Written by Jessica Rochman Fowler:

The tech industry is no stranger to age bias in employment practices. Several articles have been written over the past few years about ageist assumptions that permeate the tech world, including that older people can’t keep up with improving technology, or that older employees should “let the younger people do it,” with “it” referring to any number of tasks. The fact is, employing older people is often labeled (incorrectly) as a bad return on investment, an investment employers will find subtle ways to avoid.

Recently, an article was written titled “Cutting Old Heads at IBM,” which detailed the recent firing of thousands of IBM workers that targeted predominately senior employees and contradicted rules against age bias in the process.

According to the article, “ProPublica estimates that in the past five years alone, IBM has eliminated more than 20,000 American employees ages 40 and over, about 60 percent of its estimated total U.S. job cuts during those years.”

Finding a tech job doesn’t hold much more promise – simply put, says the Newstack, “for Baby Boomers, the chances of being hired are 60 percent less than their workforce representation.” And age bias doesn’t just mean being fired or not being hired, it can mean being passed over for promotions, being assigned work well below your pay grade, or being pushed out of your job in some other way as a result of your age.

Yet, an op-ed in WIRED magazine noted that those most affected by ageism in the workplace often don’t want to bring it up for fear of being labeled “old.” Which brings me to a broader question – when will our society address our collective fear of being “old” and acknowledge that this fear can result in unpunished acts of discrimination?

The Vanier Institute reports that 13.4% of seniors participated in the paid labour market in 2015, up from 9.2% in 1976. As people live and work longer, ageism is an issue that begs to be addressed. It’s time we start valuing the variety of skills displayed across generations and enable older people to continue participating in the workforce for as long as they’re able. This includes recognizing that ageism isn’t just a problem in the tech world, but one that resonates in many employment settings.

Referenced:

https://hiring.monster.ca/hr/hr-best-practices/recruiting-hiring-advice/strategic-workforce-planning/ageism-workplace-canada.aspx

Originally posted @allaboutestates.ca

The events over the last few weeks highlight how fragile life is. Anyone of us could have been walking on that sidewalk on that fateful day; we just never know what life has in store for us. This blog isn’t about being prepared, which is a concept I endorse but as I was never a girl guide, I may not be as well prepared as some. Rather today’s blog is about dealing with ‘a series of unfortunate events’ (thank you Lemony Snicket) and the need to recognize that we are all impacted, one way or another; some very directly and others not as much. Good mental health is our goal and getting assistance to deal with trauma and negative stress is important.

Employee Assistance Providers (EAP) are often the go-to resource for those companies that subscribe and while I do not have the statistics readily available, I hope that more and more companies see the value. Dealing with loss, witnessing a tragedy, being involved in an accident, are events that we cannot plan for and we may not know how we will react until, if and when, that situation presents itself. Working with a social worker or counsellor can be very beneficial whether dealing with post traumatic stress or loss. If you don’t have access to EAP resources, check out your extended health benefit provider as the services of a registered social worker are frequently covered, as well as possibly massage, physio or psychological counselling. Elder Care services are also more common today and can provide direction and support to employed carers before they burn out.

Failing access to either of these employer programs, the Canadian Mental Health Association offers a wide range of support programs. So, as per Bell Canada’s slogan, ‘Let’s Talk’.

* http://checkupfromtheneckup.ca/

Originally publised @allaboutestates.ca

I was intrigued by the following headline “How a stationary bike, paired with Google Street View, helps seniors with dementia” so decided that this would be the start of this morning’s blog. One of my preferred themes is dementia and the impact it has on everyone. No surprise as “dementia is the greatest global challenge for health and social care in the 21st century: around 50 million people worldwide have dementia and this number is predicted to triple by 2050. ” I have written about the need for services and about both Canada’s Dementia Strategy and the Ontario Senior’s Strategy. It continues to impact almost all of my clients so when new discoveries are made or new technology used to improve the lives of these individuals, I am interested. While there is no cure, the Lancet Commission on dementia, identified potentially modifiable health and lifestyle factors, that they indicate, if eliminated, might prevent dementia. This evidence suggests that if we change our lifestyle, we may be able to delay the onset of symptoms or maybe even prevent them. The Alzheimer’s Society provides the following health habits worthy of consideration:

