- Dementia will take startling toll as baby boomers age – a recent study
- 100th Birthday Parties Becoming More Common
- Canada in 2020 (Demographics): The Baby Boomers' $1-trillion legacy
Dementia will take startling toll as baby boomers age – a recent study…an article by Canwest News Service from Jan. 5, 2010
A new study by the Alzheimer Society of Canada says the country urgently needs a strategy to minimize the impact of the baby boomers' march toward dementia.
The study, Rising Tide: The Impact of Dementia on Canadian Society suggests that 1.1 million Canadians will have Alzheimer's disease, or a related dementia, by 2038.
If not mitigated, dementia's prevalence will create a tenfold increase in the demand for long-term care beds and cost the Canadian economy a staggering $97 billion annually, the study found.
It also suggests the amount of time Canadians spend caring for parents and spouses with dementia will triple in the next three decades, to 756 million hours a year.
“If we do nothing, dementia will have a crippling effect on Canadian families, our health-care system and economy,” said Richard Nakoneczny, president of the Alzheimer Society of Canada.
About 500,000 Canadians are now living with dementia, a progressive disease that first attacks memory and then harms other brain functions. The disease eventually robs its victims of their personality and independence.
It is the leading cause of disability among seniors and already is responsible for about $8 billion annually in direct health-care costs.
The Rising Tide study is based on the work of RiskAnalytica, a Toronto consulting firm that specializes in risk management and analysis. It is part of a two-year research project sponsored by the Canadian Institutes of Health Research, the Public Health Agency of Canada, Health Canada, Pfizer Canada and Rx&D.
The Alzheimer Society hopes the project will offer a foundation for a national plan on dementia.
The report, being released Monday, says there are currently no cross-Canada standards for the care of dementia patients. What's more, it says, doctors and nurses receive limited training in the prevention, identification and diagnosis of the disease.
Some provinces, including Ontario, have a strategic plan in place to manage the approaching wave, but politicians continue to underestimate the problem, an Alzheimer Society of Canada spokesman said.
“People don't realize the challenge they're facing,” said David Harvey, a society executive. “Governments are looking to solve health-system issues, but they haven't identified dementia as the underlying cause of so many of them.”
Health-care officials are struggling to deal with overcrowded hospitals. But some of that overcrowding, Harvey contends, results from the system's inability to deliver health-care to dementia patients at home.
Other countries have already taken action to mitigate the impact of dementia.
The United Kingdom, France, Norway and the Netherlands have all developed national plans that focus on early diagnosis, specialized home care, research and prevention.
The Rising Tide study suggests that promoting an increase in physical activity among people over 65 would significantly reduce the number of people diagnosed with dementia. Exercise has been shown to promote brain health.
It also suggests that assigning a case manager to co-ordinate the home-based care of dementia patients would significantly reduce the strain on individual caregivers and lessen the demand for long-term care beds.
Age is the primary risk factor for dementia. The risk of developing the disease doubles every five years after the age of 65.
With the first of Canada's 10 million baby boomers about to turn 65, an enormous number of people will be at increased risk in the coming decades. It means that, if unchecked, about 257,000 Canadians will be diagnosed with dementia every year by 2038, or about one every two minutes, the study said.
Caring for them will be an enormous challenge
Based on growth trends, Canada is expected to have about 690,000 long-term care beds by 2038. But that still leaves a projected shortfall of 157,000 beds, according to the study.
Part of that shortfall will be alleviated by the fact that more people will be living at home with the disease. But that will place an increased burden on both family care givers and home-care agencies.
Harvey said caregivers need education and support, including the ability to drop out of the Canada Pension Plan for several years without a financial penalty.
“If we do this right,” he said, “we've already built the last long-term care bed we should need in Ontario.”
The Rising Tide study recommends that a national strategy include new investment in research; education and support for family caregivers; more focus on prevention; and incentives to increase the number of geriatricians, neurologists, psychiatrists and advanced practice nurses in Canada.
100th Birthday Parties Becoming More Common TOP
Recent figures from the U.S. Census Bureau suggest the number of centenarians in the world will hit 6 million by 2050. Membership in the 100-year-olds' club has jumped from an estimated few thousand in 1950 to over 340,000 around the world today.
The Census estimates also show that:
within the next eight years, there will be more people over 65 than under 5
the median age for the world will increase from 24 to 37 by 2050
Japan will have the largest number of centenarians by mid-century with an estimated 627,000 - or nearly 1% of their total population. In the United States, the number of 100-year-olds will increase from 75,000 to more than 600,000 by 2050. Italy, Greece and Singapore are also expected to see dramatic increases - particularly women.
