Statement made on 08 February 2011 by Senator Terry Mercer
Hon. Terry M. Mercer:
Honourable senators, when Senator Carstairs first introduced this inquiry, I was again hopeful that everyone in this place would listen carefully. Senator Carstairs is known for her dedication on these subjects, and I thank her for the leadership she has provided over many years on the topics of aging, dementia and palliative care.
Dementia is the deterioration of a person's ability to learn and think but is not necessarily confined to one disease. It can take many forms, occur at different times in a person's life, and progress slowly or quickly. While terminal, a person suffering from whatever form of dementia can live for many years after their diagnosis. This characteristic is a large part of the reason why it is so important to detect signs of dementia early and try to prevent them altogether.
Honourable senators, I do not think there is a person in this chamber who has not been affected by, or does not know someone who has been affected by, dementia. According to the Alzheimer Society of Canada, the estimated number of Canadians living with Alzheimer's disease in 2007 was 300,000. In January 2010, the Alzheimer Society of Canada released a new study entitled: Rising Tide: The Impact of Dementia on Canadian Society. It stated that the numbers of Canadians suffering from Alzheimer's disease or related dementias is now 500,000. That number is expected to more than double in little over a generation.
Honourable senators, we have heard these statistics before, but I think they bear repeating. Senator Carstairs and other senators have told us that the Alzheimer Society study reports that by 2038 the economic burden will increase from $15 billion to $153 billion. The number of hours that Canadians will provide care to their loved ones will be 756 million hours per year, an increase from 231 million hours. These statistics are astounding. The question is: Are we prepared for it?
As we all know, the health care system in Canada is already burdened by long wait times, an inadequate number of doctors and nurses and not enough short-term and long-term care beds. We also know that improving preventative care now can have significant benefits in the future, even with dementia. Before I elaborate on the Alzheimer Society report, I will give honourable senators examples of how other jurisdictions are tackling this problem.
In February 2009, the United Kingdom released a report: Living Well With Dementia: A National Dementia Strategy. The strategy identified 17 key objectives for improving the quality of services provided to people with dementia. According to the report, there were 700,000 people in the UK with dementia at a cost of £17 billion per year. In the next 30 years, the number of people with dementia will double to 1.4 million with the cost rising to over £50 billion per year.
Some of the objectives the UK government identified include improving public and professional awareness and understanding of dementia; early diagnosis and intervention; information for those with dementia and their caregivers; and easy access to care and support following diagnosis.
In May of 2006, the Australian Health Ministers' Conference met to plan their National Framework for Action on Dementia for 2006-2010. In 2006, 200,000 Australians had dementia, and it was predicted that by 2016, dementia will be the major cause of disability for Australians, overtaking cardiovascular disease, cancer and depression. Some estimates suggest that by 2050, nearly 750,000 Australians will have dementia.
To combat this problem, the Australian health ministers identified five key priority areas: care and support; access and equality; information and education; research; and workforce and training. This information all sounds familiar.
Honourable senators, Canada is no different and will face a major crisis if we do not act soon. The aforementioned new study by the Alzheimer Society lays out similar plans for how to deal with dementia in Canada. Of course, we will not be able to help solve the problems associated with dementia if a support system is not in place to do so. Caregivers, such as spouses, children and grandchildren of dementia sufferers, need support. We recommended similar approaches in the report of the Special Senate Committee on Aging chaired by Senator Carstairs.
In my eyes, preventative measures are always the most effective. Just as education can take people on the path out of poverty, so too can preventative medical techniques solve some of our health care problems. More exercise and a healthy diet and lifestyle are always helpful to prevent the onset of many medical problems, including dementia.
This advice sounds like common sense to me but if we do not encourage these things, how can they be helpful? Are we even able to diagnose the early symptoms of dementia?
The following statistics are directly from the report of the Special Senate Committee on Aging, Canada's Aging Population: Seizing the Opportunity. The report states:
Although the number of geriatricians almost doubled from 111 to 211 between 1995 and 2007,147 this was still far short of the 538 that were estimated to be needed in 2006.