1. Break a sweat- studies have found an association between physical activity and reduced risk of cognitive decline
2. Hit the books- formal education, at any stage of life, will help reduce the risk
3. Butt out- stop smoking. Evidence shows smoking increases risk of cognitive decline
4. Follow your heart- Risk factors for cardiovascular disease and stroke (obesity, high blood pressure and diabetes) negatively impacts cognitive health
5. Heads up!- Reduce risk of brain injury- “Wear A Helmet” Chicken Little was right.
6. Fuel up right- Eat a healthy and balanced diet. The DASH diet may help.
7. Catch some Zzz’z- Not getting enough sleep (insomnia or sleep apnea) may result in problems with memory and thinking
8. Take care of your mental health- studies have linked depression with an increased risk of cognitive decline
9. Buddy up- Stay social and engaged
10. Stump yourself- challenge your mind
All excellent advice for maintain good health, mentally, physically and cognitively.
Now back to the article of interest which describes how Carriage House Retirement Residence is using ‘The BikeAround’ which originated in Stockholm. Seniors ride a stationary bike and through the miracle of technology and Google Maps, can visit their favorite places, which bring back memories and provides both mental and physical stimulation. The BikeAround originates from Sweden and will hopefully be available more widely in Canada soon.

Originally posted @allaboutestates.ca

Case Example 1:   John was a 93 year old, well -to -do gentleman, never married  and had no known family.   He lived in his own home in a nice part of the city.  His next door neighbor had kept an eye out and assisted him over the years by shoveling his walkway and offering to get groceries for him on an occasional basis.  John had a ‘Friend’ who he met while playing Bingo. The ‘Friend’ spent more and more time at the house and soon appeared to be living at the house with John.  A short time thereafter, his neighbour noticed that  there were contractors at John’s house.  He went over to talk with John and the ‘Friend’ answered  the door and said that John was sleeping. The neighbour noticed a new roof, new windows and a fancy new car in driveway.  The bank noticed large withdrawals from his checking account and his  financial advisor started to receive emails signed by John (although John never sent an email previously) asking that  large sums of money be transferred out of his account .

Q: What could his neighbour have done? What could his bank have done?   If there was a signed Power Of Attorney for  both Property and Personal Care held at the bank could this have been avoided?

Case Example 2:  Frank was a 85 year old widower, estranged from his two sons.  He lived on a large property in the country. He always kept to himself and was largely independent.  After his wife died, he did engage a trust company to act as his Attorney for Property.  No one was named as Attorney for Personal Care.   After some troubling calls from Frank to his bank,   the trust officer called a community care manager to assess how he was doing and ensure his health and care needs were being well met.   Frank’s care needs continued to increase to a point at which 24 hour care was required.  His behaviours escalated and he started to have violent outbursts.  His caregivers began to fear for their safety.  After a subsequent fall, he was admitted to hospital and was found not be capable of making his own treatment decisions. At the point that he was ready to be discharged, the hospital did not feel he was safe to return home. He was subsequently referred to the OPGT and subsequently sent to live in a Long Term Care facility.  The bank was not in a position to make health care decisions on his behalf.

In this scenario, the financial institution had its hands tied as there was no Attorney for Personal Care to make health care decisions on Frank’s behalf.  While Frank may have had the necessary funds to live in a setting other than LTC or may have preferred to remain at home or live in a dementia specific retirement residence, this did not occur.  If there was a signed Power Of Attorney for Personal Care, could this have been avoided?

Note: both of these situations are fictitious.

There have been two recent papers  discussing prevention of financial abuse amongst seniors including the Ontario Securities Commission “Seniors Strategy”   and the “Report on Vulnerable Investors: Elder Abuse, Financial Exploitation, Undue Influence and Diminished Mental Capacity”   by the Canadian Foundation for the Advancement of Investor Rights (“FAIR Canada”).

They both make excellent and similar recommendations regarding steps to develop best practices to safeguard vulnerable seniors from financial abuse.   However, neither organization recommends that an Attorney for Personal Care be designated at the same time an Attorney for Property is named.

Just asking…..

Originally published @ allaboutestates.ca

This weekend we celebrated the first nights of Passover and Good Friday and Easter Sunday. Two major holidays that coincided, along with a statutory holiday enjoyed.

