That's a large question. I'll make a few comments in reflection.
Without a doubt, if you were to consider creating collective dwellings and care facilities for all older adults—85 years plus—we simply don't have the land, the capital budgets, or the people to care for them. I also don't think it would serve them very well. In moving away from their familiar setting and away from being connected with the real world, they might be fed three meals a day and kept warm and dry, but it isn't necessarily going to add to the quality of their life.
Within the health care system, having listened to the seniors themselves, we're all working extremely hard to set up systems that support people in their own homes. I think that is where our focus has to be for the next few years, around how we do that.
Some of it is daunting for the health care system, because we are putting personal care workers into homes, with professional staff to supervise, oversee, and provide some additional help. Are we, however, going to be able to find the human resources to hire? That's one of our big questions. I think our advanced education system can ramp up a bit to create the programs, but can we fill the seats? Can we train the people so that they're there to hire? We also need leaders. You can have people in the trenches, but you need leaders who have the skills.
A lot of research has been done. I'm probably most familiar with the work out of the University of Alberta, the TREC study. This is very practical research within a residential care setting. What it shows overwhelmingly is that you get the best quality of care when you have clinical leadership that engages the staff, helps them to discern what they should be focusing on, and makes it easy for them to follow that knowledge. I heard some of those principles on financial literacy. If you have simple goals and you make it easy, you can then make things work better.
I think our focus has to be on supporting people in the home. The physical built environment plays a huge part in allowing us to support people in the home. People's own preparation of their own environment—their money management, their routines, bills being paid, and so on—the more simply they design their life, the less energy it consumes as their energy wanes. It also makes things easier for caregivers.
I think we're going to have to have some real dialogue as a society. There's always going to be a range among people's values, awareness, and skills, but what I see is that informal caregivers have a real struggle with a variety of things. They either feel responsible for absolutely everything in their family member's life and exhaust themselves or they expect the government to do everything and aren't prepared to step in with anything.
Within that range, there is a whole lot. I see family members exhausting themselves unnecessarily. There's a societal shift in thinking, and we have to challenge ourselves and have the conversations. It's going to be interesting to watch what happens around this issue over the next five to 10 years.
Seniors themselves have to shift some of their expectations. We certainly run into clients in the home who expect their daughter to come over, do their grocery shopping, do all their cleaning, and drive them to every medical appointment, and it creates a lot of tension in the family. How do you have those kinds of conversations? How do you have the ones about quality of life versus quantity of years? The fact that the medical system can do some fairly miraculous things doesn't mean that they're actually the right thing for individuals.
There are individuals themselves and there are families who feel that they should do everything to keep mom and dad alive, without a consideration of the quality of life. That's another conversation that, as a society, I think we need to have.