Community Home Care: Hope & Reality – 2

Part 2: Demographics & Funding Factors

The stage was set in my Jan.30th blog. Community home care has four factors to consider – Medical and Accommodation as outlined, and now Demographics and Funding.

Demographics. By 2031, the estimation is that the proportion of seniors 65+ in the Canadian population will be at 23%, up from 17.3% currently. (Around then, deaths will outnumber births in Canada.) If our total population reaches the projected 40 million, that would make the 65+ population about 9.2 million. These demographic statistics form a base for figuring out what various social needs are likely to be for an aging population including community home care.

Funding. The Baby Boom generation, now retiring, is the wealthiest generation in history. Bank of Montreal economist Sal Guatieri said in The National Post July 19, 2014; that “the typical senior today is 9 times richer than the typical Millennial”. Boomers are also the generation that expects to get what it wants.

Currently, given that the number of working Canadians is declining, it is unlikely that the Boomers’ demands can be met as expected. Statistics Canada states that by 2031, the number of people in the labour market for each person aged 65+ (not working), could be lower than three. This ratio was close to 5 to 1 in 2010.

The key question is – what level of responsibility must the individual assume for their living and care arrangements? And what is the responsibility of the community or governments? Who will pay for these obligations? Can we mobilize popular support for community-based programs, or must we rely on governments for action?

Canada’s current approach to funding such programs (and many pensions, too) is “pay as you go”. This means that payments for these services are taken from current general tax revenues. If there are fewer active workers than those over 65 not working, how can we expect that programs benefiting mainly seniors will be acceptable to working taxpayers, who will want some funding room for their children’s education and family health care?

In an era of tight budgets and a future with fewer taxpayers contributing to government programs, “universality” is a problem. The Canada Pension Plan was changed from “pay as you go” to fully funded with contributions by workers who expect to benefit in the future. With pay as you go, the Boomers have no “skin in the game”. The burden is on younger taxpayer – and with a smaller number of workers/taxpayers there is enormous potential for inter-generational conflict of interests.

So far, the clamour for community home care is too broad and unfocused. I’ll set some talking points for solutions for the next post – a more refined and targeted discussion, given scarce resources now and in the future.

 

Marie Howes

Community Home Care: Hope & Reality on a collision course?

Part 1: Sorting Definitions, Medical & Accommodation Factors

Community home care for an aging demographic; what does it mean? The term “community home care” s bandied about as though it has a specific meaning and that we should all know what it is – but it can mean:

Aging in place: remaining in your own traditional home, supported by housekeeping and healthcare services, until you are no longer able to cope

Purpose built or adapted housing residences: for those who want to be part of a “community” of people that might be comprised only of older seniors, or a mixture of people of various ages, as in a neighbourhood, with housekeeping and healthcare services available.

Care residences: where older seniors are the main residents because they require dedicated care provided by community members, volunteers and professionals; paid for by residents or by government, non-profit or charitable organizations or a combination of these. This is where Long Term Care facilities enter the discussion.

Essentially, there are four major factors to consider in this mix: Medical, Accommodation (housing), Demographics and Funding. Here are the first two.

Medical. There are risks to the “aging in place” model. Many older seniors become trapped in the “tea and toast” syndrome wherein they do not eat properly or take care of themselves physically and mentally. Loneliness and depression and physical injuries, which may be undiscovered for hours or days, can occur.

Accommodation. Moving to a smaller home, whether purpose-built or in the broader neighbourhood can be a daunting prospect. Most people rightly dread moving, with its stress and upheaval. Sometimes, too, family members pressure their elders into staying put since the home is “the family home” and repository of happy memories (and increased, non-taxable capital gains over time.) In terms of their housing, many older seniors are house rich but cash-flow poor.

Hope and reality on a collision course? Should government direct scarce resources into caring for seniors in need at home when the logical solution is for them to sell their valuable house and downsize, and then use the surplus to pay for the help they need?

