- Key senior issues Canadian Governments should consider
- Government of Canada improves seniors’ quality of life
- When it comes to senior suicide, don't be afraid to ask tough questions
an article from womansport.ca
The government of Canada formalized its focus on seniors on May 1, 1980, with the establishment of the National Advisory Council on Aging (NACA). That was a generation ago — or about the same time most boomers started having their own children. So, what has happened since that time?
Over the last 25 years, governments at all levels initially emphasized and then gradually de-emphasized the importance of seniors as a policy focus — to the point where, for example, the latest NACA report card on seniors in Canada has yet to be released. It's about six months overdue, at this writing.
The initial vision of a coordinated approach to seniors' matters also gradually gave way to the current situation — a hodge-podge of well-intentioned but often overlapping, under-funded and generally inadequate programs typically developed with little input from the seniors' community. Today, if a program succeeds in supporting the needs of seniors, it achieves this largely because of the personal commitment of the providers of the service rather than the design of the program itself.
A case in point is the healthcare system, a program with which Canadians are only too familiar. Canada is way behind where it needs to be with the number of available geriatricians. It is estimated that 538 are needed in Canada, but there are only 198. Canada also lacks appropriate numbers of general practitioners and nurses to support the health needs of seniors.
To properly develop, implement, and maintain a coordinated approach to seniors' care across all levels of government, Prime Minister Stephen Harper should give consideration to striking a Royal Commission on Seniors' Care with a six-month timeframe and a mandate to identify who does what, how it will be funded and how it will be effectively rolled out. While they wait for the Commission's recommendations, the provinces should contemplate appointing Cabinet Ministers with dedicated seniors' portfolios, put the pins in place to eventually develop standalone Ministries responsible for seniors' issues and establish provincial advisory councils on aging. All Canadian municipalities should think about establishing seniors' advisory committees that report through senior staff to their councils.
What follows are 10 key seniors' issues requiring the commission's review, complemented by the writer’s thoughts about how these matters might be resolved:
More seniors than ever before want to work, need to work and still have much to offer potential employers, but it is difficult for them to do so. The elimination of the retirement age in Ontario was a good first step. Flexible hours, a shorter work-week and transportation subsidies (preferably through write-off within the income tax system) should be considered;
All seniors should be exempt from de-listed health services. Seniors also have a higher reliance on prescription drugs and spend more money on drugs than other Canadians do. Using a means test based on income tax returns, seniors' prescription drug requirements should potentially be fully subsidized by provincial health insurance programs;
Home Care Services
It is far more economical to deliver services to seniors in their homes versus building government-operated seniors' facilities to house them in. Current home care services need to be expanded in their numbers and range of offerings to include meal preparation, grocery shopping, house cleaning, home maintenance and laundry.
Like their children and grandchildren, seniors need to be more physically and mentally active. More need to volunteer but fewer are doing so. They need to be encouraged to be more active in their communities. The more active they are, the healthier they will be.
The healthier they are, the less costly it will be to support them;
Governments at all levels can no longer afford to build assisted housing, seniors' housing or long-term care facilities. The private sector should be encouraged to do this, with government regulation and accreditation related to standards of care.
An appropriate shelter allowance system should be developed for seniors, instead;
The current level of universal financial assistance afforded seniors' requires review. A means test based on income tax returns needs to be put in place to determine need in place of the notion of universality and clawbacks. Seniors who require financial help should get it based on demonstrated need, so that they can live out the rest of their lives with dignity.
Those fortunate seniors who don't need government assistance shouldn't receive it simply because they contributed to the plan while they were employed;
Long Term Care
More long-term care beds are needed. However, chronic care services should be removed from the hospital setting and placed in privately operated, government regulated and inspected facilities.
Ninety percent of the fraud that is perpetrated on individual Canadians is perpetrated on seniors. All levels of government, the police, community agencies and financial institutions need to work together to develop proactive communications and securities programs that protect seniors from assault, burglary and fraud.
