Age-Friendly & Drivers of Change: It’s inter-generational.

Planet Longevity – 2nd Anniversary! As we enter our third year 2016, our basic function remains. Planet Longevity is a thought leadership panel. Our aim is to advance awareness of the changing social and economic conditions for all generations challenged by the multiple issues of living a longer life. Over the last few years, as we crafted (2012), formed (2014) and developed to where we are now; at the core of what we promote is forward thinking – with inter-generational connectivity in mind.

That fundamental notion transcends what so many often confine within their dialogue, as strictly a matter of “Boomer or Senior’s issues”. As we have said in different ways in our own conversations as a panel, and individually in our blog posts, you cannot isolate the topics such as health care, pension reforms or community design as one cohort’s concern.

With that in mind, we continue this year to support the Age-Friendly campaign, both on a local and global level, and encourage a sharper exchange of inter-generational views in the process. There are still so many differences in outlook and weighted levels of importance given to the many aspects of aging and longevity. Yet even the phrase “age-friendly” may not be as obvious in its intent to serve this inter-generational understanding.

Having said that, what we should be encouraged to know is that one subject which may bolster the age-friendly dialogue in an inter-generational exchange is technologyand its augmentation of living conditions throughout the life course for generations now and into the future.

Let’s connect some dots on this with some forward thinking.

Published in January 2016, in timing with the World Economic Forum in Davos-Klosters, Switzerland, was a Future of Jobs report in a so named “Fourth Industrial Revolution”. One of the items featured in the report was “drivers of change”. This is broken into two categories – demographic/socio-economic, and technological. A significant driver of change in the first category is “longevity and aging demographics”.

Hook that up with one of the nine specifics in the technological category, such as robotics and autonomous transport, and you get I would argue, opportunity for inter-generational participation in designing a better age-friendly society. Technology augmentation – if it’s good for the old it’s good for the young, (which is one of the principles behind the age-friendly concept); it also can be said that – if the young and old get busy behind work (jobs) that support a longevity society, then we all benefit in this fourth revolution.

As the demographic and socio-economic narrative of the world is changing at warp speed, industries, countries, communities and individuals are going to have to adapt incrementally faster. As the WEF – Future of Jobs report suggests, the period of 2015 > 2017, (which we are in the middle of right now), is when the driver of “longevity and aging demographics” picks up momentum.

Exciting times to be elevating our thoughts about our Planet Longevity!

 
Mark Venning

Advance Care Thinking in the Age of Longevity

Further to my blog post on March 13 … “Empowered end of life care…”

Speaking for yourself

Planning for longevity, well into your 80’s and 90’s or longer, means anticipating good and not so good outcomes. It takes courage to ask yourself what care I want for myself when I can’t speak on my own behalf. That is a hard question to answer and sometimes disconcerting; so when you do come around to making some decisions, write your instructions down in a document called a Living Will/Advance Care Directive.

Often when people do think of what they want if hit with a sudden health crisis, they talk about wanting to take every medical step going. The term is “Heroic Measures” – but this is best for people who are reasonably fit and with few health complications. For a frail older person with osteoporosis, the outcomes are not good.

In the other extreme people will say something like, “I’ve had a good life – just let me go”. This term is “No Medical Interventions”, but this is too restricting. A better instruction is “Comfort Measures Only” which gives flexibility for pain management and other steps for easing discomforts.

When you can’t speak for yourself

Ask someone you trust if they would be comfortable being your spokesperson, a “Substitutes Decision Maker”. Give clear concise instructions with some leeway for unexpected complications and these must be legal. Discuss with your spokesperson, that as your life conditions develop you may want to change your instructions, and that you will always keep them up to date with any changes.

For added ease in this process, it is a good idea to have a backup spokesperson in case the first person is away or unable to respond in an emergency. Keep your back up spokesperson up to date with changes too. This is a safe action to take as a Living Will/Advanced Directive can only be used when you can’t speak for yourself. Have your instructions readily available, such as a small wallet card indicating that you have a Living Will/Advance Directive, available for printing at www.advancecareplanning.ca

A good precaution is never wasted

Everyone should have a plan. It’s a good life review exercise. While it may seem like a later life issue, the young (those over the age of majority) as well as the old can have episodes in their lives when they cannot direct their care. Severe flu, accidents, drug reactions, an epileptic incident and other temporary illnesses can cause disorientation or unconsciousness – and a Living Will/Advance Directive is there for you when you can’t speak for yourself on health care decisions.

 

Mary Ellen Tomlinson

Community Home Care: Hope & Reality – 3

Part 3: Solutions, Home Care as one part of Health Care

Solutions to the issue of elder care, whether as part of “community home care” or the broader matter of frail, ill elders needing institutional care, are part of the need to consider radical changes to our health care system in general. The Commonwealth Institute think-tank, ranks Canada dead last amongst the 11 top advanced nations in terms of timely health care access by its citizens. Timely acute care access is lacking, and so is access to long-term care.

