Monday, 24 July 2017

Isolation

It's not uncommon to hear stories of seniors who are 'shut ins' - those who are isolated and do not leave their homes. It may happen because of physical issues and disabilities, mental health issues like depression or perhaps, a bit of both. Regardless of the cause, the outcome is never good. Isolated seniors are more at risk for both physical and mental health issues regardless of the underlying factor. It makes complete sense - human beings are social beings and need to connect with others. Without human interaction mental stimulation is diminished and so too is mental health.

So, how can one help a senior who seems to be socially isolated?  As a first step, it seems logical to address the reason for isolation especially if it is new behavior for the person. Is it because of  new physical issues for example, vision or hearing loss, incontinence, a feeling of sadness, a recent significant loss of someone close? If it is a physical issue, are there any adaptive technologies that can assist? If it's related to loss or depression, would the person be willing to speak with a doctor, clergy or therapist? If they won't are there family members or friends who can assist and speak with the person or visit more often to encourage them to go out and do things?

When we feel a sense of purpose, a reason to get up in the morning, we are more inclined to be less isolated. This can be anything from caring for someone or something else, volunteering, meeting friends or even having a hobby. Joining a seniors club where there are regular activities, perhaps congregate dining, and a place to meet others, may meet the needs of some. For others, getting a pet (as long as they are mentally competent) may ease some loneliness and in the case of a dog, may get the person outside for walks and opportunities to interact with others.

Although not as ideal as actually getting outside and meeting people in person, for those with physical issues that prevent them from leaving the house often, technology may assist with allowing them to interact with others through social media, email and phone/video type programs such as Skype.This is especially helpful if loved ones live far away and cannot visit often.

If you are concerned about a senior for whatever reason, do contact professionals involved with the person, a family doctor or a seniors support organization for suggestions and assistance.

Friday, 30 June 2017

National Dementia Strategy

Last week Canada passed "Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias" (Alzheimer Society of Canada Press Release http://alz.to/wp-content/uploads/2017/06/Bill_C233_PR_EN.pdf). It is projected that by the year 2031, 1.4 million people will be effected by dementia which will translate into tremendous family stress, emotional drain, lost wages, financial burden and health care spending (http://www.alzheimer.ca/~/media/Files/national/Advocacy/SOCI_6thReport_DementiaInCanada-WEB_e.pdf).

Having personally witnessed the loss of a loved one to dementia, I can attest to the impact this disease has on families, support systems and the health care system. It is unimaginable to think that in just over a dozen years, 1.4 billion people will impacted by this horrible disease that robs the essence of a person from the body we associate with them.

Canada is the 30th country to adopt a national strategy of this sort. One would hope that the strategy will be all encompassing including, funding for research to delay, treat and one day prevent the disease, increase training and people who can provide care, support for family and unpaid caregivers, improved health care and social supports, and housing options catering to the needs of the population.

It seems that it would be both cost effective and prudent as with other aspects of senior care, that we look at what others are doing around the world. Since 29 countries have gone before us, it is not a new concept at all, and I venture to guess that we can learn a lot from the mistakes and triumphs of the other 29. There are countries with care and housing models that are innovative and work very well. There are model communities for those with dementia, caregiving communities, innovative technologies... the list goes on.

We have started the process by committing to creating a strategy; I look forward to seeing what we do with it and how Canada will build on the successes of those that have gone before us.

Monday, 19 June 2017

Buurtzorg

Regular followers of our blog will know that I often write about the need for innovative care options for seniors as our aging population increases. I recently came across an article on one such idea that is taking hold in a big way in many European and Asian countries. Buurtzorg is a Dutch model of care that has been shown to not only offer quality care that encourages independence, but also save money. 

The idea was the brain child of a nurse names Jos de Blok about 10 years ago. Teams of nurses are sent out to areas with many seniors and each team is responsible for between 40 and 60 people. A team can be up to 12 nurses and they are supported by administrators and trainers. The nurses not only assist with care but also help seniors and their families understand the importance of illness prevention.

The model is very much a 'neighbourhood care' one with latitude and independence given to the nursing teams to provide care that is necessary within a given structure. It can be adapted to different health care systems and situations as different countries do have different ways that health care is delivered and paid for. 

