About one in seven Canadians (5 million of 34.5 million) is aged 65 or over with that number projected to double to nearly 10 million over the next decade as we approach the apex of the baby boomer demographic (defined as people born post WWII thru 1964). For all three levels of government where to house them and how to provide for their health needs are burgeoning issues with no definitive answers on the horizon. Successive governments saw the CPP and OAS and even the income supplement as a reward some Canadians would achieve; but no forcaster could have foreseen the average 65 year old today most likely achieving a reachable 80-81 years as a lifespan. Compounding the problem is the reality that with each passing year seniors acquire a growing list of medical issues. Some progress has been made in the critical area of housing with innovative graded care facilities becoming the norm. We are fortunate that 91% of our seniors reside in communities of population 50,000 or greater where facilities are more readily available. The two areas of the country with the highest ratio of seniors are Victoria, BC and next door to here in Niagara, both approaching 18% of the general population.

The medical model for their care is another matter. The single most substantive growth in provincial health dollar expenditures is drug programs for seniors. Any emergency department nurse or physician dreads the arrival of the senior citizen with the poly-pharmacy drug bag. There are three major issues. No human being can tolerate a dozen prescriptions daily without untoward side effect, itself a major reason for seniors unplanned emergency department/ hospital admission visits. Further, direct questioning of the senior demonstrates a significant incidence of non-compliance regarding these medications. Take the very common condition of arthritic hands for example. Ask any senior the benefit of wax bath therapy for arthritic hands and you’ll understand the problem with our pill fix approach to every medical diagnosis. Wax bath therapy have a one time cost of about $100 whereas the anti-inflammatory prescription runs a $100 tab every month. The difference? Staffing to monitor the bath and train the senior in self-care is another expense line in somebody else’s budget. Health Ministries are making some right moves.

For seniors preferring to live at home expanded visiting nurse programs can have a significant impact. Home monitoring systems are also effective……..but only as monitors. But not one dollar of this massive expenditure is going toward resolution of the single greatest health risk facing our seniors. And in real term economics, its a problem money, no amount of money can resolve. Heres a fact; more than 40 % of seniors residing in long term care and nursing home facilities receive NO visitors……….ever. Their only contact with the external world are the overworked staff charged with providing base needs and certainly no time for continuing social interaction. Another 50% of the residents receive an average ONE HOUR per month family visitation.

The other 10% are comprised of dutiful families deserving of every kudo. For seniors still resident in private homes, the numbers are almost as disheartening with the majority seeing a visiting nurse and the occasional delivery personnel and token family attendance as the norm. And these are urban environs with same city families nearby. Its only common sense that a happy person is a healthy person but for the majority of our seniors the chicken and egg question is which came first, the social isolation then the depression compounding all the other health issues or the depression response to multiple health issues leading to social withdrawal and isolation? Even seniors in the largest long term facility can become socially isolated without effective social programming, an item not prioritized on most budgets. Our seniors need to be reconnected with family and friends. We need to stop building seniors complexes at the end of the bus line. Put them on top of the malls to eliminate the weather factor. Most seniors don’t have much money but what they do have, they spend. Integrate the residential facilities with general housing. Seniors love children. When you visit, take the grandchildren. Make the facilities pet friendly. Money can’t buy you love. The Beatles got it right.

Dr. David Carll

Providing a Fresh Perspective for Burlington and Hamilton.

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