The World Health Organization (WHO) states that the number of people worldwide who are aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050 (WHO, 2011). In Canada in 2010, 14% of the population was 65 or older, and it is predicted with the aging “baby boomer” generation that this will rise to 25% by 2036.
The Canadian Medical Association (CMA) has identified many issues surrounding the care of seniors in Canada including increased costs, our outdated medicare and pharma care systems, and the lack of availability of long term care facilities and caregivers for seniors at home or in community. Unfortunately, it took the Covid-19 pandemic to truly shine the light on a lot of serious issues happening within the long term care and community care sectors that have been ignored for a long time.
On August 1, 2019 Ontario expanded OHIP+ and made available of over 4, 400 prescription drugs free of charge for everyone aged 65 and older. This strategy has improved the lives of seniors in Ontario by making life more affordable for those seniors and families on a fixed income.
With the introduction of the expanded OHIP+, steps have been made to improve care and make life more affordable for seniors in Ontario, including:
⦁ The Seniors’ Public Transit Tax Credit introduced in 2017 and saving seniors up to $450 a year on travel costs.
⦁ $17 million per year to provide a high-dose flu vaccine free of charge to seniors, beginning in 2018-19.
⦁ Shingles vaccinations are now free for roughly 850,000 seniors between the ages of 65 and 70, saving them $170 and helping to keep them healthy.
⦁ Ontario’s leadership in achieving an enhanced Canada Pension Plan, which will result in greater retirement security for today’s workers.
⦁ Aging with Confidence: Ontario’s Action Plan for Seniors, released in November 2017.
Within the City of Hamilton where Caroline works, in 2012 city council, in collaboration with Hamilton Council of Aging (HCOA) and Seniors Advisory Committee (SAC), developed a strategic Age Friendly plan. In 2014, Hamilton was accepted as a member of the World Health Organizations (WHO) Global Network for Age Friendly Cities and Communities, in recognition of the efforts the City partners were making to become an Age Friendly City. In 2016 the City updated its strategic vision: “To be the best place to raise Children and age successfully.” (City of Hamilton, 2020).
The goals of this plan are to accomplish the following:
⦁ Ensure housing choices are affordable and available.
⦁ Safe transit options to enable seniors to get around greater Hamilton public places.
⦁ Outdoor spaces and public places are accessible, safe, and inviting.
⦁ Communication and information is easy to access and understand.
⦁ Health and community services support aging-in-place.
⦁ Civic Engagement: Meaningful volunteer and employment opportunities.
In 2004, the Newfoundland and Labrador (NL) government announced the establishment of a Ministerial Council on Aging and Seniors. In 2007 the Provincial Healthy Aging Policy Framework was created to provide guidance for government's future policy development. Some initiatives are:
⦁ Close to Home: A Strategy for Long-Term Care and Community Support Services
⦁ Long-Term Care and Community Support Services
⦁ The Newfoundland and Labrador Prescription Drug Program (65 Plus Plan
⦁ Community Rapid Response Teams
⦁ Seniors' Discounts
⦁ The Violence Against Older Persons Public Awareness Campaign
While the governments have placed a significant focus and financial commitment to hospital care, other areas such as transitional care, community supports, and long-term care have been majorly underfunded. A lot of individuals in hospital across our country are awaiting long-term care and are considered “alternate level of care (ALC)” and they usually wait an unacceptable 380 days.
In Ontario it is estimated that about 14% of all acute care beds are occupied by ALC individuals. Seniors being in hospital unnecessarily leads to worsening health outcomes, decreased satisfaction, and is much more costly. An ALC bed in hospital costs about $842/day while a LTC bed is about $126/day. The estimated cost of population aging within Canada is projected to be 93 billion dollars over the next decade.
Canadian Nurses Association (2013) made recommendations that the government of Canada should create the Aging and Seniors Care Commission of Canada (ASCCC) as a national strategy to address the care of our aging population. These recommendations include:
⦁ Promoting the health and well-being of all Canadians as they age (healthy and active aging, education, activity promotion)
⦁ Supportive chronic disease prevention and management (resources, supports and improved primary health care)
⦁ Increasing system capacity around frailty and vulnerability (increasing dementia care and awareness, integrating palliative/end of life care, advancing and improving our systems)
With the current spotlight that is on the long-term care sector in the wake of the Covid-19 pandemic, we need to take the time now to focus on what we do to support our seniors and how we can improve the care of our most vulnerable citizens. The Canadian Nurses Association states that we need to develop a commission of inquiry on aging in Canada so that we can provide the best care models to provide safe and dignified care for aging people in Canada (CNA, 2020).
Adams, A. (2018, April 3). Ontario Expands OHIP+, Now Includes 65+. CARP. https://www.carp.ca/2018/03/28/ontario-expands-ohip-now-includes-65/.
Canadian Medical Association, Canadian Medical Association Position Statement: Ensuring Equitable Access to Care (2018). Ottawa, Ont.; Canadian Medical Association. https://policybase.cma.ca/permalink/policy11062
Canadian Medical Association, Meeting the demographic challenge: investments in seniors care. Pre-budget submission to the House of Commons Standing Committee on Finance (2018). Ottawa, Ont.
Canadian Nurses Association, Canadian Society for Long-Term Care Medicine, & Canadian Support Workers Association, National standards for long-term care: the art of the possible? (2020). Ottawa, Ont.; Canadian Medical Association.
Canadian Nurses Association, Three strategies to help Canada’s most vulnerable Pre-budget Brief to the House of Commons Standing Committee on Finance (2013). Ottawa, ON.
Department of Children, Seniors and Social Development, & Provincial Advisory Council on Aging and Seniors, Provincial Advisory Council on Aging and Seniors Action Plan (2017). St. John's, NL.
The Conference Board of Canada. Meeting the care needs of Canada’s aging population. Ottawa: The Conference Board; 2018. Available: www.cma.ca/En/Lists/Medias/Conference%20Board%20of%20Canada%20-%20Meeting%20the%20Care%20Needs%20of%20Canada%27s%20Aging%20Population.PDF
Weingartner, M., & Kiely, S., Hamilton's Plan for an Age Friendly City (2014). Hamilton, ON. https://www.hamilton.ca/city-initiatives/strategies-actions/age-friendly-hamilton
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