Vulnerable Persons: Canada’s Elderly
The British Journal of General Practice estimates a doubling of the population older than 75 years of age in the next 20 years (2013). According to Beales & Tulloch (2013) there are many opportunities for vulnerability among the elderly such as:
· Multimorbidity of chronic and/ or acute medical conditions
· Functional incapacity
· Socioeconomic deficits
· Psychological issues
As we age, our vulnerability is shaped by inequalities, disempowerment or access to social protection (Beales & Tulloch, 2013). This is demonstrated through a loss of income as the aging population retires or suffer health problems that affect their ability to work to generate income. Those with a lower socioeconomic status may not have savings such as RRSPs or investments like property ownership or pensions that have accumulated throughout their career. This can lead to poverty, an inability to afford food, housing, medications or other life essentials (Schroder-Butterfill & Marianti, 2006).
Functional incapacities (like dementia or Alzheimer’s) can lead to inadequate coping strategies and psychological issues such as anxiety and depression. This in return, may cause social isolation and a loss of independence that can lead to institutionalization. This change in lifestyle (oftentimes not a choice but a necessity) can be interpreted as a change or loss in personal identity and powerlessness as the individual comes to rely on full time caregivers for personal care, food, money, and medication management (Schroder-Butterfill & Marianti, 2006).
Psychological issues can further be motivated by loss of a partner or loved one, inability of a family to care for their aging counterpart and social or physical isolation. At this phase of life, individuals experience and grieve a loss of friendships, family and spouses. This may trigger a depression that can go unnoticed or be attributed to a “normal part” of aging. Loss doesn’t have to be a person. Even losing one’s drivers licence increases dependency on others for basic needs like groceries, banking, shopping or access to medical appointments and social gatherings (Schroder-Butterfill & Marianti, 2006).
How is Ontario serving these susceptible seniors who are exposed to the above-mentioned vulnerabilities? There is much debate and funding into the production of long term care and assisted living centers. As working families struggle to produce enough income to keep up with today’s inflation, childcare costs and general living expenses there is less time and money available to help our aging counterparts. According to Schroder-Butterfill & Marianti, a lack of family support predisposes people towards institutionalization in older age and family conflict may escalate feelings of being a burden, which fosters thoughts of isolation and dependency (2006). The provincial government lists the types of supportive housing available to seniors in the community including: 1) long-term care homes 2) home and community care and 3) retirement homes (Supportive housing options, 2019). All of these options are either based on financial means or by qualifications such as “what level of care do you require?” One of the vulnerabilities the elderly face is lowered income; therefore a person with lower socioeconomic means will not obtain the best outcome for them in supportive housing options if they cannot afford the cost.
So perhaps instead of focusing on long term care placement, we focused on keeping seniors in their home for as long as possible? The Ontario provincial government has a page titled “Seniors: Manage Your Finances” (2017) that offers many assistance programs to seniors such as:
· Reduced co-payment for lower income seniors
· Trillium Drug Program
· Ontario Drug Benefit program
· GAINS: Ontario Guaranteed Annual Income System
· Provincial land tax deferral program for low-income seniors
· Ontario electricity support program
· Ontario seniors’ public transit tax credit
· Ontario senior homeowner’ property tax grant
The municipal governments may offer:
· Ontario renovates: a program that provides forgivable loans to low income families to make necessary repairs to homes
· Property tax relief for low income seniors
The federal government offers pensions such as:
· Canada Pension Plan
· Old Age Security pension
· Guaranteed Income Supplement
These programs are excellent in nature, however to qualify for many you must be over the age of 65. As well, many programs only supplement an income. An example is the GAINS program that will supplement $83.00 per month to a senior’s existing income. The reduced co-payment program also reduces medication charges to $2.00 per medication renewal. Poly-pharmacy due to chronic conditions is a huge issue that affect seniors. To do the math: if a senior is prescribed 15 medications at $2.00 each, that’s a monthly cost of $30.00. Now all that’s left of the GAINS program supplement is $53.00. The senior still must afford food, clothing, heat, water, hydro, etc. Overall, the supplements are being provided, but are they enough for the expensive world we live in?
Ontario also provides a Ministry for Seniors and Accessibility (2017). This Ministry focuses on:
· Staying healthy and active
· Finding transportation and driving services
· Finding community and housing support
· Seniors active living centers
· Recognizing elder abuse
· Learning to plan for the future
· Find grant programs and seminars for senior organizations
The Ministry’s goal is to help seniors stay independent, active and socially connected thereby reducing vulnerabilities. There are phone numbers and addresses provided for many of the above offered services, however no direct online link to the seminars is provided. As well, there is a guide to services for seniors in Ontario but it is very difficult to find and to navigate the Ontario government website page. In fact it was one of the last links that I inadvertently found by exploring through a series of pages.
The webpage for seniors (most of whom may not be as technologically savvy as the younger generation) may have difficulty finding the information posted. Some vulnerabilities affecting seniors can include vision or auditory disturbances, therefore having a complicated website may negate their successful use of the mentioned resources. If a senior has no transportation, having these resources available online at the click of a mouse would provide the accessibility needed to provide the senior with the information they require.
Overall, the subsidiaries and financial supports are available to seniors from the federal, provincial and municipal governments. However, I do feel that the supports offered are not enough in the current financial landscape. I also feel that accessibility to these supports would be better accessed through easier online navigation. A gap in the services offered include the mental health of seniors- how do we address the mental health and social needs of seniors that maybe an online or virtual world cannot provide?
A Guide to Programs and Services for Seniors in Ontario. Government of Ontario. Retrieved from https://files.ontario.ca/seniors-guide-english-web.pdf
Beales & Tulloch (2013.) Community care of vulnerable older people: cause for concern. British Journal of General Practice, 63(615). doi 10.3399/bjgp13X673892
Growing Older in Canada (2017). Retrieved from https://www.youtube.com/watch?v=NI-2zh1rmoI
Ministry For Seniors. Government of Ontario (2020). Retrieved from https://www.ontario.ca/page/ministry-seniors-accessibility
Schroder-Butterfill & Marianti (2006).A framework for understanding old-age vulnerabilities. Europe PMC, 26(1). doi: 10.1017/S0144686X05004423
Seniors: Manage Your Finances. Government of Ontario (2019). Retrieved from https://www.ontario.ca/page/seniors-manage-your-finances
Supportive Housing Options. Government of Ontario (2019). Retrieved from https://www.ontario.ca/page/long-term-care-options
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