Part of the solution lies in creating new funding models for Canadian health care: systems that have already proven successful in the other 10 leading health care jurisdictions. All have a mix of public and private funding and facilities.
Some possible means of changing Canada’s “government as gatekeeper/payer” system include the following ideas:

• Phase out “pay as you go” funding (payments from current general government revenues) and replace it with revenue generated from an investment or insurance entity modeled on the Canada Pension Plan Investment Board. The smaller number of taxpayers in the future will not be able to pay for health and other services for the looming bulge of aging Boomers if the current funding method remains.

• Bring back tax incentives such as the Multiple Unit Residential Building program (MURB). Target the construction of universal access, single or multiple family residences, and long-term/chronic care residential/medical facilities, which would reduce the pressure on acute care hospitals currently warehousing patients who cannot live at home.

• Adapt ideas from the successful systems of the nine other countries with better health care outcomes. Start a meaningful discussion of alternatives. Begin by discounting the “straw man” argument that any discussion of change in Canadian Medicare means “American health care”. No one proposes American health care.

• Consider introducing “medical savings accounts” for all Canadians. It would be a voucher system where each Canadian can spend on either public OR private health care services. Special funding would be provided for chronic or exceptional cases. This was first proposed in 2002, in a paper presented by the Fraser Institute.

• Ensure that publicly funded health care programs have elements of self-funding. Require that the means test for government payments includes the value of assets not just cash flow. Many people have substantial assets that could be used to pay for services they need – yet they can access subsidies because they have low cash flow, currently the main criteria for assistance.

• Channel more medical students into specialties such as geriatrics and areas related to caring for aging Canadians. It costs over $1 million to educate a doctor in Canada. Surely, it is reasonable to expect medical practitioners to work in critical fields. There is also a shortage of medical technicians. Incentives are needed to boost their numbers, too.

• Encourage philanthropic investments in communities across Canada through special charitable donation credits for the construction and maintenance of senior and disabled-friendly residences and care facilities. Palliative care centres need to be part of this initiative. Many religious and ethnic communities have already begun providing these facilities. As a corollary, beef up the health and safety inspection of residences for seniors in care, and make penalties meaningful.

• In Norway, local municipalities are responsible for getting patients out of acute care hospitals and into innovative, long-term care facilities. Daily fines for non-compliance help focus administrators on achieving results. (Local municipalities do receive increased funding for their role in these services.) Canada and its provinces could learn from this.

Are these revolutionary ideas? Yes, but the need for discussion is urgent.

Marie Howes

Canada’s Health Care System: Facing an Aging Nation

Far too many Canadians believe that “Canada has the best health care system in the world.” The Commonwealth Institute in Washington D.C., a health care think-tank, conducted a survey in 2014 ranking the health care systems of 11 advanced countries.

The top health care system was that of the UK, while Canada ranked 10th; the United States ranked 11th. The UK and all the other countries that ranked above Canada and the USA – Switzerland, Sweden, Australia, Germany, The Netherlands, New Zealand, Norway, France; have integrated private and public health care systems.

Our reluctance to review and reform our system of “one payer” (government) is not sustainable. The tail end of the Baby Boom generation turns 50 in 2015. The number of employed workers is declining, while the number of retirees (and users) is increasing.

Some weaknesses to address in our current system include:

  • Lack of timely access to diagnosis: emergency room backlogs, limits on the number of ailments to be discussed by doctors in any one patient appointment, etc.
  • Slow delivery of appropriate care: long wait times for those requiring joint replacement etc.
  • Inadequate planning for the coming bulge of seniors needing long term care beds; continued focus on acute care
  • Creation of large and unwieldy hospital complexes: excessive administration costs; likelihood of infection spreads
  • Lack of choice in the system: people can receive and pay for cosmetic surgery in Canada, but not major surgeries or joint replacements.  Medical tourism results.
  • Poor transparency and accountability on many fronts: Infection rates in hospitals, competency of various specialist surgeons, comparisons of cost of administration etc.
  • Lax regulations/laws, compliance and enforcement of rules covering patient care, disease and infection prevention and public safety
  • Insurance programs which cannot guarantee access to diagnosis or care:  programs which are of questionable value to policyholders
  • Mistrust of the whole idea of “private” health care. Yet the top nine countries have successful systems, which DO include private facilities, often paid for through insurance.
  • Pressure on governments to reduce ALL spending – including health

So the question up for further discussion is – can system changes start small and succeed?

 

Marie Howes

Celebrating Maggie Kuhn

August 3rd was Maggie Kuhn’s birthday. This year we celebrate 109 years since her birth, and it is important to recognize this forward thinking American social activist for her work in the field of aging. Maggie is a champion of aging and the later years. In August 1970, she founded Gray Panthers.

