Last week, we blogged on serious deficiencies recently observed in long-term care facilities in Ontario and elsewhere in the country as a result of the Covid-19 pandemic. Improvement of conditions in long-term care homes has long been on the radar for many Canadian provinces even prior to Covid-19. The recent pandemic has highlighted many of the shortcomings of long-term care and provided the much-needed impetus for all levels of government to rethink ways to improve living conditions for residents.
One of the key issues highlighted by the pandemic is the reliance many residents have on family and friends to supply necessities such as food, clothing, and personal care items. Thinking about this led me to consider another important supply chain that may be suspended for residents of long-term care facilities; the supply of medical and recreational marijuana.
Prior to the Cannabis Act, S.C. 2018, c. 16, which came into effect on October 17, 2018, it was illegal to possess, obtain, produce, traffic, and import or export cannabis, except for cannabis for medical consumption. The new regime decriminalized the recreational use of cannabis, while regulations dealing with medical cannabis remained in place. The Cannabis Act was introduced for a number of reasons, one of which was to protect public health and safety to allow adults legal access to marijuana.
With the decriminalization of recreational marijuana came the loosening of stigmas surrounding marijuana consumption. A growing body of scientific studies suggest that marijuana presents a number of health benefits when used appropriately, such as relief of chronic pain, improved lung capacity, and the alleviation of feelings of anxiety and/or depression. The number of seniors using cannabis since 2012 has increased tenfold, with 52% of seniors reporting using cannabis exclusively for medical reasons, 24% for non-medical reasons, and 24% for both medical and non-medical. Unfortunately, accessing and storing marijuana is not as easy for seniors in long-term care as it is for most adults.
Notwithstanding the new regime, medical cannabis is still required to be purchased from a federally licensed producer by doctor’s order. For many residents, their primary care physician is the resident physician in their long-term care home. Naturally, not all practitioners are comfortable prescribing medical marijuana, meaning residents who prefer to consume marijuana must travel offsite to obtain such prescriptions. Even if a resident is able to obtain medical marijuana, individual long-term care facilities may have different policies in place regarding the delivery and storage of marijuana.
For some, the introduction of the Cannabis Act alleviated some of the above-noted issues by making it easier for family members and friends to purchase and deliver cannabis to residents. Given that OHIP does not cover medical marijuana, there is no financial downside to purchasing recreational cannabis (that is supplied by the Ontario Cannabis Store) rather than medical marijuana. Irrespective of their intention for use, residents in long-term care facilities should enjoy the same accessibility to marijuana as others.
Perhaps this is yet another issue that the government will consider when revitalizing and improving living standards for residents in long-term care facilities.
Thank you for reading!
A special thanks to Jane Meadus and Professor Lorian Hardcastle for their presentation on Marijuana Use in Assisted Living and Long-Term Care Facilities through the Canadian Bar Association on March 12, 2020.
Our readers will all be familiar of the issue of elder abuse, and the various forms that it can take. It is also well-known that elder abuse if underreported, giving rise to challenges in determining just how common it is and how incidence rates may be fluctuating within the context of our aging population.
A new study by Comparitech explores the issue of the underreporting of elder abuse and extrapolates reported incidents and studies regarding underreporting to gain an appreciation of how commonly it is actually occurring in the United States. Comparitech estimates that at least 5 million cases of financial elder abuse occur every year in the United States alone. While damages of $1.17 billion are reported, it is believed that the actual losses to seniors total $27.4 billion.
Technology also appears to be playing a role in increasing rates of elder abuse. Comparitech found that 1 in 10 seniors were victims of elder abuse and that the use of debit cards have become the most common tool in defrauding them of their funds. With phone and email scams on the rise in recent years, underreporting is anticipated to become a growing problem while incidence rates continue to increase without any way to determine exactly how many seniors are affected.
Thank you for reading.
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Our blog has previously featured posts about the concept of aging in place. Survey results suggest that the vast majority (93% of respondents aged 65 or older) of Canadians wish to continue living at home for as long as possible as they age. Benefits of aging in place may include lower costs (relative to living in long-term care), increased comfort, slower advancement of memory loss, strengthening of social networks, and continued independence and self-determination.
