Category: Health / Medical
I came across a blog recently, amustreadblog.com, written by Toronto sommelier Debbie Gordon. She has a lot of great insights about wine from Canada and around the world, and I enjoyed her profile of a man I’d never heard of – Anthony von Mandl – who heads up some of British Columbia’s leading wineries, including Mission Hill.
But before producing award-winning wines that have won honours around the world, Anthony gave the world a much humbler beverage that made him a fortune: Mike’s Hard Lemonade. I realized that there are a lot of different personalities in the wine world, and a lot of different paths to the top.
Then another blog entry caught my eye that reaffirmed the “different personalities” viewpoint – cannabis-infused wine.
Yes, a California winery, Rebel Coast, is marketing Marijuana Infused Sauvignon Blanc. California laws don’t allow alcohol and THC to mix, so the weed takes priority, with 16mg THC and 0.5% alcohol. As Gordon notes, “you may get high but you definitely won’t get drunk.”
I don’t know about you but as an Ontario resident, I’m still getting used to seeing bottles of beer in my local No Frills, let alone weed-infused wine. But as legalization of cannabis comes to Canada, we’re going to be seeing a lot of things that we’ve never seen before. Weed wine may be one of them.
So, what does it taste like? Gordon attended a tasting and gave this description.
“I think it’s fair to say the blend is aromatically unique from the Sauvignon Blanc I’m accustomed to. I smell citrus, hops and something else … Ragweed? It’s herbal. I tweet “grass” since I don’t want to offend. On the palate? I’m getting something akin to Mello Yello and aging asparagus. Also, higher acidity and rustic, savoury, herb-de-Provence flavours. “Notes of freshly picked pot,” the millennial to my right, knowingly adds.”
I don’t know about you, but I’ll likely be sticking to my inexpensive THC-free house wine.
Thank you for reading,
A recent report on the healthista.com website discusses ways to avoid or slow the progress of dementia.
First, the bad news: In the UK, one person is diagnosed with dementia every three minutes. One in twenty people develop dementia under 65, and after turning 65, a person’s risk of developing dementia doubles every five years.
Now the good news: there are various things that we can do to reduce the risk of developing dementia. These include:
- Stimulate your brain. This means doing more than “brain training”. Social interaction is seen as the key. Also, taking up new hobbies, interests and intellectual challenges is more beneficial than doing the things that you have always done.
- Develop a “cognitive reserve”. A high cognitive reserve, based on higher education, a complex lifetime occupation and high levels of social engagement helps maintain brain health. Lawyers, social workers, teachers and doctors were better protected from Alzheimer’s than shelf-stackers, machine operators and labourers.
- Take Aspirin. Long term use of aspirin is associated with a reduced risk of Alzheimer’s. Low doses of aspirin, traditionally associated with heart health, was found to lead to better memory and cognitive function.
- Take fish oil. This one is a bit controversial. Some studies have shown that fish oil slows the decline of cognitive function. However, a Cleveland Clinic post has suggested the research is not conclusive on the benefits of fish oil, and suggests that you should simply eat more fish.
- Help your heart, help your brain. The same processes that cause heart attacks and strokes are also associated with the development of dementia. Conversely, the lifestyle factors that help your heart can also help maintain cognitive function.
- Drink, eat and exercise. Drink champagne: one to three glasses a week. The phenolic compounds found in the grapes used to make champagne have the ability to increase spatial memory, improve cognitive function and promote learning and memory retention. Further, regular moderate exercise can prevent the onset of dementia. Even better is engaging in a sport, as this adds a social element, as well. Finally, a healthy diet, such as the Mediterranean diet, has been found by a number of studies to slow cognitive decline and lower the risk of developing Alzheimer’s.
More good news: in the next ten years, it is expected that research will reveal more specific actions that can help prevent Alzheimer’s and dementia.
Have a great weekend.
One of the challenges with demographic trends is that they tend to fly under the radar until they are suddenly upon us.
Ensuring there is adequate care for our aging population is a prime example. The oldest members of the baby boom generation are now in their early 70s, and for the most part haven’t made their way into retirement homes and long term care. In short, there’s no problem so far.
But fast forward 10 years and we may see the issue. According to the Conference Board of Canada, more than 2.4 million Canadians aged 65 or more will require paid and unpaid care support by 2026. That’s 71% more than required care in 2011. By 2046, that number is expected to rise to 3.3 million people, which is almost 10% of Canada’s current population. You can read more about the demographic trends here.
The prognosis is clear: the demand on the health care sector and assisted care facilities is only going to increase. And there is bound to be a lag in government response because governments will always deal first with any crisis at hand before dealing with future needs. For example, there is typically overcrowding in schools before new schools are built. Long term care will likely be no different.
