TRENDS IN AGING - HERE'S A QUICK GLIMPSE OF OUR FUTURE
One thing is clear; the future of aging will be different than anything we know.
First and foremost, it's now about 'the amount of life available to us' versus 'how many years we have to live'!
And we also know the following about our future as we age:
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Chronic disease will become the 'shaping force' of care-management
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Alzheimer's is the single greatest challenge facing baby boomers now
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Care-giving will become a much more 'social endeavour' than it is today
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The new focus must shift to 'primary prevention' versus 'sick care'
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'Navigators' of our long-term care will become necessary read the section on care-management, click here
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Today, we buy and sell services, tomorrow, 'reciprocity' (mutual exchanges) will prove the newest currency
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'Time-banking', a social change movement, is a signal of change forthcoming -- for every hour you spend doing something for someone in your community, you earn one 'Time Dollar'. Then you have a Time Dollar to spend on having someone do something for you. It's that simple. Yet it also has profound effects. Time Banks change neighbourhoods and whole communities. Time Banking is a social movement in 22 countries and six continents (2011).
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'Responsible saving' may be enforced (?)
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Our 'longevity bonus' is increasing (i.e. we are living longer) (therefore saving for our future is essential)
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As part of our personal planning, we are now faced with the need to put significant funds in place for our own potentially lengthy care-years.... we are destined to pay privately if we want quality care when we need it and where we want it
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We now have two generations, parents and their boomer children, as 'seniors at the very same time' in one family
12
60% of those over the age of 50 now have a surviving parent (vs. only 16% in 1960)
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In the next 20 years, there will be the highest demand for care ever placed on our already overburdened health system as the BB closes in on 75
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Caring for a parent is replacing childcare as a costly workplace problem for businesses and entrepreneurs -- care has become 'a career we never planned for ourselves' as our loved ones are living long lives but not necessarily healthy ones
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Pensions in our country are playing a greater role in providing adequate income in our later years-we also have a growing dependency on a dwindling working-age population
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We are reviewing our present model of retirement as it has changed dramatically with 'unretirements 'and 'encore careers' now options (although the average age of retirement in Canada is 62 as of 2011) Retirement is set to disappear -- so will we have 10's of thousands of well-educated people doing nothing-is that one of the "unintended consequences" of retirement as we have created a mindset that when you turn 65 you are on vacation -- we need to start seeing retirement as our 'Power Years', which means we have a sense of power (but then we have to take steps to fund that sense)
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The Boomer generation is now labelled (in the USA) as the "Generation AZ" - Alzheimer's is a disease of which there is no cure; deaths related to AZ will begin to soar, Dr. Dychtwald, leading gerontologist, says that if we could just slow down AZ, half the beds in nursing homes would be empty, so he asks, should we just build and fund more nursing homes or look at cutting AZ off at the pass! (Will there be a revolution to end AZ during the next 10 years?)
There is now a new trend to relocate eligible individuals from nursing homes back to the community - the USA initiative is called the "Money Follows The Person" and is a Demonstration Program that reflects a growing consensus that long-term supports must be transformed from being institutionally based and provider-driven to "person-centered" consumer directed and community-based"
Pour yourself a cup of coffee and take just 3.33 minutes to watch a wee video on dementia and love?
19
Senior villages programs are up and running (World Report.com Jan 28, 2011, Senior Villages Take Root as Movement Matures): 55 'Village' programs now exist in the USA and another 120 are in the works...these are being called, "Naturally occurring retirement communities'...their common goal is to help people stay in their homes...putting people in nursing homes and other institutional settings is simply not affordable in an era of tight resources and stressed government budgets (billions to fund medical services but not much to help people stay healthy and live independently in their homes). In a classic village model, members support the services through annual dues/payments/or they raise private funds ...to support an older population that has a higher level of chronic disease and need
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Domotics will be wide-spread and the norm -- home automation (also called domotics) is a field within building automation, specializing in the application of automation techniques for the comfort and security of residents.
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Happiness research (a field known as 'positive psychology' is exploding), University of Wisconsin ("Eudaimonic Happiness Study)-the newest evidence suggests that people who focus on 'living with a sense of purpose as they age' are more likely to remain cognitively intact, have better mental health and even live longer than people who focus on 'achieving feelings of happiness'. And read on for details of some of these changes that taking place now.