Where possible, seniors should be removed from federal and provincial income tax rolls. While more seniors are becoming wealthier, they are still falling behind economically because their income is growing slower than the rate of inflation and/or the rate of increase of many basic services like energy, municipal services and telecommunications.
Seniors rely on public and other forms of transportation more than most other members of society to get to doctors' appointments, perform day-to-day errands and work. There should be reduced rates for seniors on all publicly and privately operated transit systems. Seniors should also be able to write off their transportation costs through their income tax returns.
Caring for Seniors Creates Health Issues for Caregivers
There are stress issues for some who care for seniors whether the senior is a spouse, relative, friend or neighbor, says new study.
The Canadian Institute for Health Information (CIHI) released two studies in late August of 2010 that indicate that one in six people contributing to the care of seniors are not coping well with doing so. One study centered around 'informal care' and the other around care for those with Alzheimer's and other dementia.
The studies were on Canadian seniors and their caregivers only but the results may be indicative of similar issues in the U.S. and other countries.
The CIHI says of the first study, Supporting Informal Caregivers—The Heart of Home Care that they included over 130,000 seniors 65 or older in the study. Many of those who were part of it, the CIHI says, had health issues they described as "complex". All of those in the study receive publicly funded long-term home care.
Informal Caregivers and Long-Term Home Caregivers Needed
A huge majority - 98% - of those who took part in the study also had an informal caregiver to complete their care needs, more often a spouse or an adult child and sometimes a friend and/or neighbor, CIHI says. The informal caregivers provide emotional support, daily living help such as with transportation, medication management, shopping and personal care such as dressing, feeding and bathing.
And some of those that are providing that care - one in six - are having issues with depression and anger that can be linked to their role as caregivers. Nancy White is the manager of Home and Continuing Care Development at CIHI and she says that one reason to identify people having issues with giving informal care is to help them learn to cope instead of reaching a point where they can no longer provide support.
“Many seniors want to stay in their own homes as they get older, and having a family member or friend provide informal care helps make this possible,” White points out. “The good news is that most informal caregivers do appear to be coping well."
Alzheimer's Can Create Care Giver Stress
The second study, Caring for Seniors With Alzheimer’s Disease and Other Forms of Dementia found that people providing support to home care seniors with cognition problems such as memory, understanding and decision-making problems were more likely to report feeling distress. The odds of a home care client having a distressed caregiver go up to three times higher if the client being cared for had severe cognitive problems such as those related to dementia like Alzheimer’s. And of all the caregivers likely to feel distress spouses had the highest likelihood.
The CIHI reports quotes Kimberly Peterson, the vice-president of Client Services with the Champlain Community Care Access Centre housed in Ottawa, Canada, and Peterson says that it "isn't unusual" for a spouse to experience problems when they are providing care to their partner.
"This can likely be attributed to the 24-hour nature of their role...potential lack of understanding of the changes in their spouse’s behaviour...a result of the disease process and the fact that they may be seniors themselves,” Peterson says. “There are many strategies informal caregivers can use to help cope with distress. This includes accepting that there are events they cannot change, taking some time to do activities they enjoy and ensuring they get enough rest and sleep.”
Help for Distressed Caregivers Will Help Senior Remain at Home
White said that caregivers having stress issues related to giving care often want to continue to provide it but need help with their distress. "While caring for a loved one can be fulfilling, it can also be quite challenging," she points out.
"It is important to identify caregivers who are at risk of burnout, which can result in the senior being institutionalized.”
MONTREAL— From Friday's Globe and Mail
Published Thursday, Mar. 24, 2011 5:13PM EDT
Last updated Sunday, Mar. 27, 2011 4:59PM EDT
Joan Seabrook felt “absolute devastation” when she first found out that her 68-year-old mother and 69-year-old father had died by suicide.
“It was a suicide pact,” Ms. Seabrook, who lives in London, Ont., said in a recent interview. She still remembers the moment 20 years ago when her sister called to pass on the shocking news about their parents' deaths from police in Victoria.
