A GREY WAVE IS COMING
ELDERLY BABY BOOMERS WILL OVERWHELM THE HEALTH-CARE SYSTEM, EXPERTS WARN, IF WE DON'T ACT NOW
COVID-19 has alerted Canadians to the fact the population is aging rapidly, says Jennifer Mccue, president and CEO of Bethany Care Society. Experts warn Baby Boomers will overwhelm the health-care system if no action is taken.
POSTMEDIA IS TAKING AN IN-DEPTH LOOK AT THE SOCIAL, INSTITUTIONAL AND ECONOMIC ISSUES THE PANDEMIC HAS BROUGHT TO LIGHT — AND, MORE IMPORTANTLY, HOW WE CAN SOLVE THEM.
Last year was supposed to be a time of celebration for the Bethany Care Society. Staff had been planning the Alberta agency's 75th anniversary for two years.
But then COVID-19 hit and instead of celebrations, there was mourning.
“I cry at least once a week,” admits Jennifer Mccue, president and CEO of Bethany Care Society, a faithbased not-for-profit organization that cares for more than 2,100 elderly people throughout central and southern Alberta with lowcost housing, assisted living and more intense long-term nursing care.
“We love our residents, love them like family, and I'm incredibly proud of the work our teams have done,” Mccue says.
“But they have experienced loss, and we're caring for people who passed away — not just from COVID, of course — and they passed away, in some cases, after not having seen their family for a long time, so it's been a tragedy,” says Mccue, who lost her 92-year-old mother, Mary Macdonald, to dementia last April in a Prince Edward Island long-term care home at the height of the first-wave lockdown.
“My mom declined really quickly after visitation stopped,” notes Mccue. “We buried her with three people at the graveside in a snowstorm. It was horrendous. Absolutely horrendous.”
Extended family and friends were not allowed to join her and two of her three brothers at the graveside. Instead, mourners watched from their cars. No hugs. No in-person condolences.
At the beginning of the pandemic, Mccue instituted a hard lockdown of all eight Bethany care facilities, as did the entire country. Now, designated family members may visit after going through a COVID gauntlet of hand sanitization, temperature checks and screening questions, as well as being required to wear a new surgical mask and don a face shield.
From March to September 2020, only one Bethany resident who tested positive for the virus died. Then the November-to-december COVID-19 spike in Alberta struck and 45 other residents and one muchloved staff member, Joe (Jing) Corral, died.
“It's been a year of grief and loss . ... Ultimately, what's happened as a result of COVID is Canadians have been alerted to the fact that our population is aging rapidly and we need to start to better prepare for the coming wave of baby boomers heading into old age.” Other experts concur. When Bonnie-jeanne Macdonald started to work on the 2019 report The Future Cost of Long-term Care in Canada, she and her co-authors agreed: “We didn't want the report to be alarmist in any way. We didn't want it to
say that, `Canada is facing a grey tsunami.' ”
However, by the time the statistics were all compiled and Macdonald, Michael Wolfson and John P. Hirdes started writing this seminal report, they recognized that pretty much sums it up.
“I remember Michael said, `Things are much worse than I thought, this wave is coming and Canada's not ready.' That's how alarming the numbers are,” says Macdonald, who has a PHD in actuarial sciences and is the director of financial security research at Ryerson University's National Institute on Ageing.
“Everyone is so focused on the here and now, and they should be because of the COVID crisis in our longterm care homes, which has been a disaster and a tragedy. But there's a bigger picture here that's largely being ignored,” says Macdonald from her home in Halifax.
“No one talks about what's going to be happening over the next 10, 20 and 30 years, but the numbers are really frightening. Canadians need to understand what's heading our way, because if we don't prepare, the coming wave of elderly Canadians will completely overwhelm us.”
According to that report, over the next 30 years, the number of Canadians over the age of 85 is expected to more than triple as baby boomers — those born between
1946 and 1964 — move into their 70s, 80s and 90s. More specifically, according to Statistics Canada, between 2019 and 2049, the number of Canadians 85 and older is projected to balloon from 844,000 to 2.63 million.