Interesting changes taking place now
We are in the midst of a population movement in our country which is going to continue to expand over the next 25 years
We now have 'seniors' in general as our country's fastest growing population group
At present 4 of 5 seniors live in cities (one-third live in Vancouver, Toronto or Montreal ) and retirement communities are growing
Two generations of seniors in one family now is quite common
It is easy to see where most 50+ers are living in Canada and which provinces and municipalities will notice the impact most significantly
From: Statistics Canada
We are experiencing a 'phenomenon' never recorded before, for the first time in history, Canadian adults have more parents than children and this switch in balance is going to impact future family dynamics in an unprecedented manner
Do you have aging parents, aging in-laws? Have you discussed their future care needs with them?
We now have parents and children as seniors in retirement--at the very same time. Imagine two generations of seniors in one family, you and your mother for example both seniors at the same time...planning for one's own and a loved one's care-years therefore has become more urgent
Will any of your children also be in their senior-retirement years when you are too-two generations of seniors in the family--do the math?
Eldercare is impacting the workplace - how are companies responding when workers need time off, how are employees responding to emergencies with their aging parents while trying to balance work, how are unions responding to assist their members, what is best for all involved
It is a silent, growing problem costing Canadian companies an estimated $16 billion+ annually. And how the workplaces take action will become an important Human Resource Department topic
Working-caregivers, those who are juggling care responsibilities plus work duties, are becoming a priority concern for Canadian businesses.
Care-giving is due soon to be recognized as a less-silent, important workplace issue as 66% of informal caregivers are still in the workforce (thus the emerging term 'caregiver glass-ceiling') The issue is emerging as a costly one for Canadian employers.
Data on the $16 billion cost: From the Watson Wyatt Worldwide HR company study on effects of eldercare on Canadian businesses, 2003 data, as reported in Globe and Mail, March 2004: "We in Canada are on the cusp of a tsunami and the working-caregiver picture isn't pretty. 32% of workforce in Canada as of 2003, Aventis Study of employees with benefit plans (approximately 71% of our Canadian workforce) are working caregivers and 61% feel this (i.e. care of a parent) is an issue they must address. 77% of males (45-65) who are care-giving and 63%of females (same ages) who are care-giving, also have jobs and most of those are full-time jobs."
Does your company have a 'care-giver policy' in place should you have to take care of your aging parents or tend to their needs?
If you work for yourself or own your own business, what contingency plans have you in place for care of a parent in need?
As of 2010, 60% of those over the age 50 have a surviving parent, versus only 16% in 1960 - a record number of boomers are either now or in the near future going to be confronted with a variety of worrying questions concerning care of a parent
There will be a demand to recognize the value of informal caregivers as an influential group.
It has been shown that there are millions of unpaid, informal caregivers in our country and that these caregivers are providing 80 to 90% of the home-care needed in our country, equivalent to billions of dollars worth of care services
Does this describe you, over 50, aging parent(s) still alive, if so, is it time to discuss their long-term care plans?
If they do not live near you, what are your plans?
Are you an only child?
Note: My cousin, who was one of three children, once said to me during her care-years journey with her mother... 'I didn't realize I was an only child until Mum needed care.' Do you and your siblings agree on the care-plans for your parents or are assumptions just going to play out?
The majority of Canadian families are touched by this issue today - care of a loved one has become a shared theme all across our provinces
One in three Canadian families are touched...or some estimate the number to be closer to 1 in 2 families
In other words, this is an issue that most of us will face at some point and thus to reduce surprises, discussions and plans have to be front and center in a family (no time for secrets)
Care-years are rarely short-term events, with some lasting greater than 10 years...the length of time we now are spending as care-givers/care-managers is now making care-giving 'a career we never planned for ourselves'
Note: 54 percent of residents surveyed had lived in a long term care home for two years or less and 22 percent had been there less than one year (2002-2003 'National Population Health Survey'). The length of stay is declining for seniors because individuals are admitted at a later stage of declining health-we must keep in mind that care-managing and care-giving also continue when a loved one is in living in a nursing home.
