Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Dr. Puxty presents, Age Well - Your Choice

465 views

Published on

The process of aging well is yours to control. Learn the pest practices from Dr. John Puxty, Gerontologist, about finance, health care, meds, in-home care and downsizing.

Published in: Health & Medicine
  • Be the first to like this

Dr. Puxty presents, Age Well - Your Choice

  1. 1. Age Well – Your Choice Dr. John Puxty puxtyj@providencecare.ca
  2. 2. Presentation Outline Popular images of Aging Why prepare for life beyond 65 Strategies for successful aging
  3. 3. Longevity in 19th Century Jane Austin Out-lived sisters, friend and cousins Died at 42 years of age!
  4. 4. 4 Jeanne Calment lived to 122 She smoke, drank and rarely formally exercised! Longevity in 21st Century
  5. 5. Jeanne Calment 1875 -1997 • At age 85 (1960), she took up fencing, and continued to ride her bicycle up until her 100th birthday. She was reportedly neither athletic nor fanatical about her health. • Calment lived on her own until shortly before her 110th birthday, when it was decided that she needed to be moved to a nursing home after a cooking accident. • She continued to walk until she fractured her femur during a fall at age 114 years 11 months.
  6. 6. Life Expectancy at Age 65 in Canada
  7. 7. Composition of Population by Age groups 1971-2051 Sources Statistics Canada 2010, population estimates, 1971 to 2010, and population projections, 2009 to 2036.
  8. 8. New Norm • Very old becoming common • The 2011 Census enumerated 5,825 people aged 100 years and older, compared to 4,635 in 2006 and 3,795 in 2001 • By 2050 there will be nearly 50,000
  9. 9. New Norm • Very old becoming common • The 2011 Census enumerated 5,825 people aged 100 years and older, compared to 4,635 in 2006 and 3,795 in 2001 • By 2050 there will be nearly 50,000 • The oldest Baby Boomer today can expect 17-20 years in retirement • Are they prepared? • Changing expectations and realities • Baby Boomers have new roles as caregivers and future seniors • Predictions that life expectancy may increase 15-40 years by 2050!
  10. 10. Why Prepare for 65 +? • To have greater control over the circumstances and well-being of the later years • To leverage longevity (Likely 25% of life time) • To have a satisfying retirement • To heed the advice of retirees (Better to learn from others than make the same mistakes!) • To reduce costs to our health and social systems, ourselves and our families • To help maintain health and independence
  11. 11. And if you don't prepare? • Increased probability of frailty and adverse outcomes • Physical and Mental Frailty • Social vulnerability • Multiple chronic disease and polypharmacy
  12. 12. Canadian Study of Aging & Health: Frailty in Canada 41.4% were felt to be well 15.2% were considered vulnerable with some evidence of slowing up in their normal activities 13.3 were mildly frail needing some help with IADL’s such as finances, driving, managing medication or cooking 39.1 were moderately or severely frail requiring help with ADL’s such as bathing, dressing, toileting and walking Rockwood K, et al CMAJ 2005;173(5):489-9512 2,305 individuals 70 years or older were studied over 5 years
  13. 13. Probability of Institutionalization Avoidance Based on CSHA Frailty Scale Rockwood K, et al CMAJ 2005;173(5):489-95 Well Vulnerable Mild Frailty Moderate to severe Frailty 13
  14. 14. Probability of Survival based on CSHA Frailty Scale 14 Rockwood K, et al CMAJ 2005;173(5):489-95 Well Vulnerable Mild Frailty Moderate to severe Frailty
  15. 15. And if you don't prepare? • Increased probability of frailty and adverse outcomes • Physical and Mental Frailty • Social vulnerability • Multiple chronic disease and polypharmacy • Disproportionate use of health and community services
  16. 16. Seniors: Heavy Users of Health Care Seniors represent 14% of population, yet utilize  45% of all provincial/territorial public-sector health spending;  40% of acute hospital stays;  85% of hospital-based continuing care;  82% of home care; and  95% of residential care. They are also more likely than younger adults to visit family doctors frequently and make claims for publicly funded prescription drugs. 16