Its an interesting concept and one that may indeed make sense in Canada especially with the costs of current care and the limited number of nursing home beds in our system. An ongoing concern is that while there are many retirement homes in existence, the cost is often higher than basic pensions and so there are many who could benefit from the care but cannot afford it. This concept, along with perhaps co-housing models, and inter-generational housing, with a mix of funding for retirement home living, may allow us to assist people who with our current system, are not able to get the care they need because of financial limitations. 

Concerns about caring for our increasing aging population may not be so difficult to resolve if we step outside the box and take the time and initiative to look to models in other countries that are both innovative and well researched. 

To find out more about Buurtzorg visit http://www.buurtzorgusa.org

Information for this blog obtained from: https://www.theguardian.com/social-care-network/2017/may/09/buurtzorg-dutch-model-neighbourhood-care 

Friday, 2 June 2017

Happy Seniors' Month!

June is Seniors' Month. For the past 33 years, every June, the province seeks to encourage communities to highlight the contributions of  the 2.2 million seniors in Ontario; an opportunity to celebrate and honour their contributions to the world we live in.

Every year there is a theme to the month and 2017 is no different. Our theme this year is 'Living Your Best Life'. Seems that this should be a theme for all of us - young and old.

There are events all across Ontario with opportunities to celebrate. Most community centres/senior centres have several events ranging from entertainment to seminars to fairs.  Additionally, there are two provincial senior award programs - The Ontario Senior Achievement Award (deadline June 15, award is presented in the fall) and The Ontario Senior of the Year Award (deadline April 30 however award is presented during Seniors' Month).

To find out more about these awards visit the website https://www.ontario.ca/page/honours-and-awards-community#section-1. To find out more about Seniors' Month visit the website for the Ministry of Seniors Affairs at www.seniors.gov.on.ca. To find out about events in your community one only needs to search the internet or drop by a local seniors' centre.

Do take the time to celebrate and thank the seniors in your life this month.

Friday, 19 May 2017

The Cost of Care

A recent study by CIBC has found that caring for aging relatives in Canada costs billions - actually $33 billion annually - between personal expenses and time off work (either in the form of unpaid leave or paid vacation). It is projected that that figure will increase significantly in the next 10 years as the number of seniors grows.
Added to this is the physical and emotional toll of caregiving that you cannot put a price tag on. So, while caregiving for a loved one can be very rewarding, one must also keep in mind the harder aspects of this very necessary and important role.
While there is no easy solution to the financial cost of care beyond government funding and devising innovative ways to care for seniors in communities (which is something that will likely take years and many dollars to figure out), there are ways to reduce the physical and mental toll caring for someone else can cause.
It is of paramount importance that caregivers take the time to 'care' for themselves. Seek out support, and assistance to allow yourself time to meet your own needs. Don't be afraid to ask for help and accept it when it is offered. It is always beneficial if there is someone you can share responsibilities and decision making with.
Communicate openly with medical personnel, family, friends and employers. Find out about any available support groups or Employee Assistance Programs you may have access to. Educate yourself about the medical aspects and available resources - both paid and unpaid, available to your loved one. Do what you can to plan ahead in light of their medical issues and projected prognosis, if possible.
Stress management is important so take some time to understand the signs of stress, how your body reacts to it and what you need to do to relieve it. Keep in mind that while you may not be able to control a situation, you can control your reaction to it and how you deal with it. Ensure a balance in your life and prioritize tasks. Be realistic and don't allow others to guilt you into taking on more than you can cope with. It really is okay to say 'no'.
It is only if you care for yourself, that you can provide care to someone else.


Thursday, 4 May 2017

Seniors in the News

Seniors have been in the news this week a fair bit. Apparently the census results are in and Canada officially has more seniors than children. And the fastest growing age group are centenarians (those 100 and up). So we are living longer. Presumably we are living healthier. But, the older people get, the more likely they are to end up requiring care and ending up in a nursing home. As the number of seniors increase, so will our need for more organized and innovative care and housing.

