Every three seconds, somewhere in the world, there is a new case of dementia. The global economic impact of dementia is estimated to be more than a staggering $1 trillion per year and, in Canada, the annual costs associated with dementia are projected to exceed $16.6 billion by 2031. Are we equipped to meet the needs of our aging population?
If the past year is any indication, the answer is no. During the pandemic, our continuing care system performed poorly due to a lack of system capacity and an absence of quality care. It has been widely reported that Canada’s nursing home deaths were well above the international average. Sadly, these results come as no surprise to the researchers, health care professionals and families who have been advocating for change and system improvements for years.
We can no longer ignore the imperative for substantive change. Opportunities for innovation abound as we seek new and better ways for Canadians to age with dignity and purpose. We can look to other countries like Denmark, Japan and Australia for inspiration, but we have the talent and expertise to make Canada a leader in healthy living and aging.
In a recent survey, over 95 percent of Canadians 65 years of age and older report that they want to age in their own home. In response, we must examine our funding models which are disproportionately skewed towards large long-term care institutions and focus instead on increasing access to and availability of community-based programs and services that enable people to retain their independence and remain at home as long as possible.
Home modifications, assistance to navigate the complexities of the healthcare system and the development of programs and services that align with individual needs and preferences cost significantly less than higher-level care options such as the hospital and residential facilities. Let’s design a system that gives people what they want.
We need a vigorous public education campaign about risk reduction measures that helps to prevent or delay cognitive decline. While age is the biggest risk factor for developing dementia, dementia is not a normal part of aging. In fact, 30 percent of cases of dementia are believed to be preventable through modifiable risk factors such as diet, physical exercise, education and maintaining social connections. Let’s do whatever we can to keep Canadians healthy and living independently in their own homes.
For those who are unable to remain at home, let’s move away from a task-based, medical model of care towards a person-centred, relational model of care. Let’s offer a choice of care settings such as small homes designed for six to eight people that are embedded in residential communities and offer dignified, respectful care which includes consistent care assignments, access to the outdoors, pets and for couples to remain together.
Investment needed to support healthcare workforce
Furthermore, everybody working with people living with dementia and their families should have dementia-specific skills and knowledge. An investment in a skilled, supported healthcare workforce will result in better quality of care, reduced stress for families and a reduction in healthcare costs.
We must design a system that recognizes the essential role of family care partners who provide millions of hours of unpaid care. Without adequate support, this invisible workforce is at risk of burnout and developing their own health issues which results in unnecessary hospitalization and premature institutionalization of the person they’re supporting.
The global goal for investment in dementia research in developed countries is one percent of the annual cost of caring for dementia patients. For Canada, this would amount to approximately $120 million per year. Canada’s current funding is far below this target with an investment of approximately $12 million per year, 10 times less than what is recommended. We need an investment in both “cure” and “care” research. There is still much to learn about healthy aging and how the brain works.
There is currently no known cure for dementia. Twenty-five percent of Canada’s population will soon be over the age of 65 and many will be at risk for cognitive decline and require care and support. The subsequent impact on our economy will be enormous.
Scientists around the world came together to create a vaccination for COVID-19 in record time. We need the same effort to prevent and treat the many kinds of dementia and other forms of cognitive decline. We can no longer ignore this growing segment of our population and we need to create a system that offers high quality, personalized care. In the meantime, Canada would be wise to take action to keep our population healthy and productive to mitigate the costs of care.
Lisa Poole, a family care partner, is the co-chair of Dementia Advocacy Canada, a member of AGE-WELL’s Older Adult and Caregiver Advisory Committee, and Imagine Citizen’s Healthy Living and Aging Working Group.