NNPCN #IFA #GrayPanthersNYC #HonoringNursingHomeLivesLost #KupfermanJ #NipissingUniversity 15th Global Conference on Ageism, IFA International Federation on Ageing, Session 138.Kupferman, J. and Do Coutto Monni, M.. Honoring nursing homes lives lost. Short video produced by NNPCN in partnership with Nipissing University School of Nursing, Prof. Keri McGuire-Trahan and students
The COVID-19 pandemic has affected how we live our lives and provide care to older adults. In this unprecedented moment during which the world is searching for ways of overcoming the challenges associated with the COVID-19 pandemic, older adults have been disproportionately affected by the direct consequences of the pandemic and associated social distancing regulations. Within the elderly population, older adults with sensory impairments such as vision and hearing impairments are facing additional structural barriers in accessing care and rehabilitation services.
The population worldwide is ageing rapidly, and Canada is no exception. By 2036, one in four adults in Canada will be above 65 years of age. Analysis of the Canadian Longitudinal Studies on Ageing 2016 data indicates that up to 1.1 million Canadians experience some forms of concurrent hearing and vision challenges (referred to as dual sensory loss/DSL). DSL is a condition that is more complex and disabling than hearing or vision loss alone. Given this distinct impairment, challenges in communication, accessing information, and mobility hinder many aspects of access to healthcare. The Institut Nazareth et Louis-Braille du CISSS de la Montérégie-Centre (INLB) is a part of the Center for Interdisciplinary Research in Rehabilitation of Metropolitan Montreal (CRIR), which is the largest rehabilitation research centers in Canada. The INLB’s programme de surdicetité (Deafblindness Program), a shared rehabilitation program designed to integrate the needs of clients with DSL, is co-coordinated with the Institut Raymond-Dewar du CIUSSSS Centre-Sud-de-l’Île-de-Montréal, another CRIR rehabilitation center specialized in hearing impairment. The mission of INLB is to spearhead the development of rehabilitation interventions that promote the functioning and social participation of their clients with DSL across all levels of impairment and all ages. While assisting clients with DSL, it has often become evident that there is an utmost need for more research and development of emerging technologies that could benefit their clients with DSL in improving their functioning and quality of life.
During the COVID-19 pandemic, the INLB adapted their strategies and interventions to meet the needs of their DSL clientele in addition to meeting the provincial government’s policy responses. The aim of the workshop is to make professionals in the ageing field aware of the challenges faced by the INLB organization and then present micro- and macro-level strategic solutions that they used to adapt to the changing situation. We will present the telehealth related challenges faced by older adults with DSL and pinpoint to the adaptations that were made. The workshop would emphasize the best strategies that worked despite the evolving public health policy regulations. The workshop would be interactive by using case examples from the INLB older clientele with DSL and how they were served during the pandemic. Moreover, using the findings from a COVID-19 research study that INLB is supporting, information will also be presented on barriers to health information and tele health for older adults with DSL in Canada.
Human Species in Fast Flux: the Geoeconomical Politics of Ageing
Presented at the 15th Global Conference on Ageing – IFA International Federation on Ageing
Author: Monica Do Coutto Monni, IAHPC Advocacy Focal Point Canada, NNPCN E.D.
When I was invited to participate in the IFA 15th Global Conference on Ageing “Rights Matter,” and to be part of the WHO World Health Organization Orientation Workshop, I had to conduct a soul search. What could I possibly contribute, in terms of that take-home one message, that could be remembered by each of you? After all, the IFA Conference is an exquisite treat to us all, providing massive, specialized information from the greatest experts in the world.
I got my inspiration from the work I currently do. A true adventure, as the Executive Director of a Visiting Palliative Care Hospice in Northern Ontario, Canada. Northern Ontario is 860,000 km2 – the size of France plus Germany – with harsh sub-arctic climate, six months of winter with average temperatures varying between – 18 and – 45 C, severe snowstorms, and one of the lowest demographic densities in the world – 0.6 to 1.4 people per square kilometer – second only to Greenland and the steppes of Mongolia.
My palliative care clients, mostly ageing individuals living in remote rural or hard-to-reach areas, travel an average of 1h30m to the nearest city with a primary care facility, when they have a medical emergency or need specialized care.
My volunteers must do the same, driving an average of 1h30m to see their clients living in isolated properties in these remote rural areas. This is an immense region with several First Nations reserves, most of them off the grid, with poor or no access to telehealth.