Coupled with the fact that boomers had fewer children than their parents and the workforce is more mobile — meaning family members can't always live nearby to provide unpaid care — statistics show that Canada is sailing toward a perfect storm that could swamp our health-care system and drain government coffers. We must outrace the coming wave of this triple threat with new strategies, policies and attitudes.
Experts hope the calamity the pandemic has wrought on our long-term care (LTC) residents will act as a much-needed catalyst for change when it comes to how we care for our frail older citizens.
Most people know that COVID-19 has primarily killed the elderly. According to Health Canada figures, 96 per cent of the 21,234 Canadians who have died from the pandemic (as of Feb. 19) are 60 and older. The National Institute on Ageing's Long Term Care COVID Tracker shows most of those deaths — 69 per cent — took place in LTC homes or other congregate living homes for the elderly.
Dr. Samir Sinha — the director of geriatrics at Sinai Health System and an associate professor of medicine at the University of Toronto and Johns Hopkins University School of Medicine — says if “the catastrophe” that has occurred in Canada's LTC homes doesn't provide the jolt required for needed change, nothing will.
“Do you know what the fastest growing demographic group in Canada is right now?” he asks. “People over the age of 100.
“Right now across Canada we have 430,000 Canadians who have unmet home care needs and we have 40,000 Canadians who are on longterm care wait lists,” says Sinha, who is also the director of health policy research at the National Institute on Ageing (NIA.)
“This really speaks to the fact that Canada spends 30 per cent less than the average OECD country on the provision of long-term care,” he said, referring to the Organization for Economic Co-operation and Development's 37 member nations.
“I don't think many people paid much attention to this sector until we had the massacre that unfolded across Canada,” says Sinha. “Canada actually holds the international record for having the highest proportion of deaths occurring in long-term care homes. We're about double the OECD average.”
The provinces' attempts to save money on long-term care costs don't actually save taxpayers' resources — on the contrary, it's costing much more. When sick elderly people can no longer be cared for at home and there are no rooms available in a nursing home, they wind up in hospital, which is much more expensive.
According to Sinha, about 15 per cent of hospitalized Canadians at any given time are elderly people designated as “alternate level of care” patients, or patients who should be in a nursing home or even in their own home with more supports.
According to NIA studies, an acute-care hospital bed costs about $730 per day, while a LTC bed costs about $182 per day and home care costs $103 per day. Home care is 609-per-cent less expensive than hospital care and 76-per-cent less costly than LTC, yet Ontario is the only province in Canada that spends more of its LTC budget on keeping people in their own homes rather than in nursing homes.
Sinha says Canada ended up in this dire situation quite organically.
“When we created our universal health-care system that's so beloved in Canada in 1966, the only things we put on the list were physician services and hospital services. Back in 1966, the average age of a Canadian was about 27 years of age, so society wasn't thinking too much about old age.”
As well, families were much larger and there were more hands to help care for an elderly relative.
Ito Peng, a professor of sociology and the Canada Research Chair in Global Social Policy at the University of Toronto, says baby boomers will not stand for being housed in a shared room with a shared bathroom — a scenario that exacerbated the spread of the virus in LTC homes, especially in Quebec.
“The current baby boomer generation, which is wealthier than their parents' generation in general, will have very different expectations of what their old age will look like and we're already seeing some of that,” says Peng.
Macdonald believes Canada missed the boat in establishing a publicly funded long-term care insurance program, like what is available in Japan, which has the oldest population in the world.
But Peng notes Canada's age demographic today is similar to Japan's in 1997, when the LTC insurance program law was passed there.
“People over the age of 40 had to start paying into the program in 2000, when the proportion of the population over the age of 65 in Japan was about 15 per cent, which is the same as what we have now,” says Peng. “It's not too late for Canada to do the same thing.”