Advocating for better elder care
By 2036, seniors aged 65+ will make up one in four Canadians. Is our health-care system prepared to meet their complex care and medical needs? How are doctors helping, and how can you make a difference?
The pandemic made it clear to many older adults that they were uncomfortable about leaving the security of their homes for the unsettling unknown within the long-term care system. Will they have access to their primary care physician? Will they be looked after appropriately and be well-fed? Will they feel lonely in an institutional setting? Will they feel their freedoms and enjoyment of life will be lost?
Indeed, studies show that more than 95 per cent of seniors in Canada would prefer to live out their years at home and not go into long-term care (LTC). But that poses a real problem for those without the financial means or good health to manage without helpers. At-home care is expensive and hard to access — and in the coming years, that will escalate. For some, these services are sought for decades before LTC is the only remaining option.
As seniors get older, who can they count on to be their advocates? Family, of course, but many spouses and children of aging adults with complex needs can easily feel they’re in over their heads. So, families need physicians to act as their beacon in this confusing and ominous journey.
Unfortunately, our health-care system isn’t well set up to deal with the current and future needs of our growing senior population, says Dr. Jennifer Ingram, a specialist in geriatric medicine and founder of Peterborough’s Kawartha Centre — where aging adults facing memory loss, dementia or other age-related challenges find assessment, treatment, research and advocacy for patients, families and caregivers. As Ingram explains, “We have a very challenging health-care system, one that is not supportive of seniors getting access to the kinds of home care and primary care they need.”
Our system is better equipped to help those with acute care needs (like a broken arm or a planned surgery) than those with a long list of underlying conditions. Think about times when a doctor told you to bring forward only one issue. Or physiotherapy that is structured to stop after a few visits — long-term physiotherapy is left up to you. Chronic home care offers a shower or bath twice a week as a starting point for those in the community; more if you have gone to a hospital emergency. That is funding focused on what government wants to provide, not on what the person needs, says Ingram. That’s why “person-centred care” is needed.
For seniors to get the care and services they need, “it’s critical to have the support and advice of a primary care physician and professionals who understand the complete scope of the patient’s needs and challenges, holistically,” advises Ingram. Physicians work with seniors and family members to access what’s available to make it possible to live at home successfully for a longer period of time and can advise the best options for assisted living and long-term care when living at home is not an option.
Ingram cites a couple of good assisted living examples in the region: “555 Bonaccord in Peterborough is an assisted living building for people of all ages, where the Victorian Order of Nurses provide support services called ‘Cluster Care,’ popping in and out of people’s apartments and nearby homes as needed, with PSWs on call all night,” explains Ingram. “Other examples of affordable co-housing initiatives in the region include Abbeyfield in Lakefield and Oasis supported apartments in Kingston.”
Indeed, community services are lacking and physicians who are acutely aware of the needs of their patients are essential. They are your advocate to access what is available, according to Ingram. They also work with government and community to create a more user-friendly system.
Physicians need families to be vocal advocates as well. As Ingram suggests, it’s important for family to “be prepared and get educated. Learn how to access care through Home and Community Care Support Services and understand eligibility and rights to get the most from the system.”
Finally, everyone can and should advocate for their own future care. “Consider how you’d like to manage if you could no longer live alone,” explains Ingram. “Do this early, and discuss it with your family. Make plans and investigate options so you are ready. In the event of a serious health problem, be sure you have pre-discussed your goals for care and your wishes.”