Senior Toronto blog

March 30, 2020

Under the coronavirus cloud

The coronavirus pandemic is bad enough, but there’s another one following in its wake. Blatant, unapologetic ageism is going viral too.

It began early, when Canadian public health officials were downplaying the threat by assuring us that the virus affected mainly the sick and elderly. So there might be some losses, but they would be socially acceptable, and it would be business as usual for everyone else. Then the virus began rampaging through long term care homes, exposing all the weaknesses of a poorly regulated and poorly monitored industry. And as the cases ramp up and strain intensive care services beyond their limits around the world, medical staff are now posing out loud the question of who should get the ventilator: the 75-year-old pensioner, or the 30-year-old father of three. Will seniors get extra points if they provide a home for their adult children, or child care for their grandchildren? If we seniors do get turned away from intensive care, what sort of death will we be facing? I can’t imagine that there will be many palliative care beds available for coronavirus patients. Will we just be sent back home, then, to die on the bathroom floor?

Who lives and who dies? Doctors may well be facing that dilemma in Canada soon. I hope that the decisions will be guided by fair, value-neutral ethical principles, using a variety of factors, and not just age. I don’t envy them the task. And I fear for the suffering of those of us who get triaged out.

Stay home. Wash your hands. Keep yourself safe.

February 29, 2020

Designing for seniors

Bottles with screw tops you can’t open without a wrench. Clamshell packaging you can’t open without a Swiss Army knife. Medication bottle labels you can’t read without a magnifying glass and a flashlight. Digital devices with keys so small you hit three keys at once, land in some dark corner of cyberhell, and can’t get out. There are a lot of us seniors now. Why can’t they design things to help us instead of throwing up all these roadblocks?

It shouldn’t be very complicated, really. Some of us need to compensate for vision and hearing problems. Some have health issues affecting fine motor control. Some are inexperienced in using digital devices. And some have cognitive issues affecting memory and attention. If designers were to bear these issues in mind, the results would benefit not just seniors, but many other groups as well.

Here’s a novel concept: ask seniors what we want. Involve us directly in designing our products. Don’t make assumptions about what seniors are looking for in a product. Ask us what we need before you start designing. Watch us interact with products, and solicit our reactions. Listen to us as we evaluate existing products. Learn from what we say.

An American organization called Tech-enhanced Life has been doing just that. Groups of seniors meet monthly to explore new ideas, products and services that show promise for improving life as we age. They also explore unmet needs, and brainstorm potential solutions to those unmet needs. They publish their recommendations and selection guides for a wide and eclectic variety of products and services: everything from medical alert systems to apps, medication management guides, clothing and everyday objects. It’s a sort of Consumer Reports for seniors. Check them out at Tech-enhanced Life.

This is an American group, so some of the products they list are not available in Canada. Wouldn’t you love to see a Canadian version of this initiative? What a fantastic project this would be for some enterprising Canadian seniors.

January 29, 2020

The Planet of Pain

I live on two planets. One of them is regular Planet Earth. Sure, I’m a senior with my share of aches and pains. I have to exercise a lot to keep the joints moving, and to build strength in my back to deal with bad spinal osteoarthritis. My activities are more limited than they used to be, but I can still look after my home, run errands, go to band rehearsal, meet with friends. It’s a quiet life, but I’m content with it. Then all of a sudden, I make one wrong move, or even just cough or sneeze, and I’m catapulted over to the Planet of Pain.

Someone has lit a match to my spine. The sharp, searing, white-hot pain shoots across my hip and down my right leg. The tiniest movement sets it off. It’s hard to put my right foot down, so I limp and scuttle and hang on to the walls to get around. I can’t roll over in bed. I try to find one position that’s bearable and stay put, but after an hour or so of lying down the pain is worse. It takes about ten minutes of scrabbling around, a millimetre at a time, to get from lying down to sitting up. These osteoarthritis flare-ups last anywhere from a couple of days to a couple of weeks. After a few days, I’d gladly jump off a bridge, but how can I get to one? I can’t get out the door, can’t even bend to tie my shoes.

