COSCO Senior’s Health and Wellness Institute

The Council of Senior Citizens organizations of BC created the Senior’s Health and Wellness Institute in 2007 which has developed 44 (to date) health and safety workshops that are available free of charge to any seniors' group all over BC. 

For those following this blog, you know that I am a big believer in exercise, heating healthy and staying healthy as we age. I joined this program because it lines up with my ideas and values in this area.

I just spent a week being trained as a Facilitator in this program. It was an exciting and very interesting week. I will be presenting four of these workshops in October and I am excited at the opportunity to give back. 

My plan is to give one workshop a week to ease my way into this new adventure. Last year the Institute gave over 300 workshops which reached over 5,000 people.

Each session lasts for approximately 90 minutes and a trained volunteer senior facilitator delivers the program. The workshops contain practical and usable information and are free of technical jargon. 

Participants are encouraged to make concrete plans to create a safe physical environment and to adopt strategies for healthy living.

The focus is a part of a movement to shift away from preoccupation with health after illness and accident to focus on PREVENTION of illness and accidents rather than treatment

Over the last few years, thousands of people throughout B.C. have participated in one of the COSCO Seniors’ Health and Wellness Institute’s free health promotion workshops.  Benefits of this approach:

• Reduced pain and suffering among seniors
• Continued enjoyment of active life in own home and community
• Impact on health care – saving $$$$
• Impact on health care – improved delivery of timely care (e.g. decreased wait time for hip replacement if fewer broken hips)

Habits of Wealthy People

Thanks to Jim Yih for the idea and some of the content

There is not get rich scheme that will work for all of us, to get to be wealthy as the top 1% we have to be earning $215,000 a year or have a net worth of 2.5 million. Many Canadians have this net worth because they own property that has accumulated in value over time, but they do not consider themselves rich. In order to accumulate wealth in Canada or any other country you have to have some good habits.

What are these 20% doing right to accumulate the majority of the wealth in Canada? Numerous books and studies have tried to answer this question so here are some habits of wealthy Canadians.

Save regularly.

80% of the wealthy are first generation and they built their wealth one step at a time. One of the key habits wealthy people possess is a systematic disciplined savings plan. The best way for anyone to develop this habit is to start an automatic monthly savings plan where money comes off your paycheck or out of your bank account before any other expenses or deductions. Studies suggest that wealthy Canadians save about 20% of their income.

Live below your means. (Spend less than you earn)

According to the book the Millionaire Next Door by Thomas Stanley and William Danko, you may be surprised at what a wealthy person looks like. According to their research, the typical wealthy person might not be the one that drives the nice new Mercedes, living in the biggest house, wearing the top designer clothes. Rather, the millionaire next door is the person living in the same bungalow they have lived in for the past 20 years, they may drive a nice car but it is an older well taken care of car with lower mileage.

Have a Budget to know where your money is being spent.

If you want to become wealthy, you should develop a habit of tracking where you are spending your money on a monthly basis. Budgeting can be a very intimidating word but the fact remains, it is an essential habit for wealth accumulation.

Go into debt only when necessary.

Wealthy Canadians make a very conscious effort to avoid, minimize and pay off debts. It is so easy in our society to access debt. One of the habits you’ll need to build wealth is to avoid spending money you don’t have.

They maximize income.

In a study by Statistics Canada, there is a correlation between wealth and income. The more money people make the more likely they are to build wealth faster. Take time to train your mind to think outside the box about ways you might be able to increase your earning power. This might mean getting more education or starting a business or getting a part time job, etc. No one said building wealth did not take some effort.

Go into debt to own your home, or other assets that increase in value over time

The majority of wealthy people own their own home. Most wealthy Canadians have equity in other appreciating assets like business, stocks and real estate. The next time you put your money into something, ask yourself if it is an appreciating asset or a depreciating asset.

Use a team of Professionals to help you acquire and keep your wealth.

Wealthy people typically have a team of professionals to help them accumulate, manage and protect their wealth. This might include accountants, lawyers and financial advisers. Studies suggest that although they use professional advisers, they ultimately make the final decisions themselves. If you want to become wealthy, you must seek help but ultimately you must retain control over key decisions which means getting educated about wealth accumulation.

Concerns of Boomers

 The senior advocate spent some time talking to seniors in my province and in her report listed 13 major concerns of seniors. These are (in no particular order):

1. Being unable to continue to live where they want. Seniors are concerned that, because of a lack of supports and/or because of regulatory roadblocks, they will be forced to move. Across the spectrum of housing, from the single family house to the condominium to assisted living and residential care, seniors identified issues that potentially pushed them to the next level on the continuum prematurely. Some of these issues were financial in nature, others were regulatory, and some related to the lack of adequate supports in a particular community to enable a senior to remain at home.

