For the caregiver community, the COVID-19 pandemic has shown just how important it is to help aging Canadians thrive at home.
Senior care in Canada has long been a complex and disconnected system. Home care and long-term care exist separately from healthcare services like hospitals, labs, and pharmacies as well as social services such as employment, lifelong learning, financial literacy, and arts and culture. Each part is funded separately and is managed by different government ministries. Seniors are largely left to fend for themselves, navigating a complex set of services with little help or direction.
This all started to change almost overnight when the virus hit Canada’s elderly, says Zayna Khayat, an expert in healthcare innovation and a future strategist at SE Health. The pandemic forced all the separate parts to start communicating and pushed care-providers to reassess where and how they were delivering services to seniors.
“Everyone just started working together. Everything became a little more blended and more seamless,” Khayat said. “We all realized that we had a very medical model of senior care… what we should’ve been doing is building a wraparound system that helped older adults live their best life, safely and happily, at home.”
A better system is urgently needed as the virus continues to impact the most elderly citizens across the country. Months into the spread of the virus, just over 80 percent of the country’s known COVID-19 deaths were among the residents of nursing or long-term care homes, according to a report from the Canadian Institute for Health Information. This was nearly double the average for countries in the Organization for Economic Co-operation and Development (OECD).
As a result of social isolation measures, many support services were reduced or cancelled in the first few months of the pandemic, leaving a lot of seniors isolated and vulnerable. While there is still no comprehensive tally of elderly people dying from causes linked to social isolation and confinement caused by COVID-19 closures, evidence is mounting that the pandemic took a broader toll on their wellbeing. Experts now believe the elder-care system in Canada needs to take a more seamlessly integrated approach that connects long term social services more closely to the healthcare system.
“The future of aging is more holistic,” says Khayat. “The future of aging is about life care.”
This kind of holistic system of care has started to manifest this year in response to the pandemic. Efforts have been made to focus on mental health: iPads or similar devices, for example, have become more available at nursing homes to help seniors stay in touch with families that could no longer visit them in person.
But much more still needs to be done to reimagine social systems and infrastructure, implement training for skills and capabilities, and create products and services that will improve the lives of people as they age.
The number of seniors is set to more than double over the next decade or so, which will see an explosion in demand for home care. Public opinion polls consistently show that Canadian seniors want to live and age at home – a trend that is being further amplified by the pandemic. This means caregivers will need to find ways to empower senior patients to take charge of their aging.
At the recently held 2020 Future of Good summit, Diane Roussin, project director at The Winnipeg Boldness Project, said aging that integrates social and health aspects will require caregivers to redesign senior-care institutions so they’re not “built just for getting by and surviving” but “for thriving.”
“If we valued the voice of our seniors, and the role of seniors in our society, we would find ways to integrate them into our day-to-day living,” Roussin said. She described the future of elder-care to be similar to an Indigenous clan model, where elders live interdependently with their families and their communities. A model like this would see more multigenerational housing and more ‘senior-friendly’ city-building and services.
As opposed to the current system, which removes and isolates seniors to long-term care homes, “responsibilities should be split between families, caregivers and institutions,” Roussin said.
A holistic approach like this would also strengthen the healthcare side of Canada’s elder-care system. According to Khayat, “COVID-19 has opened the channels of communications, which will be a game-changer in home-care.”
Khayat believes the use of telehealth services – such as digital assessment tools to measure blood sugar levels and monitor heart conditions – during the pandemic will become an increasing part of senior-life moving forward. This will free up home-care providers to help empower seniors’ personal healthcare by focusing on things like exercise, nutrition and emotional wellbeing, as opposed to time-intensive medical tasks.
“We need to teach doctors how to help people stay at home and ensure they have better lives there,” said George Heckman, an associate professor in the school of public health and health systems at the University of Waterloo. Heckman notes that only six out of the 16 teaching hospitals in Canada have mandatory geriatrics training and specialized geriatricians are absent from nursing homes.
This became a problem during the pandemic: Heckman said he heard multiple stories from doctors who urged seniors with heart conditions to exercise as cardiac rehabs turned people away. These doctors found that, as home-care visits were paused at the time to limit exposure, seniors had no other path to exercise on their own.
“If we link them all together then everyone — doctors, home-care providers, family members, and seniors — is mutually accountable,” Heckman said.
To ensure that the future of aging sees this integration of the social and health aspects of elder care, policy makers and service providers will have to adopt innovative thinking and new leadership, according to experts.
“Long-term care is not about buildings and beds,” Khayat says. “It’s about an entire system of care for the elderly; that’s what we now need to build. That’s the reckoning.”