Thank you for the invitation to appear today.
As a nurse, my research has largely focused on vulnerable older people who are living in the community, especially those with dementia, but also more broadly, older people with physical impairments and social vulnerabilities. These are people who are isolated, maybe living apart from family, with a narrowing circle of support. Essentially these are people who find it difficult to get out of their homes, and when they do, they find there are fewer opportunities for engagement, for them to be connected with the larger community.
My research has explored the rather broad question of what is meaningful activity for this group, and more to the point, what can we do to support it? I'm going to briefly describe some of what we've seen through this research that might suggest some possible solutions.
I'm a community-engaged researcher. I'm really on the ground, so I'm not going to speak so much about top-down solutions but rather what I see happening from the bottom up.
Over the past several years we've seen ever-increasing numbers of small, community-based programs offering various kinds of group activity for older people and those living with dementia. These groups are diverse, they're often very innovative, and they exist largely outside the health care system. People are gathering in community centres, in church halls, and even in hotel meeting rooms. Our research has shown that these groups offer a range of health and social benefits, and against all odds, they seem to have staying power. They're really not disappearing.
In the interest of time, I'm just going to share two examples from some of the research we've been doing in B.C.
The first example is Paul's Club, a group for younger people with dementia, people between roughly 50 and 75 years of age. It's a social enterprise run on a volunteer basis. They have one part-time paid staff member. It was the brainchild of Nita and Michael Levy, a retired couple from Vancouver who wanted, really for very personal reasons, to do something for this particular population. They have over the past five years basically invented an approach that combines physical and social activity, all happening in the heart of the city. They have about 15 members who meet three full days a week.
These were people whose dementia had progressed to the point where they were no longer able to get out and about on their own. They were isolated at home but also unable to be left alone. Paul's Club has provided for them a new community of friends within the group, and it has them out walking in the neighbourhood every day where they are visible, active, and engaged with the broader community.
The second example I will share is Arts & Health: Healthy Aging Through the Arts, a program in which community centres across the city are offering weekly workshops for older people to work together for a year with a professional artist. It targets those who are identified as being at risk for isolation and marginalization. Our research showed that this program enabled these groups to make a real contribution to their community, bringing their artistic creations into public space and building social connections, while also improving members' physical and emotional health, but probably most importantly, what we saw was that it allowed them to build a real sense of belonging.
The program began in 2006 as a collaboration initially between the city and the regional health authority. It's my understanding that the health funding has essentially disappeared over time, but the programs themselves have continued, and in fact they've grown, becoming much more deeply rooted in their local neighbourhoods.
This research is really offering examples of how these kinds of groups can improve physical and emotional health for seniors, but the strongest finding, consistently, is how it enhances their social inclusion.
I'm not the kind of researcher who's going to argue that it will reduce health care costs. That's not the work I do. But I do argue that these are the kinds of supports we want to have in Canada as we grow older. It's not only to support well-being and quality of life so we feel and do better as individuals, but that we want our society to be one that welcomes age and that allows space for older people to not only be well supported but to contribute as active social citizens.
As for “where next?”, the evidence is growing that these kinds of programs work, especially for the groups that are offering physical and creative activities for older people. These are becoming increasingly popular across Canada and internationally as well.
To some extent, it's now a matter of sorting out details—what kinds of programs work best for whom, and which particular approaches work best—but the big question remains, which is about how to create solutions that make these kinds of grassroots initiatives more broadly accessible. There are very real challenges, of course, and there's always the matter of funding. These groups tend to expend a lot of energy finding sufficient money to keep going, so what kinds of funding models might work better?
Also, reaching the target group isn't easy. Those who are isolated can be very hard to find. Even when we succeed, transportation is a really important issue. How do we bring people together, especially when they're outside urban centres? Transportation isn't just about making sure people get to the doctor's office. It's also about seniors getting out to attend meetings and to meet with friends and stay connected.
My final point is about the community capacity to provide these kinds of programs, which remains quite limited. Here, I'm talking about two things. There's capacity in terms of the knowledge and skills that are required to work with a population that can be quite complex, but also, and I would say more importantly, we need to build capacity in terms of our collective awareness and understanding around aging and, in particular, dementia. For too long, our awareness has been couched in fear of the so-called grey tsunami. Our work is showing that we really need to confront that problem of underlying ageism if we're truly to be an aging-inclusive society.
Thank you.