Healthier Aging

The number of seniors aged 65 and older is increasingly rapidly in the United States and Canada. According to information from the US Census Bureau, there were 36.3 million American seniors in 2004, and they made up about 12% of the population. By 2050, it has been projected that there will be 86.7 million seniors, and they will comprise 21% of the population. Similarly, Statistics Canada reports that seniors 65 and older currently make up 13% of the population, and this figure is expected to increase to 23% to 25% by 2031.

The Canadian Senate's Special Committee on Aging was created to review a wide range of issues affecting seniors' lives, and to determine how public programs and services could better meet their needs. The Committee conducted hearings and sent questionnaires to seniors' organizations across the country to identify the major challenges facing seniors and possible options for addressing them, and their recommendations formed the basis of the Committee's Second Interim Report: Issues and Options for an Aging Population, which was released in March 2008. The report contains 84 options for improving the lives of seniors. These options have not yet been evaluated for feasibility, but they do offer interesting food for thought for seniors and policymakers on both sides of the border. We will provide an overview of some of the more general items here.

Active and Healthy Aging

• Healthy aging doesn't just mean maintaining physical health, but also good mental health and a strong social network. Healthy lifestyle habits, such as regular exercise, lifelong learning, and community involvement should be encouraged in people of all ages, so that they will maintain these habits later in life.

• Volunteerism has many benefits for seniors, and helps them stay physically and socially active. But contrary to popular belief, seniors are less likely to volunteer than people in other age groups; although, seniors who do volunteer tend to spend more hours on volunteer work than younger people. Governments can encourage seniors to volunteer by providing tax credits for volunteerism, skills-matching programs for volunteers, and long-term funding for volunteer organizations. In communities where such programs already exist, volunteering opportunities could be better promoted to seniors.

• Encourage life-long learning and promote its benefits for seniors.

Healthcare

• Integrating the many medical and non-medical support services exist for seniors and their caregivers is a top priority. Currently, the lack of integration makes it more difficult to access services, and creates costly inefficiencies. An integrated care system should offer "one-stop shopping" for seniors and their caregivers, an emphasis on independent living, and increased portability of services when seniors move from one region to another. In the United States, integrated seniors' care programs have been tested on a small scale, and a 2000 study reported that such programs are feasible and have the potential to significantly improve the delivery of healthcare and social care.

• Create a registered chronic care savings plans or provide tax incentives for chronic care savings to encourage people to save for their future healthcare and living expenses.

• Nonprofessional or paraprofessional home care staff provide many services for seniors. Better training standards and regulations are needed to ensure that all staff can provide good quality of care.

• Better practices are needed to prevent and address senior abuse and neglect. Solutions include preventing caregiver burnout, improving training for healthcare workers, and increasing staffing in senior care facilities.

• Increase training in palliative and end-of-life care for healthcare professionals and volunteers. Increase public education on available services and the need for advanced end-of-life planning.

• A greater number of healthcare workers are needed in the fields of gerontology and geriatrics, chronic disease care, palliative care, mental health, home care, and other areas related to the health needs of seniors. How to encourage healthcare professionals to enter these fields requires further study.

• Healthcare professionals and organizations can place a greater emphasis on sharing information on best practices in integrating care, the prevention of elder abuse, and other issues related to senior care.

Work & Money Issues

• Competent senior workers are sometimes pushed into retirement due to ageism and occasionally mandatory retirement policies. It's also difficult for seniors to reenter the workforce following a loss of work. To help combat the problems, governments could offer unemployed older workers longer employment insurance benefits. Awareness campaigns, stricter enforcement of age discrimination laws and regulations, and employer incentive programs for training and hiring older workers may help combat ageism in the workplace.

• Promote phased retirement and greater flexibility during the transition from full-time work to retirement. For example, in 2007, the Canadian government introduced a new policy that allows working seniors to receive a partial pension from their employer while simultaneously contributing to their government pension plan (CPP), and the government hopes this will encourage phased retirement.

• Ensure that all eligible seniors are receiving the retirement and age-related benefits to which they are entitled.

• Compared to men, women tend to earn lower wages, spend more years out of the workforce due to childrearing and caregiving duties, and have longer life expectancies. These factors mean that women are more likely to have insufficient funds during retirement and require government assistance in later life. Thus, any changes to social security benefits and retirement income policies should be assessed to ensure that they will not have a disproportionately negative impact on women.

Societal Changes

• Whenever possible, seniors should be able to live in the place of their choice, and most wish to remain independent and live in their own homes for as long as possible. To accomplish this, seniors need access to affordable housing, home care, community support services, and funding for renovations to make homes safer and more accessible.

• The community to which seniors belong plays a large role in their quality of life, and caring that occurs in the home and community is important to seniors' health and wellbeing. Communities should try to take the needs of seniors into account when designing neighborhoods, transportation services, and social, recreational, and support services. For more information, see the WHO's Global Age-friendly Cities: A Guide and the Public Health Agency of Canada's Age-Friendly Rural and Remote Communities Guide.

• A greater number of affordable assisted living and supportive housing facilities are needed for seniors who can no longer remain in their own homes.

• Family caregivers play an important role in caring for seniors, and can benefit from more financial and practical support. Tax deductions, tax credits, and more flexible work policies can alleviate some of the financial pressures associated with caregiving. Currently these options are often underutilized by caregivers, who may not be aware of all of the options available to them. Family caregivers also need more information on how to care for elderly relatives and how to maintain their own physical and emotional health.

Active and Healthy Aging

Healthcare

Work & Money Issues

Societal Changes

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Sheng Wang

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