The question is, what can each of us do on an individual basis to plan for the care we might need?
What’s your plan?
Since none of us can predict the future, the safest course of action is to assume that you will need care at some stage of your later life. According to the Ontario Long Term Care Association, the average age of a long term care resident is 85, with 90% of residents having some form of cognitive impairment and one in three using a wheelchair. There is a very real chance that you will be in that situation some day.
So what can you do now? If you’re a baby boomer, there are a few steps you can take to increase your opportunity for adequate care if you should need it. These include:
- Having a power of attorney for both finances and personal care
- Ensuring you have a guaranteed income stream in your later years (such as annuities or pensions). For example, you may want to defer your receipt of Canada Pension Plan payments as late as possible (age 70) to maximize your guaranteed income in later years
- Considering products such as long term care insurance that can pay a benefit if you need care.
New products might also emerge. This recent article in the Globe and Mail discusses longevity insurance – a deferred annuity that pays out later in life.
In short, the private long term care sector may be filling the gaps in the system to an even greater degree in the future, and having the means to pay for this private care can ensure you have the care you need.
Thank you for reading … Enjoy the rest of your day,
Unless there’s an unexpected shift or delay by our government, the Cannabis Act will make the use of cannabis for recreational purposes legal sometime this summer. Each province will have a system in place that provides for the sale of the drug.
While “pot for fun” is coming soon, “pot for treatment” is already here, as the use of cannabis for medical purposes is legal under the Access to Cannabis for Medical Purposes Regulations (ACMPR). Today and in the future, individuals can buy or grow medical cannabis when authorized by a doctor or nurse practitioner who is treating them.
What’s changing on the medical cannabis front is that insurance companies are exploring coverage for it under group benefits plans. One major Canadian insurance company – Sun Life Financial – recently added medical cannabis coverage as an option that companies can add to their employee plan. Don’t be surprised if this type of coverage becomes more widespread, as other insurers already offer coverage on a case-by-case basis.
Pain management is one of the principal uses for medical cannabis, and with opioid abuse a growing concern, coverage for medical cannabis could be a timely addition to group benefit plans. Under its new coverage option, Sun Life will reimburse medical cannabis expenses for five specific conditions and symptoms. Those are:
- Multiple Sclerosis
- Rheumatoid Arthritis
- Palliative care situations
As evidence of the therapeutic effect of cannabis for other medical conditions grows, coverage for medical cannabis may also grow to cover a greater range of medical issues. This recent article from the Harvard Medical School provides an overview of the many ways that cannabis is being used to treat a variety of medical conditions.
Thank you for reading,
Section 241.1 of the Criminal Code sets out a detailed procedure for determining when medical assistance in dying can be provided. However, the medical and legal communities are still grappling with the application of the provisions.
In A.B. v. Canada (Attorney General), 2017 ONSC 3759 (CanLII), two physicians concluded that AB met the criteria for a medically assisted death. A third doctor, however, did not, as he felt that AB did not meet the Criminal Code requirement that a natural death was reasonably foreseeable. Although only two medical opinions are required, the opinion of the third doctor had a chilling effect on one of the other physicians, who declined to provide assistance to AB for fear of being charged with murder.
AB then applied to court for a determination that she met the requirements of the Criminal Code, and a declaration that she may receive medical assistance in dying.
Justice Perell, who had previously considered the issue of assisted death in another proceeding, heard the application.
Ontario and Canada took the position that a declaration should not issue, as the regime established by the Criminal Code does not require judicial pre-authorization. Further, the civil courts should not issue a declaration as such a declaration would interfere with the prosecutorial discretion of the Crown by predetermining criminal liability.
Justice Perell agreed with the position of Ontario and Canada. However, he felt that their position was “as unhelpful as it is technically correct.” The practical effect of such a position was that AB qualified for medically assisted death, but no physician was prepared to assist.
In his decision, Perell J. thoroughly reviews the legislative history of medical assistance in dying. He agrees that it is the medical practitioner and not the court that is to decide whether the Criminal Code criteria are satisfied. He agrees that the court cannot make the decision for them.
However, Perell J. expresses that some form of declaration would be “useful” and have “utility”.
Perell J. walks a fine line in his decision. He accepts that the court is not to make declarations that the Criminal Code criteria for assisted death are met: that must be done by the medical practitioner or nurse practitioner: s. 241.2(3)(a). What Perell J. does, however, is attempt to clarify what is meant by s. 241.(2)(d): the provision that requires the person to meet the criteria that “their natural death has become reasonably foreseeable”. As a matter of statutory interpretation, he declares that in AB’s case, AB’s natural death is reasonably foreseeable.