  17. 17. Health Care use is not uniform by Seniors
  18. 18. Compared with younger adults, seniors •Commonly have multiple chronic diseases •Seek care in EDs more often •Spend more time once in EDs •Are hospitalized at higher rates for conditions sensitive to ambulatory care 18 Room to Improve: Managing Chronic Conditions
  19. 19. Prescription Drugs: 19 In 2009, 63% of seniors on public drug programs claimed ≥5 drugs from different classes, while 23% claimed ≥10. Five of the top 10 drug classes used by seniors treat high blood pressure and heart failure.
  20. 20. Drug Safety Is a Concern In 2009, ~1 in 10 seniors were taking drugs that were potentially inappropriate. Seniors are more likely than younger adults to take over- the-counter drugs and supplements. Seniors are at increased risk of drug side-effects and interactions, compared with younger adults.
  21. 21. And if you don't prepare? • Increased probability of frailty and adverse outcomes • Physical and Mental Frailty • Social vulnerability • Multiple chronic disease and polypharmacy • Disproportionate use of health and community services • Loss of “control” over future housing decisions
  22. 22. Seniors in Residential Care Settings From 1981 to 2006, rates of institutionalization among seniors have ↓, but since 2004, intensity of care provided in residential settings has ↑ Seniors in residential care are more likely to be older (85+ years), unmarried and functionally dependent compared with those in community settings. 22 Characteristic Descriptive Home Care (%) Residential Care (%) Age % accessed seniors pop age 85+ 40 57 Marital Status Not married 64 76 Functional Status (Activities of Daily Living) Extensive assistance/ dependence 18 74 Cognitive Performance Scale Moderate to severe 14 60
  23. 23. Room to Improve: Flow Across Care Settings 23 47% of seniors designated ALC are waiting for LTC placement.
  24. 24. Age Well – Your choice!
  25. 25. Planning for Aging Well • Improving Physical and Mental Health • Modify diet: reduce meat increase vegetables, tofu and beans
  26. 26. Planning for Aging Well • Improving Physical and Mental Health • Modify diet: reduce meat increase vegetables, tofu and beans • Regular low-intensity activity • Sedentary people lose large amounts of muscle mass (20-40%) • 6% per decade loss of Lean Body Mass (LBM) • Aerobic activity not sufficient to stop this loss • Need combination of balance and flexibility training, capacity building exercise 3-5 days for 30 minutes each week and weights/stairs
  27. 27. Planning for Aging Well • Improving Physical and Mental Health • Modify diet: reduce meat increase vegetables, tofu and beans • Regular low-intensity activity • Reduce risky behaviours
  28. 28. Planning for Aging Well • Improving Physical and Mental Health • Modify diet: reduce meat increase vegetables, tofu and beans • Regular low-intensity activity • Reduce risky behaviours • “Sense of Purpose” (Ikigai ) • Eat to 80% full (hara hachi bu) • Drink moderate amount of wine • Improved chronic disease management
  29. 29. Improving Chronic Disease Management Customize “best practices” based on patient goals and life expectancy
  30. 30. Improving Chronic Disease Management Customize “best practices” based on patient goals and life expectancy Seek to avoid polypharmacy (deprescribing)
  31. 31. Is it feasible and safe to use a medication discontinuation strategy Generally approximately 2/3 of referrals have opportunities for discontinuation Typically involves  Anti-hypertensives  Diuretics  Anti-psychotics  Sedatives  Lipid lowering agents  Analgesics Failure rate of discontinuation 20-30%
  32. 32. Improving Chronic Disease Management Customize “best practices” based on patient goals and life expectancy Seek to avoid polypharmacy (deprescribing) Desirability of case management to link effort and care Need for “system navigation” and knowledge of system opportunities Caregiver support is crucial!
  33. 33. Planning for Aging Well Improving Physical and Mental Health Maintaining and building strong family and social networks
  34. 34. Planning for Aging Well Improving Physical and Mental Health Maintaining and building strong family and social networks Preparing housing and community to be “age- friendly”
