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The Future of Aging in Canada Virtual Symposium: What we heard

From: Federal/Provincial/Territorial Ministers Responsible for Seniors Forum

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List of abbreviations
AGEWELL NCE
AGEWELL Networks of Centres of Excellence
CFOJA
Canadian Femicide Observatory for Justice and Accountability
CIHR
Canadian Institutes of Health Research
CMHC
Canada Mortgage and Housing Corporation
CNPEA
Canadian Network for the Prevention of Elder Abuse
COVID-19
Coronavirus disease of 2019
FPT
Federal, provincial and territorial
HSBC
Hongkong and Shanghai Banking Corporation Limited
ISC
Immigrant Services Calgary
LGBTQIA2S+
Lesbian, gay, bisexual, transgender, queer, intersex, asexual, 2-Spirit, and other identities
MLA
Member of the Legislative Assembly
NSERC
Natural Sciences and Engineering Research Council of Canada
RESNA
Rehabilitation Engineering and Assistive Technology Society of North America
RNAO
Registered Nurses Association of Ontario
SCWW
Seniors Centres Without Walls
U of T
University of Toronto

Participating governments

*Québec contributes to the Federal, Provincial and Territorial Seniors Forum by sharing expertise, information and best practices. However, it does not subscribe to, or take part in, integrated federal, provincial, and territorial approaches to seniors. The Government of Québec intends to fully assume its responsibilities for seniors in Québec.

Acknowledgements

Prepared by Candice Pollack Consulting for the Federal, Provincial and Territorial (FPT) Forum of Ministers Responsible for Seniors. The views expressed in this report may not reflect the official position of a particular jurisdiction.

Executive summary

On June 8, 2021, the Federal, Provincial, Territorial Forum of Ministers Responsible for Seniors hosted a Virtual Stakeholder Symposium on the future of aging in Canada. With help from national partner organizations, AGE-WELL NCE, the Canadian Association of Gerontology, the Canadian Network for the Prevention of Elder Abuse, and United Way Centraide Canada, the Symposium explored 4 key themes:

The opening presentation highlighted the growing role of technology, or AgeTech, in supporting aging in place. Recent results from an AGE-WELL NCE survey indicated that more than 70% of Canadians over the age of 65 are confident using current technology and 66% of those aged 55 and over are willing to pay out-of-pocket for technologies that will help them remain at home and in their communities.

However, barriers remain to successful adoption of technologies that support aging in place. Guest speakers and Symposium participants shared that not all seniors can afford new technologies and the necessary infrastructure for high-speed internet is not accessible in every community. Moreover, many technologies are not designed with senior users in mind, making them difficult to use and incorporate into everyday life. And, lastly, support and training are needed to improve digital literacy for older Canadians, as they did not grow up with the kinds of technologies that are available today. As more and more of the world goes digital, increased efforts will need to be made to bridge the digital divide for seniors in Canada.

The next theme discussed at the Symposium was research and innovation in healthy aging. Aging research plays an important role in informed decision-making at individual, community, health service delivery, and policy levels. Symposium speakers and participants were asked to consider the core elements of a research agenda for the future of aging Canada:

During the second half of the Symposium, the conversation shifted to focus on some of the important social issues that seniors are facing: elder abuse and social isolation. Elder abuse comes in many different forms, it can be physical, emotional, financial, psychological, etc. Recent data suggests that the prevalence of elder abuse and mistreatment in Canada is about 8.2%. However, because elder abuse is so often underreported, it is estimated that up to 10% of older Canadians are actually victims of 1 or more kinds of abuse.

The situation worsened during the pandemic. As Canadians were asked to remain at home, many older adults became further disconnected and socially isolated, which are important risk factors for abuse. Symposium speakers and participants identified several areas for further research and action. The first was improved data collection on elder abuse to better understand its prevalence and the ways it is experienced by different groups of seniors. More training and education programs, as well as information on existing interventions and best practices were also discussed as critical components of a broader roadmap to ending elder abuse in Canada.

Lastly, Symposium speakers explored emerging best practices in supports for seniors and responding to social isolation. Even before the pandemic struck, the International Federation on Ageing had declared social isolation as the number 1 issue facing seniors in Canada.

