The challenge of caring for Atlantic Canada’s aging population

Mike Browne remembers when he was told his mother was going to be moved out of town. She had to go where a higher-level long-term care bed was available. 

Her destination hadn’t been settled, but it would be a facility at least 45 minutes away. 

He was upset, and spoke to others with family facing forced relocation for care. High demand means there often aren’t beds where people are living, or no beds at all for some needing to transfer out of acute care. 

“Then to have to relocate them at a crucial time of their life, near the end of their life, was certainly heartbreaking to the patients and heartbreaking to the families,” Browne said.

His mother (who fell ill and ultimately wasn’t transferred) died a few years ago at age 92. By then, he and his friend John Burke had petitioned and demonstrated, calling for an increase in the number of long-term care beds in their town. 

The Newfoundland and Labrador government is building additional long-term care facilities through public-private partnerships. 

Shovels are expected to hit the ground this summer for a 60-bed care home in Grand Falls-Windsor, where Browne is now deputy mayor. Another 60-bed facility is going up in Gander, an hour away. There are new beds coming in Corner Brook and St. Anthony.

Browne says new facilities in central Newfoundland will reduce wait times and transfers temporarily, but they won’t be enough to meet swelling demand. 

“For our town, I mean we expect the government to address the serious situation we’re going to have in 10 years, with all the baby boomers needing Level 3 health care…,” he said. 

“So, although the 60 beds will help, I think it’s imperative that the government come up with some programs to deal with what will be a significant problem.”

very province has to grapple with the same pressures, on a limited budget.

Canada is not alone in facing a challenge of demographics and care. The percentage of people over the age of 65 has been on the rise throughout the G7 countries. 

While birth rates are down since the baby boom, people are living longer, and, while there are plenty of healthy seniors, in general, care demands increase with age.

At the time of the 2016 census, 6.8 per cent of Canadians 65 and over were living in nursing homes or seniors’ residences. The figure jumps to 30 per cent for those 85 years and over.  

Atlantic Canada has the added challenge of trying to keep younger, population-building immigrants from moving on to larger centres like Toronto and Montreal. By 2038 (based on a 25-year forecast from 2013), this region is expected to have the highest proportion of seniors in Canada — more than 30 per cent.

And, as the region struggles with chronic illness, it’s generally worse off than the national average when it comes to health indicators like the obesity rate — only adding to the long-term health challenge.

“We’re seeing the aging population requiring health care for complex issues. So, it’s not just that people are getting older and what might come with that, but they’re bringing with them already underlying health conditions, which I think has to be acknowledged,” said Debbie Forward, president of the Registered Nurses’ Union of Newfoundland and Labrador.

Forward said the system is struggling with care placements and the movement of people with long-term needs out of the acute-care setting. 

The result is over-capacity hospitals and long waitlists. 

In addition, a wave of people are reaching retirement age and leaving the workforce. Unions throughout Atlantic Canada say more staff are needed in care facilities. In a vicious cycle, staff shortages contribute to greater rates of injury and illness, compounding the shortcomings.

There has been a move in Atlantic Canada toward “home first” programming. But making it possible for seniors to stay in their own homes longer requires more supports for homes and communities.

There are a mountain of issues to work through, particularly in rural areas. But, it’s clear the status quo and brick and mortar projects aren’t enough. 

As of February 2019, more than 1,000 Nova Scotians were waiting for nursing home beds, while about 20 per cent of hospital beds were occupied by people awaiting outside placements.

Caregivers at home — the people who are expected to help make ideas like home first work — need more support. The Canadian Medical Association has called on the federal government to put another $21 billion into seniors health care over the next decade. 

While the system is being adapted, personal costs keep going up….(Readmore)

The challenge of caring for Atlantic Canada’s aging population