I know the flare-up will end sooner or later, but how do I live through it in the meantime? For pain relief, all I have are Tylenol and Naproxen, and they don’t do anything for pain like that. I can’t escape in sleep, because the pain keeps waking me up. I detour to the twelfth century with Brother Cadfael, or to 50 BC with Astérix. I turn on CBC Radio and let those calm, rational voices wash over me. I’m just trying to get from one minute to the next and don’t much care what they’re saying. I just need reassurance that there’s still a sane world out there. Eventually I’ll get back to Planet Earth.

The Internet is full of advice for coping with osteoarthritis flare-ups. Most of it is pitifully inadequate and must be written by people who have never experienced a flare-up. The best advice I can find comes from the sixteenth century. The French essayist, Michel de Montaigne, suffered from kidney stones, which cause acute episodes, sort of like my osteoarthritis flare-ups. Montaigne doesn’t complain. Instead, he plays a mind game. He tries to persuade himself that the stones are a blessing. His suffering provides him with valuable training in Stoicism. During an acute episode, he can show off his courage in front of his friends. And best of all, as he says in his essay, On Experience:

Is there anything so sweet as that sudden change, when from extreme pain, by the voiding of my stone, I come to recover as if by lightning the beautiful light of health, so free and so full, as happens in our sudden and sharpest attacks of colic? Is there anything in this pain we suffer that can be said to counterbalance the pleasure of such sudden improvement? How much more beautiful health seems to me after illness, when they are so near and contiguous that I can recognize them in each other's presence in their proudest array, when they vie with each other, as if to oppose each other squarely! Just as the Stoics say that vices are brought into the world usefully to give value to virtue and assist it, we can say, with better reason and less bold conjecture, that nature has lent us pain for the honor and service of pleasure and painlessness.

December 30, 2019

Seniors and climate change

Droughts, heat waves, melting glaciers, rising sea levels, wildfires: climate change isn’t in the future any more, it’s already here. How will it affect seniors, and how should we respond?

We older adults feel the effects of extreme weather more than younger adults. Our aging bodies, limited mobility and sometimes our medications make us especially vulnerable to high temperatures, polluted air and vector-borne diseases. If the power goes out, we can’t use our electric medical devices or refrigerate our medications. If we live alone, we might not get the help we need to get through an extreme weather event. Remember the heat wave in France in 2003? Of the almost 15,000 people who died, 80% were seniors.

There are plenty of younger people who won’t be sorry to see us suffering from climate change, since our generation has caused it. Many of us now feel guilt over our inaction. But guilt is paralyzing. Somehow we have to turn that guilt into responsibility and action. What can we do?

We can certainly take action in our personal lives. We can recycle, go vegan, give up the car, use energy-efficient appliances and light bulbs, fix things instead of throwing them away and so on. These gestures may help to quiet our conscience or deflect our grandchildren’s anger, and they’ll reduce our carbon footprint. But they won’t go far enough. Avoiding the worst impacts of climate disruption means changing the way the power sector operates, and implementing mitigation and adaptation policies both nationally and globally. The science is clear and can’t be denied any more. The ball is in the politicians’ court now. But the politics are complex and daunting. How many politicians are willing to pay up front for an uncertain result in the future, coordinate their policies with whose of other nations, and regulate and downsize a sector with the power of the fossil fuel industry? Not many, as we learned from the climate conference in Madrid a few weeks ago.

But the stakes are high, time is short, and we have to keep trying. At the very least, we need to vote out all the politicians who deny climate change, and those who talk a good game but don’t act. We have to let politicians know that climate change is a top priority now and we will or won’t vote for them depending on their climate policy. We also have to tell them that we accept what these policies may mean for us, in terms of higher prices, the disappearance of some jobs and creation of others, and maybe a shift in the economy away from growth. We have to keep learning and talking about climate change. We seniors need to leave a better legacy than climate disruption and chaos. The young people, marching in the streets in the thousands, are watching us.

