Population Aging and Healthcare

Population Aging and Healthcare

• Population aging can increase the pressure on the health care system.
• Population aging accounts for about 10% of rising healthcare costs in Canada.
• The primary reasons for rising healthcare costs include:
  • Hospital costs
  • New technologies
  • New pharmaceuticals
• Medication usage increases with age on average
• Issues related to increased medication use include:
  • Equity of access and drug costs
  • Need for research on drug interactions
  • Additional drug testing with older/very old/ patients
  • Education regarding drug compliance and management.

Drug Use, Misuse and Abuse

• Key challenges for older adults taking medications:
  • Over-medication
  • Non-compliance
  • Problems with dosage
  • Problems with efficacy

Anti-Aging and Health Care

• Numerous products, treatments, and surgeries aim to slow or reverse aging.
• The anti-aging industry is valued between $50 and $80 billion USD.
• Anti-aging practices promote ageism.
• These procedures are class-based and not accessible to everyone.
• The industry is filled with scams and false claims, including unproven drugs and treatments.

Barriers to Health Care

• Equal access to healthcare is not available for all Canadians.
• Major barriers include:
  • Living far from services
  • Language barriers
  • Lack of transportation
  • Cognitive deficits and decline
  • Minority membership status
  • Cultural barriers

COVID-19 and Health Care

• The COVID-19 pandemic exposed significant issues in the health care system
• Lack of homecare and long-term health care
• The pandemic increased stress for older adults in private households trying to meet everyday needs.

Integrated Model of Health Care

• Concerns about rising health care costs and the effects of an aging population have led to critical examinations of current health care models for older adults.
• Integrated models of health care delivery have been proposed.
• Integrated models create more seamless delivery systems for older persons.
• These models combine health, housing, and social services.
• They improve coordination between acute care, continuing care, and long-term care, despite fragmented health care systems.

Summary

• Physical and mental health are determined by complex biological, genetic, lifestyle, and social-structural factors.
• Prevalence of dementia, especially Alzheimer’s, is growing.
• Canada’s healthcare system is under stress due to inflation in the cost of providing high-quality health care and medications.
• The healthcare system pressures will increase as baby boomers reach old age.
• Health care reforms must cover medical treatments and focus on integrated health.
• The health care reforms must also include:
  • Community care, national home care
  • Pharmacare programs
  • Increased mental health services
  • Healthy aging programs

Older Adults Who Never Married

• About 7% of older adults in Canada have never been married (and do not live common law).
• Most adults who never married are not lonely or socially isolated because they develop friendships with non-relatives or extended family.
• Older never-married women tend to be well educated and financially secure.
• Male counterparts tend to have lower education and financial insecurity.

Childless Older Adults

• Approximately 14% of the older population is childless.
• This percentage may increase due to later marriages and more people choosing not to have children.
• Childless older persons tend to report high well-being levels.
• Childless older people usually have sufficient support networks and are socially active.
• Older persons without children often receive support from family or friends.
• People over 85 are less likely to have someone close who can provide personal care, especially if they are widowed.
• The risk of being admitted to long-term care facilities is higher among older childless people.
• Three commonly reported advantages of being childless in later life:
  • Fewer worries and problems
  • More financial wealth
  • Greater freedom
• Three reported disadvantages of being childless in later life:
  • Lack of companionship
  • Lack of support and care
  • Missed experiences around parenthood and thus feeling incomplete (mainly reported by women)
• Potential Challenges includes:
  • Heightened risk of social isolation and loneliness
  • Stigma and social attitudes

Policy and Support

• Policy and support needed for older adults with no children
• Accessible and affordable home care and caregiving options
• Age-friendly communities foster social interaction and community participation
• End-of-life planning that includes medical and financial policies

Life Transitions

• Family life changes drastically when major life transitions occur.
• These changes include:
  • Marriage
  • Birth of a child or grandchild
  • Empty nest/refilled nest
  • Divorce
  • Remarriage
  • Retirement
  • Widowhood

Empty/Refilled Nest

• The empty nest stage can bring relief from domestic responsibilities associated with raising children.
• It can also result in a reduction of financial responsibilities.
• It often presents an opportunity for lifestyle changes for parents when they are now “empty nesters”.
• Some research indicates that marital satisfaction increases during this time.
• Most parents experience 'empty nesting' positively.
• Many adult children return to the family home (nest), which can 'refill' the nest.
• “Boomerang” kids move out but then return home, sometimes due to personal crises.
• Many adult children also delay moving out for many reasons, including high living costs
• The experience can result in mixed emotions for parents.

Divorce

• Divorce occurs more often in earlier life stages but late-life divorces are increasing.
• Approximately 10% of older adults are divorced.
• Divorce rates are slightly higher among women (12%) compared to men (9%).
• Divorce has both positive and negative consequences for divorcing partners.
• Men may have a higher risk of depression and health decline following divorce.
• Women are more likely to experience financial strain than men.
• Some divorcees report liberation and personal growth.

Widowhood

• 20% of older adults are widowed.
• There are generally more female widows than male.
• Rates are declining due to longer life expectancies and more divorces.
• For many, widowhood is often preceded by caregiving/institutionalization of a partner.
• Widows (women) often fare better than widowers (men).
• Widowers (men) are more likely to date, cohabit, or re-marry than widows.

Dating, Cohabitation and Remarriage

• Most older men have partners while most women do not.
• Approximately 61% of men and 43% of women are married or in common-law partnerships.
• Cohabitation or remarriage is becoming more common as the number of unattached older persons grows.
• Divorced persons and men are more likely to remarriage or cohabitate than widowed men and women.
• Most remarrying people report satisfaction with their new marriage.
• Dating in later life differs significantly from the past.
• Many dating sites and apps exist now.
• People still meet in-person through religious, cultural, and community groups.
• Challenges may arise when managing grief, but many people enjoy dating as an older adult.