This Is Getting Old
Aging population and care shortfall means trouble’s brewing in Boomerville
by Gregory Beatty
But when loathsome old age pressed full upon him, and he could not move nor lift his limbs, this seemed to her in her heart the best counsel: she laid him in a room and put to the shining doors. There he babbles endlessly, and no more has strength at all, such as once he had in his supple limbs.
That’s how Homer described the plight of Tithonus in Hymn to Aphrodite. Kidnapped, according to Greek myth, from the royal house of Troy by Eos, goddess of the dawn, Tithonus became her lover. Wishing him to be with her forever, Eos asked Zeus to grant him immortality. This Zeus did, but because she neglected to ask for eternal youth, Tithonus grew progressively frail and aged, and ultimately longed for death.
I spent the last four years providing supplementary care to my aunt at a Regina nursing home before she passed away in November, so Homer’s words resonate strongly with me. Unlike Zeus, we, as a society, can’t grant immortality. But through sophisticated medical technologies and drug regimens we’ve had remarkable success extending the human lifespan.
But no matter how fit and active seniors aspire to be, old age eventually catches up with everyone, reducing our physical and mental abilities and making us incapable of caring for ourselves.
Early this year the Alzheimer Society of Canada released The Rising Tide: The Impact of Dementia on Canadian Society. Currently, 500,000 Canadians live with dementia. After age 65, the risk of developing the disease doubles every five years.
With the first of Canada’s 10 million strong baby boomers set to turn 65, the study warned, by 2038 there will be 1.1 million Canadians stricken.
“If we do nothing, dementia will have a crippling effect on Canadian families, our health-care system and economy,” said society president Richard Nakoneczny.
Last May, the Saskatchewan government appointed Sask Party MLA Laura Ross legislative secretary, Long-Term Care Initiative. After a meeting in Edmonton in early September with federal, provincial and territorial counterparts, Ross conducted consultations in 13 communities.
“She was appointed to examine five specific issues that would inform the development of the Seniors Care Strategy,” says spokesperson Dawn Skalicky-Souliere. “Those include the abuse of older persons, home-care support, accessibility of personal care homes, fall prevention and the feasibility of establishing a seniors’ secretariat.
“One of the goals was to capture the voice of seniors,” says Skalicky-Souliere. “In addition there were health care professionals, family members of seniors, plus some representation from unions in the province.”
Ross doubtlessly heard some harrowing stories. A while back I spoke with a man living in north-central Saskatchewan. He’d just had a hip relacement and at the time of our interview was on crutches for another month. His mom had just passed away, and his 91-year-old father was living alone on his farm.
“Dad has a hard time dressing himself,” said the man, who did not want his name used. “He still can make some meals. But when you’re out on the farm by yourself, he could slip and fall, break a hip. There’s no cell coverage where he lives, and he’s deaf, so you can’t really talk to him on the phone anyway.”
His dad is on waiting lists for private care homes in the area, he says. As for the publicly subsidized facility in town: “We had him assessed, and they said he was too sound in mind. How bad do you have to be before you can go into a home? You have to have no marbles left?”
For now, two other brothers are taking turns checking on their dad. “Before anything changes, I guess he’ll have to have one foot in the grave,” says the son.
Spring is when Ross is expected to present recommendations to the Minister of Health, says Skalicky-Souliere. “The findings from her review, along with the Patient First review [conducted by Tony Dagnone, who filed his report in October], will then be used to inform the development of the Seniors Care Strategy.”
October was also the month CUPE released its national report, Residential Long-Term Care in Canada: Our Vision for Better Seniors’ Care. Currently embroiled in contract negotiations along with two other unions at the provincial level on behalf of 25,000 health care providers, CUPE brings a valuable front-line perspective to the growing challenge of providing quality care for our aging population.
Of 9,000 health care workers currently employed by Regina Qu’Appelle Health Region, says CUPE’s Sinta Cathcart, “50 per cent of the services they provide are in long-term care. So it’s a big issue.”
Cathcart herself worked in long-term care from 1981-2005. Oddly, she says, CUPE wasn’t invited to Ross’s consultations. “We found out through the media and by visiting the government website.”
One hunded pages long, CUPE’s report offers a comprehensive overview of what is undoubtedly a demographic timebomb. Between 2005-2031, says the report, Canadian seniors will increase from 13 to 23 per cent of the population.
In 1992, deep in debt thanks to the Devine Tories, the newly elected Romanow NDP government stopped funding Level One and Two care homes for seniors with less severe health needs than those in Level Three and Four homes. That opened the door for privately owned care homes. Initially, they were limited to 10 beds. In 1996, the limit was bumped to 40. And in 2002, the cap was eliminated altogether.
In the U.S., private care for seniors is big business. In Saskatchewan, the number of licensed private care homes rose from 243 to 263 between 1996-2009. The number of beds increased from 1,629 to 3,264. And the number of homes with more than 10 beds jumped from 32 to 85.
If, after assessment by the System Wide Admission and Discharge Department, a senior is deemed in need of Level 3/4 care, they enter a publicly subsidized facility where the monthly fee for rent and meals (but not other things like medications, incontinence products, foot and hair care) are means-tested. Adjusted annually, the fee ranges from $955 to $1,815 a month. The average private care home in Saskatchewan, conversely, charges $2,686 a month (or $32,232 annually). Again, things like medications and incontinence products are extra.
In its report, CUPE argues that federal and provincial governments need to incorporate long-term residential care into medicare with improved government funding and legislated standards.
“With private care providers,” says Cathcart, “it’s proven there’s less staffing, less quality care and higher costs for individuals, which translates into there not being equal access.”
Having spent the time I did with my aunt, and having recently interviewed a woman who worked for four years at a private home, it’s impossible not to agree with that assessment [see sidebar]. Yet in November, after committing $152.8 million to rebuild 13 outdated long-term facilities in its March budget, the Saskatchewan government postponed the initiative to cut costs.
“Business opportunities abound in our society,” says CUPE’s Tom Graham. “Trying to make money off disadvantaged people, off elderly people, is just the wrong way to go. In the private sector, it’s about profit for the operator, while in the public sector it’s about care of our elderly. It’s as simple as that.”