It is no secret that Ontario’s population is rapidly aging, as it is elsewhere in Canada and the world. As Baby Boomers enter their sixties and seventies, questions have arisen about the ability of the province’s health and long-term care system to deal with this demographic.
Ontario’s Long-Term Care Association recognizes that the doubling of the seniors’ population across Canada over the next two decades, will, in turn, increase demand on long-term care homes for support. However, above and beyond the expected demographic that generally resides in Long-Term Care facilities, there is a growing group of individuals under the age of 65 that are also living in these residences, another matter that these facilities must be prepared for.
Long-Term Care Home Residents Under Age 65
According to the Ministry of Health and Long-Term Care (the Ministry), more than 90,000 individuals spent time in long-term care homes last fiscal year. The average age of these residents was over 83; however, approximately 6% of these individuals were under the age of 65, including almost 2,500 in their early 60’s, more than 2,300 in their 50’s, and about 500 in their 40’s. There have even been instances where individuals in their 20’s have entered long-term care homes, largely due to there being nowhere else for them to go to receive long-term care.
A spokesperson for the Ministry recently confirmed that the province has no long-term care homes specifically for adults under the age of 65. Younger individuals can end up in a long-term care facility if they can no longer live independently in their own home, or if they require 24/7 assistance. This can be due to a variety of things, such as serious brain injury, developmental disability, stroke, or a degenerative illness such a multiple sclerosis (MS).
In an interview with the Toronto Star, Dr. Abraham Snaiderman, the Director of the Neuropsychiatry Clinic at the University Health Network’s rehab institute said that long-term care homes are “suboptimal” places for treating conditions such as MS, since they are designed primarily for elderly residents. Dr. Snaiderman further pointed out that even if the services and care offered by the home are “perfect”, a long-term care home resident who is much younger than other residents can be psychologically impacted by the age difference between themselves and the other residents. According to Dr. Snaiderman:
As a society, we’re not prepared to deal with younger patients with cognitive or physical impairments.
The MS Society of Canada has recognized the challenge faced by younger MS sufferers who may have to reside in a long-term care home. The Society is lobbying governments across the country to place patients in what they call “age-appropriate” facilities. Regarding the struggles faced by younger residents of long-term care home resident, Julie Kelndorfer of the Society has stated:
It’s the difference between a house and a home…[a] home is where there are people like you, where you have a sense of belonging, that you feel comfortable and safe. I think those are all challenges for young people living in long-term care.
Ms. Kelndorfer points out the various challenges that young people living in long-term care facilities include, for example, not wanting to eat at the times that many seniors do, or wanting different foods (i.e. pizza in lieu of a traditional Sunday roast). There are also more significant challenges, such as the lack of opportunities to form meaningful bonds (friendships or romantic relationships) with people of the same or similar age.
Ms. Chartier has said that the Long-Term Care Association, which currently represents more than two-thirds of private, public, and not-for-profit long-term care homes in Ontario believes that long-term care is not the most suitable environment for individuals under 65.
Putting a Face to the Issue
The Toronto Star recently highlighted the story of Deborah Cross, a former Ottawa resident who was 56 years old when she moved into a long-term care facility in Maple, Ontario.
Ms. Cross, who has secondary MS that has limited her mobility, said that moving into a home for seniors was her only option. Ms. Cross estimates that she is at least 15 years younger than almost everyone else in the residence.
Ms. Cross echoes some of the concerns raised by Ms. Kelndorfer, including the struggle to find age appropriate activities and the challenges of making similarly aged friends. She told The Star that she “loves” her home, but that it is difficult to be surrounded by people who are much older, and who are dealing with much different day-to-day issues, such as end-of-life illnesses and related matters. Ms. Cross does not consider herself to be in the final stages of her life, as many of her fellow residents are. While she has made a point of getting to know the other residents, it has been difficult to befriend individuals who are nearing the end of their lives.
She also points out that the activities organized by her home, such as bingo games and easy crossword puzzles do not mentally stimulate her in the same way they do for her older neighbours. Many of Ms. Cross’ recreational activities take place outside of the home.
Suggestions for Moving Forward
The MS Society of Canada has explored alternative models for helping younger adults who may be in need of long-term care. The Boston Home, located in Massachussetts, has been suggested as an example of what Ontario should be working towards. The Home is a long-term care facility specifically focused on individuals with MS and similar neurological illnesses. The average age of the residents there is 58. The Home offers exercise, recreation, rehabilitation and social programs and is advertised as a place for “intellectually curious adults who want to live full lives not defined by their disabilities”.
It will be interesting to see the progress made by the Ministry and the province to address the very real challenges faced by long-term care facility residents who may not necessarily be part of the demographic status quo in those facilities. We will continue to follow developments in this regard, and will provide updates as they become available.
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