Newsletter
- Aging Population a challenge
- Many struggle to provide care to aging seniors
- Adapting your home to age-in-place
- Dementia will take startling toll as baby boomers age
Aging Population a challenge
…an article from the Niagara Falls Review, August 2010
Will governments have the cash to meet the health needs of an aging
population without increasing debt to unsustainable levels? That's the
question politicians have to answer as seniors make up the fastest growing
population group in Canada.
"I'm not sure the government of Canada has all the information it needs to
answer this important question," said Sheila Fraser, auditor general of
Canada.
"I believe that the answer lies in sound, long-term financial projections. This is
one of the most effective ways to understand the implications of policy
choices on spending, taxation and debt.
"Canadians and the government need to know the challenges ahead and
how policy choices will affect the financial burden on present and future
generations. And fiscal projections that look only a few years down the road
won't give them what they need," as stated at the Canadian Medical
Association's annual meeting.
Fraser's presentation addressed some of her office's health-care related
audits, such as electronic health records and infectious disease surveillance.
She talked about health indicators and how demand has grown for increased
accountability for both performance and outcomes at all levels of health care.
Fraser said one of the reasons for the need of health-care transformation in
Canada is because of the country's shift in demographics.
It's estimated by 2041, people who are 65 or older will make up one quarter
of Canada's population. Not only will that mean slower growth in the labour
force and the risk of lower productivity, it will also lead to increased fiscal
pressure on the country's social safety net, especially the health-care system,
said Fraser.
For example, between 1999 and 2008 in Ontario, the cost of health as a
percentage of total program spending rose to 45.5% from 38.6%. Some
predict half of all program spending will soon go to health care.
"This past June, a new report by top economists ... went even further," she
said. "By 2036, it states the number of senior citizens is projected to more
than double, outnumbering children for the first time. At that same time,
health-care costs are set to reach 70 to 80% of total spending."
She said to support healthcare transformation, there needs to be sound
information, including both short-term information and long-term projections.
"This information will help governments at all levels improve health-care
planning, as well as increase accountability for the use of health-care dollars.
"Once (electronic health records) are fully implemented, they may provide
better data that will help assess how the healthcare system is performing. In
addition, reporting on health indicators can help measure progress on
renewal."
For years, officials with the Niagara Health System have said one of the
biggest challenges facing local health-care providers is an aging population,
and that it will continue to put an enormous burden on the system unless it's
addressed. While a problem across the country, they've argued the issue is
especially difficult in Niagara as the region has one of the highest proportion
of elderly people in Ontario.
"Those over 65 are more likely to use hospital services than younger age
groups," said Sue Matthews, NHS vice-president of patient services and chief
nursing executive.
"Elderly people, most often, have complex medical needs, meaning they have
different things going on at the same time. It's more complicated to care for
them, to address their needs."
NHS spokeswoman Christine Clark said people 65 and older make up
roughly 75% of admissions through Niagara's three emergency rooms.
Many struggle to provide care to aging seniors
…an article from www.ctv.ca
While caring for an aging senior can be rewarding, many Canadian
caregivers are struggling to cope with the stress, new research finds.
Two new related studies from the Canadian Institute for Health Information
found that one in six people -- 16 per cent --providing informal care to seniors
is experiencing some kind of distress.
Those caring for a senior with dementia are most at risk.
The two CIHI studies looked at more than 130,000 seniors who received
publicly-funded long-term home care in 2007–2008. Virtually all of these
seniors (98 per cent) also relied on an informal caregiver, such as a spouse,
adult children or friends.
The informal caregivers often helped out with the senior's daily living
activities, such as shopping, transportation and medication management to
bathing, dressing and feeding.
The researchers found:
• Almost 75 per cent of aging seniors who were married received
informal care from a spouse.
• Almost 75 per cent of those who were not married (widowed, divorced
or single) received care from an adult child.
But the stresses of the 24-hour a day caregiver job can mount – particularly
for spouses, who often have difficulty coping with their role as caregiver.
About 25 per cent of spouses providing care to a spouse reported distress,
the study found.
Spouses were twice as likely to experience distress as other family members,
such as adult children who cared for parents.
"It isn't unusual for spouses to experience distress when providing informal
care to their partner. This can likely be attributed to the 24-hour nature of their
role, a potential lack of understanding of the changes in their spouse's
behaviour that are a result of the disease process and the fact that they may
be seniors themselves," Kimberly Peterson, Vice President of Client Services
with the Champlain Community Care Access Centre, said in a news release.