Due to the low demographic density in the area, most ageing people had already experienced chronic and severe social isolation even before COVID-19. This is an Indiana Jones quest in itself; however, I am not here to talk about the challenges of supporting ageing clients in these extreme conditions today.
The take-home message I want to share with you today is far more extreme than that. COVID was a nudge towards better understanding about the reality our grandchildren will face when it is their turn to age. This passes through the geoeconomical politics of ageing.
National policies of retirement and pensions currently walk hand in hand with the institutionalization of our ageing population in long-term-care facilities. We must address this challenge together with our governments.
Long-term-care facilities, as they are set up at present, are mostly industrial-like facilities for massive herding and institutionalization of the ageing, based on the old paradigm of cutting costs and maximizing results. A depersonalizing environment, looked upon as a life sentence by most ageing residents.
Although the roots of a retirement pension go back as far as the military in the Roman empire, nothing prepared our nations to the fast change our species has experienced in the last two hundred years or so, in terms of longevity, in terms of the cultural mainstream perception of ageing, and the role of the elderly in society.
In his 1905 valedictory address to the Johns Hopkins Hospital, the eminent Canadian physician William Osler expressed his conviction that a man’s best work was done before he was forty years old, and that by age sixty, he should retire. He called the ages between twenty-five and forty the “15 golden years of plenty.” Workers between ages forty and sixty were tolerable because they were “merely uncreative.” But after age sixty the average worker was considered useless.
By 1935, the widespread idea became to pay older individuals enough as an incentive for them to quit working. A Californian, Francis Townsend, proposed a plan offering compulsory retirement at age 60. In return, the Legislature would pay benefits of up to $200 a month, a sum identical at the opportunity to a full pay for a center pay laborer. In response to this, President Franklin D. Roosevelt proposed the Social Security Act of 1935, which made the workers pay for their own retirement.
Currently, retirement age is at 65 years old and long-living individuals in developed countries have an average life expectancy of 86 years old.
What our society is missing is that death is not an instantaneous event: it is a gradual mind-and-body breakdown process. Right now, the Baby Boomer generation is experiencing 20 to 25 years of gradual breakdown, from 65 to 90 years old.
In developed countries like Canada, at least a third of us will need long-term care. From those of us wanting to age and die at home – which is the preference of the great majority of ageing individuals – another third of us will need home care and/or palliative care.
Our species is in fast flux, a real quantum leap in terms of quality of life and human lifespan. Our grandchildren will likely experience an average life expectancy of 120 years old. If they start the gradual break down of their bodies and minds at around 70 years old, that means they may experience half a century – 50 years – of gradual breakdown until death around 120 years old.
Do you want to be institutionalized for half a century? That is equivalent to a life sentence for the crime of being long-lived. It is clear we need a more human and realistic approach to retirement, ageing, end of life, and better planning and preparedness at all levels – social, cultural, educational, political, and economic.
The Baby Boomer generation has been unique and privileged. After the two World Wars, governments of developed nations opened the pathways to prosperity before our feet: we had port-a-rooms quickly set up in the backyards of our schools to offer education to all. Jobs were created for us when we became young adults.
We changed the face of world culture by protesting about nuclear weapons and the destruction of the natural environment. We asked for the end of wars like Vietnam and fought terrorism back. We advocated about women’s rights and human rights. We had our children vaccinated in mass and reduced childhood mortality dramatically, for the first time in the evolutionary history of our species. UNO and WHO members have recently started to advocate for palliative care and quality care in end of life as a universal human right.
We the Baby Boomers have changed reality in so many ways. I think we are not done yet. Our generation will have passed away by 2050 but we can leave one last contribution to the future of our grandchildren, who will age in the second half of the 21st century.
We must bring this dialogue to privileged forums like the UNO and the WHO, and think together about the geoeconomical politics of a species that is doubling their lifespan in less than 3 centuries.
What kind of world do we want leave to our descendants?
I hope we all join forces to plan now for a world where our grandchildren and greatgrandchildren can age in liberty and equality, in home-like small long-term care facilities or cohousing small communities, with sustainable pension plans, sustainable national budgets, and equitable distribution of resources, to secure end-of-life quality primary care and psychosocial support, in a prejudice-free society that counts on the relevant contribution of the ageing generation, fruit of their accumulated expertise, experience and concrete work during the half century of their gradual breakdown to death, between their 70’s and their 120’s.
May all nations, by the middle of this century, see the ageing not as a burden but as a force of nature.