How can we best care for our aging population?

TimesColonist.com – life – Health-care system must adapt as baby boomers reach retirement age
November 20, 2011.    By Neena Chappell, Times Colonist

This year, the first members of Canada’s baby boom generation turned 65, drawing attention to the demographic trends gerontologists have been discussing for years.

Because physical health declines with the aging process, the prospect of large cohorts of baby boomers reaching their 70s and 80s raises concerns about the provision of care.

Moreover, baby boomers are providing most of the necessary care to those who are already elderly. Their significance extends beyond the fact that they will greatly increase the share of seniors in the population in the near future and includes their caregiving role at the present time.

Given the needs of an aging society and Canada’s existing health-care system, what policy challenges lie ahead?

Policies that support the needs of caregivers are important for several reasons: The formal care system could never replace all of the support provided informally; many caregivers make great sacrifices in order to provide the care that they do; and caregivers express a desire to continue in this role.

Without assistance, however, caregivers’ own health can deteriorate, forcing care recipients to rely on the formal healthcare system at a much greater cost.

The issue of who provides care for the elderly is a question of the boundaries between state and family responsibility – that is, who should be providing what care and how much. Unpaid care provided by family and friends is the mainstay of care to older adults. Even with women entering the paid labour force and changes in family forms, families still provide care.

Virtually all countries accept the notion that families have some responsibility to care for their members. And research tends to show that providing care is something that informal caregivers typically want and prefer to do rather than having formal care providers come into the home.

This suggests that one of the first policy interventions required is to support caregivers in the care they willingly provide. But at the present time, except for a few modest tax measures or programs (such as the compassionate care leave available through the employment insurance program), there is no national policy addressing family members (or others) caring for disabled older adults in Canada.

Home-care programs are under provincial jurisdiction and vary widely.

In Canada, it is assumed that family care is readily available so family caregivers do not benefit from any direct public support.

The health-care system acts as a safety valve when family care is not available or not sufficient. And, at the point of entry into the health-care system, policy typically is oriented toward the older adult, not the needs of caregivers or the caregiving unit.

We need to establish a comprehensive home-care system that links and partners with informal caregivers and community organizations to form a support network for informal caregivers and care recipients that is integrated into the overall health-care system.

This would be cost-effective and is the most appropriate option for an aging society.

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