Preparing for an Aging Population

The Importance of Sustainable Health Care Systems

It’s no secret that the world’s population is aging at a rapid rate. Globally, as life expectancy and the standard of living and care continues to increase and fertility rates continue to decline, the population cohort sixty years of age and older represents the fastest growing of all age demographics.
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As people continue to age and retire, it not only puts a greater strain on available resources, the tax base simultaneously decreases as well, which presents a unique challenge for communities to overcome.

This is especially true of health care systems and delivery. Much can be done to mitigate and prepare for these challenges but it will require proactivity and investment, as well as new ways to approach old problems to prepare for the inevitable future.

According to data from World Population Prospects: the 2017 Revision, the number of persons sixty years of age and older is expected to more than double by 2050 and triple by 2100. In 2017, there were 962 million people in the sixty-and-over cohort, a number that is expected to reach 2.1 billion in 2050 and 3.1 billion in 2100.

In Europe, a crisis is certainly looming as it has the greatest percentage of the people in the sixty-and-over cohort globally. This will require law makers and decision makers to take a closer look at pension reform and benefit structures, as well as the retirement age.

While Europe’s outlook is the worst, it is a problem that will impact North America, Central and South America, Australia, China, India and the Caribbean. No country is immune to the impacts of an aging population.

With age comes a greater risk of illness and disease and a greater need for care, which will inevitably place greater demand on existing health care systems, which are already being strained in terms of both funding and resources. As people age, they require additional care as well as increased diagnostic testing, and this necessitates more visits to specialists and places greater demand on existing resources. Aging populations also have a greater need for prescription drugs.

While Medicare continues to represent a stable part of a country’s gross domestic product (GDP), prescription drug costs continue to rise, making prescription drugs and health supplies coverage an area of concern for governments.

Increased health care demand, and therefore increased costs, could spell certain financial disaster if not properly addressed. While many are concerned about the future and how existing systems will be able to handle an influx in demand, these challenges could also be viewed as opportunities to invest and improve existing resources to deliver a better standard of care for all age demographics. Now is the time to allocate funds and invest in existing health care systems, adopting new and innovative approaches to care for an aging population to ensure sustainable systems for all in the future. Focusing on an aging population can have positive results for every age demographic.

As the focus on an aging population and the new demands it can place on health care resources grows, so too do the perspectives and approaches for addressing these challenges: there are some very innovative and cost-effective approaches to elder and long-term care that can promise sustainable results.

Some communities have invested in age-friendly cities or housing options that enable people to age together in a setting that meets their unique needs. In some cases, it simply requires that existing systems be adapted to improve safety and independence.

While some retirement homes are terrific and offer a great standard of care for residents, there are many institutions that are struggling to make ends meet and require greater investment and resources to ensure the needs of residents is foremost. Confronted with unsustainable demand, some organizations have taken new approaches and adopted innovative ways of addressing the needs of an aging population. One such example is building on other assisted and extended-care communities.

While the costs are not yet sustainable, an issue that is currently being discussed with the government, Canada is set to welcome its very first community, or village, designed for dementia sufferers. “The Village” will be located in Langley, British Columbia and is modeled after the first dementia village of its kind in the Netherlands, Hogeweyk.

The Village will consist of six single-storey cottage-style homes, as well as a community centre and a barn and will be home to 78 dementia sufferers who will have unfettered access to the community, which will give them the independence to conduct routine daily activities. Residents can shop, get a haircut or a coffee, walk their pet if they have one, enjoy gardening and community spaces and retain a sense of normalcy as they struggle with the disease under the watchful care of 72 trained staff. The community even has guest rooms for short-term visitors.

The community is expected to be completed this year and will redefine elder care for those suffering from dementia. Not only will it improve the quality of life of its residents, enabling them to live a fuller life in their golden years, it will offer family, friends and the community the peace of mind of knowing that their loved ones are being cared for and are able to live their best lives.

Another unique perspective considers why elderly people receive more intensified care. Given the increasing vulnerability of their health, elderly and aging populations are more frequently subject to invasive procedures and diagnostic testing, which is very costly and could have negative implications on their health and wellbeing.

There is no question that early diagnosis can make all the difference in life expectancy when diagnosed with serious illness and disease, but in the case of elder care, some argue less is more, and want preventative care to start earlier so that elderly patients are not subject to rigorous testing that can take a physical and emotional toll.

Studies have shown that patients in high versus low spending health care regions are no more satisfied with the level and outcome of their care, and many of these procedures come with a potential for risk of harm or death. As this is a fiscal and community matter that can have significant implications, government officials and community leaders have a plethora of options to consider when addressing the strains an aging population can have on existing health care systems.

Issues for governments to consider include funding and equal allocation of resources across demographics, as well as tiers of care including hospitals, home care, and clinics for remote populations who have the same rights to access of care. Equal funding helps to ensure that health care delivery is sustainable, accessible and delivered at a high standard.

Investment must also be dedicated to human resources: to the recruitment and retention of a diverse and skilled workforce, as well as wage equity. Investments in training and education can help to ensure a pipeline of talent is available and can help maintain a reputable standard of licensed care and delivery.

Communities can also make greater efforts to recognize and acknowledge the contributions of unpaid and informal caregivers and volunteers that support and reinforce health care systems, especially where resources are constrained. Efforts can also be made to refocus home support services to include non-profit or volunteer or lay worker care as part of the community’s health care delivery system.

Technology and innovation are other tools that can be leveraged by decision makers and stakeholders in the health care field to improve the delivery of care as aging populations continue to increase the demand on existing health care resources and infrastructure.

Telemedicine, leveraging technology to meet patients where they are, and bringing care to their homes in non-urgent scenarios will alleviate the strain on existing care providers and facilities while improving access to care for many, especially aging rural populations and those with mobility issues or limited access to transportation. The integration of service delivery will also play a part in the achievement of a sustainable health care system, as demand for services and care grows as the population continues to age at what could be an unsustainable rate if not properly addressed.

Preventative care and special topics such as chronic disease management that address community-specific needs based on the size, age and conditions of the local and regional populations are being considered in the design of nutrition, care, activity and recreation, prescription and other related programs relevant for an aging population to ensure an elevated standard of care for all, regardless of age.

Given the rate of growth of the sixty-plus demographic around the world, the challenges associated with an aging population will impact everyone and will require a proactive and multifaceted solution from decision makers before it is too late.

As former U.S. Vice-President Hubert Humphrey once stated, “The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; those who are in the shadows of life, the sick, the needy and the handicapped.”

June 24, 2019, 4:16 PM EDT

The Road Ahead

While there is no single hard and fast definition of self-driving cars, The Union of Concerned Scientists – a non-profit group founded by scientists and students at the famous Massachusetts Institute of Technology “to use the power of science to address global problems and improve people’s lives” – considers self-driving vehicles to be those where human drivers “are never required to take control to safely operate the vehicle.”