursing homes. Many physicians, who do not know that much about aging, assume every complaint from an older person is simply because they are getting older. We need to educate physicians, including internists who are not specializing in geriatrics; about what are really just age related issues and :
  • What is a disease
  • What is correctable
  • What is preventable
If we are to honour our seniors we should act on the following principles:

Promote Independence, not isolation
Programs and initiatives that support independent living must do so without contributing to isolation. Helping seniors to remain at their current address is only a positive investment until it begins to limit their access to food, medical care, and active living. Making investments that help seniors age where they want to age, and to do so in the context of a supportive community, are as equally important as investing in “aging in place.”

Value Seniors as Assets not liabilities
Valuing seniors as community assets rather than just service-users opens up an array of possibilities for leveraging investments by funding senior programs that provide opportunities for seniors to invest in the lives of others. As seniors are increasingly valued as a community resource, investments in seniors will begin to make an impact in the lives of other seniors and younger generations in whom seniors invest their time.

Work on Early Intervention not late
Preventing injuries, illnesses, and crises in the life of older adults is important to maintaining quality of life as well as improving cost savings for seniors and local support systems. Investments that help prevent falls, malnourishment, and other costly and potentially deadly outcomes are simultaneously economical and empathetic. More broadly, since life expectancy and vulnerability vary across the county (and by race and gender in particular), current benefit eligibility standards for older adults as defined by the ages of 60, 62, and 65 may prove to be too late for some seniors

Some Resources for Seniors in Canada


Sources: 

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