Designing health care for an aging population

When the country's health-care system was set up about 50 years ago, patients were much different than they are today, according to Dr. Samir Sinha, the lead for the province's seniors' care strategy.

The average person could only expect to live to be in their late 60s, as opposed to today's average life expectancy of 81. Fewer people had disabilities. Many seniors lived with their families, unlike today, when seniors' offspring often live far away.

At the same time, with the baby boomers getting older, the percentage of those over the age of 65 is set to double in the next 20 years, Sinha told those gathered at a Sept. 6 Rotary Club of Sudbury Sunrisers meeting.

Then there's the fact that the province is currently facing a $15-billion deficit, and that health-care spending could consume 80 per cent of Ontario's budget if no changes are made to how health care is delivered, he said.

Taking into consideration these factors, Health Minister Deb Matthews appointed Sinha in May to develop recommendations for a provincial seniors' care strategy as part of her efforts to reform the health-care system.

Sinha is the director of geriatrics at Mount Sinai and the University Health Network Hospitals in Toronto.

He's also the chair of the health professionals advisory committee for the Toronto Central Local Health Integration Network and a medical adviser to the Toronto Central Community Care Access Centre.

“The minister said 'You're a really smart guy, you know a lot of stuff, and you may think you have the answers, but before you come to me, I want you to go around Ontario and listen,'” Sinha said.

“So what we've done is we've launched a public consultation strategy. We had over 5,000 older adults engage with us this summer, telling us what's on their mind.”
He said he expects to submit his report to Matthews sometime in October.

Accompanied by North East Local Health Integration Network (LHIN) CEO Louise Paquette, Sinha is consulting with seniors, caregivers and other stakeholders in Northeastern Ontario this week, visiting Sault Ste. Marie, Sudbury and Timmins.

On his itinerary in Sudbury were visits to Finlandia and the Shkagamik-Kwe Health Centre.

Sinha said seniors are saying they want to stay out of long-term care homes as long as they can by accessing community services or supportive housing.

“A lot of older Ontarians are saying we want to have services and programs that focus not just on health care, but on prevention and wellness as well,” he said. “How do we focus on staying healthy so we can stay at home longer?”

Providing access to community care is especially important in the northeast, where there's chronic issues related to a high demand for hospital and nursing home beds, Sinha said.

The province is attempting to divert patients from these expensive resources to lower-cost community care programs, he said. In the last budget, the government boosted community care spending by four per cent, while hospital spending was frozen, Sinha said.

“The goal of the seniors' strategy is to understand what those sorts of investments (in community care) need to look like, and how do we best support older adults to stay in the community,” he said.

Sinha said he's glad the people of Greater Sudbury and Northeastern Ontario will soon have access to a second geriatrician.

The region's first geriatrician, Dr. Jo-Anne Clarke, set up practice in Greater Sudbury a few years ago. Earlier this summer, Health Sciences North announced geriatrician Dr. Janet McElhaney has been recruited from Vancouver, B.C. to fill the newly created hospital position of medical lead for seniors' care.

The province only has about 200 geriatricians, but actually needs 800, Sinha said. The government is making a concerted effort to attract more of the professionals to the province, he said.

Paquette said she hopes Sinha will include the need for more affordable supportive seniors' housing in his recommendations.

“Affordable housing and assisted living is an integral part of the solution to caring for the frail elderly,” she said.

Access to primary care, or the care provider who “has a handle on the overall, holistic approach to their health,” is also important for seniors, Paquette said.