For me and perhaps for many of you, these holy days have a traditional familial connection rather than a religious one. The foods eaten, or perhaps the foods not eaten, while symbolic of a religious theme, also provide a cultural comfort and familial custom. It is this connection and the lifelong memories associated with these annual holiday celebrations, which I believe remain with us. For me, it is the family gathering, the specialty foods and singing of songs that stay. I think for many with memory decline, this holds true as well. For those who lost a loved one, an empty seat at the holiday table can be particularly difficult. For the many families that are in conflict with one another and may not be talking, this too can prove challenging.

Every year I take comfort in making my late grandmother’s friend turkey recipe, which is one of my family’s favorite meals. This is a recipe handed down to my mother and then to me, which one day I hope my sons will be making. However you celebrated and whatever foods you enjoyed, I hope you too had a special holiday long weekend.

Blog # 1: Setting the Stage

THE WHAT:

Recently on most days newspaper articles are highlighting some injustice or abuse regarding seniors living in Ontario’s Long Term Care facilities, commonly known as ‘nursing homes’ or ‘old people’s home’. This is a major problem facing society and one that we must get under control. Last week’s Marketplace Crying Out for Careexposé highlighted abuse amongst residents in many facilities within Ontario. Frankly, it likely caused nightmares for many families as they worry about their family members who reside in some of these facilities.
The yearlong investigation found that in Ontario, “the reported rates of abuse have doubled in 6 years and every day, 9 residents are harmed by another resident and 6 are harmed by staff who are supposed to care for them. The investigation revealed that staff-to-resident abuse increased 148 % from 2011 to 2016.”
I thought I would spend the next few blogs discussing this important issue. This first blog will help set the stage.
I have found that almost all of the seniors I have met would like to remain living in their own homes. I am no different and am sure you feel the same way. The 2011 census data supports this as over 90% of seniors aged 65 plus live in their own private households[1].

In helping families to decide whether ‘to stay or to go’ which means either remain living at home with available care and modifications that might be needed or to explore alternate accommodation, I review the the 3 C’s which include: Care, Cost and Choice. Included in the discussion is explaining the difference between Long Term Care, which is publicly funded by the Ministry of Health and retirement living, which is privately paid.

THE WHY:
However, many seniors don’t have a choice as they cannot afford to either stay at home as their care needs exceed what is possible at home or cannot afford to pay for a private retirement setting. As such, the demand for publicly funded facilities that provide 24/7 nursing care continues to increase. Stats Can tells us that from our current demographics that older seniors, those 85+ are the 2nd fastest growing demographic with centenarians (those aged 100 and older) leading the way as the fastest growing age group[2]. The demand on our health care and home care sectors is ballooning and cannot keep up with the current demand for care.
As well, we know now that there are more seniors over age 65 than children under 15, resulting in less workers contributing tax dollars as well as fewer individuals, whether paid or by size of family, who are interested or able to assume a caretaking role.
The demand on employed carers (35% of working Canadians provide unpaid care to a family member or friend) is high, with the average employee spending 9 hours per week on caregiving. Families are juggling to keep up.
Income for many seniors prohibit them from hiring private care (averaging in the GTA at approximately $28 +) and without family to assist, they often do with the little that is available from the LHIN’s (Local Health Integration Network, formerly the Community Care Access Centres or CCAC). The services provided by the LHIN will be discussed in a subsequent blog.
The Conference Board of Canada in their report, Future Care for Canadian Seniors, A Status quo Forecast” shared: “The status quo forecast indicates that by 2026, over 2.4 million Canadians age 65+ will require paid and unpaid continuing care supports—up 71 per cent from 2011. By 2046, this number will reach nearly 3.3 million.” Older seniors (85+) tend to have greater care needs which greatly impact their ability to live on their own. Functionally they are limited, whether it be from a cognitive or physical impairment. Falls are the number 1 reason that senior have to leave their homes.
In sum, this introductory blog highlights our demographics and sets the stage of the who and the why of those individuals who require Long Term Care. Our Long Term Care options are in a crisis and unless there are some major changes, the future does not look bright.
Subsequent blogs in this series will address eligibility, costs, alternate level of care beds, challenges for younger differently abled adults and the LGBT community, those with dementia and behaviorial challenges and hopefully concluding with some suggestions for improving the system and some options. Stay tuned!
Blog # 2: Who is impacted

