Historian Landon Jones famously said that almost exactly nine months after the end of World War II, “the cry of the baby was heard across the land.” This statement was made in response to the 3.4 million babies born in 1946 in the United States – a 20% increase from the previous year and more than ever before. The “cry” would signify the beginning of an era which saw populations surge in most industrialized countries. In Canada, the gross birthrate (the annual number of live births per 1,000 inhabitants) in 1946 jumped to 27.2 compared to 20.1 in 1937. This rapid increase lasted until 1965 and was largely due to improved economic conditions accelerated by the Second World War. Today, these aging “baby boomers” are making a mark in Canada’s changing demographics, presenting a unique predicament to the nation’s socioeconomic infrastructure.
As of 2015, Canada has more citizens over the age of 65 than under 15. In fact, this “senior” population increased by 16.9% between 2011 and 2016 – the greatest increase in the proportion of older people in Canada since Confederation. With baby boomers making up 30% of this senior population, projections from Statistics Canada suggest that the age imbalance in Canada will only grow. It is expected that about one in four Canadians will be seniors in 2031, a fraction that would place Canada among the world’s oldest countries. Based on these statistics, questions are being raised about how the Canadian health care system and economy will be affected.
HOUSE AND HOME
One of the most pressing issues surrounding the aging Canadian population is long-term care. Most provinces currently have seniors on extensive wait lists for long-term care facilities. Indeed, between 2012 and 2013, Ontario reported that 34,312 individuals were on a wait list for their preferred choice of long-term care residence. This back-log has led to seniors being stochastically placed in facilities that may be extremely far from their homes and families. In order to prevent this, Nova Scotia and New Brunswick have recently implemented legislation prohibiting seniors from being placed in a facility over 100 km from their homes. According to the Canadian Medical Association, improper use of facilities and lack of infrastructure are among factors to blame for this build-up. Long-term care facilities are often over-crowded with people who don’t necessarily need around-the clock support, but find themselves there due
to the paucity of in-home care resources.
To rectify this, researchers have been exploring new technology, including robotics and artificial intelligence, to improve the quality of life of seniors at home. A research group from the Georgia Institute of Technology has put this idea into practice with a pilot project known as Aware Home. A home located on the institute’s Atlanta campus has been furnished with safety features aimed at addressing some of the most concerning difficulties faced by seniors who are living alone, such as cooking. The stove at Aware Home is equipped with a large-coloured light system and frame with sounds that alert the residents when the oven has been left on unattended. The house is also fitted with devices that collect data on the inhabitant’s routine, including gait-sensing technology in the hallway to analyze walking patterns. If the device detects something is amiss, it will contact family and emergency services. These homes will not eliminate the need for long-term care facilities but instead alleviate their overcrowding and provide alternative measures to ensure the safety of seniors.
THE COST OF CARE
Not only are Canadians aging, but we are also living longer. This inflation in life-span is also associated with an increase in chronic disease. Currently, an estimated 16 million Canadians live with at least one chronic condition including diabetes, high blood pressure and kidney disease. Accordingly, these people see an increase in emergency-department visits, prescription drugs and specialist’s appointments. Not only is this inefficient, it is incredibly costly to the health care system. To improve healthcare for seniors, the Canadian Academy of Health Sciences proposes that patients with chronic conditions should be able to access a team of clinicians who can co-ordinate treatment and services in a “one-stop” shop approach. This plan, which includes teams of doctors, nurses, pharmacists and dieticians, is currently being implemented at Women’s College Hospital where the Complex Care Clinic (CCC) was created to help stabilize and optimize chronic medical conditions to support and improve health. Ultimately, the CCC provides comprehensive medical assessments that include physical and psychosocial evaluations, education about disease process, intensive medication assessment and self-management guidance. This model aims to integrate all aspects of a senior’s health care, facilitating communication between professionals and reducing fragmentation in how services are delivered at a fraction of the existing cost.
Alternatively, the Canadian Nursing Association (CNA) addresses burgeoning health care costs by proposing a redirection of health care funds to preventative health care services and programs. Health promotion and disease prevention are typically viewed as strategies for youth engagement, but there is growing evidence that this approach may be effective on seniors as well. Promotional campaigns can be employed in interventions on exercise and diet, and can also be used to change attitudes and behaviours towards social support, sleep habits and certain preventive measures like psychotherapy. These approaches aim to improve both physical and mental well-being, and are currently being implemented in Ontario with programs like senior hiking initiatives and yoga launching in many communities.
As the largest ever generation of Canadians enters the stage of life where physical and cognitive impairments become more apparent and dehabilitating, medical specialists and economists are bracing themselves for challenges. The preparatory work ranges from predicting demand for certain medical specialties, such as orthopedic surgery, to developing next generation technologies that keep seniors in their own homes for as long as possible. Funding is being allocated to preventative measures and chronic care clinics, helping baby boomers manage and identify symptoms of disease early. These solutions, along with others, are needed to take care of a generation of individuals who have contributed immensely to the Canadian economy and who continue to contribute to our communities.
- History.com staff, Baby Boomers. History.com, (2010). http://www.history.com/topics/baby-boomers
- Statistics Canada, Census in Brief: Age and sex, 2011 Census. Stat Canada, (2011). http://www12.statcan.gc.ca/census-recensement/2011/as-sa/98-311-x/98-311-x2011003_2-eng.pdf
- Kimura, T. and Mayer, A. Demographic directions: Did the population in your hometown shrink or grow? CBC News, (2016). http://www.cbc.ca/news2/interactives/census/2016/population/
- Grenier, E. Canadian seniors now outnumber children for 1st time, 2016 Census shows CBC News, (2017). http://www.cbc.ca/news/politics/2016-census-age-gender-1.4095360
- Gollom, M. “We’re so far behind:” Canada unprepared for housing needs of rising senior population. CBC News, (2017). http://www.cbc.ca/news/business/seniors-canadian-census-aging-home-care-1.4097293
- Lord, R. Canada lock of long-term care space is forcing seniors as far as 200 km from home. Global News, (2017). https://globalnews.ca/news/3873819/the-wait-for-long-term-care-space-is-forcing-seniors-as-far-as-200-km-from-home/
- Howard, J. Using technology to help older adults keep their independence. CNN, (2017). https://www.cnn.com/2017/09/25/health/older-adults-home-safety-technology/index.html
- Hipolito, C. Canada’s aging population will strain the health-care system. The Glove and Mail, (2012). https://www.theglobeandmail.com/opinion/editorials/canadas-aging-population-will-strain-the-health-care-system/article543638/
- Women’s College Hospital- Complex Care Clinic (CCC) http://www.womenscollegehospital.ca/programs-and-services/complex-care-clinic
- Canadian Nurses Association. Chronic Disease Related to Ageing: Brief to the House of Commons Standing Committee on Health. (2011). https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/hesa_brief_on_chronic_disease_and_aging_e.pdf?la=en
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