“Learning and sex until rigor mortis.” ~Maggie Kuhn

Her work is notable not only because she was ahead of her time. She also broke stereotypes and at age 65, she embarked on the most important work of her life. In fact, rather than accept her employer and society pushing her into a quiet retirement, she chose to take action and work for the rights of older people.

After being forced into retirement from the Presbyterian Church, Maggie, along with her friends in similar circumstances, organized and founded the group that became the Gray Panthers. The organization focused on the issues of older people including pensions and pension rights, health care and age discrimination. Gray Panthers also addressed the larger social issues of the time such as the Vietnam War.

By the year 2020, the year of perfect vision, the old will outnumber the young.” ~Maggie Kuhn

Maggie was a charismatic and energetic leader. She advocated for older adults to have a voice and a position at the table for programs, practice and social policy and encouraged older adults to stay involved and take action on social issues. In doing so, she started a cultural revolution.

Maggie also believed in the power of intergenerational connection. One of her mantras was ‘Young and old together’. Under her guidance, Gray Panthers came to represent the possibility and power of later life. She herself demonstrated how older adults can be active in the world working for social issues that are important to them.

“There must be a goal at every stage of life! There must be a goal!” ~Maggie Kuhn

Until death at age 89, Maggie continued her work as an activist and advocate. She redefined aging and she is a role model to us all – women and men, young and old alike.

 

Suzanne Cook

Fitness Incentives: Motivation for Active Aging?

Endless data confirms that staying physically fit has significant benefits as we age.  I recently read an interesting story in Arianna Huffington’s new book ‘Thrive: The Third Metric to Redefining Success and Creating a Life of Well-being, Wisdom, and Wonder’ that made me think – what motivates us to stay healthy as we age?

In 2005, US based supermarket Safeway learned that their annual employee health care bill was $1 billion and rising by $100 million/year. Researching the reasons behind these figures, they found that 70% of health care costs were associated to people’s behavior.  This revelation led Safeway to develop a win-win solution, introducing programs that provided employees with tools to address health issues such as weight loss, controlling blood pressure and managing cholesterol levels.

Safeway then established a baseline health insurance premium with behavior based discounts.  Employees got discounts based on working towards better self care which resulted in decreased costs for the employee and increased productivity for the company. It was a huge success.

The Ontario government has taken a similar step through the introduction of a Children’s Fitness Tax Credit allowing parents to claim up to $500/year to cover registration costs associated with physical activity programs for their children. It’s time people over 55 enjoyed a similar benefit.

As early as 2011 the Canadian government began to review an Adult Fitness Tax Credit, proposing a credit of up to $500 annually for those 55+ to stay or become more active, utilizing eligible fitness expenditures. Studies related to the proposal suggested the credit would increase the physical activity of almost one million Canadians, thereby providing better health outcomes for the individual and ultimately saving long term health care costs. In the last election the Conservative government promised the Adult Fitness Tax Credit would be introduced once the federal budget was balanced, which is expected in the 2015-16 fiscal year.

Now the question is – Would we be motivated to make positive changes that impact our overall well-being if monetary incentives were provided through the government or health insurers?

Why not go for a walk and think about it.
Sandra Downey

Owning Our Health As We Age

In today’s multimedia world, we have fast access to abundant knowledge on practically every health and health care topic in the known universe. The good news is we can self educate. The bad news is that there is a tendency to self diagnose, which may not help in making well informed decisions.

As we age we’re faced with growing concerns around:

  • maintaining our health, well being and independence
  • affordable health care being available – when we need it
  • having enough money to cover unexpected health costs
  • living a life that will help sustain optimum health, for years to come

How do we avoid the stress of over-thinking that intake of abundant knowledge? The stress created by a sense of vulnerability negatively impacts us mentally and physically. Worry keeps the mind in overdrive and wears down the body’s resources.  It’s easy to get caught up in the negatives but that only contributes to the downward spiral of anxiety and worry.

Good health isn’t merely the absence of disease (dis – ease) or symptoms; it’s a state of well-being.  There are many ways we can own our health that require minimal time or money.  It may not be through familiar methods, but staying open to the options allows us to explore areas that complement standard medical treatments. 

For thousands of years balancing the mind, body and spirit has been achieved through what we may view as non traditional methods.  This includes natural remedies such as herbs or plants; physical exercise such as walking or yoga; as well as spiritually based practices such as prayer and meditation.

All you need to do is take time to listen to your body.  What is it telling you?  If you need quiet time, find 30 minutes in a day to sit with your eyes closed while breathing deeply from your belly. Your body will relax. If you feel restless take 30 minutes a day to go for a walk. You will feel energized. If you feel like you’re coming down with a cold or flu explore natural remedies available. They will work in alignment with your body.

Remember; our bodies always seek to heal themselves. We just have to listen. We can own our health as we age.

Sandra Downey