Anne Dudman sits amid packing boxes and dusty mementos in her recently sold Edmonton bungalow, recalling the pit she sank into six years ago after losing both her husband and her eyesight in quick succession.
“I couldn’t even see to sign the death certificate. I found that devastating,” she says. Unable to read, with no immediate family, how could she handle the confidential dealings required to wrap up her husband’s engineering business? How could she manage the daily demands of life, from cooking to laundry? How could she be of use to anyone? How, in short, could she continue?
Fortunately, Anne Dudman took those questions to the CNIB, and began to discover answers. She soon had coloured dots to help identify dials on her stove and washer, magnifiers for reading and writing, strategies for navigating life. But most of all, she gained the confidence to reach outside herself, lobbying for change.
Now she’s ready to give up the burden of a yard and house she can barely see, even though it means the agony of downsizing. She tours seniors’ complexes, looking for a new home, but can’t yet picture herself there. “I’d probably be the only one with coloured hair,” she chuckles. Finally, she chooses an apartment in her own neighbourhood. There, she can be independent, among people of all ages—and next door to familiar transit routes.
The swelling grey wave
As a senior coping with life changes, Anne Dudman is part of a growing wave, across Canada and beyond. Think quarter: in a quarter century, fully a quarter of the population will be seniors. Before the industrial revolution, fewer than 3 per cent lived beyond age 65.
Being a young province, Alberta will see a less dramatic proportion of seniors than Canada as a whole, perhaps less than the 19 per cent Florida has right now. But the trend is the same: For every two seniors in Alberta a dozen years ago, there are now three; by 2016, there will be five. About 10 per cent, or 272,953, of our province’s 2.74-million people were over 65 in 1996, according to Alberta Health. By 2016, our provincial population will be 3.75-million, and 14 per cent, or 506,393, of us will be seniors.
Among that crop are the healthiest, most active seniors Alberta has ever seen—and some of the frailest. Our wealthiest citizens, whose dollars boost the economy and support local causes—and some of our poorest. Each brings a lifetime of individual experiences that deepens personality differences, notes Dr. Sandy O’Brien Cousins, University of Alberta exercise gerontologist. “They share some common histories, but beyond that, seniors are unique.” Furthermore, she added, seniors feel their bio- logical clock ticking, and many have strong opinions about how they want to spend their time.
Besides being the International Year of Older Persons, 1999 may be the end of an era when politicians and business leaders could afford to ignore Anne Dudman and all her peers, or make assumptions about what people need and want in that final third of life we call “senior.” Yet the provincial government has regressed in recent years, leaving a wake of angry seniors and tired caregivers. Despite the energy of grassroots Albertans who are busy developing some of the nation’s best seniors’ initiatives, this province lost ground exactly when ground should have been gained.
Alberta seniors feel betrayed after a decade and more of cutbacks that left many scrambling to pay the bills and standing in line for scarce services. Those cutbacks accelerated in 1994, when 15 crucial programs for seniors were rolled into one. Suddenly, most seniors were paying up to $408 a year for health insurance, fielding more of the bills for health needs, receiving less assistance for staying in their own homes, paying the education portion of property taxes. All that and more, on top of the squeeze faced by Albertans of all ages as Ralph Klein rolled out his austerity program.
“Seniors were manipulated,” said Don Campbell, speaking on an Alberta Council on Aging (ACA) panel in Red Deer as Community Development Minister Stan Woloshyn (responsible for most seniors’ programs) listened in. “Conferences were held, but let’s face it, an awful lot of them were about seniors, not listening to seniors.” As a province-wide advocacy group for seniors, the ACA was active in those sessions—and now wonders whether that’s one reason why its own provincial operating grant has plunged from $125,000 to zero in recent years.
“I guess we were the bad guys because we didn’t agree with what we saw happening,” says Neil Reimer, long- time ACA leader. “What I’m personally concerned about is the impact on other organizations that are scared to speak out because they worry about losing funding. I’ve never experienced any government in Canada that’s had such an ideological drive as this one.”
Chris Lawrence, who served as ACA Executive Director during the worst of those cuts, recalls that some seniors found their income dropping by 25 per cent, literally overnight. “It put them in huge trouble, a lot of them,” she says.
“Seniors have had to shoulder a big burden of the cuts with generally unsympathetic public attitudes,” says Jan Reimer, who visits communities all across the province as project director for Senior Friendly, an initiative of the ACA.
In Alberta, contrary to public perception, fully half of all seniors live on incomes of $16,000 a year or less. True, a growing number of seniors are retiring wealthy, on self-made fortunes, while those at the low end of the income spectrum have the support of federal and provincial safety nets. In fact, seniors’ incomes have risen faster than other incomes in the past 15 years. Yet, on average, seniors remain poorer than the young—with single women, especially the frail elderly, most at risk.