November 30, 2019

Mall rats

Never mind teenagers; we seniors are the real mall rats. There we are marching up and down the aisles with our mall walking group, before the stores even open. Or we’re having a coffee in the food court and catching up on news with our friends. Or maybe we’re just relaxing on a bench, watching people go by. If you just want to get out of the house and while away a few hours, you can’t beat the neighbourhood mall. It’s safe from the weather, climate-controlled, it has washrooms and security guards and comfortable seating. We can just fit in with the crowds and stay as long as we like, with no admission fee to pay and no obligation to spend. It’s not what they were designed for, but neighbourhood malls have turned out to be wonderful, accessible gathering spots for seniors.

But times have changed. Major department stores that used to anchor these malls have disappeared. Many people now would rather shop online than take a trip to the store. Big box power centres and large upscale malls like the Eaton Centre and Yorkdale are still thriving, but many neighbourhood malls are in decline. Indoor malls are expensive to heat in winter and cool in summer. Some are trying to reinvent themselves. A few are building condos onsite, then surrounding them with medical offices, some basic stores, and maybe a community centre or small park. Some have decided to focus on the upscale and high-fashion youth market. We seniors may love our malls, but mall developers may not love us back. They’re not generating much profit from a senior who occupies a food court seat and just sits there sipping a cup of coffee for two hours. If they want to attract a hip younger crowd to the mall, then the presence of a lot of seniors spoils the vibe. The old Don Mills Centre was a magnet for the large local senior population. Redeveloped as the Shops at Don Mills, it’s now a grid of outdoor streets with trendy fashion stores for young people. They designed us right out of there.

All we seniors really need is an indoor mall with a food court. I hope at least some neighbourhood malls survive the changing times. I can’t imagine what could take their place as gathering spots for seniors.

October 29, 2019

Pie in the sky

If you’re a millennial, or middle-aged – in other words, a senior-to-be – then do your future self a favour, and start advocating for some of these policies. It won’t be easy, you’ll come into conflict with some powerful business interests, but you’re going to want these policies in place when you’re a senior. I’m not greedy; I’ve kept the list short.

  • Protect company pensions. Remember what happened to Sears pensioners? Sears had underfunded their pension plan. Then when they went bankrupt, whatever money they had went to their investors, and the pensioners got shafted. Insolvency legislation in Canada is not fair, balanced or equal when it comes to dealing with pensioners. Other creditors can negotiate terms to protect their interests, but pensioners can’t. So far, politicians have not agreed to force companies to fund their pension plans adequately or to move pensioners up in the queue on the creditor priority list.
  • Make extended healthcare affordable. Think of all those items not covered by OHIP: eyeglasses, hearing aids, dental care, mobility devices. Seniors need those things, and they’re all expensive. Unless you were a teacher or a government employee, you’re on the hook for all these costs when you retire. Insurance companies rig the system so that, for most seniors, the cost of the premiums is about the same as or more than the cost of the service. I went looking for research into the gap between the premiums people pay and the benefits they get paid back to them. In 2011, the most recent year I saw mentioned, Canadians were getting 74 cents for every dollar they paid. That’s down from 92 cents in 1991. Private insurance should be replaced with public alternatives, or there should be new stringent regulations imposed on the private insurance sector so that we get better value.
  • Build more not-for-profit long term care homes. Research has shown repeatedly that the quality of care is better in not-for-profit homes. They have lower mortality and hospitalization rates, and offer more hours of care per resident per day. But that’s not what we’re building. In Ontario, 60% of long term care homes are for-profit. Long term care is funded on a cost-shared basis with residents. Instead of using Ministry of Health money to fund private profits, we should be ensuring that all those public dollars are invested in quality care. Long term care homes should be run by local governments and not-for-profit groups.
  • Restore OHIP coverage for physiotherapy, chiropractic and eye examinations. In 2004, the Ontario government cut back OHIP coverage of physiotherapy, chiropractic, and some eye examinations. The impact of these cuts falls disproportionately on low-income seniors. These are services that help seniors recover from surgery and keep us functioning in the community. The OHIP physiotherapy clinics that are now offered to seniors provide only short group sessions, and are not a substitute for patient-centred care. These cuts were unjustified and should be reversed.