A Report on Health and Aging in Canada 1

There is a very large study of 50,000 Canadians aged 45 to 85 taking place now. The study is on Aging and is one of the biggest and most thorough studies on the health and well-being of the country’s aging population. Today and tomorrow, I will highlight a number of the key findings of this report.

The researchers out of the Research Institute of the McGill University Health Centre and the Research Centre on Aging of the Université de Sherbrooke published a report called ‘The Canadian Longitudinal Study on Aging Report on Health and Aging in Canada: Findings from Baseline Data Collection 2010-2015 (pdf file)’. The report examines physical, mental, and social aspects of aging based on data from participants, who are followed every three years.

Findings from Baseline Data Collection 2010-2015

 As a country, where the average life expectancy is 80 for men and 84 for women, people are living longer. The addition of these extra years of life is a good sign in itself. They demonstrate Canada’s high standard of living, innovative public health, and high-quality health care. But we have to make sure that these extra years are worth living: More time to work and contribute wealth and wisdom to society, as well as more time to enjoy with family and friends.

Around the world, the population is aging. In 2017 for the first time, the population of Canadians 65 and older was larger than the number of children under 15. It is easy to look at aging as a challenge for the individual and for society and indeed there has been a tendency to look at aging as a set of physical symptoms, organ by organ, illness by illness, and tallying the personal, social and financial burdens imposed on families and societies.

Aging has been presented as simply an issue of decline and loss. The perception of what it means to be in one’s 60s, 70s, 80s, and 90s has not kept pace with modern medicine, and neither have our ways of optimizing the extra years that modern public health and medicine have given us. If we end seeing aging only in cycles of deterioration and dependence, we can capitalize on the concrete features of aging and fund policies and plans that support not only existing longer but also living well. The likely continuing participation of older adults in society will be wasted if a change in the understanding of a certain negativity of aging does not take place.

One of the many pressing policy implications of an increasingly aging population in Canada is on health and social care affordability. Conservative forecasts suggest that the proportion of the Canadian population aged 65 years or more will increase over the next 20 years to approximately 23% to 25% of the Canadian population, or almost 10 million Canadians, by 2036.

 This increase is unprecedented. Total health and social care expenditures in Canada now exceeds $300 billion with health care alone at approximately $211 billion, the largest expenditure item in provincial budgets. As the baby boom generation moves toward retirement or enters second careers (an emerging phenomenon), the challenges, and opportunities that Canada faces in supporting a diverse and multi-ethnic aging population will intensify. The baby boomers’ shifting lifestyle choices make them one of the most compelling demographics to study. A challenge for health and social policymakers is the lack of strong evidence to inform public health and social policy decision making that is directed toward preventing morbidity and improving the health of Canada’s aging population.

The target sample size of the CLSA was 50,000 participants; in 20 5, the CLSA completed recruitment and baseline data collection from  5,338 community-living women and men aged 45 to 85 years from across Canada. Participants were asked to provide a core set of information on demographic and lifestyle/ behavior measures, social measures, physical measures, psychological measures, economic measures, health status measures, and health services use. CLSA participants undergo repeated waves of data collection every three years and will be followed for at least 20 years, or until death (or other reasons for termination of participation)

The Caregiver’s Emotions

There is a balance between the jobs of a caregiver and the feelings of a caregiver.  If you can detach yourself from the many emotions you feel when you have taken on this hard job, many of the “tasks” are fairly routine.  Whether it’s doing your mom and dad’s laundry or grocery shopping or paying the bills or filling out the Medicare paperwork, much of the “stuff” of being a caregiver is pretty humdrum.

But just doing the chores of taking care of your aging parent’s physical needs is not all there is to be a caregiver.  If that was all there was to it, you could hire someone to handle that.  No, the real challenge of being a good caregiver for your elderly parent is the emotional support you give to them as they struggle with a tough part of their life.

This is particularly true if you are helping your mom or dad through the trials of a terminal illness.  Even if they are good at putting up a brave front for the grandkids and the people at church, your mom or dad experience a gamut of feelings if the end of their lives is directly ahead due to that illness. 

The caregiver’s emotions at helping your parent deal with this somber realization are tremendously complex.  You have your personal emotions that are a preliminary form of grief.  That is why at the funeral of a senior citizen who passed away from a lingering disease, the caregiver doesn’t seem to be grieving as much as others.  The truth is, the caregiver gets most of her grieving out of the way while the senior is still here and they work together to cope with the decline and passing as best they can.  So by the funeral, the caregiver is usually “all grieved out.”

But your emotions about how you feel about your loved one and about this job of taking care of mom or dad in their final months or years will have a direct effect on how you go about the job of taking care of your mom or dad and how you feel about that job as well.  Probably the two emotions most commonly associated with taking care of an elderly person in decline are pity and compassion.

Pity is not really a good summary of the feelings you have about taking care of your elderly parent or parents.  You don’t really “feel sorry for them” the same way you might feel toward a hurt puppy or a baby that cries.  Pity is not an action emotion.  The action emotion that doesn’t just look at the suffering or unhappiness of the parent and say, “that’s a shame” is compassion.  Compassion sees a need in the elderly parent and doesn’t just feel bad about it.  Compassion says, “There’s a need. What can I do about it?”  Compassion is the genuine emotion of a caregiver.

Can you influence whether you will react with pity or compassion to your elderly parent?  Yes, and how you manage your emotions will be a big factor in how successful you are as a caregiver.   There are three key tips you should keep in mind constantly to help you manage not only your emotions but how you react to problems that come up in your caregiving.  They are…

·       Focus on the one you are caring for, not on yourself.  Focusing on yourself breeds self-pity and resentment.  Focusing on them builds bonding and affection for your mom or dad.