  35. 35. Age-Friendly Community Dimensions Outdoor spaces and Public Buildings Transportation Housing: accessibility and safety Social Participation Respect and social inclusion Civic Participation and employment Communication and information Community support and health services
  36. 36. 36 Are Businesses “Age Friendly” ALL RESPONDENTS Above Average Average Below Average Don't Know Pharmacies 31% 57% 8% 4% Vacation destinations 27% 54% 9% 10% Seniors clubs / associations 25% 48% 7% 20% Book stores /sellers 20% 64% 7% 9% Specialty magazines / books 20% 60% 8% 12% Specialty food stores 19% 58% 10% 13% Restaurants 19% 67% 9% 4% Doctors 19% 58% 20% 4% Health / fitness clubs / gyms 18% 53% 16% 14% Pharmaceutical companies 18% 56% 19% 7% Travel agents 18% 58% 10% 14% Hotels 17% 65% 9% 9% Ranked in order of “above average” in meeting the needs of aging baby boomers, the following “top 12” businesses, services or professions are shown:
  37. 37. 37 ALL RESPONDENTS Above Average Average Below Average Don't Know Gasoline companies 3% 33% 56% 8% Provincial government 4% 40% 50% 7% Federal government 3% 41% 49% 6% Municipal government 4% 47% 43% 7% Retirement homes 15% 44% 25% 17% Automobile dealers 7% 58% 24% 11% Automobile manufacturers 8% 59% 23% 10% Airlines 8% 57% 23% 12% Home builders 7% 57% 23% 14% Banks 14% 59% 22% 5% The businesses ranked most negatively – the percentage aging baby boomers who believe their needs are met on a “below average” basis : Are Businesses “Age Friendly”
  38. 38. Planning for Aging Well Improving Physical and Mental Health Maintaining and building strong family and social networks Preparing housing and community to be “age- friendly” Technology
  39. 39. Technology • Incoming residents and baby boomers represent the first generation to grow up around technology • Expect a wave of innovation over the next 10 - 20 years to meet the growing needs of this market. This is the group that will be shopping for their parents now. • Emerging trend for developments aimed at keeping seniors at home longer
  40. 40. Technology Ollo Wearable Voice activated cell phone, sensors and GPS Broad for falls, cardiac monitoring etc
  41. 41. Technology GPS sneakers GPS embedded in sneakers outfitted with a microcomputer with satellite tracking can find anyone 24/7 Broad implications for cognitive impairment
  42. 42. Technology Driving systems – ‘aware’ car equipped with warning systems to control speed and monitor distance of oncoming traffic. Helps drivers make left hand turns and tailors airbag and steering wheel placement for seniors of smaller stature.
  43. 43. Planning for Aging Well Improving Physical and Mental Health Maintaining and building strong family and social networks Preparing housing and community to be “age- friendly” Technology Transportation – anticipate 7-10 years survival beyond safe driving capacity
  44. 44. Fatality Rate by Age and Distance Traveled  On the basis of estimated annual travel, the fatality rate for drivers 85 and over is 9 times as high as the rate for drivers 25 through 69 years old.
  45. 45. Planning for Aging Well Improving Physical and Mental Health Maintaining and building strong family and social networks Preparing housing and community to be “age- friendly” Technology Transportation – anticipate 7-10 years survival beyond safe driving capacity Finance: 40% have inadequate planning
  46. 46. Plans “post-retirement” At Desired Retirement Age I Will ... 8% 52 % 18% 22% Continue working on a full- time basis No longer work Not sure / don't know Continue working on a part- time basis By Age 55% 52% 52% 50% 47-49 50-54 55-59 60-64 By Net Worth 53% 50% 50% 59% <$100,000 $100K - $249K $250K - $499K >$500,000 … Continue Working On Part-Time Basis.
  47. 47. Planning for Aging Well Improving Physical and Mental Health Maintaining and building strong family and social networks Preparing housing and community to be “age- friendly” Technology Transportation – anticipate 7-10 years survival beyond safe driving capacity Finance: 40% have inadequate planning Ongoing access to information/education
  48. 48. www.sagelink.ca
  49. 49. 49 Enjoy life to the fullest!

×