There were stories of seniors being pushed out of their homes because they could not afford simple repairs and maintenance such as roof replacements or furnace repairs. There were stories of seniors who were challenged by a lack of home care services, who needed assistance with household chores such as snow shovelling or chopping wood. Isolated seniors were challenged by a lack of, or inadequate, transportation.

Seniors universally felt that their first choice was to remain in their own homes, and that all possible supports to achieve this should be fully utilized before a move to the next level on the housing continuum is required. Evidence suggests that, given more support in the community, some seniors could have delayed or prevented the move to assisted living, and that changes to the current assisted living regulations could have delayed or prevented the move to residential care. Seniors voiced that this is particularly significant given the scarcity of residential care that exists in some areas and the fact that, in some cases, residential care is clearly the appropriate choice given a senior’s care needs.

2. Having an adequate income to meet future health and housing needs. Seniors described facing economic hardship as a result of unforeseen expenses and rising costs. Statistics Canada data indicates that most seniors in British Columbia live on less than $25,000 per year. Provincial data shows that more than 52,000 seniors in B.C. live on $17,000 per year or less. In particular, many seniors identified that costs related to their housing, dental care, drugs, eyeglasses and hearing aids are causing current hardship or worry about future hardship. Federal and provincial governments provide a number of programs and subsidies to assist low-income seniors. Most seniors however, voiced their frustration with how they access those programs and with the bureaucracy involved in securing and keeping those benefits. Many questioned the adequacy of some programs that were established years ago and may not have kept pace with inflation. It was identified that no programs exist to help seniors with dental care, eyeglasses and hearing aids unless they were on certain types of income assistance before becoming seniors.

3. A lack of transportation to medical appointments and support services. Many seniors expressed grave concerns about their ability to get out and about once they are no longer able to drive. There were emotional stories from seniors about the trauma they experienced from the driving assessment process, and the devastation they faced upon losing the independence that driving provides. Those seniors who no longer drive appreciate services such as HandyDART, but they also highlighted concerns about the limitations of such services, frustrations around processing applications, wait times, frequency, and the cost for low income seniors.

4. A lack of, and inconsistency with, home care services across the province. The type and frequency of home care services varies significantly throughout the province. Needs appear to be met in some communities, but fall short in others. The elimination of meal preparation, reductions in services due to staffing shortages, changes in staffing, the availability of live in and overnight respite, day programs and residential respite care in some communities and not in others, and concerns about the capacity of the new Better At Home program were among the issues seniors and their family members raised. Inconsistency in the provision of home nursing services, and limited rehab for clients in the community and in assisted living, were also highlighted as gaps

5. The inability to secure a residential care bed at the right time and in the right place. Access to, and types of, residential care bed varied greatly throughout the province. In some communities, the average wait time to secure a first available and appropriate residential care bed (FAAB) is 32 days, whereas in others it is more than 89 days. It is not clear to the Advocate that the Ministry of Health’s FAAB policy is consistently applied in all health authorities. Local conditions significantly influence when and where a senior secures a FAAB. In addition, while provincially, 69 percent of seniors secure a FAAB within 30 days, in some communities only 30 percent of seniors secure that crucial bed within that time. In addition, families expressed significant frustration with the time it takes a senior to secure a bed in their facility of choice. The impact on seniors of the location of their care facility can be profound, as it often dictates the ability of a frail spouse and other family members to visit their loved one. Research clearly supports the positive therapeutic effects on residents of visits from family members. Health authorities recognize that they do struggle on this issue, but there was some evidence to suggest improvements could be made that would allow the objective of the FAAB policy to be met while reassuring families with a reasonable and accurate estimate of time to move to a facility of their choice.

6. Concerns about the quality of care in residential care facilities. Seniors and family members shared stories of their experiences with residential care that ran the gamut from “exceptional” to “appalling”. The care and compassion of staff was the most cited reason for satisfaction, and lack of staff and food quality were most often cited as reasons for dissatisfaction. In some communities, residential care facilities offered a single room with en suite bath, while others had more limited options, including four beds to a room with shared bath, while charging residents the same – 80% of income. Concerns were expressed by unique populations, most notably the multicultural, First Nations and lesbian, gay, bisexual, transgendered and queer (LGBTQ) communities, about discrimination in residential care and assisted living and the lack of culturally sensitive care. Many service providers acknowledged the need for more education and training to ensure that all residents feel safe and respected regardless of their ethnicity or sexual orientation