Past research found: 28% of
total
care-giving lasts 3-5 years, with 22% 6-10 years and a further 22% lasting greater than 10 years--this type of extended LTC experiences with loved ones is becoming more common
Note: My intensive long-term care journeys lasted 16 years in total, some simultaneously. Most care required is not of a formal nursing-type care but the ordinary everyday activity type-the type that demands 24/7 attention ...doing activities of our daily living, such as getting up, bathing, getting meals, dressing, organizing meds, moving from one location to another
The vast majority of care-giving is done by family members - and that is having significant impacts on those family members who are acting as care-givers...this loving, albeit difficult role needs to be addressed by all as everyday needs of today's environments and lifestyles will begin to force change
We will see multiple generations in the same family becoming more common. Change in the structure of the basic family unit will force a re-think on how we will care for elderly grand-parents and parents since today, family and friends account for over 80% plus of the support and care provided to Canadian seniors.
The question becomes, with multiple generations, can our current types of informal family-member care-giving continue. 1 in 5 Canadians 45 years and older provides care to a senior at present but current research is issuing a warning, telling us that the health of those seniors providing care (whether an offspring or a spouse) is greatly at risk.
We have grown out of the term 'sandwich generation' already, as the shift is now the BLT-generation (3 levels) or as sometimes referred to by Dr. Ken Dychtwalk, the Rubik-cube generation (since it is 3-dimensional with so many sides that can pop up and need working with at the same time)
Think, who is going to be the hands-on everyday caregiver of a parent if something changes in her/his health...You? One of your siblings? One of your children?
(You might want to read the section, care-giving versus care-management as that will impact your thinking around this
question click here)
Rural care-giving poses distinctive challenges. Just 20% of Canadians live in rural areas and small towns with a population of less than 10,000. In many rural setting, larger percentages of residents are elderly compared to our urban centers. It has been found in rural areas that even with a network of family and friends, it is usually one individual who assumes the bulk of the care-giving
3 generations of women
We are going to feel the economic ramifications of having less working people supporting a large senior-age population
The number of our 'potential support ratio' (i.e. working-age people, ages 15-64, per senior) is falling and is programmed to fall significantly over the coming decades, declining between 2000-2026 from 5 working-age persons for each senior, to just 3.
In short, we are going to have more children and elderly depending on our working-age population
Our 'dependency ratio' (i.e. the relationship of children and elderly to the working-age population) is declining-currently for every 100 people of working-age, there are 46 children and elderly people, but by 2026, research shows that range will be between 55-60 children and elderly for every 100 persons of working-age.
Public pensions in our country are going to play an extremely important role in tomorrow's seniors' incomes
Only 42% of boomers will receive some pension from their work place.
We know that seniors are now our country's fastest growing population group but the number of persons aged 65 and over is expected to double from nearly 4 million in 2000 to almost 8 million by 2026.
We also know that considerably less than half of boomers households contribute on a regular basis to an RRSP, and as a result, many of tomorrow's seniors will rely on public pensions.
Today's figures show that public pensions alone are not very good at providing adequate incomes for the unattached senior category, which is to be more numerous in the future.
Seniors currently make up 13.2% of our population yet account for
~46% of our provincial health costs...the questions this imbalance pose will not prove popular
Between 1975 and 2004, real inflation-adjusted public-sector health spending increased by 3.3% per year on average, compared to 4.3% for private sector spending.
The relative amounts of public and private health financing shifted after the period of government fiscal restraint during the mid-1990s.
Inflation-adjusted public spending per person on health declined by 2% between 1992 and 1996, while private sector health spending grew by almost 14% over this period.
From 1997 to 2004, public sector spending increased on average 4.9% annually. Private sector spending over the same period increased on average 5.4% per year. (From CIHI 2005 "7-/30 Split Report")
Women dominate the 'seniors grouping' but differences are evening out in the older age groups especially. Longer life expectancy in the past among women explains their over-representation in older age groups. However, differences in life expectancy between women and men have begun to narrow and consequently the gender composition of older age groups is expected to become more even in the coming years.
If we are relying on government programs to be available for our parents' care or even our own care, should we be rethinking this attitude given the increasing costs of health care in general, especially since the governments are hinting strongly that their programs and services are to be thought of as 'the provider of last resort'? Is care considered 'preventive health' or....? What are we expecting of our politicians as they wrestle with this complex problem?
Interested in an animated population pyramid illustrating our population's changing age structure? Click here to view a Stats Canada presentation and click the arrows at any time to stop it at any point.