Changes in seniors’ programs were supposed to shift public money to those who need it most by erasing universality. In practice, says MLA Laurie Blakeman, Liberal seniors critic, the cuts dealt a broadside to people who had counted on those programs and services when planning their retirement. “Seniors feel the deal they had was broken—that’s why they are so angry,” she says. “Now they’re on a fixed income, and they have no ability to adjust.” The poorest seniors slip ever closer to destitution.
One sign of that slide is a dramatic increase in the number of seniors standing in line for free meals at Operation Friendship, an agency that serves seniors in inner city Edmonton. “Before, we rarely exceeded 115,” says Executive Director Sheila Smith. “Now, we regularly have to keep people waiting for a second sitting.” The agency is reluctantly drawing from the lottery pot to expand its three-meals-a-day service.
At the Society for Retired and Semi-Retired, Fran MacDonald reports a similar trend in seniors’ housing. “Many who could afford to rent a two-bedroom suite in the marketplace for many years are having to give that up and move into subsidized housing,” she says. In Edmonton, escalating rents are hastening the exodus, but seniors also miss the renters’ assistance and property tax rebates that previously helped balanceie the budgets.
Most affected by the move away from universal programs were seniors just above the cutoffs set for the new Seniors Benefit—and those hit by unexpected expenses. “If you were married and healthy, with a little bit of money socked away, you might be okay,” says Lawrence. “Until your spouse dies, or some major health catastrophe comes along.” Those circumstances are not at all unusual; nearly half of all seniors no longer have a partner, and more than 40 per cent require regular health services for chronic health conditions.
Beyond monetary loss, seniors acutely feel the human costs of today’s health-care system, says University of Alberta Professor Donna Wilson. She’s studying how hospitals have coped since half their beds were closed in the early ’90s. “Seniors either didn’t get into hospital, or went home much sicker than in the past,” she says. Some shift to shorter stays and day surgery was overdue in Alberta, she adds, “but it really has an impact on seniors and their families.”
Caroline Anker of Wetaskiwin is a case in point. Despite her protests, husband Pete returned home from the hospital so sick that Caroline resorted to a kitchen chair on casters to manoevre him through the front door. She tried to cope with his care despite a full-time job, but Pete soon wound up in hospital again, where he waited nearly a year for a room in a long-term care centre.
Home care could go a long way toward helping such families cope, Wilson noted. And the province did create a pot of money specifically to help care for people in their own homes. But that fund lasted just three years. “The number of people in hospital waiting for a bed in a nursing home has increased. Many of those seniors could manage at home—but there’s no home care.” That’s especially true in rural Alberta, Wilson added. “Some regions have virtually no home-care services—they just kept their hospitals going.” In other regions, long waiting lists are typical. Because health care is regionalized, both the health authority and the government deny responsibility when families say they can’t cope, or when seniors lose their zest for life after months in a hospital corridor. “Since regionalization came in, the amount spent on administration has doubled. And yet you wonder who’s running the show,” says Wilson, venting the frustration that has put her behind many microphones in the past decade.
Such waits can be deadly, Wilson says. “I’m working a shift today in hospital, and when I look at the people sitting there waiting for placement, I know it’s not good for them.” Many are able to walk and feed themselves, yet have little opportunity to exercise and keep their minds alert.
Recreation therapist Renate Sainsbury calls this the “warehousing syndrome,” and she knows from personal experience why it has increased in recent years. Like many trained therapists, she lost her job in the thick of the budget crunch, despite written letters of support from the seniors who were regaining their interest in life under her care at Edmonton’s Misericordia Hospital. Similar cutbacks at lodges and continuing-care centres leave staff barely enough time to keep the floors clean, let alone help a resident do woodworking.
Too true, says ACA Executive Director Arlaine Monaghan. “Sometimes it’s those very things that humanize a facility that are cut first. The things that keep people well by making life fun.”
A flurry of studies about seniors will land on the minister’s desk this year. Might this be a glimmer of hope that seniors will be heard at the policy table? Perhaps, but seniors remain to be convinced.
Some expect the results will be sanitized, like the impact study of the early ’90s that provided the impetus for Kevin Taft’s best-selling book, Shredding the Public Interest. That analysis, which showed spending on seniors’ programs falling since the early ’80s, was shredded soon after Ralph Klein became premier in 1992, and a substitute analysis was created to support the government’s argument that costs were out of control.