For many, with old age comes physical limitations that may result in decreased mobility and expose seniors to an increased risk of accidents while living at home, whether they are living with or without the assistance of caregivers or other support, absent sufficient safety measures. We recently discovered a guide to making homes senior-safe, which is available online for free through the Senior Safety Reviews website.
The guide features the following:
- 34 practical tips to assist in preventing falls;
- Measures that may assist in the prevention of theft, elder abuse, burns and fires;
- Technology that can be used to promote at-home safety; and
- Preparing the home for extreme weather.
The guide reports that, notwithstanding the goal of many individuals to remain at home into old age, only 1% of homes are currently equipped to safely facilitate aging in place.
This user-friendly guide may be of assistance to older clients and supportive family members in allowing seniors to safely age in place.
Thank you for reading.
Some people would be surprised to know that there are now more Torontonians ages 65+ than children aged 15 and below. By 2041, the number of people over the age of 65 is expected to double. Nationally, seniors are projected to constitute one-quarter of the Canadian population by the year of 2036.
The City of Toronto found that a plan and an appropriate strategy were needed to be put in place, in order to ensure that the needs of the growing population of seniors are being met.
The City first addressed this question on April 12, 2011, when Council directed the Executive Director, Social Development, Finance and Administration to develop a comprehensive strategic plan for seniors in consultation with other levels of government, school boards, relevant community organizations and individuals, businesses and academia that is adequately funded, financially feasible and able to be implemented. A particularly important aspect of Council’s direction was the request that the strategy include helping seniors remain in their own homes longer.
On May 7, 2013, Council unanimously approved the Toronto Seniors Strategy: Towards an Age-Friendly City. Between 2013 and 2017, various progress reports were generated and on July 4, 2017, City Council adopted the Tenants First Phase 1 Implementation Plan. A particular area of interest in this plan was that the City Council approved the strategic integration of City programs and services for seniors and responsibility for management of the 83 seniors-designated buildings within the Toronto Community Housing Corporation portfolio under a new Seniors Housing and Services entity that is separate from Toronto Community Housing and is more directly accountable to City Council.
Most recently, a report for action was generated on April 30, 2018 indicating that the manner in which the City currently organizes its housing and services for seniors does not meet their needs and this problem will be exacerbated as the population continues to grow over the next 10-15 years.
The following recommendations were made:
- City Council to approve Version 2.0 of the Toronto Seniors Strategy and direct City Divisions and Agencies to implement the 27 high-impact recommendations contained in the report;
- City Council to direct the Executive Director, Social Development, Finance and Administration to work with the Executive Director of Financial Planning to report back on the financial impact of fully implementing the 27 high-impact recommendations once the service delivery plans have been fully developed for the medium-term initiatives.
It is encouraging to see that the City of Toronto is taking initiatives such as these to care for its aging population, moving forward. To learn more about this important endeavour check out the Toronto Seniors Strategy Version 2.0 report here.
Thanks for reading!
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Is it possible for today’s seniors to return to their hippie past? For some, plans are in the works.
Youth of the 1960s were a powerful social force that introduced a greater acceptance of community or “commune” living. While the concept never went mainstream, commune-type living is a niche arrangement that takes many forms today, from housing co-operatives in the city, to back-to-the-earth rural compounds, to religious groups seeking to live with their own kind.
If there’s a “hippie” feel to all of this, it’s for good reason. Many of these communities are progressive, socialist in leaning, and seeking a higher ideal in their living. It sure sounds like the 1960s.
Which takes us to commune living for seniors. I heard about this first from a group of men who played hockey together and lived in the same neighbourhood. Recognizing that many would need to “cash out” and sell their homes as they got older, the group lamented the possible loss of their community. One answer was to establish a single housing collective that everyone could move to to maintain their social bonds.
While that idea has never gotten beyond beer talk (at least not yet), I recently learned of another friend who was actively involved in a group that had moved beyond the talking stage and were scouting potential building sites. It may not be for me, but it certainly put the idea on my radar.
