Better care for our aging population is a collective responsibility

As baby boomers age, Canada is undergoing a profound demographic shift that will have significant ripple effects across an already overwhelmed healthcare system.

Nearly one quarter of Canadians will be over the age of 65 by 2043. Those aged 85 and older are among one of the country’s fastest-growing age groups. In Ontario alone, the province’s population over the age of 80 is increasing by nearly four times the rate of the rest of the population. By 2040, the number of Ontarians over 80 will be nearly double what it is today.

Our society has made significant investments and changes to support the baby boomer generation throughout their lives. As one example, when they were young, the school system was expanded to meet their needs. Now we have a generational challenge to increase the services and supports while they age.

Below is a snapshot of our current state:

A recent survey by Abacus Data of seniors aged 68 to 76 years of age (the first of the boomers soon to turn 80) found that maintaining autonomy and control was what mattered most to them as they aged. The vast majority said they want to age at home, yet only 12% said they had given serious thought to where they might live or what type of care they may need if they developed complex care needs. When presented with the potential costs of round-the-clock care if needed, only 13% said they could afford it. And just one in five said they planned on asking family or friends for help.

In Ontario, 730,000 seniors receive homecare services every year that help them to continue to age safely at home. Their care complexity and needs, however, have increased substantially over the last five years, and supports – to both seniors and the providers caring for them – have not grown in kind.

While the majority of Canadians can age at home to the end of life with an appropriate level of home care and community care services, approximately 20% of people over 80 years of age have complex needs that require the high level of care and support provided by long-term care. These individuals are living with conditions such as advanced dementia or significant mobility and care needs. In Ontario, only 5.7% of today’s long-term care residents could be cared for elsewhere with the current level of other health care supports.

Ontario’s long-term care home wait list is currently more than 43,000 people for approximately 76,000 spaces. This lack of capacity creates pressures across the system: in Ontario hospitals, for example, approximately 40% of all hospital alternate-level-of-care patients are waiting for long-term care.

The Ontario government has made significant investments to increase long-term care capacity, expand home care, enhance primary care and increase the health-care workforce, but there are concerns that these investments will still not be enough to meet the burgeoning need for services.

More seniors than ever currently rely on Ontario’s four million caregivers – family, friends or neighbours who provide vital support. Those caregivers are feeling overwhelmed. A recent survey of Ontario caregivers by the Ontario Caregiver Organization found that 43% reported feeling depressed. More than half (52%) said they need a break from caregiving and nearly three-quarters (73%) said they are concerned they are not going to be able to handle all their caregiving duties in the future.

With additional homecare services, community supports and primary care, as well as supports for mental health and addictions, rehabilitation and caregivers, we believe more older adults could be supported to live safely and with dignity in their homes. A comprehensive, coordinated system of supports would not only benefit seniors at home: it would help to delay or reduce admission to long-term care and ensure that long-term care capacity is available for those with the highest needs.

In a first for Ontario, our eight organizations have joined forces to raise awareness and offer practical, cost-effective and scalable solutions to address the growth of the rapidly aging population.

Together, we have created an 11-point action plan, How to Support our Frail Elderly, that highlights successful measures already in place that could be scaled provincially to help ensure a safer and more sustainable future for seniors and those requiring the highest levels of care.

Our collective recommendations cover four main areas:

expanding services that support, encourage and help Ontarians to age at home;
prioritizing the highest-need individuals to ensure they have timely access to long-term care and can avoid unnecessary hospital admissions;
bridging services and supports to actively plan for people to return home safely after they are discharged from the hospital; and
expanding supportive and affordable housing that promotes a home first approach to care.

Together, the steps outlined in this plan can help to reduce Ontario’s long-term care home wait list and support and enable more people with increasingly complex care needs to age at home where they want to be. In turn, this will fast-track access to long-term care for those who need it most urgently.

Better supporting seniors requires collective responsibility across our entire healthcare system and throughout our communities. Our goal is to continue to work collaboratively with the government and our many partners across the healthcare system to identify opportunities, improve the lives of our aging population and ensure a better future for all. Our growing frail elderly population is depending on us.

About the Author(s)

Amy Coupal, CEO, Ontario Caregiver Organization
Anthony Dale, CEO, Ontario Hospital Association
Donna Duncan, CEO, Ontario Long Term Care Association
Lisa Levin, CEO, Advantage Ontario
Camille Quenneville, CEO, Canadian Mental Health Association (Ontario Division)
Deborah Simon, CEO, Ontario Community Support Association
Deepy Sur, CEO, Ontario College of Family Physicians
Sue VanderBent, CEO, Home Care Ontario