The Barrie Advance
Sunday, November 26 2006
Seniors and Stress: Good News, Bad News
by Paula Terry-Lancaster: Special
The good news these days is that we’re all living longer. The average Canadian life expectancy is the highest it’s ever been, at 75 and 81 for men and women respectively, according to the most recent data from Statistics Canada.
The medical research community is meanwhile happy to be making significant breakthroughs in the treatment of some cancers and other ailments that used, until recently, to be associated with increased mortality in the last decades of life.
There is hope of treatment within a decade for both Alzheimer’s and Parkinson’s disease, for example, and early clinical trials seem promising in the diagnosis and treatment of a number of other ailments as well.
The senior population, however, is expected to almost double in the next 40 years as the baby boomers, now in the second half of their lives, reach old age in copious numbers.
By 2041, the percentage of those of us over 65 will increase to form 22.6% of the Canadian population, versus only 13% of the national population today.
With these figures in mind, many health care professionals and economists are encouraging governments to seriously consider new and revised policies regarding alternatives to institutional long-term care for the elderly.
Today’s seniors are, in many ways, more youthful and vigorous than ever before. However, partly due to our living in an increasingly mobile society, more seniors today live further from their adult children than was typical even a single generation ago.
That isolation from family members can prove stressful for seniors at critical moments in their lives – and stressful, too, for their sons and daughters who, in many instances, live too far away to offer day-to-day physical help.
Increasingly, it seems, seniors must fend for themselves or rely on the friendship of others to see them through life’s most stressful moments.
Dr. Kim McKenzie is a GP in Barrie specializing in geriatric medicine, and runs the Healthy Aging Clinic at the RVH every Thursday afternoon. With the most obvious affection for his senior patients, he explains that there are four main stressors in the lives of seniors: physical, emotional, cognitive and social
The most obvious physical stressor is the overall deterioration of the physical health of the body. Very often seniors are taking multiple medications, and often will have reduced ability to care for themselves because of one or more physical illnesses.
A primary emotional stressor is the increased likelihood of depression due to the loss of a spouse or the physical separation from adult children and grandchildren or other family members, or because of a decreasing social circle in the wake of the death of companions and friends.
Cognitive stressors include an increased incidence of confusion and the possibility of dementia, which always has a profound affect on the domestic living arrangements of a senior.
And social sources of stress include the fact that, in their elder years, a senior’s role in life changes profoundly. After retirement, seniors no longer play an active role in the workforce, and this changes their identity, particularly the respective identities of men.
Seniors are also the victims of what might be called ‘ageism’ – social discrimination based solely on age. In a youth-obsessed culture, people tend to devalue those who are of senior years.
Ageism is present when people dismiss the opinions of older people or speak on their behalf when they’re capable of speaking for themselves. When people use disrespectful or dismissive labels or epithets to describe old people, it’s both demeaning and insulting.
Ageism is also actively present when people abuse and exploit seniors. Many health professionals and educators are increasingly calling for widespread public education, so that the aging process is demystified and the valuable role seniors actually play in our society is much better understood.
In some communities, it’s been determined that much more emphasis needs to be placed on early education, for example, to promote positive attitudes towards aging. Programs like Adopt-A-Grandparent, amongst others, are seen by some activists as creating a good start in bringing about a change in societal attitudes.
So what, then, can be done by us younger folk to help seniors who feel overwhelmed by life’s most stressful moments?
“Plenty,” says Kim McKenzie, who admits that there is an acute need to improve our assessment and accurate recognition of the medical problems seniors face.
“We need to recognize and treat dementia and we need to recognize and treat depression,” he says. “Both those conditions are currently terribly under-recognized and under-treated.”
“We need also to recognize that the elderly are an ongoing important part of society, who deserve our respect and support, especially during the transitional times of their lives”.
That means not just ensuring seniors have adequate medical services, but adequate access to community services, social services, support services, physical services and recreational services as well.
Currently in Canada there’s a gross shortage, not just of doctors, but of occupational therapists, physiotherapists, recreational therapists, personal care workers and nursing staff in the community at large.
In terms of the physician shortage, Kim McKenzie believes governments are working on a remedy, but one that won’t bear fruit “for another ten or fifteen years. We’ve begun to make it easier for foreign-trained doctors to be able to practise here, as long as they’re able to meet the same high standards that Canadian-trained doctors have to meet. But we also need to dramatically increase the number of admissions to Medical schools.”
Those two things may well ease the physician crunch in the medium-term, but many other health disciplines, like occupational therapy and physiotherapy, “are really almost more important than doctors to the elderly, because it’s not their physical problems so much as their functional problems that create the trouble,” explains Kim.