·       Focus on the solution to the problem, not its effects.  A good doctor doesn’t cure symptoms, he cures the disease.  Don’t dwell on how bad something is but on what can be done to eliminate the problem entirely.

·       Focus on creating joy and happiness, not grief and sadness.  Look for the good in a day.  Look for joyful moments, times when you and your elderly parent can laugh, enjoy a meal or a good movie and use this time for fellowship and being together.  That is the real joy of being a caregiver and one only you will enjoy to its fullest.

If you use these three “marching orders” of being a caregiver, your emotions will get in line and you will function out of compassion and not pity.  Then your emotions will become powerful aids in your goals to help your elderly parent.

Taking Care of Yourself is Part of the Job

The job of becoming the primary caregiver for your aging parent is universally recognized as one of the most difficult transitions we will go through.  To start with, it’s hard to go through the reversal of parent and child.  All your life, mom or dad were the strong ones.  They were the ones you ran to for help and who were always there to tell you, “It’s ok. Everything will be all right.”

But now as your parent ages and you have to witness their demise mentally and physically, you realize that everything may not be all right especially if your parent is going through a slow decline of a terminal illness.  When the only outcome of what you are dealing with in your parent’s life is death, that makes it tough to stay upbeat, creative and proactive about how to handle life’s daily challenges.

The task of caring for an elderly parent is overwhelming.  You have concerns about their finances, their medications, the progress of their disease if they are battling something terminal, their mental state, their diet and their emotional state as well.  It’s easy to begin to “hover” your senior citizen in an emotional attempt to block any more harm coming to him or her.  This is a parenting instinct and one that your dad and mom probably won’t resist because they want to be cared for.

You feel the anxiety of your parent and the fears they face as the months and years ahead hold uncertain dangers and a certain outcome.  So there is an instinct in caregivers to give 100% of your time, your energy and your resources to caring for that elderly loved one.  

The problem is that you, the caregiver do have other obligations other than caring for your loved one.  You may have a job, a family and your own health and upkeep to think about.  So it’s a good idea for you the caregiver, the family of caregivers and event he one being cared for to keep your eyes open for caregiver burnout to help the one who is trying so hard to take care of Grandma or Grandpa to also take care of themselves a little bit so they will last a lot longer.

Underlying much of the intensity of effort many caregivers put out to help their aging or align parents is guilt.  Guilt can be a powerful force that feeds on itself in an unhealthy way.  The outcome does not only makes the primary caregiver feel guilty that mom or dad are even having to go through age-related illness, they feel guilty for any time they take for themselves or to care for their own needs or the needs of their family.

Caregiver burnout can result in a decline in health in the caregiver and eventually may lead to changes in attitude about the task of caregiving and in some cases a nervous breakdown.   Symptoms include poor sleep and eating habits in the caregiver, a possible increase in drinking to help “settle the nerves” and an inability to think about anything else than what mom or dad needs.

If you see these symptoms in yourself or someone you know and care about who may be suffering from caregiver burnout, act fast to get them some help.  They need to realize that taking care of themselves as part of the task of caring for their aging parents.  It may even be a situation that calls for a talk with the caregiver along with the one being cared for.  If that senior citizen can see that they need to encourage their caregiver to go be with family, get some rest, see a movie and forget the responsibilities of caregiving for a while, that respite from the stress can do a world of good for that important person in their lives.

Listening to Your Parents even Now

Have you ever had that aggravation that you go over to your aging parent's apartment or house to help with the housework and get some serious “caregiving” done and the senior himself seems to be bent on stopping your progress? You no doubt came over with a list as long as your arm of things to do at the apartment to help your parent live a clean and healthier life by getting the place into shape.

You know that part of your job as a caregiver is to take care of chores and do the things your aging parent cannot do any more or just doesn’t do because of fatigue or general lack of attention to detail. So when your parent wants you to forget all that work and just sit and talk, what is aggravating to you may be very important to your parent, maybe even more important than the apartment getting cleaned up.

It’s good for you to think about your role as the caregiver because you really are not just called to be a maid, chauffeur, and cook. Anybody could do those things. The reason you are perfect for the caregiving role is you are close to the heart of your aging parent and you are the one that will understand when she talks about things she is thinking or feeling that day.

So don’t downplay the value of just being a companion to your parent during your visits. The emotional and family support you provide to your parent is central to his self-esteem and feeling of who he is in the world. He will be storing up dozens of little anecdotes and stories to share with you when you come over. So in order to let him get all of that sharing “out of his system”, it's important for you to be a good listener.

A good listener doesn’t just let the other person talk and say “uh huh” every so often. If you are just tolerating your parent as she shares little things with you, that will become apparent and be worse than if you didn’t talk to her at all. The best way to fit your fellowship and relationship time around work time is to start out each visit with some time together just to talk.

Perhaps you might make it a habit that every time to come over, you and your parent will sit down and just talk about a half hour over coffee, a snack or tea. That is when you can focus all of your attention on what mom or dad has to say. Listen with focus and attention so when something is funny, you laugh and you can ask questions and explore the concept or situation being discussed in some depth.

Then at an appropriate time, you can say, “Gee Mom, I would like to tidy up those dishes. Can you sit at the table and we can keep talking while I do that?” That is a nice easy transition to starting your work and keeping the lines of communication open. And you can continue to let your mom or dad “follow you around” as you do chores chattering away the whole time.

Don’t censor the topics or insist that what you talk about are only the important things. You should know from talking to your kids that you have to be ready to talk about the trivial things in their lives to prime the pump of communication about the hard issues and ones that will take some mature understanding to deal with. So be patient and open with your aging mom and dad and once they know you have good listening ears, they will open up about important things going on in their lives. And that is when your listening skills will really pay off.