Caring for a senior with cognition problems, such as forgetfulness or
confusion, increased the risk of distress among the caregiver by three times,
compared to those caring for seniors without these problems.
The study also found the odds of having a distressed caregiver were nearly
two to one for home care clients with symptoms of depression. Behaviours
such as resisting care, conflict with family and friends, and socially
inappropriate conduct were also significantly associated with caregiver
distress.
Nancy White, Manager of Home and Continuing Care Development at CIHI,
notes that many seniors want to stay in their own homes as they get older.
She says that the good news from the study is that most informal caregivers
do appear to be coping well.
"It is important to identify caregivers who are at risk of burnout, which can
result in the senior being institutionalized," she noted.
Among seniors with dementia, the study found that marital status was an
important factor in determining whether a senior with low impairment was
newly admitted to a care facility rather than at home with home care. The
odds of being institutionalized were nearly double for those who were not
married, compared to those who were married.
The odds of a senior with mild dementia being placed in residential care were
seven times more likely if the senior had a tendency to wander.
Adapting your home to age-in-place
…from an article found on the internet
Seniors who want to age gracefully in their own homes or with their family,
find that simple home modifications improve their quality of life, reduce
opportunities for accidents and longer periods of time are spent
independently in a familiar environment.
How to make a home more accommodating for aging-in-place:
Entrances
• Widen walkways and entrances into and throughout your home
• Replace steps outside your home with a graduated ramp
• Install handrails along walkways and steps
• Add non-slip grip on and around stairs and entrances
• Eliminate step-down or step-up door thresholds
• Add colour contrast to door entrances, especially if there is a change
in floor texture or grade of door threshold
Lighting
• Install sensor lights outside to illuminate walkways and steps
• Make sure all stairwells are well lit with easy-to-reach light switches
• Install two-way light switches at all entrances and exits, rooms and stairwells
• Ensure there is sufficient lighting around all appliances, halls and doorways
• Add electrical outlets in easy to reach locations
Doors
• Replace heavy doors with doors that are easier to open and close
• Install intercoms or flashing lights to replace doorbell
• Install lever handles and relocate locks to convenient locations
Stairs
• Relocate commonly accessed rooms and appliances (such as laundry, bedroom, bathrooms. kitchen etc) to main floor level
• Install stair lift systems if main rooms in house cannot be relocated for easier access
• Install extended handrails at top and bottom of stairs
• Replace worn carpet or stair coverings
Kitchen
• Adjust sink and countertop height to a convenient working level
• Install easy-to-grip-and-adjust lever faucets
• Remove cupboards to create knee space for sitting at counter or sink
• Lower existing cupboards and shelves
• Add pullout storage devices to ground-level cupboards
• Install electrical outlets in convenient locations (add colour contrast to outlets for greater visibility)
Bedroom
• Pad or eliminate sharp corners and turns within the bedroom
• Secure corners of rugs, carpets or floor coverings
• Install vertical grab bars near bed
• Install light switches that illuminate room near bed and doorway
• Install phone near bed for emergencies
Bathroom
• Install grab bars at strategic locations around bathroom
• Install non-slip flooring
• Install walk-in shower or transfer bench in bathtub
• Add vertical grab bar inside tub/shower entrance
• Adjust hot water heater to ensure tub/shower temperature is moderate
• Insert a waterproof light fixture in tub or shower
• Raise toilet seat to a convenient height
• Relocate toilet paper roll to easy-to-reach area
Storage
• Install lights in closets
• Install easy-to-reach shelves and/or clothing rods
• Add hooks or drawers in convenient-to-reach locations Daily Activities
• Relocate appliances to convenient location within rooms
• Adjust shelves and add countertops to reduce need to bend or stretch excessively
• Widen door wells, hallways and rooms to allow for walkers, canes and
wheelchairs
To determine the home adaptations that best suit your needs, define which
daily activities are challenges or often result in near accidents. Specialized
adaptations can be made to any home for most mobility issues, visual
challenges and hearing impairments. Friends or family can quickly install
some adaptations, while others will require contractors or specialists. Contact
your local disability resource centre, senior resource centre or CMHC for
more information and resources on home adaptations that suit your needs.
Dementia will take startling toll as baby boomers age
...from a study out of Ottawa
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 homebased
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.
