There is no doubt that the aging population is a worrisome thing. 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.
There are 3 factors affecting this: longer lifespans, decreased fertility and new births, and the aging of “baby boomers”. For as long as I have been working as a nurse, I have been hearing about the aging population and how that is going to affect us. Working in long-term care and acute care as a manager, I got to see the negative results that come from poor care in the community and hospital, and to see the stress and grief it causes seniors and their loved ones, to be in hospital for months at a time waiting for a long-term care bed.
There has always been concern around the care of seniors in our country, and around the world, but it took the unfortunate events of the Covid-19 pandemic to truly shine the light on the major issues around community and long-term care for seniors. I remember seeing on the news and reading about it online the issues that the military found when they went to assist LTC in Ontario and Quebec during the initial Covid-19 outbreak and I was shocked, but not surprised. Long-term care and community care have been severely under-funded for a very long time and change needs to happen!!
The Canadian Nurses Association (CNA) states: “In those long-term care institutions, the pandemic has further exposed a crippling lack of leadership, funding, standards, basic supplies and equipment for patient care, and safety supplies (especially personal protective equipment). There is not enough staff, including too few professionals, while many of the unregulated care providers who do the bulk of the work lack proper training and support.” (CNA, 2020). If we do not create a robust and sustainable plan for the rapidly aging population and how to care for them, we are going to be in a terrible situation in another few years.
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Association (CMA) has identified many issues surrounding the care of seniors in Canada including increased costs, our outdated medicare and pharma care systems, and the lack of availability of long term care facilities and caregivers for seniors at home or in community, and the high number of “informal” and unpaid caregivers for those seniors in the community.
Our Medical Care Act was developed in 1966 when the median age of Canadians was 25.5 year. Now, the median age is 40.6 years, and is expected to rise to 42.4. While that doesn’t sound old, that is the median. And with the trending population aging and less births being recorded, we are in trouble if we don’t act fast. Canada is, sadly, currently the only developed country in the world that has a universal health care system that does not include publicly insured prescription drugs.
Lack of federal funding has not been an issue in acute care. The issue lies with the fact that Canada’s entire health-care system is founded on an act over three decades old. The Health Act does not include pharma care, home care, or long-term care and therefore we are not obligated to provide it the way it needs to be.
Length of stay (LOS) for hospitalized alternate level of care (ALC)
patients with a median LOS of 182 days.
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 (CAN, 2020).
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 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 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.
CBC News: The National. (2021, January 14). Senior left in soiled bed for days after homecare cancels over Covid-19. Bing. Senior left in soiled bed for days after home care cancels over COVID-19 - YouTube
CIHI. (2017). Infographic: Canada's seniors population outlook: Uncharted territory. Canadian Centre for Health Information. https://www.cihi.ca/en/infographic-canadas-seniors-population-outlook-uncharted-territory.
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.
TEDxTalks. (2016, April 5). How We Can ACE the Care of Older Canadians | Samir Sinha | TEDxQueensU. YouTube. https://www.youtube.com/watch?v=TBNPCsJU86s.
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
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