Others, including Phyllis Matousek of the Seniors Action Liaison Team, fear a repeat of 1994, when consultations resulted in cuts. “This whole exercise is a red her- ring they’re dragging across the trail, trying to instill fear and concern about what will happen when all these baby boomers become seniors,” she says.
But MLA Karen Kryczka, who heads an Impact of Aging Albertans study, co-chairs a Long-Term Care Commission, and chairs the provincial Seniors Advisory Council, says that is not her agenda: “I’m not looking at any kind of cuts. We’re looking at improving programs and services.” In fact, she adds, it may be time to review seniors’ benefits, since five years have passed since eligibility criteria and dollar amounts were set.
Community Development Minister Stan Woloshyn sounded a similar note at the ACA general meeting, when inundated with seniors’ complaints. Perhaps the cutoffs for seniors’ basic security have fallen behind inflation, he pondered. “This tells me we have to be very vigilant not to leave anybody out who needs help.”
Indeed, the Impact committee’s first report, released in June, identifies seniors’ benefit levels as one of several areas requiring review. Although critics scoff at the lack of detail in that report, it does pinpoint the very issues that arise in any discussion with struggling seniors and their families, including confusing programs and gaps in such key services as health, housing and transportation.
“The report has opened the door for those who have the courage to speak,” says Neil Reimer, who sits on the Impact committee. What’s needed now is a government with listening ears, and the political will to follow through.
The Liberals’ Blakeman agrees. “I think we need to have an educated and thoughtful discussion with seniors themselves,” she says. “These are intelligent human beings who have lived a good life, and we’ve all benefited from that. I don’t want to see the upcoming group of seniors repeat what happened to this group.”
Why worry now?
As analysts such as Herb Northcott are careful to point out, the coming grey wave is not a crisis. A full 90 per cent of seniors live quite independently, in homes they own or rent. Seniors contribute to Alberta as grandparents, mentors, donors and taxpayers. Nearly a quarter of Canada’s seniors volunteer, not counting the ones who simply lean on each other for support. Some innovative private and private-public housing options are popping up, serving as models that should help ease the demand for institutional care.
Yet the fact remains that a person’s need for health services typically increases with age. In Alberta today, a senior uses 10 times more health dollars than a child; seniors use nearly 45 per cent of the patient days in hospitals; seniors’ drug use is rising nearly three times as fast as their numbers. Meanwhile, the percentage of very old seniors is expanding fastest of all, thanks to increased longevity: the number of Albertans 90 and older, already 9,000 (6,455 women, 2,667 men), will double by 2016, reaching 18,736 (13,656 women, 5,080 men). Unlike younger seniors, the very elderly are typically frail and need high levels of care. Clearly, the cost of continuing the current course could stagger us financially.
Speaking in Red Deer on behalf of the provincial Long- Term Care Commission, Dave Schindeler recounts a conversation with his son about what the future might hold. “I told him, ‘You have two choices: You’re either going to have to pay more taxes, or you’re going to have to look after me.’” Not too pleased with either of those options, his son asked if there might be a third. “Yes,” Schindeler said, “we can do things differently—and smarter.”
We already know a lot about what “smarter” means, and fortunately it’s exactly what many seniors want: enough support to meet the needs created by aging while encouraging an active life. A senior with dementia who goes to a day program may gain enough coping skills to avoid a move from home, while giving his spouse a much-needed break. A senior able to join an exercise class just down the hall may regain strength and flexibility earlier lost through disuse—and cut future declines in half.
As the number of seniors expands, concerted home care, recreation and exercise programs alone could dramatically reduce the financial impact of seniors’ health and housing needs. And concerted effort does pay off, notes gerontologist O’Brien Cousins. According to one set of surveys, Alberta’s population of physically active seniors leapt from 40 per cent to 60 per cent in just two years, thanks in part to a strong provincewide network of centres promoting active living. If supported long-term, such trends are sure to translate into savings, offering seniors a better life without breaking either personal or communal banks.
So far, it’s been up to people on the front lines to chart that smarter way. And amazingly, they’re doing just that, battling budget constraints to develop promising initiatives based firmly on seniors’ experience and advice.
One of those initiatives is Senior Friendly, an Alberta- born toolbox for improving services and facilities for seniors (and for everyone else, as it turns out). The tools grew out of focus groups in which seniors told passionate tales of feeling invisible, wrestling with heavy doors, straining to read tiny type, putting up with condescending clerks, receiving second-class service.
Hearing those stories, the Senior Friendly team saw a need for guidelines to help specific businesses meet seniors’ needs, and decided to begin with taxis, which can serve an important role in helping seniors stay connected. Wanting the process to be a “two-way street,” the team invited Edmonton taxicab owners to collaborate. Not one company was interested, recalls Project Director Jan Reimer.
