Yet new data about elder caring gaps, this for Canada

Here is the start of a Globe & Mail article the other day, and it totally supports our ealirer UK posting on this subject:

Sys­tem must fo­cus on se­nior care strat­egy
AN­DRÉ PI­CARD api­card@globe­and­mail.com
The Globe and Mail Metro (Ontario Edition)
19 August, 2013

Cana­di­ans have lit­tle con­fi­dence in the abil­ity of the health-care sys­tem to meet the needs of a bur­geon­ing num­ber of se­niors and they are look­ing to gov­ern­ment to shift their pri­or­i­ties and come up with a plan.

That’s the mes­sage that emerges from a new poll com­mis­sioned by the Cana­dian Med­i­cal As­so­ci­a­tion.

“The anx­i­ety Cana­di­ans have about health care in their so­called golden years is both real and well-founded,” said Anna Reid, out­go­ing pres­i­dent of the CMA.

Na­tion­wide, three in five re­spon­dents said they be­lieved there would not be suf­fi­cient hos­pi­tal beds, long-term care and home-care ser­vices to meet de­mand in their golden years.

How­ever, there are sig­nif­i­cant re­gional dif­fer­ences. In Que­bec, for ex­am­ple, 56 per cent of those polled said the health sys­tem is ready for the so-called grey tsunami, com­pared to 31 per cent in At­lantic Canada.

Where there is near-unan­i­mous agree­ment – 93 per cent – is around the idea that gov­ern­ments should unite to de­velop a com­pre­hen­sive se­niors’ strat­egy. A large num­ber of re­spon­dents, 78 per cent, said Ot­tawa should play a sig­nif­i­cant role in de­vel­op­ing the strat­egy, de­spite the fed­eral gov­ern­ment’s stand that health is strictly a pro­vin­cial mat­ter.

“Let there be no doubt that a na­tional strat­egy for se­niors’ health care should be a fed­eral pri­or­ity,” Dr. Reid said.

She added that the poll re­sults send a strong mes­sage that the pub­lic wants ac­tion.

The repeating key point is that the system can't deliver to meet our expectations about eldercare. We need to work harder than ever to plan ahead, to research needed resources, to define and enlist  the help of others… lots to do! And we can't start soon enough anymore. 

Care of the elderly a challenge that’s growing everywhere

Take a look at this short story on the BBC tonight: http://www.bbc.co.uk/news/health-23810109
 
It's an excellent example of the kinds of help and support shortages that will keep growing not just in England, but across Canada and the United States, too.
 
All the more reason to think about what kind of care our aging parents will need and likely when, and then plan now for how to get that help. 

Open, honest communication is essential

If one is a geriatrician, a good part of one’s practice is focused on individuals either living with dementia or concerned about having symptoms that might be dementia. It is often a frightening prospect, at times more so for the family members than for the person with the symptoms, depending on their awareness of the problem and insight into the implications.

As I looked through the health record, I saw the neuropsychological report that supported my initial clinical diagnosis of likely dementia. The symptoms suggested it was probably a type of Alzheimer’s type. There was a note that my secretary handed to me from the patient’s spouse which reminded me of many requests I have received over the years from family members accompanying a loved one to such a medical visit. She did not want me to share an adverse diagnosis with her husband

Years ago, families and physicians sometimes conspired to withhold the true nature of a patient’s condition. As a result, patients and families were denied the opportunity to honestly express their important thoughts and feelings to each other before the patient died.

Gaining trust

What should I do about this latest request? I looked again at the wife’s note and asked the couple to come into my office. I knew that I would have to gain the couple’s trust to ensure our future relationship would be productive. After our initial greetings, I turned to the issue of the neuropsychological report. “So how did that go?” I asked the patient. “I think pretty well. What was the result?” he replied.

I responded that the reason I sent him for the examination was because his wife and I had concerns about his memory, and that I suspected dementia. I could see the patient tense up when I used the term dementia. I continued, “You know that we use the term dementia to mean something is not right with the way the brain and its ability to remember things works. There are many disorders that can cause dementia…”

Breaking the news

The patient concentrated on my every word. I continued, “Fortunately, we now have medications and other treatments that can treat these conditions, including Alzheimer’s disease.”

I want to try one with you and start it now at a low dose to give you the best chance of tolerating it until I see you in a few weeks for follow- up. Is this OK with you?” I could see his wife with a bit of trepidation waiting for his response. “Sure…are there any side effects?” he asked. I replied, “Most people tolerate the medication well but I always start with a small dose just to make sure.” 

As he got up to leave with his prescription, I said that I looked forward to seeing him. I did not tell him or his wife what to expect so that there would be no pre-conceived ideas of his treatment. As she left the room, the wife said, “Thank you, I did not believe we could do this and we did.” I’ve learned through many years that open and honest communication between doctor and patient (and their family) is more helpful than avoiding the truth. It has to be done with sensitivity and sometimes over time rather than in one meeting.

Aging parents, eldercare blog starting next week

In just days, we're starting to post blogs on a regular basis.

Our goal is to provide good counsel that  helps all those with aging parents and other loved ones better address the issues they face. We will be posting blogs on a regular basis.

As well, our newest Parenting Your Parents book will be in bookstores and available online as of September 21st. Pre-ordering can be done now.

We are looking forward to engaging you, offering sound insight into the issues we all face around eldercare in the family, and receiving your feedback.