The ad said that The Centre for Rural and Northern Health Research (CRaNHR) and the Rural Ontario Institute (ROI) were going to be hosting a day-long forum on 28 November 2013 to explore the complex challenges of supporting healthy aging in seniors living in rural northern Ontario. This invitation went out to numerous agencies, including the municipal sector, health promotion agencies, front line service providers, rural health practitioners, and community organisations. The challenge was for these people at the sharp end of the issue to join together and provide some answers to the question, "Are we ready?"
With Ontario’s rural population already older than the provincial average and continuing to grow, will this region be ready to support them with effective healthcare services? According to a report issued in 2012 by the Ontario Ministry of Finance, the population of North Eastern Ontario is predicted to be approximately 567,000 in 2036, and around 30% of those will be senior citizens. The meeting got underway with opening addresses by Dr. Wayne Warry, the Director of the Centre for Rural and Northern Health Research and Louise Paquette, CEO of North East LHIN.
The other keynote speakers were as follows:
Dr. Samir Sinha
Director of Geriatrics, Mount Sinai Hospital
Provincial Lead, Ontario’s Seniors Strategy
Living Longer, Living well
Mr. Terry Tilleczek
Sr. Director, Policy and Health System Planning, North East LHIN
Dr. Janet McElhaney
Senior Researcher at Advanced Medical Research Institute of Canada and Health Sciences North Volunteer Association Chair in Geriatric Research
Presenting Healthy Aging in Rural Northern Seniors
Dr. Kristen Jacklin
Associate Professor of Human Science, Northern Ontario School of Medicine &
Karen Pitawanakwat, R.N./Care Coordinator, Nahndahweh Tchigehgamig Wikwemikong Health Centre, Home and Community Care
Presenting Aboriginal Aging & Dementia
Dr. Birgit Pianosi
Chair of Gerontology Programme, Huntington University
Presenting Perspectives on Gerontology & Education
The focus of the forum was that the future of health care for seniors will be to keep them in their own homes for as long as possible. In order to accomplish this, some changes need to be made to the way health care services are delivered.
It's not a secret that the great wave of baby boomers is coming over the horizon, and in fact the first cohort of that generation already started collecting Old Age Pension a couple of years ago. It should not be a surprise to anyone that our society is not ready for them. There has been lots of talk, but very little, if any, action. The participants in this forum were given an opportunity to come up with solutions to whatever they identified as major challenges going forward. While there were lots of good ideas emerging from this exercise, this article will concentrate on two key items, communication and training.
Right now, all the various agencies involved in seniors care work as standalone bodies. Communication between these agencies was one of the more important suggestions made by the forum. Of course, to do this there would have to be a standardisation of forms, records, and procedures. Everyone would have to be on the same page and speak the same language; stopping the use of acronyms would, it was suggested, help in this regard. While it is normal for all industries to develop their own jargon, in this industry we could be talking about life and death situations. One advantage cited was the possibility that it would allow one agency to step in for another should the need arise.
Working directly with the elderly falls mainly to Personal Support Workers (PSWs). This is an unregulated group that is the lowest paid and has the least amount of training in the medical system. It is only recently that a PSWs desiring to work in a facility regulated under the Long Term Care Act have come to be expected to have completed a one-year course of study at an approved educational facility. Even so, there are some exceptions to this rule, and given that half of the PSWs working today are over the age of 50 you can expect a continuing need for these workers over a lengthy time period as the older group retires. This also suggests that the older PSWs will have had a different and variable training regime with most of their knowledge gained through practical experience. In fact, we were told that very few people, regardless of their professional designation, working with the elderly are educated in gerontology, and that would include doctors.
Eventually, because of the current trend in formalized training, PSWs will likely achieve a heightened status in the health care industry. While it is unlikely that PSWs would ever become a registered profession due to the fact that the PSW training is only for one year, this may not matter. Because there is more emphasis being placed on formal training, which includes a geriatric component, their value to an employer will be greater, and in a fair world this should result in improved wages and benefits. That large wave of elderly baby boomers coming along will mean that these folks will be in even greater demand and this alone should guarantee it, though you can be sure there will be resistance from the service providers. The provincial government will likely have to take a hand in guaranteeing a minimum level of care in all cases and it is not impossible to see all PSWs organised in a single bargaining unit, but that is down the road.
This idea of keeping people out of institutions and in their own homes wherever possible has been floating around for some time now and the great thing about it is that it is doable and it is expected to be cost efficient. According to Dr. Sinha, the funds for this new approach are already in the system, things just need to be realigned.
A lot of senior citizens don't need 24-hour care. They may only need a few hours a week and their requirements will vary, as will their needs. A change of bandage, a bit of shopping, some laundry perhaps, and any of the other normal things that people do around a house to make it comfortable and liveable. It won't only be the PSWs that are doing the visiting: Doctors and probably nurses, as well as social workers and all the other trained specialists who call on people now, will continue in that roll but with improved communications between the service industries. Things will be more efficient and effective. One great idea suggested at the forum was to make use of the paramedics. We are told that 80% of a paramedic's time is spent waiting for a call, what a waste of all this great expertise. They could provide a great service to this programme.
It is recognised that our geographically large but sparsely populated area would present some unique challenges that you wouldn't find in other parts of the province, so unique solutions would have to found. One suggestion was made regarding First Nations reserve communities. Instead of having to bring in outsiders to handle some of the routine chores, why not train a resident as a PSW? The PSW would be a familiar face that would be more acceptable to the residents plus some of the holes in current service levels would be filled. This idea could probably be applied to almost any small community.
From an outsider's perspective, I found this forum most enjoyable and educational. I learned a lot of things that I never knew before. I had no idea of the number of different groups that could be involved in the process and I found myself hoping they would get past the talking stage soon. There is no doubt that, as with any new idea, there will be any number of naysayers and much politicking, but those people must be taught to bear one thing in mind: sooner or later, if we live long enough, we're all going to need this type of care. Where would you like to die, in some long term facility surrounded by strangers in unfamiliar surroundings, or at home? Old age is not a disease so let's not treat it as if it was; it's a stage of life for which there is no cure.
Glenn Murray
Val Caron, A Greater Sudbury Community
About the author: The author is a senior citizen in his declining years who wants to spend his last days in the same house he's lived in since 1975. Like many others, he finds himself the last member of his family still living and/or living here.
The site for the Sudbury working-group of The Media Co-op has been archived and will no longer be updated. Please visit the main Media Co-op website to learn more about the organization.
The Sudbury working-group of The Media Co-op was formed to create independent media in the North, to speak to our issues and outlooks on our communities as well as the world around us. Independent media provides an avenue for people who are wishing to gain critical perspective on the issues that matter most to us, and to give a voice to those people and stories that you won't find in the mainstream media.
The Sudbury working-group site is no longer being updated and has been archived.