7. Proper dementia care. Whether seniors were housed in a residential care facility or in the community, there were concerns about the availability of supports necessary to provide proper dementia care. In facilities, this related to the physical environment, the training and clinical expertise of staff, the level of staffing and the use of antipsychotic drugs. In touring several facilities and meeting with service providers, it was clear that best practices are in place in some facilities and not others. Proper training of staff, the proper number and complement of staff including recreational, occupational and physical therapists, and the use and tracking of anti-psychotic medication varied across the province. In the community, there are concerns about getting support when needed and in properly addressing the possibility for those with dementia to wander and get lost. Linking families that are caring for a loved one with dementia to community resources is a challenge in some places, particularly in more rural and remote parts of the province.

8. Fragmentation of services. Seniors recognize that a significant number of services and supports are available to them; however, knowing what those services are and how to access them can be difficult, and navigating the application paperwork involved is daunting. A streamlined system of access, and better awareness of what services and supports are available, is required before the government and health authorities can be confident that the services they offer to seniors are actually being delivered.

9. Caregiver burnout. A significant number of seniors spoke of their role as an unpaid caregiver to a spouse or parent who is most often suffering from dementia. Seniors were unanimous in their commitment to care for their loved one and in their willingness to sacrifice many of their own needs, but they clearly require more support. Additional resources ranging from day programs that have been reduced or eliminated, to respite beds that are either overbooked or not available, to using home support as respite, not just care, were among the supports identified as lacking

10. Elder abuse. Seniors, service providers and stakeholders all shared their worries about the growing abuse of seniors. Concerns include:
abuse by paid caregivers, and questions about the regulatory adequacy of the Care Aid Registry to monitor:

• the concern about abuse of seniors within families, particularly financial abuse;
• resident-on-resident abuse in care facilities;
• conflict between concerns of self-abuse / neglect and personal autonomy.

 11. An ageist society that devalues seniors. A clear message from seniors was their strong desire to ensure that society values what they can do and their sense that they often feel “invisible”. While some seniors do need assistance, seniors actively contribute to their communities in many ways and their contributions should be recognized. Many, many seniors expressed their dismay at the portrayal of seniors as a drain on the system. Seniors spoke of the contributions they make as volunteers, as unpaid caregivers and donors to many philanthropic causes, and pointed to the taxes they pay and have paid in support of services available to all British Columbians.

12. A lack of respect for the decision-making abilities of seniors. While it is recognized that some seniors lack the capacity to make sound decisions, many seniors feel that long before this happens, care professionals and even family members begin to assume they know what is best for seniors. Respecting the right of seniors to make their own decisions will require a paradigm shift for everyone who is involved in the lives of seniors.

13. Challenges faced by the multicultural community. The multicultural community is concerned about a number of challenges faced by seniors who came to Canada from other countries. Their financial status can be precarious as they are often not able to enjoy the full benefit of a number of entitlements, and their isolation and loneliness can be exacerbated by language barriers. While not wholly successful in directly reaching some seniors in the multicultural communities, the Advocate focused, by necessity, more on the stakeholders and providers who serve them

Harper and his abuse of Power (time for progressives to act)

Stephen Harper and his Conservatives have racked up dozens of serious abuses of power since forming government in 2006. From scams to smears, monkey-wrenching opponents to intimidating public servants like an Orwellian gorilla, some offences are criminal, others just offend human decency. 

The online paper the Tyee originally published 59 examples, and asked readers to suggest any they may have missed. Among the many suggestions gratefully received, the Tyee concluded that 11 more met the criteria for “abuses of power.” 

To download the book go here (This ebook is a compilation of all 70 items into one omnibus of abuse by the Stephen Harper government.) 

Health Care for Seniors

Two questions raised by Donna McCaw in a recent article merit some consideration. The second question is about serving the health needs of seniors

Canada still does not have any health policy at the federal or provincial levels to deal with an aging population. Baby Boomers may be healthier than the previous generation but subject to the slings and arrows of outrageous health fortune like others

My accountant told me that the biggest risk he sees in his older clients is lack of planning about health care. About two thirds of Canadians cite health as their biggest concern as they age but only about 22 per cent have planned or saved for a medical issue. 

A federal election is on the horizon but discussion or policy suggestions for health care for the coming increase in the aging population is not. Not yet, anyway.  The Canada Health Act is federal legislation which deals with transfer payments to the provinces who then organize and deliver care.  Those transfer payments are not increasing.