Dr. Robert Butler, President and CEO of New York's International Longevity Centre predicted a surge for demand for nursing homes, assisted living centres and other special housing given the wave of aging boomers who will be at increased risk of Alzheimer's disease. "The implications are more than considerable," he says. "Healthy centenarians are not a problem, and many are. But if you have a demented, frail 100 year old, they can be very expensive."
Canada in 2020 (Demographics): The Baby Boomers' $1-trillion legacy TOP
One of Canada's greatest successes of the past decade must be shaking off the albatross of federal debt. It once seemed an insurmountable feat: during the mid-1990s, our national debt peaked at more than $562 billion, or more than 70% of GDP. The Fraser Institute, a conservative think-tank, ranked us among the world's most indebted countries. (Among our G7 peers, only Italy fared worse.) But surpluses since then allowed successive finance ministers to pay it down, and a growing economy further eased the burden. Whereas the International Monetary Fund lectured us a decade ago to put our books in order, today it praises us for fiscal restraint.
Yet for reasons long understood, our victory over this budgetary Hydra may be fleeting. The oldest baby boomers will celebrate their 65th birthdays in 2011. As this bulge in population charts crosses the retirement line over the coming decades, the face of Canada's demographics will be characterized by drooping eyelids and weather-beaten complexions. This spells a red-hued nightmare for finance ministers coast to coast, and that's even before bills fall due for the recent recession.
Canada's birth rate has fallen steadily since the 1950s. And while we've been relatively successful in attracting immigrants, there simply aren't enough of them arriving to significantly alter our demographic landscape. So the "providing ratio" — that is, the number of working-aged Canadians relative to those over 65 — will fall. There are currently five working Canadians for every person above 65, but that's expected to dwindle by half between now and 2040. As retirees begin outnumbering the young people replacing them in the workforce, our tax base will be eroded.
Meanwhile, government spending will rise. True, a greying population spends less on education and family benefits. But any such gains will be more than offset by health care, which becomes exponentially more expensive as citizens navigate their sunset years. Pension costs and old-age benefits will also mount. This will inevitably result in a fiscal squeeze. Since the provinces are largely responsible for health-care spending, their books will bend the most.
William Robson, president and CEO at the C. D. Howe Institute, attempted to quantify the looming demographic bill to both Ottawa and the provinces. In a report published in January, he arrived at a liability of $1.5 trillion over the next 50 years. Health, education, and elderly and child benefits presently run about 15% of GDP; Robson says they'll increase to more than 19% by 2056. In terms of today's economy, that would represent about $68 billion in additional spending each year, or $3,100 per worker. Canada is ill-prepared to absorb these costs, Robson says.
The timing of these demographic pressures is particularly unfortunate. At the end of fiscal 2008, our federal debt stood at $458 billion. A few short years ago, most forecasters predicted that thanks to continued surpluses, it would remain on a steady downward trend for years to come. But that was before the federal government pumped billions of dollars into the economy to combat the recession.
We'll be paying for it even as we should be saving for the demographic bills that are coming. The federal government currently expects deficits until at least 2014–15; Dale Orr, an independent forecaster, says the feds put too much stock in their ability to contain growth of program spending. "Especially this government," he adds. "Their record for being able to say no is very, very bad." He expects the federal government won't return to balanced budgets until 2017–18, by which point they will have racked up roughly $150 billion in additional debt. "Because of the recession, we're going to hit 2014–15 with a level of debt way higher than what we would have expected."
It still won't be as bad as the burden we faced in the 1990s, Orr says. Yet tough decisions lie ahead. Bridging the demographic squeeze will likely require a combination of fiscal and non-fiscal measures, including policies to boost labour productivity to make up for the dwindling workforce. More budgetary discipline, of the sort that enabled us to reduce debt over the past decade, will be necessary. There will likely be a close examination of the soaring costs for health care and public pensions, although it's hard to say where the axe would fall. However, it's clear that many Canadians will have little choice but to work longer before retirement.
The most likely solution is the one nobody wants to talk about. Robson has written that "barring some wrenching changes in public finances," the rising costs of Canada's social programs will compel young Canadians to pay higher taxes than previous generations did. And the IMF's chief economist, Olivier Blanchard, recently declared that higher taxes are "inevitable" in nearly all advanced economies to pay for the recent stimulus.
But there's another alternative that's less appealing still. Christopher Ragan, an economics professor at McGill University in Montreal, believes the demographic squeeze will be felt most between 2020 and 2040. Before an audience in Kingston, Ont., Ragan recently hypothesized what would happen if Canada absorbed the coming squeeze through increased debt alone. He concluded that it would return us to debt levels reminiscent of the mid-1990s, when our anxieties were at their greatest. The situation could leave us vulnerable to rising interest rates and drain money that could be used for social spending. We would be squandering all the progress we've made — not to mention condemning future generations to the serfdom we sought so desperately to avoid ourselves.