“It’s seniors’ functional problems that determine their ability to live well day-to-day. You need to provide good access to recreational facilities, fitness instructors, physiotherapists and OTs, because they’re the ones who help maintain a senior’s ability to enjoy life to its fullest extent, right in the heart of his or her community.”
We here in Barrie are in a difficult position in terms of ensuring that seniors’ many needs are met, not just because our population is rapidly aging like that of Canada as a whole, but because we have a higher-than-average percentage of older people versus the rest of Ontario.
This is partly due to the fact that Barrie and its surrounding area is increasingly perceived – and marketed – as a prime retirement destination, along with Wasaga Beach and Collingwood.
As more and more older people move into the area, there’s a widening gap between seniors’ needs and our ability as a community to meet them, due in part to our having insufficient numbers of physicians and other adequate community-based services.
It’s critically important that seniors feel safe in their communities, and a whole range of solutions, from neighbourhood watch programs, buddy systems, phone-check programs, fall-prevention programs and elder-abuse education programs, could be much more highly utilized to help seniors feel safe, whatever their domestic circumstances, and whatever the kind of housing in which they live.
But repeatedly, seniors will tell you that maintaining their independence, and remaining in their own homes, is the primary quality-of-life issue for them., and one many of them feel they could attain if only there were sufficient support services in place and available to them.
Enter a new breed of professional helper – the Professional Organizer & Relocation Specialist, who does for seniors what a perfect adult child would do, if only he or she were here, were equal to the task, and had sufficient time, energy and resources.
In Barrie, one such professional organizer is Lisa Gabriele, whose company’s called Everything In Its Place.
With a very affable manner and a great empathy for the stresses seniors face when they’re downsizing or planning a move – particularly when their health is not as robust as it once was – she offers an extremely personable and affordable service which looks after all aspects of a client’s move, from soup to nuts.
Whether the assignment involves moving an independent senior into a smaller house, condo or apartment, or whether it involves ensuring the safe and happy move of a less physically-able senior into a shared long-term facility, Lisa’s had experience in working with seniors of all physical abililties.
“There’s an incredible amount of work to be done, and a huge number of little details which are vitally important, but easily overlooked, when a senior moves home,” says Lisa.
“My staff and I offer a complete turnkey service which takes all the stress out of moving – and it’s a huge relief both to the person moving and to their family members when they discover that I can look after the entire transition for them. Often, family members aren’t sufficiently involved in the day-to-day life of their aunt or uncle or parent to know exactly what needs to be done”.
Lisa liaises with realtors and lawyers if a home has to be sold, works with the moving company to arrange availability, price and insurance, and works with the senior himself or herself to help make decisions about what to take or not to take, what treasures to display in the new home and which items to disburse to family members, which to sell and which to dispose of.
“Since many of our senior clients are often moving out of generously-appointed homes into much smaller residences, we make sure they’re able to edit their possessions while still feeling at home in their new surroundings,” she says.
Lisa cancels utilities and services, ensures new services are hooked up as appropriate, notifies banks and government agencies of her client’s change of address and informs doctors, friends and other relevant parties of the change in residence.
In terms of physical work, she personally helps pack and unpack, disposes of boxes and packing materials, and will even ensure that rooms, if the senior so desires it, are painted to match the familiar colours of the client’s former home.
“There’s a huge amount of stuff to be done, as any young couple will tell you. For an older person, especially a senior on his or her own, there’s just too much for them to do alone.”
As a special treat to make the actual moving day special, Lisa arranges for a companion to take her client to a spa or a concert or a restaurant, so that when the senior arrives at his or her new home, everything will indeed be ‘in its place’.
“Clothes will be in drawers, pictures will be hung exactly where we’ve together decided they should go, furniture will be exactly where we’ve agreed it should stand, milk will be in the fridge, treasures will be on display. From the moment the senior opens his or her door, my goal is for the room or the apartment, wherever it is, to feel just like home.”
In terms of cost, “if three siblings each live a plane ride away, it’s often much cheaper to split the bill and know Mum or Dad will be completely taken care of,” says Lisa.
“The children of seniors have busy lives themselves, with careers and families and children of their own. The most rewarding aspect of my job is the relief and satisfaction it offers, to me, to my clients and to their loved ones.”
Norah Busby, 79, and Edith Rich, 91, are two friends here in Barrie who continue to live in their own respective apartments, but who have found it important to ask for, and receive, help from friends and neighbours when both live so far away from their adult children.
“If I had to move again I’d need help with packing and lifting heavy boxes,” says Norah. “My daughters live in Ottawa and Canmore, so I’d certainly pay something for local help that was near to hand.”
Edith found it very stressful going through her late husband, George’s, papers in the wake of his death, trying to establish which documents were important and which could be discarded.
