Older People

The imminent dramatic increase in older people in our population has never been faced before in human history -- in a few years, one in four of us in British Columbia will be over 65.

I think this will make us view the human life cycle in a new way. Now, we tend to view "seniors," people over 65, as a homogeneous group. In fact, in the same way that people from 35 to 65 are not all the same, people from 65 to 95 are very different.

To adjust successfully to the coming major age shift, several aspects of how we live and organize things will have to change. As well as living longer, older people are more active and healthier than ever before, with fewer disabilities. We'll need to change workplaces and other institutions, and change ageist attitudes, so older people can continue to work and to participate.

What else must change?

Our current health-care system was designed many years ago to focus on acute health problems. In a world where over-65s outnumber children, the illnesses that affect most people are chronic ones and the system needs to focus more on ongoing management of chronic diseases. Primary care renewal with multidisciplinary teams and more appropriate evidence-based use of health-care resources, including drugs, is needed to do this.

Many older people have mobility, hearing, or visual decreases in function, so we'll need to reshape our houses, neighbourhoods and public spaces to accommodate people of all ages and abilities -- easy to walk, with accessible shops and community resources. We'll need, for example, to change notices that are too small to read, or traffic lights that don't allow time to cross.

Another change is needed because, as well as more well-functioning older people, there will also be more people who are very old or frail. Almost without exception, these older people want to remain in their homes and communities. No one wants to go to a long-term care facility if they can be helped to stay in their homes safely.

Research here and in other countries shows that supporting seniors to age in place improves their quality of life and life expectancy and when you compare costs for the same level of care clients, home care costs less than facility care. This nonmedical home support includes assistance with activities of daily living, meal preparation, housekeeping and home maintenance for those assessed as being unable to do these things safely themselves.

How are we doing on making all these adjustments and changes?

We are making progress on some, but it's slow on others -- for example, development of a home-support system so older people can avoid having to go to a facility. A very limited range of home-delivered services is provided in B.C., and that only to individuals assessed as having high