Of the 211 geriatricians, however, the Committee heard that many have other responsibilities, reducing the number of active fulltime equivalencies to probably less than 150. Even more alarmingly, the number of internal medicine residents entering geriatric medicine programs has decreased dramatically over the last 10 years.
The problem is becoming worse. The report continues:
The Canadian Geriatric Society reports that in 2007 there were only five trainees in English-speaking programs for the entire country. Likewise, Care of the Elderly family medicine training programs have many vacancies, and there are only 140 physicians with this training in Canada.
Honourable senators, if my math is correct, for 2007 there were 150 geriatric doctors for 300,000 Alzheimer's patients. That ratio is 2000:1. I believe that statistic says it all. Honourable senators, we need more research, more preventive measures and more doctors and nurses. We need a lot of things, but how will we pay for them? Does the government have a plan?
As many senators have already stated, the cost of dementia care will increase from $15 billion to $153 billion. This is staggering.
Canadian families also want the option of caring for loved ones who have fallen ill at home. Our rapidly aging population is putting increased pressure on our health care system. Family caregivers are responsible for 80 per cent of Canada's home care services. One can well imagine the stress on these caregivers when dementia is taken into account. The Special Senate Committee on Aging heard stories firsthand from families who had exhausted their personal time, and even their health and finances, to care for loved ones.
While it appears government has no plan, it seems some people have been listening to these statistics. To help families care for their loved ones, the opposition in the other place, the Liberal Party, has a plan to invest $1 billion annually in a new family care plan to help reduce the pressures faced by hundreds of thousands of Canadian families. The Liberal plan will introduce a new six-month "Family Care Employment Insurance Benefit" so that more Canadians can care for their ill family members at home. The plan also offers a new family care tax benefit which would help low- and middle-income family caregivers to compensate for the cost of providing care to a family member at home.
Combined with further government support, loved ones with dementia can be taken care of at home by family members, with the help of professionals, for a longer period of time. Not only does this save money in the long term in the health care system, but it also gives dignity to the person with dementia and their families.
As I said, everyone here has a story to tell about a family member, a relative, a neighbour, or someone they know who has suffered from dementia. Honourable senators, my own mother, in the last few months of her life, suffered from the symptoms of dementia. We only discovered later that it was not dementia, but a brain tumour. However, she had the classic symptoms of dementia. I salute my family members who provided the care to her over those last few months. As well, I salute a couple of her grandchildren. On the final Christmas my mother lived, we visited my sister for Christmas. We were going there on Christmas Eve and my son and my nephew drove my mother up to my sister's cottage. At that time, because of her problem, my mother needed to stop at every washroom along the way. Thank God there are so many Tim Hortons restaurants in Nova Scotia; conveniently, there is one almost at every interchange. Here were these two young men, aged 29 and 30 years old, with this 89-year-old woman in tow, stopping at Tim Hortons establishments along the way, taking her into the men's washroom, taking her into the cubicle and helping her to use the facilities. While I mentioned my son and my nephew, that is the kind of care that is being given by hundreds of thousands of Canadians right across the country every day.
This morning, I made a phone call to another relative of mine who was recently diagnosed with early stages of dementia to find out how he was doing. I was encouraged — and this is a positive story — because he has been put on a regimen of new drugs. Amazingly, it has helped to stabilize his condition and has helped him to come back so that he is able to participate more in his day-to-day life and has been able to maintain his ability to drive, which is important. He lives in an extremely rural part of Nova Scotia. Without his ability to drive, he would probably be institutionalized, which would be disastrous for both him and his family. This has dramatically improved his quality of life.
Honourable senators, there are things we can do to help prevent a catastrophic rise in health care costs associated with dementia. I only hope the government benches have listened to what honourable senators have said regarding this inquiry. Again, I thank Senator Carstairs for leading this discussion and hope that she will continue to do so.