Senior Care, The Red Flags are Present

The demand for senior care, in-home and assisted living facilities, is projected to rise 55% within 10 years[1] (2031) nearly doubling the cost as Boomers are reaching 75 years old. Echo-boomers, or millennials as some would designate, are not only struggling to afford their own houses, but many are also ill-prepared to care for their aging parents. The projected cost of providing care over this 10-year span exceeds $490 billion with home care accounting for the largest portion, about 75%. This year’s government debt burden is 51% according to C.D. Howe Institute. After fighting a pandemic for the past year, who can afford this cost? More importantly, where are we to find additional resources in an overworked, highly regulated health care system?

Policy decisions making better use of home care and transitioning patients from hospitals to long-term care to home, can significantly lower the cost. However, as we have all witnessed during the COVID-19 pandemic, we simply do not have the capacity to meet the demand. More help is needed.

As has been shown[2] (pre-COVID-19), hospital care in Canada costs $69 billion annually, with the average cost of a standard hospital stay over $1,000/day compared with long-term care facility at $150/day and home care of $21/day. One obvious cost reduction initiative would be to move towards a better home care environment.

More than just cost factors, seniors want to remain at home, patients want to go home, caregivers (especially family) prefer home care. Solutions clearly lie outside of hospital walls.

COVID-19

Nothing short of a disaster, seniors bore the brunt of deaths due to COVID-19 in LTC facilities.  Politics overshadowed science. Family & family caregivers were banned; part time, untrained and roaming caregivers replaced them. COVID-19 spread rapidly from facility to facility and caused[3] pain, suffering and anguish to all, resulting in almost 80% of all COVID-19 related deaths.

“LTC staffing shortages were exacerbated in parts of Canada as a result of staff illness due to COVID-19 and higher absenteeism rates”, the report stated. Removing family caregivers from caring for family was probably the most detrimental purely political decision, resulting in secondary mental health problems, including depression, for both seniors and their families.

As of July 2021, the pandemic remains with variants and the unvaxxed leading the charge. It is proven that vaccines, masks, good hygiene saves lives so why do we continue to allow politics to override science? When did breathing and good mental health become less important than a major sports match? Or in-person shopping? Or travelling? As one twitter feed stated, are we becoming a society where the educated are subservient to imbeciles?

Happily, with almost 60% of Canadians currently fully vaccinated, 71% have received at least 1 dose, injections were prioritized with our most vulnerable- seniors and front-line workers. We have learned much from this effort, most importantly, vaccination works. I am so proud of this important advancement and the seriousness with which my fellow Canadians are pursuing the testing and vaccination policies.

The result: deaths due to COVID-19 are way down, as are hospitalizations and infections. The economy is starting its recovery and hopefully, we will continue to mask where appropriate and continue vaccination until everyone is fully protected.

Long-Term Care is progressing

I recently visited a Canadian province which funds nursing care and various services leading up to it, opening my eyes to the better side of human nature. The concept being, if you can afford to pay, you pay. If you can not afford to pay, the government will pay. However, regardless of who pays, you always receive the care you need.

As a senior, you are offered a progressive path. You may begin by rent a condo or apartment in a facility with a pool, restaurants, bowling alley, movie theatre, beauty salon and bingo. In short, all the amenities of life. As you progress in age with decreasing cognitive ability, mobility and health, you choose to move to another building nearby, where an increased level of care is available. You can choose which services are needed or attractive. As example, medication assistance services can provide your daily medications to your room. Food may be ordered from the kitchen or eaten in a common dining area. Organized group outings, trips and in-house entertainment is available. Even staff physicians are available 24×7, on call.

Progressing to the next level of care might include bed lifts, more dedicated and round the clock monitoring, mobility assistance and dementia assistance. Finally, the last stages include full nursing and palliative care. In that facility, kindness is even extended to visiting family. Family may stay for brief periods in their own room, provided at very low cost, for a meaningful and caring time with a departing loved one.

Each facility while providing more services, affords a continuity to the senior, a stay-at-home feel. Staffed by younger and more tech-savvy resources, they are always on the lookout for digital health and technology products to maximize utility and extend shared human resources even further.

The sense of pride you feel in touring such a complex is welcome relief and heartfelt joy in knowing progress has been made. You walk away knowing that at least the process is in place, we know how to better care for our aging society. We simply need to elect parliamentarians who will act, rather than award yet another think tank, a study with resultant recommendations that go unimplemented.