Perell J. cautions that in making a declaration, he is not conferring immunity on the physicians from prosecution. He also states that he is not finding that courts could or should grant pre-approvals for persons seeking medical assistance in dying. It is unclear as to whether this will provide much comfort to medical practitioners.
Thank you for reading.
Canada’s population of seniors continues to rise and with that comes the concerns of attending to the unique needs of an ageing demographic. In 2016, Canadian census data showed that the number of seniors in Canada was slightly higher than that of children 14 and under. Canada, like the rest of the world, has been undergoing changes to account for the population changes that include a growing number of individuals struggling with dementia. Today, I’ll explore an innovative new project in British Columbia aimed at providing a safe yet independent living environment for seniors with dementia.
The Village is a new residence which will accommodate those with dementia in an environment meant to provide the feel of a small village or community. Residents will live in cottage style residences with nearby amenities such as a grocery store, a salon, a coffee shop and a community garden. While residents will be able to go about their lives in the community, they’ll also have the care they require. The project is modeled after the first “dementia village” that was opened in Amsterdam. The goal behind such communities is to move those with dementia away from an institutional setting so as to improve their quality of life.
With estimates that approximately 940,000 people will have dementia in Canada by 2031, it’s great to see new and innovative options available for those with such an illness. Right now, the project in BC is slated to open in 2019 and is a private endeavour meaning residents (or their family) will be responsible for the full cost.
While the project is still in its infancy, it will be interesting to see how it develops and how it might be implemented in the rest of Canada.
From a legal (and Ontario-centric) perspective, it is interesting to note how the goals of “dementia villages” align with the Residents’ Bill of Rights under Ontario’s Long-Term Care Homes Act, 2007. The Residents’ Bill of Rights includes a lengthy list of rights of residents of long-term care facilities designed to promote recognition of the dignity, security, safety, and comfort of residents. Included in the Residents’ Bill of Rights is “the right to receive care and assistance towards independence based on a restorative care philosophy to maximize independence to the greatest extent possible.” The development of dementia villages shows one way in which this right may be furthered.
Thanks for reading!
Anxiety, depression and other mental health issues can occur for any number of reasons, but they often emerge when a loved one has died. While grief is a natural occurrence that’s distinct from depression, it’s not unusual for the grief over the death of a friend or family member to trigger a major depressive episode. And these conditions can worsen if the death results in family conflict, whether over the estate or other family issues.
When dealing with a mental health issue, we typically consider a number of treatments, from therapy, to medication, to increased social supports to help the person recover. These can all play a critical role in improving mental health.
But what can sometimes be overlooked are psychological improvement activities that a person can undertake themselves – ones that can have a measurable mental health benefit. One of the most surprising – and easiest to carry out – is a walk in nature, through a ravine, urban park, or rural area.
Taking a walk? Make it green
Exercise has long been proven to have significant mental health benefits. Many of us know this first hand from that “feel good” sensation after a workout. But there can be hurdles for someone suffering from a condition like depression to initiate even moderately intense exercise. These hurdles can include age, unfamiliarity with exercise routines, or just a lack of energy.
A walk – on the other hand – is something that most people can undertake quite easily. The key from a mental health perspective is to ensure that the walk takes place in a natural setting. A 2015 study compared the brain activity of people who walked 90 minutes through an urban setting to those who walked for the same length of time through a natural setting with trees and vegetation. The nature walkers showed significantly lower activity in the portion of the brain linked to ruminations, which can be a key contributor to depression and anxiety:
This isn’t the first study to show the link between time in nature and better mental health – and the science is strong. The Canadian Mental Health Association – Ontario has even funded park walks for youth with mental health issues, suggesting that nature walks are truly a beneficial activity for all ages.
Thank you for reading,
The interplay between evolving social norms and the legal foundations that predate or accelerate these changes has seen significant development in the last decade. Courts of law and of public opinion have made important strides in shaping social policy in many areas, such as medically-assisted death, gender diversity and inclusion, and marriage rights, to name a few. A recent case out of the Ontario Superior Court of Justice considered this last issue, marriage rights, with a particular focus on predatory marriages.
In Hunt v Worrod, 2017 ONSC 7397, the Court was tasked with assessing whether an individual who had suffered a catastrophic brain injury possessed the necessary capacity to marry. In 2011, Kevin Hunt suffered a serious head injury following an ATV accident and spent four months recuperating in hospital. He was eventually discharged into the care of his two sons, but three days after his release, Mr. Hunt was whisked away by his on-and-off girlfriend, Kathleen Worrod, to be ostensibly married at a secret wedding ceremony.
