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Another Perspective About Elder Care

Yesterday was Father’s Day. I felt very blessed to celebrate with my Dad who is now 89.5, and is still living in his own home with my mother. So many of my friends no longer have the privilege of celebrating with their parents.

I have been thinking a lot about elder care lately. The horrific stories about the conditions in so many of our long term care facilities in Canada have caused me to feel very, very sad. How can we treat our parents and our grandparents like this?

The reality is that we no longer value family care giving in our culture. Extended families, except in some of our immigrant communities, is no longer the norm. An elderly wife will take care of her husband as well as she can, through her own failing health, until she can no longer manage his care at which point they may both need to be institutionalized. How can their kids help when children and parents are often thousands of miles apart, children have full time jobs and kids of their own to take care of?

How can children take care of that elderly person when the parent has advanced dementia, doesn’t know their own family, wanders away and start fires? Yes, at this point family care giving is extremely difficult, if not impossible. The person is institutionalized to keep them “safe”. This is the accepted “elder care” practice in our society. The rare exception is that if the parent or grandparent is wealthy, they may be able to fund a retirement home life and/or bring in enough services to support them in their own home, but this is not the usual case.

Our government is focused on improving elder care in institutions, which is an important issue. We do need fewer beds per room and more highly trained staff. However, more thought and money needs to go into supporting seniors in a setting they can thrive most in – their own home, or the home of a family member.

This can be accomplished by paying family caregivers and supporting aging in place with increased access to professional health care support in the community. Educational and support groups for family caregivers with non-medical backgrounds are also needed to enable them to take care of their loved ones. This will lead to happier, healthier seniors and end up costing the government, (and therefore taxpayers) a lot less than housing people in institutions. It will also mean fewer emergency hospital trips, less mental health interventions and less chronic disease in our seniors. Altogether, this will represent a huge savings economically for Canada.

Earlier intervention – especially at the point when a partner dies and a person is left on their own – can make a huge difference in offsetting chronic disease. Timely lifestyle changes can prevent mild cognitive impairment from developing into dementia. Our society believes that chronic disease is a sign of “aging” and that dementia is inevitable, and yet it doesn’t have to be. For example, prolonged loneliness, a sedentary lifestyle and reliance on fast foods, all risk factors for dementia, can be modified.

Where are the initiatives addressing these issues? According to the LIHN in Ontario, (the provincial home care overseeing agency), supporting aging in place has been a priority for the last five years. I don’t see much offered in the way of disease prevention. I don’t see much offered in the way of cognitive stimulation or physical training. Thirty minutes for help with a bath once a week, always provided by a different PSW, is not enough to support someone living at home. We need a radical overhaul of our elder care system, and that goes far beyond reducing beds in an institution from four to two per room.