THE WHO:

The sad story of our Long Term Care crisis continues and this blog will focus on what’s available and the seniors who apply for them. As we know, Long Term Care homes provide Ontario residents with access to 24 hour nursing and personal care and are available to those 18 years or older whose care needs cannot be safely met in the community. As the Ministry website states: “you can expect much more nursing or personal care here than you would typically receive in a retirement home or supportive housing[1]”. In 2017 there were 627 long term care facilities operating 78,120 beds in Ontario[2]. From these, approximately 550 beds are convalescent care beds are allocated to provide short term care and 400 beds are allocated to provide respite care.

In terms of who lives there, in their report, Building Better Long-Term Care: Priorities to keep Ontario from failing seniors. the Ontario Long Term Care Association provides the following resident profile:

 Average age is 85 year old female
 9/10 residents exhibit some form of cognitive impairment with one in 3 being severely impaired.
 Over 40% exhibit aggressive behaviours stemming from their cognitive condition
 1 in 3 are completely dependent on staff and all others require frequent support with their activities of daily living
 2/3 of residents use a wheelchair
 Almost every resident exhibits multiple chronic conditions.

The bolded points above are, in my opinion, a major contributing factor to the worst of the problems- assaults between residents and between staff and residents. “In many cases, the lack of privacy afforded in older homes, particularly those with three- and four-bed wards, results in more seniors displaying responsive behaviours[3].”
These homes are funded, licensed and regulated by the Ministry of Health and Long Term Care under the Long Term Care Homes Act, 2007 and Ontario Regulation 709/10. This spells out residents’ rights, care and services available however most amazingly does not spell out a required staffing patient ratio.

Eligible applicants can apply for either a private room (private room and private bathroom) or a semi private room (2 beds per room with shared bathroom in an older building or a private bedroom with a shared bathroom in a newer building) or a ward or basic bed, which can be up to four beds in a room. The applicant can select up to 5 different facilities. Then the wait begins…. The average placement wait time as of June 2017 was 137 days, with a wait list of 32,046 people. Not every one is equal on the wait list. There is a priority wait list which is determined by the placement coordinator from the LHIN and is based on the Inter RAI assessment[4]. The waitlist priority breakdown[5] is determined in a number of different ways based on:

1) Crisis: People who need immediate admission or in crisis
2) Spouse/partner Reunification: People who need to be reunified with their spouses/partners, who are currently residing in LTCH.
3A) Religious, Ethnic or Linguistic Origin: People waiting for LTCH serving those of a religion, ethnic origin, or culture. People with high care needs but can be supported a home.
3B) Religious, Ethnic or Linguistic Origin: People waiting for LTCH serving those of a religion, ethnic origin, or culture. People with care needs currently managed at home with supports.
4A) People who have high care needs, but can still be supported at home until be become available.
4B) People with care needs who are currently managing at home with support
Once your name gets to the top of the list and a bed is offered, you have 24 hours to either accept or reject the offer. If it is your 5th choice and you are not interested and decline the bed, your name is taken off all of the lists and you must wait 3 months before reapplying, unless there is a significant change in your condition or circumstances. If you accept, you then have 5 days to move in.

Each resident must pay a monthly co payment; regardless of where one lives in the Province the rates are the same. As of July 1, 2017 they were:
Type of Accommodation Daily Co-Payment Monthly Rate
Basic Long Stay $59.82 $1,819.53
Semi-Private Long Stay* $68.02-$72.12 $2,193.65
Private Long Stay* $78.27-$85.45 $2,599.11
Short Stay (Respite) $38.72
*Varies depending a home’s structural class and date of move-in.
Source: Ministry of Health and Long-Term Care, Senior’s Care: Long-Term Care Homes.
Government subsidies or a rate reduction is available for those who can’t afford to pay the full amount, however it is only available for Basic room accommodation.
Lessons Learnt:
Apply early, ask questions of the placement person, research your options, visit and tour each facility, check the Ministry wait lists and the licensing and annual inspection reports of the selected residences.
Most importantly choose wisely so whichever facility has a vacancy and when a spot is offered, you are ready to make the move. My next blog will discuss some of the challenges I have experienced first hand with my clients.
[1] https://www.ontario.ca/page/find-long-term-care-home
[2] City of Toronto 2017 Long Term Care Homes & Services https://www1.toronto.ca/wps/portal/contentonly?vgnextoid=63fedefa5c528510VgnVCM10000071d60f89RCRD&vgnextchannel=8a87116288528510VgnVCM10000071d60f89RCRD
[3] https://s3-us-west-2.amazonaws.com/oltca/bsc2017/OLTCA_Budget_Submission_Request.pdf
[4] http://www.interrai.org/long-term-care-facilities.html
[5] https://www.oltca.com/OLTCA/Documents/SectorDashboards/TC.pdf