The push for senior communes
The attractiveness of senior communes is that it bypasses traditional retirement homes (too institutional) or living alone arrangements (no community, too lonely). A commune brings like-minded people together who can care for each other – and bring in help as needed as group members age.
Of course, there are countless hurdles to such arrangements that range from funding, to legal status, to rules relating to who can live in the complex and what the responsibilities of living there entail.
The Huffington Post ran an article about this recently.
One of the Toronto groups mentioned in the article, Baba Yaga Place, is in the process of making their community living project a reality. It’s modelled on a Paris commune of senior women that is up and running. The Paris commune took 13 years to establish, but Baba Yaga Place is hoping their development stage is quicker. You can follow their progress through their website.
Are you ready to channel your inner-hippie as you enter your senior years? You may soon have options.
Thanks for reading,
A recent survey commissioned by HomeEquity Bank suggests that the majority of older Canadians plan on staying in their homes as they age (otherwise known as aging in place) rather than downsizing and/or moving into assisted living or retirement communities. 93% of survey respondents aged 65 or older felt that it was important that they remain at their current home throughout retirement. 69% of them advised that their primary reason for wishing to remain at home was to maintain independence as they age.
The older respondents (75 years or older) advised that it was important to them that they remain in their current home to stay close to family, friends, and/or the community (51%) and that emotional attachment and memories were also contributing factors (40%).
In order to remain living at home as long as possible into retirement, advance planning in terms of finances and logistics may be necessary. A recent article appearing in Forbes suggests that the following steps, unrelated to financial planning, may be especially useful in facilitating successful aging in place:
- Maintaining social connections to avoid social isolation;
- Identifying who will help, whether family members, friends, or public services;
- Planning for the transition as needs change over time and identifying the resources and services available in the community;
- Preparing the home to accommodate increased needs (for example, by installing grab bars and a chair in the shower);
- Reviewing and updating the plan to age in place as may be necessary (due to a change in health, available support, or financial constraints).
Notwithstanding one’s plans to continue living at the family home, increasing longevity, a lack of liquidity, unrealistic expectations in terms of income sources after retirement, and the high cost (or local inaccessibility) of caregiving services may contribute to a decision to sell the home and relocate earlier than intended.
Thank you for reading.
The Supreme Court of Canada recently refused leave to appeal a decision of the Quebec Court of Appeal that raises the issue of whether old age should be considered as a factor during sentencing.
The appellant had been convicted of fraud, conspiracy to commit fraud, and laundering the proceeds of crime at the direction of or in association with a criminal organization. A prior appeal regarding the conviction itself had been dismissed by the Quebec Court of Appeal.
The Lower Court recognized the role of the appellant as a directing mind of a criminal organization and the losses suffered by the government as a result of his fraudulent acts. The Court had stated that age, even if it could be taken into account, was “only one factor among many”, which “cannot have a determinative impact because of the great number of aggravating factors”.
The appellant subsequently sought leave to appeal his four-year prison sentence. The appellant asserted that, at 81 years of age and in a poor state of health, his sentence ought to be replaced with a conditional sentence to be served in the community or otherwise limited in duration to allow him the prospect of life after prison.
The Quebec Court of Appeal summarized the law as it relates to the consideration of age during sentencing as follows (at paras 38, 39, 42, 43):
The advanced age of an accused must be taken into account when determining a sentence, as Chief Justice Lamer indicated in R. v. M. (C.A.)…
The age factor must, however, be considered in light of the health of the offender as it relates to his life expectancy. Consequently, the mere fact that an accused is elderly is not, in and of itself, a mitigating factor in determining a prison sentence, unless the evidence reveals that he has little chance of serving the sentence before passing away. This is increasingly true with the general aging of the Canadian population and the raised probability of longer life expectancies.
