Recoding a Care Agenda in a Longevity Society.

As the statistics on aging demographics continue to spill in the news, are we really in a race against time before we begin to hit the heavy numbers, when health and other social services become more dominant an issue than they already appear to be? How long will it take to get it right? Is 2030 that watershed year, when early millennials start to push into their fifty’s? Are we even seeing things with 2020 vision?

Well for years now, we still seem to be in the process of over-ruminating on this subject – improving our health care & social systems. I’m feeling something akin to a seven year itch. In October 2010, in the design and facilitation of a conference agenda with my colleague, Marie Howes, for the Retirement Planners Association of Canada (RPAC), we included this care agenda under the broader title – Re-framing Retirement & Longevity Issues in 21st Century Canada.

Our opening speaker was Dr. Raisa Deber, PhD, University of Toronto, with her talk titled – Health Care from House Calls to Hospital Stays: how can our system be improved?  She set the tone for our next day keynote speaker, Dr. John Sloan, MD., who had just authored the book A Bitter Pill: How the Medical System is Failing the Elderly. Dr. Sloan’s quite arresting presentation followed with by a panel, which included him, another doctor and elder care specialist Lisa Wiseman, RN.

What I retain in particular, was that panel discussion where the central question we posed was – what is your vision for a hybrid model of health care? The subtext on this was how we could best provide health care delivery between home, hospital and care facilities. One leftover discussion point that followed from this notion of a “hybrid” was that we need to determine – what is appropriate care and at what level, to meet our numerous diverse needs on the aging continuum.

At that time, I don’t recall anyone using the term integrated care, but that’s what we were talking about. Here we are still searching for the answers at another point in time October 2017, when stories about hospital overcrowding continue to headline – Elderly Sudbury man a victim of hospital overcrowding. And in September there was Ontario considers reopening Toronto hospital to help with overcrowding.

Better public discourse, without the hype of crisis & chaos

Considering the responses to these concerns, I’m not sure our 2010 vision around creating that hybrid model is anywhere closer to an “appropriate” reality. However, it will be up to people to make it a priority as a social issue in the next Ontario election. But in order to have the best informed conversation, everyday citizens need to do their research and make it a learning objective. A good start might be with the 2014 Ontario report – Experiencing Integrated Care. After reading that, then ask yourself, how does this report square up with the current news cycle?

In a longevity society I would submit that a hybrid or integrated model of care is not just about hospital and medical systems, it also includes home care networks, the role of individual caregivers and the integration of technologies. It does take time to recode a new way of living with all this, especially as we are still finding it hard to let go of the models we have known for decades, while at the same time asking, what are we willing to reinvest in with our tax dollars?

With every conversation I encounter, the subject of health, caregiving and aging demographics is increasingly top of mind. So I make it my business to keep informed and push the need for better public discourse without the hyped language of crisis and chaos getting in the way of making intelligent decisions, and driving home the message that a healthier and more easily and accurately understood care agenda is every generation’s inheritance.

In aid of this discourse, in August 2018 the International Federation on Ageing is holding its 14th global conference, Towards a Decade of Healthy Ageing, From Evidence to Action. One of the Master Classes in advance of the conference on August 7th is Implementing Integrated Care. All part of a great opportunity to close the distance for me, from that 2010 conference, as we still ask – how can our care systems be improved?

Is 2030 that watershed year? Tempus fugit, indeed.

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