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 

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.

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.

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.

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.

Legacies

I have recently embarked on a project with my daughter. We have taken all our family's old photos that have until now sat in shoe boxes or ancient crumbling albums, scanned them, organized them and are creating a family album that spans 4 generations (thank you Shutterfly!). We are fortunate that my grandparents kept organized records in an ancient book that detailed births, deaths and marriages so we have some context to work within. It is beyond fascinating to wander through their lives through photos and dates and to create a family history for my children. I wish I had the foresight when my grandparents were alive to ask them more questions and have conversations with them about generations before them. There is a richness in learning one's family history and understanding how you got to where you are and how very fortunate you are that certain decisions were made well before you were born. I've often thought of the importance of legacies, of family histories or gifting future generations with things we have learned and how they got to where they are today.

I encourage all of you who read this to consider creating your own legacy to pass down to your families. Photos are wonderful but not everyone has the time or patience to pull it all together and with computers and video camera on every phone, there are other ways to save and transmit memories and history. If you have elder relatives sit down with them and ask them questions - I found a list online that is quite apropos so I'm going to include  a few of them them below but the full list of 20 questions can be found on https://www.agingcare.com/articles/questions-to-ask-elderly-parents-147907.htm if you are interested in expanding on these. Write down their answers or better yet, video tape them as they answer them. Ask them to show you photos of important people in their lives and consider scanning or photographing them so you can include them in your creation. It can be a wonderful bonding and special project for grandchildren to do with their grandparents or children to do with their parents.

If I had a chance to sit down with my grandparents now, these are  some the questions I would ask them.
Who is the person who influenced your life the most?
What was the happiest moment of your life?
What are you most proud of?
What are the most important lessons you've learned in life?
What was school like for you as a child? 
Do you remember any fads from your youth? 
What world events had the most impact on you?

(Questions from: https://www.agingcare.com/articles/questions-to-ask-elderly-parents-147907.htm)

What questions would you add to the list? What things would you like to know about the generations before you? And what do you want your children to know about you? 

Knowing where we came from, helps us to understand where we are today and where we want to go.

Inter-generational Relationships

I enjoy reading "Humans of New York" posts. It's an interesting concept - for those who aren't familiar with it, the author takes a photo of someone and publishes it online along with a quote from that person. Sometimes its about that moment in time, who they are pictured with, or something they are doing, other times its a life story, how they are feeling or an experience they had. It's always interesting and underlines both the unique nature and the common thread of humanity. Lately, the posts have been from people in Brazil.

I saw a post a couple of weeks back that has stayed with me - and one I wanted to share with our readers as it particularly relates to seniors and inter-generational relationships........
Above it is a photo of a young mother and her daughter and this is the quote:

“For Heloisa, every elderly person feels like a grandparent. And she loves her grandparents. So I asked her if she wanted to have her sixth birthday party at a home for the elderly. She loved the idea. So I contacted a local home and planned everything with the coordinator. We sent invitations to the family members of all the residents. I’m a photographer, so I went a few days early and took nice portraits of all the residents. On the day of the party, I printed out the photographs and brought them as gifts for their family members. We did games and activities. There was so much joy. Everyone had such big smiles. The residents were crying. Their families were crying. I was crying. I think Heloisa will remember the experience forever. Afterward, her school friends came home with us and we had an old-fashioned pajama party.” (São Paulo, Brazil) from: http://www.humansofnewyork.com/post/157584321356/for-heloisa-every-elderly-person-feels-like-a

Firstly, what an amazing mother and child! Secondly, what a brilliant idea! It is no secret that children brighten the lives of adults and that children in a senior's home bring smiles and conversation to even the most stoic of person. On occasion I hear about inter-generational programs or young children visiting a senior's residence but something like this goes beyond that and is such a wonderful gift to give to both that child and those seniors. 

The post, brought a smile to my face - I hope it did the same for you.