Mr. Hunt’s children brought an application to the Court on his behalf to void the marriage, partly to preclude Ms. Worrod from accruing spousal rights to share in Mr. Hunt’s property or assets. Ultimately, the Court concluded that Mr. Hunt did not possess the requisite capacity to enter into the marriage.
In its reasons, the Court relied heavily on the opinions of several expert witnesses and the existing body of legal authority. The Court began by reviewing section 7 of Ontario’s Marriage Act, which provides that an officiant shall not “solemnize the marriage” of any person that the officiant has reasonable grounds to believe “lacks mental capacity to marry.”
The expert evidence tendered by the parties suggested that Mr. Hunt had significant impairments in his ability to make decisions, to engage in routine problem-solving, and to organize and carry out simple tasks. He was characterized as “significantly cognitively impaired”, and was assessed as being incapable of managing his property, personal care, or safety and well-being.
The Court subsequently relied on the test for capacity to enter into a marriage contract established by the British Columbia Supreme Court in Ross-Scott v Potvin in 2014. The Court held that a person has the capacity to enter into a marriage contract only if that person has the capacity to understand the duties and obligations created by marriage and the nature of the commitment more generally.
The Court also identified the tension between balancing Mr. Hunt’s autonomy as against the possibility that he lacked the capacity to appreciate the legal and social consequences of marriage. Ultimately, the Court was satisfied that Mr. Hunt’s children had met their burden of demonstrating that their father lacked the necessary capacity to marry Ms. Worrod. The marriage was declared void ab initio, and the attendant spousal property rights that would have otherwise flowed to Ms. Worrod were lost.
Thanks for reading.
We all know exercise is good for you. However, a survey of recent studies compiled by Business Insider shows that it is really, really good for you.
The article confirms that the best sort of exercise is aerobic exercise, or “cardio”. Exercises that increase the heart rate have been shown to be the most beneficial for body and mind.
The article refers to various studies showing the diverse ways in which cardio can be beneficial. These include:
- lower the risk of dementia;
- protection of your immune system from age-related decline;
- increased muscle tone;
- improved heart and lung health;
- the reversal of some heart damage associated with aging;
- improved mood and reduced stress;
- change the microbial makeup of your gut, reducing inflammation;
- the lowering of bad cholesterol levels;
- prevention or management of diabetes;
- improved look and feel of your skin;
- reduction of the symptoms of depression
- increased brain connectivity, thereby reducing the likeliness of cognitive impairment;
- reduction of the adverse mental impact of chemotherapy; and
- an increase in the size of brain areas linked to memory.
The article contains links to the studies supporting the conclusions.
Now get out there and move!
There’s no shortage of bad news, and 2018 is starting off much the same. So how about focusing on some of the positives? There’s a lot of research showing that a focus on the things we’re grateful for is a key to greater happiness. Even the Harvard Medical School agrees.
So, let’s focus on the big picture, as Canadians. What are we grateful for? Here are five things you may want to ponder – and I’m sure there are many more:
- Democracy: We have to put this as number one. We are not beholden to a dictator or total state control. We vote in fair elections and we choose our leaders and lawmakers. Millions of people don’t enjoy this privilege. Whatever your political leanings, let’s be grateful for the ability to express our views freely.
- Water and energy: We have some droughts and some floods, and there are many legitimate environmental concerns, but we can drink from our taps and plug in our devices, and know that both water and energy are plentiful. So many in the world can’t say the same.
- Health care: It’s not a perfect system, but Canada delivers high quality, affordable health care to all. Good health is key to a good life. Our health care system helps deliver it, to rich and poor alike.
- Proximity to the United States: Yeah, I know, a bit of a controversial topic right now. But it’s kind of nice living beside the world’s largest and most innovative economy. Don’t let the political climate blind you to the fact that we benefit a huge amount by our trading relationship with our neighbour. Of course, it’s actual “weather” climate helps too – January in Palm Springs or Miami is awfully nice for those who can travel there.
- No inheritance tax: Hey, this is an estates blog after all. Okay, this may not be a “top 5” gratitude item, but as estates professionals, this is one we’re grateful for. You can discuss the political merits of inheriting wealth, but inheritance taxes only serve to promote aggressive planning to avoid them. Our efforts are better spent building wealth rather than finding ways to protect it. Pay some capital gains taxes, fair game. But let’s pass on the wealth and put it to good use!
And if you want a slightly more light-hearted look at the benefits of being Canadian, CNN has 10 that you may want to consider.
Thank you for reading … have a great day,