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“They weren't ill, they had no medical issues,” she added. “They lived in British Columbia and everybody else in the family lived in other cities.”
But Ms. Seabrook, who was a 41-year-old school principal at the time, says there were probably hints that something wasn't right which the family didn't pay attention to.
“When I look back I think there were some signs that my dad was getting disconnected from the joy of life, (like) not doing his gardening which he was always doing,” she said.
Ms. Seabrook won't talk about how her mother and father took their own lives, but says it had been carefully planned in advance.
“They had it well organized and felt that it was something that they were comfortable doing ... that it was their choice and that they had lived a good life and they were ready to leave,” she recalled.
Her parents left a note behind, but Ms. Seabrook did not want to share its contents, except to say that they mentioned they were very proud of all their family.
“They were very organized in terms of letting us know, very thoughtful, very caring,” she added.
Ms. Seabrook, who is currently vice-president of the Canadian Association for Suicide Prevention, has some advice for families of elderly parents: Don't be afraid to ask questions.
“If you have a parent or a loved one – an elderly person that you have concerns about – that you think they might be depressed or have suicidal thoughts, you need to get on it,” she said.
“If it's an elderly parent, don't be afraid to ask ... they're not going to fall apart.”
Marnin Heisel, who studies suicide among older adults, says he's particularly worried about baby boomers who are now starting to reach 65.
“Compared to their parents, grandparents, great grandparents generations, baby boomers on the whole tend to have higher rates of suicide at the same age,” the University of Western Ontario expert noted.
Dr. Heisel, a clinical psychologist, analysed U.S. statistics looking at suicides in the American baby boomer population of more than 77 million between the late 1990s and 2007.
“What I was somewhat surprised to see is that the rate seemed to be increasing – it wasn't necessarily a huge increase over time – there seemed to be rising, not falling rates of suicide,” he said.
Dr. Heisel says there really needs to be a raising of awareness around the whole issue of seniors who take their own lives.
Charts prepared by the Calgary-based Centre for Suicide Prevention show that male and female suicides in Canada in the 65 to 74 age group generally fluctuated between 2003 and 2007.
There were 247 suicides in 2003 compared to 217 in 2007.
During the same five-year period, there was a gradual increase in suicides involving Canadians between the ages of 75 and 89.
In 2003, 172 Canadians in that age group died by suicide, while the figure rose to 221 in 2007.
Dr. Heisel points out that for the most part, suicide among older adults is not about terminal illness, but has more to do with transitions that can accompany aging.
Ongoing difficulty coping, possible changes in lifestyle and “certainly depression” can lead to suicide by seniors.
Dr. Heisel adds that any talk about “wanting to be dead” should be taken seriously.
Nona Moscovitz, who manages mental health services in a west end area of Montreal where there is a high seniors population, says her challenge is to be able to identify those who are at risk of suicide and get them the help they need.
“We do see a lot of seniors who are presenting what looks like perhaps depression or thoughts of suicide,” Ms. Moscovitz said in an interview. “Depression is not a normal part of aging.”
She has had family members calling her to say they are concerned because their mother has been talking about wanting to die.
“Sometimes a parent will say: ‘I have nothing worthwhile to live for anymore and I would like to die’,” Ms. Moscovitz said.
She also points to non-verbal signs to watch for, like a parent giving things away, withdrawing or finding no interest in life.
There may also be changes in sleep patterns and appetite patterns.
Ms. Moscovitz feels the suicide rate among the elderly may even be under-reported.
“I think perhaps some deaths are documented as accidental when in fact it was maybe more intentional,” she said.
“Either under- or over-medication can be a very silent way of leaving this Earth without being overly dramatic like shooting oneself or killing oneself by hanging.”
Experts suggest people seeking help or who may be struggling with thoughts of suicide should visit a doctor or an emergency room – if the risk is high, they should call 911 or local telephone distress lines.
The Canadian Press