Canada’s population is aging rapidly, with one-quarter of residents expected to be 65 and older by the year 2036. Yet a recent report from B.C.’s seniors advocate says family caregivers are dealing with extremely high levels of stress.
As UBC launches its new Master of Health Leadership and Policy in Seniors Care, Jennifer Baumbusch, associate professor in the UBC School of Nursing, discusses why the health needs of aging adults are in urgent need of attention.
How are the health needs of seniors different from the rest of the population?
Compared to the younger adult population seniors have more complex health-care needs, because they tend to have more chronic diseases. Whenever a senior comes into the health-care system you’re looking at multiple issues. And it’s not just health issues but social, housing and financial issues as well. You have to look across all of those things, which are changing as people age.
We have to shift our thinking away from short-term solutions. We need to be planning to support people as they age over time. Policy makers and leaders need to design services and supports that meet the complex needs of this population.
What can the health-care system do to prepare for those needs?
When I started my nursing career 20 years ago, we were talking about the aging population. It’s a little late to be still talking about “getting ready.” We need to be ready now. We know that there are great evidence-based models for care that exist in the community and hospitals and in residential care. We need to commit to implementing them over the long term.
In particular, we look at our hospitals, which have not been oriented to seniors care at all. We need continuing education for clinicians as well as leaders in that sector; by and large they may not have chosen to work in seniors care but now, by virtue of the population they serve, they’re working in seniors care.
Within our undergraduate programs, where people have an interest in working with different populations, older adults tend to be at the bottom of the list. There’s a real mismatch at times between how people are being trained for health care and who they’re actually going to be caring for.
What type of training is needed?
Health-care providers need to understand that if we have someone who comes in with a broken hip, they may also have dementia, they may also have diabetes, they may also have heart failure, and you need to be keeping all those balls in the air.
It’s also much more important for seniors to maintain their level of activity and their level of function. For an older adult to spend 24 to 48 hours in a hospital bed, there will be a much greater loss of function than with a younger adult.
What can individuals do to prepare themselves or their loved ones for the challenges of aging?
People often say, “I don’t want to end up in a nursing home when I’m old,” but then they don’t really do any realistic planning beyond that. People really need to think about they want their senior years to look like and make a plan. There are all kinds of resources and services that people can access, but they need to think in real terms about what they want, and then communicate that to their family members and their health-care providers.
In particular, they need to have that conversation with their family physicians or nurse practitioners providing primary care. We often hit a crisis and people end up in the ER, and no one knows what this individual wants. At that moment it’s too late to put a different kind of plan in place.