As a result, if at the time a sentence is imposed, the offender’s state of health does not suggest that he is unlikely to complete the sentence before his demise, the judge then has the necessary discretion to impose an appropriate sentence in light of all the usual factors and criteria…
It is possible that an offender’s state of health deteriorates following sentencing. This possibility increases with the age of the offender. The sentencing judge may not, however, speculate on this subject and must determine the sentence in accordance with the evidence before him when it is rendered…
The Court nevertheless considered the prison sentence to be appropriate, notwithstanding the expectation of the appellant that he may not survive it. The Supreme Court agreed with the reasons of the Quebec Court of Appeal.
With Canada’s aging population, cases like this, in which an individual convicted of a crime is elderly and/or in a poor state of health, can be expected to increase in frequency. The Supreme Court has confirmed that (for the time being at least), while age is a factor to be considered during sentencing, it is merely one to be assessed among others, rather than being determinative of the issue.
Thank you for reading.
According to the Alzheimer Society of Canada, 25,000 Canadians are diagnosed with dementia each year, and more than 500,000 are currently living with the disease. While dementia can occur at a relatively young age, the risks increase as we grow older. According to the federal government’s Chief Public Health Officer, the average age of the onset of dementia symptoms is 70 years for men and 74 for women.
One of the risks for those with dementia is losing the ability to make sound financial decisions, or, even worse, falling victim to scams in which they willingly transfer money to others without a full understanding of what they are doing. In the United States, many financial advisors have put a safeguard in place to protect their senior clients who might develop the disease – it’s called an emergency contact authorization form.
How the Form Works
With an emergency contact authorization form, the client identifies someone they trust that their financial advisor can contact if the advisor believes the client is having trouble managing their finances or is being taken advantage of financially. You can view a sample form here: [http://www.virginialynn.net/files/72367/2016%20Emergency%20Contact%20Authorization%20Form.pdf]
The form only authorizes the financial advisor to discuss the situation with the designated individual. It does not give that individual authority to manage the client’s financial affairs, as a power of attorney would. The designated individual may be the same person named in the power of attorney, but it doesn’t have to be.
Because dementia is progressive, moving from mild, to moderate, to severe cognitive decline over time, financial advisors who advise seniors are in a unique position to see these changes occur between portfolio review sessions – or to spot any unusual financial requests or transactions that seem out of character for the individual. The emergency contact authorization form gives the financial advisor the ability to take action, and discuss the situation with someone the client has indicated they trust.
It’s a protection that we hope will gain greater prominence in Canada soon. You can learn more about the use of these forms in the U.S. here: http://www.themckenziefirm.com/financial-firms-roll-out-form-aimed-at-stopping-financial-elder-abuse/
Thank you for reading … Have a great day!
As the population continues to age and individuals are living longer, healthier lives, various demographic changes are developing.
One trend among seniors in good health is to spend several months of the year travelling abroad. Such activity was historically limited to wealthier members of the population, who could afford to retire early and/or take long periods of time away from work. However, according to a recent article in the Daily Mail, more and more British seniors are spending their retirements travelling and are funding the expeditions by what is referred to as “S.K.I. – Spending the Kids’ Inheritance”.
A new BBC series called the Millionaire’s Holiday Club follows older travellers as they explore the world with ITC Luxury Travel Group. While there is clear desirability behind spending money that would otherwise form assets of one’s estate on travel, some of the individuals credit other reasons as motivation for spending more money than they otherwise might on vacations. Some participants of the television series wish to leave their children an inheritance sufficient to allow for financial security, but not so large that it discourages them from working to earn a living and funding their own luxurious travel. Others report that they choose to travel as a way of remaining independent as they age.
For some seniors, travelling without a travel insurance plan risks incurring significant healthcare costs in a foreign jurisdiction. Due to costs that typically increase with age, travel insurance may be less accessible for older individuals who choose to travel, and especially those who have experienced serious or chronic health conditions. Depending on age and medical history, travel insurance simply may not be an option, and should be a serious consideration of a senior in deciding whether or not to travel. While there is nothing wrong with enjoying oneself by frequent travel, older individuals should be careful to ensure that they retain enough money to fund their ongoing costs of living, which can significantly exceed projected costs with time and the deterioration of physical and/or mental health.
Have a great weekend.