This sets context for the next blog post on demographics and funding. In brief, Boomers looking forward should consider their assets owned as well as their income streams; as their hope and reality for community home care for themselves may be on a collision course.

 

Marie Howes

Longevity & Community Care – 2

Age awareness has meaning to everyone at every life-stage, so by leading a charge advocating for community home care for older adults the question is; how are we serving our community if we don’t bring a broader range of insights to the issue? After reading Carol Goar’s Dec.9 Toronto Star article “Senior citizens are mobilizing against ageism”, it occurred to me that we need doable solutions that everyone can share in.

In my work with Big Brothers Big Sisters of Toronto over the years, I’ve always been drawn to their ‘strength based’ approach to mentoring.  Simply put, volunteer mentors are trained to allow the child to be who they are without ‘fixing’ them or trying to make them ‘better’.  It’s about accepting them ‘as is’ and building their self-confidence. This in turn allows them to be equipped with a toolbox of life skills that (as studies confirm), serve them as they mature.

Likewise, the conversation on confronting ageism raised by organizations like Carewatch needs to be strength based. What are the skills that all segments of the population (from Gen X, to Millennials, to Boomers) bring to the table, and how can we take each groups strengths to assist those who need help. What if we made care of seniors who wish to remain in their home a community issue, not just a family or government issue?

Let’s look at ageism through a different lens by examining an inter-generational approach which would allow learning and support at all ages. If we looked at community home care as a way to build a foundation for a caring community – we would all be better together. And it’s not just about health care delivery. There are other basic living and social needs to be served with more of what we might call an “age share model”.

For example, how about having a high school student earning community hours by teaching a housebound senior computer applications that could open a new world to them? Cyber-Seniors is an example.

What if a local apartment/condo dweller who loved to garden was matched with an older homeowner who was unable to tend to their garden, and took on the task of planting and tending a vegetable or flower garden in their yard? Tyze is an example of one of those doable solutions; an inter-generational social network.

So literally – let’s look in our own backyards to find other workable options for advocating quality community care.

 

Sandra Downey

Longevity & Community Care – 1

Of this longevity conscious age, one could say that the grand narrative related to aging demographics has more than one story line – and how these all converge and involve everyone of all ages, does require forward thinking. Building on opportunity for this age of longevity will require respect for each age cohort in society. There is a place for everyone at every stage of life.

We formed Planet Longevity as a thought leadership panel and our vision was – put the wider conversation out there; influence, enlighten and challenge assumptions around how we all will actually adapt to the experience of aging and longevity in a foreseeable future.

If you want to change the narrative on a longevity issue that you care about, and ensure your message is listened to positively – and make a call to action for support of your cause; then you put that message up front so you don’t distract.

One of the key longevity story lines is community care. Planet Longevity wants to get out in front of that conversation and support others in their efforts to create a proactive model. But frankly speaking, we don’t think framing the story around the verbiage of ageism is helpful. It’s too easy to pluck on those strings and distract from making a positive pitch.

So when we read Carol Goar’s Dec.9 piece in the Toronto Star “Senior citizens are mobilizing against ageism.” about the group Care Watch, we could only ask, are they taking a step back with this angle in the narrative on community care?

From a marketing communications point of view, we think this distracts from what positive contributions Care Watch is able to make. Their website tagline is Advocating Quality Home & Community Care.” After that, the home page loses it impact to positively engage whatever target audiences it may have, by currently focusing their AGM message ‘Mobilizing Against Ageism”.

Care Watch could actually benefit from dusting off its brand message. Reach out with its big ask for us to help “advocate” for its real purpose, by speaking more to a greater mass – the Boomer audience, many of whom are in care-giving mode with older parents and also have children who are the future cross-generational participants in home and community care giving.

The aging demographic curve is still in motion and will be for many years to come. Our wish for Care Watch leaders, given all the ages and stages that you have lived through, is use the constructive value of your knowledge and experience to mobilize wider support.

 

Mark Venning & Mary Ellen Tomlinson