The number of dementia patients is expected to double by 2031 to 1.4 million putting great pressure on families and facilities and yet we have no plan.  Bill C-356, a bill to address some of the realities of dementia care, was proposed in 2011 and reached second reading in December of 2014 but it may fall by the wayside as we go to a Federal election.

The Canada Health Act (the Act), proclaimed in 1985, sets out the framework for Canada’s a national health insurance program. Although there is one national Act, the insurance programs that fund the services that make up the public health care system across Canada, are in fact 13 provincial and territorial plans. The Act sets out the common features that each provincial/territorial plan must meet for the province/territory to be entitled to its full share of funding from the federal government.

Our current government has taken steps to dismantle the Canadian Health Act by severely cutting funding. Prime Minister Harper turned this on its head by tabling a budget that will use federal transfers in order to eliminate national standards in health care.

Buried on page 279 of the 2014 federal budget is a measure that will make it next to impossible for provinces to provide health care services on equal terms and conditions. The purpose of this budget item is to strike a blow to the heart and soul of universal health care in Canada.

The Harper government is eliminating the equalization portion of the Canada Health Transfer (CHT) and replacing it with an equal per capita transfer. This means that less populous provinces with relatively larger and more isolated populations will have more and more difficulty delivering more expensive universal health service

Justice Emmett Hall, a principal architect of national health care in Canada, articulated the platform required to realize a national health care system. In order to establish and achieve high national standards for health services, the federal government needed to establish a funding formula that took into account the capacity of provinces (and territories) to achieve national standards. In other words: no equalization in health transfers, no national Medicare.

This regressive budgetary change will be matched with a second regressive measure. Beginning in 2017, the six percent annual increase for the health transfer will be replaced with a formula that links the health transfer to economic growth. This means that in times of high unemployment and economic downturn – when Canadians need access to care the most – the federal transfer will be reduced. This measure alone will result in a $36 billion cut in federal funding for health care over the next decade.

With Harper’s cuts to health care funding, the share of federal CHT cash payments in provincial-territorial health spending will decrease substantially from 20.4 per cent in 2010-11 to less than 12% over the next 25 years. This, according to the Parliamentary Budget Office, will bring the level of federal cash support for health care to historical lows. National Medicare was implemented across Canada by provinces and territories on the understanding that the federal government would contribute roughly 50 percent of the spending on Medicare.

The shrinking level of federal funding for health care will be matched by a withdrawal of federal enforcement of national standards contained in the Canada Health Act. The use of the spending power to establish national standards is common in all OECD federations. National Medicare will clearly not survive this ‘cut and run’ course being set by the Harper government. Instead, it will fragment into 14 separate pieces where access to essential care will depend on where you live and your ability to pay.

What does this mean for seniors who have come to rely on having a strong national health system? Health Care in Canada, 2011: A Focus on Seniors and Aging has some ideas Many seniors depend on strong primary health care and prescription medications to help manage an increasingly complex mix of health conditions and protect their health. While the majority of Canadians (95%) older than age 65 have a regular family doctor, some reported challenges accessing their doctor when they needed care. Visits to family doctors are more frequent among seniors with multiple chronic conditions.

Survey findings show that it is the increasing number of chronic conditions, rather than increasing age, that drives primary health care use. Data on the use of prescription medication echoes these findings, with the proportion of seniors taking multiple prescription medications rising in recent years. Nearly two-thirds of seniors on public drug programs have claims for 5 or more drugs from different drug classes, and nearly one-quarter have claims for 10 or more. More than half of seniors on public drug programs regularly use prescription drugs to treat two or more chronic conditions, and among this group, the most commonly used medications were for treating high blood pressure and heart failure (used by 65% of this group).

Health spending per capita on seniors is more than four times that of non-senior adults (age 20 to 64 years) in absolute terms, the rate of spending growth for seniors was actually lower over the past 10 years than the rates for non-senior adults.

Over the last decade, population aging has contributed relatively modestly to rising public-sector health care spending, adding less than 1% to public-sector health spending each year.

This result may appear counter intuitive when considering seniors’ use of health care services; compared with non-senior adults, seniors are proportionately higher users of hospital and physician services, home and continuing care, and prescription drugs.

The increasing number of seniors itself will not threaten Canada’s health care system, but it will require the system to adapt to meet changing health care needs. Among those challenges: to what extent the Canadian health care system has met seniors’ needs to date, how it will likely need to adapt to continue to meet these needs into the future and how Canadians’ health care needs may change as the population shifts over the next 20 to 30 years. However for this to happen we need to have strong Federal government support not a government which cuts transfer payments and weakens our Health Care programs across Canada.