When one’s partner dies it’s an unplanned event which invariably causes a huge amount of stress to the surviving party.
“There’s enough stress in that alone”, says Norah, who lost her own husband suddenly 12 years ago, “without the extra attendant physical work as well.”
Not all seniors are lucky enough to be able to live independently, of course, and there continues to be a lamentable lack of supportive housing services for seniors in Canada.
Those seniors who move into nursing homes or long-term care facilities can still, however, “rely on their being treated with dignity and respect”, with their holistic well-being given primary importance, says Carol Spencer, Senior Administrator for the Leisureworld facility on downtown Barrie’s Owen Street
“Very often our residents come to us having already spent a brief ‘trial run’ in a short-stay bed, perhaps after surgery or in order to give family members some respite,” says Carol.
“By the time they move here permanently they’ve usually explored all their other options and are very happy, and ready, to move in. Our staff work really hard to minimize the stress associated with the move. And seniors themselves have a much wider range of choices now than they did even a decade ago,” she explains.
“Retaining their dignity by exercising a lot of personal choice is important to them. The family, our staff and the resident all work together to ensure the resident’s goals are met.”
The wait for a room to become available in a nursing home or long-term care facility can sometimes seem rather long, but the waiting period can actually be a useful time “to get used to the idea,” says Anne Bell, Executive Director of Simcoe County’s Community Care Access Centre. “Families need to make sure they take advantage of other support services, such as a personal support or in-home care, during the wait.”
For seniors, another very common aspect that causes stress and sadness is often loneliness. This is where community facilities like the Parkview Seniors’ Centre on Blake Street in Barrie’s East End can play such a huge role in the social lives of our mature citizens.
Owned by the City of Barrie, Parkview is a full-service drop-in centre that runs every weekday from 9am to 4pm, and also plays host to some weekend and evening programming too.
Heather Kenehan, Parkview’s Recreational Programmer, positively beams at the huge impact her centre has on the lives on the hundreds of members and visitors who attend the centre each and every day.
For only $50 a year, Parkview offers full participation in all its volunteer-led programs, and offers programs led by qualified instructors that often cost only a few incremental dollars more.
“The primary motivation of many of today’s seniors is the need to stay active”, explains Heather. “Today’s senior knows the importance of staying active, and knows how to stay active, too. We offer our clients a place to meet friends and stay socially connected, and this helps maintain their social integration in the community. The ability to stay physically active and the desire to interconnect with one’s peers can work hand-in-hand at a place like this.”
Parkview, established in 1974, is primarily focused on leisure and recreation, offering everything from watercolour painting to specialized exercise classes and yoga to bingo, shuffleboard and bowling.
Volunteer Charlie Gordon, 71, is one of more than 150 volunteers at the Centre, and has been a fixture of the place for the last 15 years.
“I’m best known around here for my really bad jokes,” he says.
Some Parkview classes, like the bid euchre Charlie runs on Wednesday afternoons, attract 120 people, many of whom come for the volunteer-run soup & sandwich lunch that takes place first.
Other courses, like the Driver Refresher program, led by Constable John Parliament of the Barrie Police Force, require a small incremental fee.
Sebastian Caradonna, 80, who’s been a member for many years, says he wanted to stay safe on the roads, but also enjoys being a member of the Centre’s Travel Club.
“We’ve had week-long trips to the States and to Quebec, and we have a huge amount of fun,” he says.
“The challenge for today’s baby boomers, who’ll be tomorrow’s seniors, is for them to make health and fitness a complete priority,” explains Heather Kenehan.
“It’s self-evident today that there’s a tight correlation between quality of life later and exercise now. Given the fact that longevity continues to increase, we’ll all statistically have longer lives to enjoy, more years for a part-time career, more time to volunteer in our communities, more time to enjoy leisure and fitness pursuits. There are a huge number of opportunities awaiting today’s boomer in his or her senior years.”
Obviously, it seems the success of centres like Parkview lies in providing real and desperately-needed recreational and social opportunities for seniors, and such facilities needed to be treasured for the activities they provide to the segment of our society that they serve.
There needs to be a continuing and increased focus, however, on more fully-integrated elder care – and many seniors have expressed a great desire for fully-accessible health care, home care and support services available in one physical location.
Further, with the right kinds of support structures, more and more seniors are confident they could retain their independence – and their dignity – much longer than is now the case.
The key is proactivity, says Kim McKenzie.
“If we, as a society, continue to be merely reactive, it’ll never work. You’ll never be able to fix it.”
“But what we can all do,” he says, “is help prevent the difficulties and stresses of the senior years, by striving for better physical health and a better overall quality of life, dependent not so much on purely medical care but on a whole host of other preventative, proactive factors as well.”
Our seniors, surely, deserve as much.