Recent reports have alluded to the fact that our hospitals, with less beds than 2 decades ago, are over crowded with people waiting in hallways for beds in the acute care sections of the hospital. The Ontario government, in an attempt to ease this problem, is embarking on a pilot project with the retirement home sector to see if they can alleviate the overcrowding. They are testing a program of offering 'vouchers' for people to go to retirement homes  temporarily. The target group are those who are unable to return home directly because of incapacity/dependence and a need for either long-term care or home care. The cost of paying for a short term retirement stay for medically stable people, is far less than the cost of keeping them in an acute care bed. While the program is termed 'innovative' it is only meant as a short term measure until alternate arrangements like long-term care placement or returning home with assistance, can be arranged.

Using retirement homes for short term stays, is not new. However, it has been something out-of-reach to those on a limited basic pension. So, while it's a great step that the government is taking, utilizing the private sector for convalescent care, especially when it is far cheaper to house people in retirement homes than in acute care hospitals, this step will only solve a small piece of a much larger problem. There is a black hole out there that is only getting bigger. We have seniors who need retirement level care that they simply can't afford. Because retirement homes are private and cost more than basic government pensions, they are not accessible to everyone.  For those who need it but are on a limited income, they end up waiting until they are long-term care level often living in poor conditions and declining simply because they can't afford adequate help or support. In fact, if people go to a retirement home early enough, they may be able to completely avoid long-term care or at the very least defer it. With proper nutrition, medication monitoring and socialization, people do live healthier longer. And with the often long wait for long-term care homes, there are many waiting in hospitals or in their homes at a substantial expense to the government. It seems the the true 'solution' is to provide funding, subsidies or vouchers, on more than just a short-term temporary basis.

The writing is clearly on the wall - we have a few years to find better and more economical ways to care for our seniors. We may be heading on the right track but we still have a ways to go.

Wednesday, 12 April 2017

The Downsizing Dilemma

A recent article in my local newspaper caught my eye - it spoke of the high number of 'unused bedrooms' which are contributing to the increased housing prices and lack of affordable housing for young people. As children grow up and leave home, couples are left with large homes that are quite empty. When faced with a choice of move or stay, many are opting to stay simply because the cost of moving is too great and the options are limited. For many, staying in their mortgage free home, is far cheaper than moving to a condo where expenses far exceed what they are currently paying to run a home. Most have their homes as their greatest asset for retirement and want to save the funds they have for their older years rather than deplete it on unnecessary living expenses. Additionally, the offerings that do exist are often too small for those moving from a house, to consider. Just as there are no inexpensive options for young people, the same is true for those at the other end of the age spectrum. And so, downsizing becomes something many choose not to consider until they are forced by circumstance.

Those living in smaller and more isolated communities face additional challenges as they age because of the lack of resources in many areas which they may not feel until they become less mobile. While living out of the city is attractive when one is young, independent and raising a family, it can be problematic as one ages. Older seniors who stay in their homes which are a distance from amenities like healthcare and shopping may become increasingly isolated and may have difficulty organizing adequate in home supports, as they age.

Housing options, affordability and, for seniors, resources and care are key issues many are faced with. It seems that we need to start looking for innovative housing options for both the young and old. Just as I worry that our young adults of today will never be able to afford to own a home, I am concerned that our seniors of tomorrow will find the cost of retirement living prohibitive and/or will not be able to afford the care they require. So many are already in this predicament; unless we make changes to the way housing and care are offered to our seniors, even less people will be able to cope with the challenges of aging they may someday face.

This is indeed a huge issue that will take years of planning and coordination to resolve, so where do we start?

There is a fair bit of research on Age-Friendly Communities that our policy makers may find helpful. As a start, a document produced by the World Health Organization summarizes the importance of including many parameters for the cities of tomorrow (http://www.who.int/ageing/publications/Global_age_friendly_cities_Guide_English.pdf ). As well, there are many interesting co-housing, care in place, and multi-generational models that work well in other countries. As with so many things, rather than 'reinventing the wheel', perhaps our best solution has already been discovered and we need to just look beyond our borders to explore innovative ideas and options that can help both young and old with their housing dilemmas.