When you are 85 – Don’t go to a “Home”

In 2036 PEI will have 12,000 people, mainly women, over the age of 85. It costs about $50,000 a year to look after one person in a manor. That is $600,00,000 a year based on current costs. Who knows what this will be in 2036 dollars? Will we not have to think of another way as we all get older? The good news is that we have.

Marmot’s insight into the power of social status on our health is proved also when we get so old as to lose our place in the family and society. As we reach 85, if we do, we become more frail. Many families encourage their elderly parents into an institution. My own mother is one.  But we are finding that this loss of identity drives a collapse in ability and health. With no control and no role, who are we?

Veterans Affairs Canada has had more experience in this field than any other institution in Canada. They have been supporting the families of the WWI and now WWII and Korean conflicts. What they have found is that supporting people to stay in their homes is the best way to keep them well.

Those who reach 70 and are fit can often live for 30 or more years. They have avoided the kind of illness that takes the 65 or less population earlier. But there comes a time for this fit group where they become more and more frail and are less able to take care of themselves in their own homes.

The current  “Normal” is to put them in an institution. But the problem with this is that once they are in an institution, they lose all sense of control and so often become ill.

The problem is compounded by how well our medical system can keep them alive when ill. The result is a growing population that we keep alive for decades at great expense.

No organization has more experience with the very old as “customers” as VAC. VAC has the lead for the Federal Government for Seniors

VAC had always seen institutionalization as “Normal” until they too looked ahead and saw the consequences. They could see that they too would have a budget and so a political crisis if they did not find a different route. They had to find a way of offering their elderly vets more for less. They had to find a new model.

• Mapping the System – Like CIBC, VAC went beyond their first look at how the numbers worked to find out what were the key drivers. Again the who, why and where. They discovered that the worst thing they could do was to institutionalize the elderly.  The reason for the collapse in health was the loss of control and status. The loss of control and status often leads to a collapse in health.
• A non medical problem – Knowing now that the cause of this groups ill health was social changed everything. Like CIBC, VAC looked outside the medical model for a better way. They started with the situation of a person or a couple who was well but increasingly frail. The objective was to keep them in control and independent as long as possible.
• A non medical solution – From this question came the Veterans Independence Program where services were provided that would enable couples or even single survivors stay independent for as long as possible.

Since the introduction of this plan back in 1981, VAC has put ever more emphasis in the delivery system on keeping the elderly independent. VAC, like CIBC now understands the lifecycle of Disability in the Elderly and can intervene early. VAC has made major progress is both reducing its costs and also in improving the lives of its senior families and their children.

The medical system is important but is now in a support role.