The other day I was reminded that we are all getting older. I am surfing the leading edge of the Boomer wave; the first of us turned 65 in 2011. It is predicted that, as early as 2015, seniors will outnumber youth in Canada and that, by 2036, seniors will comprise 25 per cent of the population. Interestingly, P.E.I. has a younger population than any of the other Atlantic Provinces.
Daily we hear concerns that our health care system will be unable to meet our growing health care needs. Given the current state of the economy, it isn’t surprising that many of us continue to work beyond the traditional retirement age. Thanks to the wonders of modern medicine, we are living longer and remaining more active in community and family.
In a report entitled “Health Care in Canada, 2011: A Focus on Seniors and Aging” by the Canadian Institute for Health Informatics, a number of important points were made, including: the number of chronic conditions a person has is more important than their age in determining health care resource utilization. While health spending per capita on seniors is more than four times that on younger adults, the rate of spending growth for seniors was lower over the past 10 years than the rate for non-senior adults.
The vast majority (93 per cent) of seniors live in private households. In terms of formal support, an estimated 1 million Canadians receive home care services. Most informal care (about 80 per cent) comes from unpaid family members, friends and neighbours. Multiple drug prescribing remains an issue, with 23 per cent of seniors taking 10 or more prescription drugs. More than one third (34 per cent) of Canadians receiving home care services report daily pain and 14 per cent report signs or symptoms of depression. Some 97 per cent of home care clients also have informal support to help maintain their independence but these informal caregivers—typically seniors’ spouses and children—are burning out.
Almost a third (31 per cent) of seniors in long-term care show signs of depression, almost one in six (16 per cent) report daily pain and five per cent had an advanced pressure ulcer. Data on wait times in emergency departments and acute care settings show that seniors wait longer for care than their younger counterparts. Almost half of seniors designated as alternate level of care during hospitalization are eventually discharged to long-term care facilities (47 per cent), compared with only one-quarter (26 per cent) of non-senior adults.
If you make it to age 65, on average, you can expect to live until age 83 (males) or 86 (females). You need to consider your options while you are still young enough to do something about it. Sit down with your family and discuss late and end of life care. What’s going to happen when you are no longer able to care for yourself or your spouse? If you are counting on the government to care for you, you had better take a close look at what that really means. It may be a whole lot less than you think. If you haven’t done so, research long term care insurance.
Ask yourself the following questions.
1. Do you lead a healthy lifestyle? If so, you are more likely to live into your 80s or 90s and need long term care.
2 What does your family's health history look like? The more chronic diseases in the family, the more likely you will be to need long-term care.
3. Are you willing to divest yourself of your assets and become dependent on the state, or on your family, should you need care? Unless you have access to over $5,000 a month, you probably won’t be able to afford private long-term care.
4. Can you afford a premium that would provide you a reasonable amount of coverage?
The lifetime probability of becoming disabled in at least two activities of daily living or of being cognitively impaired is 68 per cent for people age 65 and older. There needs to be an increased focus on disease prevention if we are going to successfully manage the health care impact of the Boomer tsunami. We must demand integration of care across the continuum, from primary care, through public health, acute care, rehabilitation, restorative care, home care and long-term care. An integrated system has an excellent chance of succeeding in our small province if everyone gets with the program.
The challenges are huge, but not insurmountable. Be prepared.
By Desmond Colohan
- Desmond Colohan is a aging P.E.I. physician with a particular interest in responsible health care policy and a growing interest in the future availability of long term care resources.