Attitudes changed, however, after Betty, a blind senior, rode several cabs while wired for TV, and had her story aired on the evening news. Suddenly, the one company that helped Betty with her bags, walked her to the door and treated her with respect had lots of senior customers. And the Senior Friendly line was buzzing with cab companies wanting to talk.
Slowly, others are joining those taxi owners in waking up to the rewards of serving seniors well. And As Betty proved, there’s nothing like concrete evidence to shift an organization into gear. The Senior Friendly initiative capitalizes on that fact by including experiential exercises in its kit of tools. “It’s a real eye-opener when people put on those glasses to simulate glaucoma, or wear gloves to simulate arthritis,” Reimer says. “You just know they won’t be as impatient when senior customers are choosing their favourite tube of toothpaste, or counting out their change at the cash register.” The initiative’s success in Alberta recently led to a nationwide launch, and a partnership with training organizations that allows businesses to be certified Senior Friendly.
The people of Edson, meanwhile, have set a goal of making their entire community Senior Friendly, with a menu of initiatives ranging from strength training for older adults to business workshops to benches along walking trails. Central to it all is a downtown seniors’ housing complex offering diverse living options next door to stores, offices and a park. Edson’s plans are garnering awards and recognition. But more than that, notes Carl Ulrich, Director of Community Services, being senior friendly will help the town keep a whole generation of citizens, serve rural folks looking for a place to retire— and perhaps even attract seniors from outside the region.
Gail Johnston is one Edson resident who applauds that move. She heads the Evergreen Foundation, which runs lodges and other subsidized housing programs. “There’s no cleaner, more environmentally friendly industry than serving seniors,” she says. Camrose learned that long ago, she noted, and 20 per cent of its population is now 65 or older, twice the provincial average—a fact that certainly hasn’t kept that community from thriving. In Edson, meanwhile, seniors make up 8 per cent of the population, a few notches below the provincial average.
Johnston took a sabbatical last year to search the world for housing options that might work for seniors in rural Alberta, and came away convinced that Edson’s housing plans make particular sense. If properly supported by at- home care, the centrally located homes will allow people to stay in one location as their needs grow, a concept gaining popularity under the rubric “aging in place.”
Already, Johnston’s foundation is applying a similar philosophy in its three lodges, partnering with the local health authority to provide nursing care for residents who need more than the basic meals and housekeeping service. That enhanced service not only saves money by keeping people out of continuing care facilities, but allows the lodge to concentrate on what it knows best. “People are staying home as long as they can, and when they do come to a lodge, they need more health care than ever before.” Yet lodges were designed to house healthy seniors, she adds. “The lodge system we have in this province is really quite an extensive and wonderful resource, but we’re at a point in history where we need to start looking at lodges differently.”
Neither can seniors be herded together for convenience. “Overall, my impressions are that we need to stop thinking of seniors as a group,” Johnston observes. “We need to encourage them to live wherever they want to live, and figure out how to go about making that possible.”
A senior who stays at home by using $500 a month in such support as housecleaning, shopping, medical care and cooking saves the province six times that amount in nursing home costs.
Johnston’s research uncovered a host of intriguing approaches: In Japan, parental leave allowing children to care for their senior parents; in Australia, Community Aged Care packages offering a full range of support for aging in place; in Holland, Home for Life houses, certified as user friendly from birth to death.
Taken together, her findings grew into a book, The Road to Grandma’s House (to be published by The Muttart Foundation in early 2000). The first copy, she says, goes to Community Development Minister Stan Woloshyn.
A crucial crossroads
The provincial response to such insights, and to the grassroots efforts afoot across Alberta, will profoundly shape our future.
That future affects us as taxpayers, of course. A senior who stays at home by using $500 a month in such sup- port as housecleaning, shopping, medical care and cooking saves the province six times that amount in nursing home operating costs, not counting the initial investment of creating that institutional bed. And that’s just the tip of the iceberg.
That future also affects families. Nearly everyone has a personal story to relate about parents, spouses or dear friends caught in long waiting lists, languishing in hospital, unattended in nursing homes, somehow abused and bruised. Like many senior advocates, Hazel Wilson views such conditions against the backdrop of her own family’s experience of the depression. She shakes her head to think those times have come again, this time amid prosperity. “I can’t help but feel sad that the present society is not friendly to vulnerable people,” she observes. “I wonder how many will be deprived in later years because of what is happening now.”
The first of the baby boomers will reach age 65 in just 11 years. As the Liberals’ Blakeman likes to say, in planning terms, “That is a nanosecond.”
Cheryl Mahaffy is an Edmonton journalist and former editor of internal publications for the City of Edmonton.