Blog # 3: My Experiences

This blog will address some of the first hand experiences that my clients and I have had when interfacing with the Long Term Care sector.
1. Younger adults. I worked with a 42 year old gentleman who lived with a degenerative motor disease. He could no longer live on his own and spent several years under Alternate Level of Care (ALC) status in a hospital. This is not a new issue and the Toronto Star wrote an article highlighting some of the challenges.
At that time, there were only 2 LTC’s that identified themselves on the placement selection list as catering to younger adults. I am aware of only one setting that actually had its own distinct unit for younger people rather than integrating them with the general population. It goes without saying that one’s interest in their 30’s is quite different than those of someone in their 80’s. Individuals who are developmentally delayed also face tremendous challenges.
2. Residents with behavioral difficulties. As highlighted in last week’s blog, over 40% of residents exhibit aggressive behaviours stemming from their cognitive condition. There is not enough staff and/or they are not equipped/able to actively problem solve and explore the reason for the outbursts and intervene in a helpful way. Simply put, there is not the time to understand the A,B,C’ of someone’s behaviour (A= antecedent, B= behaviour itself and the C=consequence). There are a handful of settings that are specifically designated to accommodate those with significant behaviourial challenges but again, there simply are not enough spaces to accommodate. There were previous concerns regarding the high number of residents who were on anti-psychotic medications. Health Quality Ontario[1]reported in Ontario in 2017 that almost 23% of LTC residents are on this medication without a diagnosis of psychosis. This is an improvement from the 2015 data that documented 27% of residents were being given this medication.
3. Couples who want to continue to live together also face challenges as bed offerings are rarely two at a time. This was highlighted in a few different newspaper articles
4. LGBT community has also had to provide specialized training to staff however other residents may not all be so welcoming.
5. Securing a linguistic and culturally appropriate setting can also be very difficult. For many in the later stages of dementia, they revert back to their mother tongue. While we are an ethnically/linguistically diverse community, it seems that many of those working within these facilities do not share these language skills.
This blog has highlighted several challenges that families experience daily. I know there are others but these are my starting point. My next blog will highlight some of the steps the Ontario government is taking to hopefully address them.
[1] http://qualitycompass.hqontario.ca/portal/long-term-care/Antipsychotics?extra=pdf (October 2017)

Blog # 4: Looking Ahead

My last 3 blogs have highlighted some of the challenges we are currently facing in our Long Term Care sector. The bottom line is this: there are not enough residential placement beds to address the current and growing demand for those individuals whose care needs can no longer be met within their own home setting.
The answer is not simply an increase in beds but also providing the necessary care and support to residents who occupy these beds. This includes providing a standardized and reasonable ratio of staff to residents to ensure access for individualized 1:1 attention and care. Most critically, staff require additional hands as well as training to deal with residents who exhibit behavioral challenges related to dementia.
In November 2017, Dr. Hoskins, who is now stepping down as Health Minister, unveiled a New Action Plan called “Aging With Confidence”.
In terms of promises directed towards supporting seniors requiring intensive supports (Long Term Care), several areas for improvement were identified including:
 Modernizing Long Term Care (LTC) homes– including eliminating 4 bed wards
 Reducing the wait time for LTC – creating 5,000 new beds by 2022 and will create 30,000 more over next decade
 More staffing and support in LTC- increasing nursing hours, PSW hours and specialized behaviourial training and end of life care. A recommendation of an increase to 4 hours PSW care daily
 Promoting innovation
 Culturally appropriate LTC
 Strengthening safety in LTC
 Strengthening the office of the OPGT
 Improved end of life care- more hospice beds closer to home
All of these initiatives are needed now for a system in crisis; unfortunately the implementation of this appears to be slow and evidence of these improvement are not yet apparent. Have you seen anything that you think is an improvement?
We need to be able to think in broader terms, and consider changes such as dementia only care residences, settings that provide a village- like community, closer proximity of day care settings and the list continues. For most of us, LTC is considered to be at the end of the journey. I know that is not where I want to spend the last chapter of my life if things continue the way they are going. We need to continue to put pressure on the government to do what is right for all of us as we grow older. We deserve better.

