Issues affecting seniors are complex and far-reaching and involve all levels of government. Perhaps that’s why no one seems to take the lead on tackling them, and no one is held accountable for the lack of initiatives to accommodate, support and care for this fast-growing sector of society. Canada’s federal government has notably failed to show much interest in seniors’ health and well-being.
The three major federal parties mention seniors, but only the Conservatives are without a health focus. Instead, they focus their policies and platform on elder abuse, in line with their law-and-order agenda. The Conservatives have also proposed a mandatory private pension plan. The Liberal Party’s platform focuses on the renewal of the 2004 health accord. As part of the new agreement, it hopes to implement a national pharmaceutical strategy. In addition, the Liberals promise to increase Canada Pension Plan and employment insurance benefits, introduce a family care program that offers tax breaks and invest in home care. The New Democratic Party would work within the Canada Health Act to develop affordable prescription drug programs. It also has a five-point plan focused on universal programs, such as Guaranteed Income Security, and programs addressing long-term care.
What would a nationwide comprehensive seniors’ health strategy look like? Will these platforms address current and future needs of seniors?
In most developed countries, between 85% and 95% of elderly people live in their own homes — but often only because of help from informal caregivers such as friends and family. Our federal leaders should consider options to support informal caregivers such as tax credits and changes in employment law to enshrine time off work to care for ailing parents or relatives. Offering corporate tax breaks for companies that have support programs for staff caring for families and loved ones may decrease some of the burden. But even with more support, we cannot count on families to do everything. Any comprehensive strategy will fail without serious investments in programs to support the frail elderly, including respite care, home care, day programs and rehabilitation services.
Let’s be clear: for the 5% of seniors who need them, beds in assisted living and long-term care facilities are essential. The shortfall is causing tremendous problems in hospitals, where far too many frail elderly are trapped in an acute care bed because they have nowhere else to go. That situation directly results in cancelled surgeries, long stays in emergency departments and patients being cared for in hospital corridors. Our acute care hospitals — and our frailest citizens — desperately need and deserve a solution for that 5%.
The federal government could create a partnership program to bring together private and public sectors to develop more residential options for seniors. With the right incentives and programs, the private sector could play a large role in providing affordable institutional, residential and elder daycare.
With increased home and institutional care for seniors, more nurses and other health professionals will be needed. Postsecondary education is a provincial responsibility, but the provinces might welcome federal programs designed to increase training opportunities for health care professionals, improve interprovincial mobility and speed up integration of foreign-trained health care workers now living in Canada.
If we want to keep 95% of seniors healthy and living independently, we should consider how best to plan cities and other living spaces as well as offer transportation and recreational and public health programs earmarked for seniors.
There are many policy options for the federal government and others to consider as part of a nationwide comprehensive seniors’ health strategy — options that could be tailored to fit almost any political philosophy.
However, given the many complex issues facing seniors, we should not settle for simple solutions or a patchwork of programs. Any comprehensive strategy should be multifaceted, evidence-informed, cost-effective, flexible and person-centred. Helping seniors is not only good public policy but good politics — a winning combination when facing the voting public in the coming year.
The next health transfers agreement, due in 2014, is a perfect opportunity for the next government to negotiate with provinces and territories to deliver a seniors’ health strategy.
Footnotes
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Competing interests: See www.cmaj.ca/misc/cmaj_staff.dtl.