What actions need to be taken if we are to improve care of the frail elderly living in nursing homes at the end of life? Let us suggest two areas in which we believe the federal government can play a leadership role.
TREC has demonstrated that we need a coordinated, system-level approach that assists in bringing together the many jurisdictions involved in the care of frail and vulnerable older Canadians. The federal government needs to develop, as soon as possible, a long-term care act for community and residential care that parallels the Canada Health Act for acute care and physician coverage.
The act needs to include a long-term care insurance fund, such as has been adopted in many European countries. The act will need to specify standards for quality care, including what constitutes adequate and appropriate staffing. Across the country, the variation in resources available to support long-term care and in the rules governing access to this care is considerable, making it difficult for families to relocate older members in need of community or residential long-term care closer to them.
Secondly, we need to expand the volume of research to inform long-term care, particularly in supporting large-scale studies such as TREC that are expensive to mount and sustain. The threat of a budget cut to CIHR has the potential to constrain the already inadequate level of research--and even shrink it.
Most importantly, the number of researchers devoted to clinical and health services research focused on the older population in long-term care must be increased. This will require an expansion in the graduate and post-doctoral awards needed by students to support their studies.
Without a near-miraculous discovery that will prevent and treat age-related dementia, we are faced with a serious national challenge that will stretch over our lifetimes and those of our children and grandchildren. Even with a dramatic discovery, nursing-home care will be with us for a long time. We need to figure out how we are going to do it well.
Research is important, but it's not sufficient to create the changes needed to appropriately serve frail elderly Canadians with dementia. That will require a willingness of Canadians and their public servants to focus needed and coordinated attention on a group of citizens who once did contribute, but no longer can in the same way, to the nation's productivity, but who, we argue, still contribute to the fabric of Canada.
Thank you.