Originally posted @allaboutestates.ca

Delirium is one of the 3 big ‘D’s that we see with our older clients. The other ‘D’’s are dementia and depression but I suppose the biggest ‘D’ out there is death.

I recently came across a Reader’s Digest article while waiting at a doctor’s office that had been reprinted from The Walrus. The original title is “Why Is No One Talking About Hospital-Acquired Delirium?’ The story describes a bright, on the ball 83 year old gentleman who was admitted to ER for a nose bleed. During the next few days at the hospital, he did not get much sleep and was disturbed by the noise, lights and activity and he was worried that the bleeding would return. He was sent home and 48 hours later, his wife called 911 as he was confused, restless and began hallucinating that he saw writing on the blank television screen. Back at ER, he was combative and swore at the staff. The doctors determined he had a magnesium deficiency and prescribed supplements. Upon returning for a follow up appointment they learnt that the confusion and mood swings were as a result of a hospital-acquired delirium.

I learnt that according to Dr. Gordon Boyd, neurologist at Queen’s University, that ‘hundreds of thousands of patients leave Canadian hospital with a newly acquired mental disorder caused in large part by inadequate care.’ A 2016 study reported that 15% of the 469 patients who were part of this study, developed delirium during their hospital stay. They reported that those patients had a ‘significantly increased’ risk of dying within ninety days of their admission- in part because of poor nutrition, disturbed sleep and the use of restraining devices.’

Delirium is often misdiagnosed as dementia ‘but delirium is an acute confused state, whereas dementia is a chronic condition characterized by memory loss.’ Also note that capacity may also be impaired if someone has delirium.

Dr. Boyd discussed that the system is working against itself. Seniors are admitted into hospital more than any other age group and usually stay longer and use more resources. This stay increases the likelihood that they will develop delirium, which means they are more likely to be readmitted. Furthermore once someone gets a diagnosis of delirium they remain more vulnerable.

I have often said that hospitals are not good places for sick people and besides the possibility of acquiring MRSA or C Difficile, delirium remains a real concern. On a positive note, some forward thinking hospitals are working to keep patients mobile, oriented, hydrated and rested thereby being able to reduce the chances of acquiring delirium by 40%.

Lesson Learnt: Remember Delirium as part of the 3 D’s and the ways to minimize its risk.

Originally posted @allaboutestates.ca

As Carol King so aptly wrote in 1971 “when you are down and troubled and need a helping hand…( sing along here as I am sure you know the lyrics)…you’ve got a friend, …ain’t it good to know you’ve got a friend”? Everybody needs a friend, regardless of age and seniors in particular often find themselves lonely and isolated. Being alone is different than being lonely. Loneliness is defined as “sadness because one has no friends or company[1]” We may all have felt lonely from time to time but for many, this becomes their constant state.

Statistics Canada reported[2] 1.4 million elderly Canadians report feeling lonely. Psychologist Ami Rokach states that loneliness has become a public health crisis and related health effects are at epidemic levels[3]. Dr. Rokach states that “loneliness itself doesn’t directly cause health problems …[but] that depression, desperation, feeling unappreciated and unwanted can cause seniors to neglect their health”.

Reports[4] indicate that approximately one in five people experience loneliness and this reference is not limited to just seniors. The United Kingdom recently appointed a Minister of Loneliness to address social isolation and several Canadian think that this might be needed here as well. The UK task is to develop policies to what has been described as “the sad reality of modern life”. There is a difference between an older person who outlives family and friends and finds themselves both alone and lonely as compared to young people who are technologically wired and interact with an avatar rather than with peers face to face. Both can be lonely. However there are some actions that we can take to address this disconnect. Are you thinking about grabbing something for lunch today and eating at your desk? Maybe invite someone to join you……

Thought for the day: We may not need a Best Friend Forever but we all do need a Friend.

[1] Oxford Dictionary

[2] https://www.canada.ca/en/national-seniors-council/programs/publications-reports/2014/social-isolation-seniors/page05.html

[3] http://www.cbc.ca/radio/thecurrent/the-current-for-september-20-2016-1.3770103/loneliness-in-canadian-seniors-an-epidemic-says-psychologist-1.3770208

[4] http://www.cbc.ca/news/canada/british-columbia/seniors-expert-applauds-u-k-move-to-appoint-ministry-of-loneliness-1.4494466

Originally posted @allaboutestates.ca

Last week I had the  pleasure of presenting to a group of caregivers from the Alzheimers Society Kingston Frontenac & Addington chapter.  One thing that everyone in the group had in common was that they were all loving someone who had a diagnosis of dementia.  Just to refresh terminology, “dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example. Alzheimer’s is the most common type of dementia.”[1] So for those in the group regardless of the type of dementia their family member was diagnosed with, they were there to gain practical and useful information.  I spoke to them about the importance of planning ahead, including communication with family members, the need to have key documents  prepared (POA’s, Advanced Directives) and the costs and options related to transitioning from home to retirement to Long Term Care.

My co presenter was Ron Beleno [2] who, along with his mother, had been a caregiver to his father  for over 10 years. Ron’s dad had dementia. Ron is proud to have creative nerdy qualities and skills to be innovative in hacking away at solutions around dementia and caregiving. Over the years, as the challenges increased, Ron was able to configure his dad’s home environment with technological aids so that he could observe and/or keep in touch with him from afar so that his dad was able to live out his last days at home.  Ron set up a computer monitor facing the front door of his parent’s apartment and through remote technology was able to keep a visual on his dad, when his mother was not home. He knew the signs and general timing of when his father would be most likely to wander out the door and would talk to him, redirecting him to another activity. Ron also used GPS alerts and was able to know where his father was at all times.

Ron shared tips and encouragement to his fellow carers including sharing the caring , choosing words such as replacing ‘problems’  with ‘challenges’ , taking one day at a time

and the importance of involving the community at large. We had a great session and there is always something to learn whether you are the presenter or an attendee.

Lesson Learnt:  The caregiving journey to someone with dementia can be lengthy; planning ahead and reaching out for support along the way can help to improve the lives of both the carer and the care recipient.

Originally posted @allaboutestates.ca

My last 3 blogs have highlighted some of the challenges we are currently facing in our Long Term Care sector.  The bottom line is this: there are not enough residential placement beds to address the current and growing demand for those individuals whose care needs can no longer be met within their own home setting.

The answer is not simply an increase in beds but  also providing the necessary care and support to residents who occupy these beds. This includes providing a standardized and reasonable ratio of staff to residents to ensure access for individualized 1:1 attention and care. Most critically, staff require additional hands as well as training to deal with residents who exhibit behavioral challenges related to dementia.

In November 2017, Dr. Hoskins, who is now stepping down as Health Minister, unveiled a New Action Plan called “Aging With Confidence”.

In terms of promises directed towards supporting seniors requiring intensive supports (Long Term Care), several  areas for improvement  were identified including:

  • Modernizing Long Term Care (LTC) homes– including eliminating 4 bed wards
  • Reducing the wait time for LTC – creating 5,000 new beds by 2022 and will create 30,000 more over next decade
  • More staffing and support in LTC- increasing nursing hours, PSW hours and specialized behaviourial training and end of life care. A recommendation of an increase to 4 hours PSW care daily
  • Promoting innovation
  • Culturally appropriate LTC
  • Strengthening safety in LTC
  • Strengthening the office of the OPGT
  • Improved end of life care- more hospice beds closer to home

All of these initiatives are needed now for a system in crisis; unfortunately the implementation of this appears to be slow and evidence of these improvement are not yet apparent.  Have you seen anything that you think is an improvement?

We need to be able to think in broader terms, and consider changes such as dementia only care residences,  settings that provide a village- like community,  closer proximity of day care settings and the list continues.   For most of us, LTC is considered to be at the end of the journey. I know that is not where I want to spend the last chapter of my life if things continue the way they are going. We need to continue to put pressure on the government to do what is right for all of us as we grow older. We deserve better.