When asked about promising practices to reducing social isolation, Symposium speakers and participants acknowledged the important contributions of senior-serving community organizations. Community organizations provide supports like service navigation, grocery shopping, meal preparation, housekeeping, etc. and ensure seniors stay connected through wellness checks, social and physical activities, and regular programming. For many seniors, community organizations became their main point of connection to food, services, mental health support, and friends over the last year. These organizations continuously step up to the plate to make sure that older Canadians receive the supports they need in their communities.

Technologies and intergenerational programming were also highlighted as effective tools for reducing isolation. Symposium participants shared success stories of pivoting to online services and how digital platforms have allowed them to connect more seniors. They also discussed the positive impacts of intergenerational programs like InterAGE, which help seniors form meaningful relationships, learn new skills, and stay connected to their communities while also providing mentorship and connection for young people.

At the close of the Symposium, speakers and participants considered their vision for the future of aging in Canada. In this future, aging will be supported. AgeTech will be accessible, affordable, and designed to meet the needs of older Canadians. Senior-serving organizations will have the flexibility and the resources they need to support seniors aging in community. Additionally, intergenerational relationships will keep older adults connected and engaged with family members and friends throughout their life course.

The future of aging will also be inclusive. In 20 years from now, the diversity of experiences of aging will be better heard and understood. Ageism will be as unacceptable as racism, and concerted efforts will be made to reach seniors in underserved communities and provide culturally competent and safe services to Indigenous seniors.

Lastly, in the future, aging will be celebrated. Older adults and their caregivers will be acknowledged as valued partners at every table, and more cities and communities will be age-friendly. The path forward to achieving this vision requires collective action. But, together, Canadians can build a future where everyone can age well at home, in their communities, and surrounded by the people they care about the most.

Introduction

According to Statistics Canada, by 2036, approximately 25% of Canadians will be over the age of 65 (Statistics Canada, 2015). After a lifetime of working hard, raising families, and contributing to their communities, older Canadians want to have the supports they need to age at home for as long as possible. While Canadians expect to experience continued personal growth and lifestyle changes as they age, they also expect to experience new challenges associated with getting older. Chronic health conditions like heart disease, diabetes, and dementia are more common among seniors (Public Health Agency of Canada, 2020). New mobility limits can impact activities of daily living like going grocery shopping or taking care of hygienic needs. Finances may become more restricted as seniors retire from the workforce, and new challenges to participating in social and recreational activities may arise.

Over the last year in particular, Canadians have witnessed the disproportionate impacts of the COVID-19 pandemic on the aging population. Seniors were at greater risk of becoming seriously ill from exposure to COVID-19 (Government of Canada, 2021; World Health Organization, 2020). Older Canadians living in long-term care facilities were among the most affected groups; during the first wave of the pandemic, residents of long-term care homes accounted for approximately 80% of COVID-19 related deaths across the country (Hsu et al., 2020). In addition to the increased health risks, physical distancing orders left many seniors socially isolated from their friends and families and prevented them from receiving some of the supports needed to stay engaged and connected to their communities (Armitage & Nellums, 2020).

By limiting social support networks and exacerbating healthcare needs, the COVID-19 pandemic shed a light on the many challenges that Canadian seniors were already facing to aging in place. As the population continues to age, Canadians need now, more than ever, to be asking themselves critical questions about what they want the future of aging to look like in Canada.

About the Virtual Stakeholder Symposium

On June 8, 2021, the Federal, Provincial, Territorial Forum of Ministers Responsible for Seniors (Forum) hosted a Virtual Stakeholder Symposium (Symposium) on the Future of Aging in Canada. The Symposium aimed to bring together experts, practitioners, and researchers from across the country to discover and discuss innovations and promising practices in aging. Over 650 people from every province and territory in Canada tuned in over Zoom, with many more Canadians livestreaming the event on YouTube.

The Symposium began with welcoming remarks from the Ministerial Co-Chairs of the Forum, Honourable Josephine Pon, Minister of Seniors and Housing for the Government of Alberta, and Honourable Deb Schulte, Minister of Seniors for the Government of Canada. Their remarks were followed by words of welcome from the Prime Minister of Canada, Rt. Honourable Justin Trudeau. Following these introductions, 4 key themes regarding the future of aging in Canada were explored:

Each of the 4 themes were introduced by 1 of the Symposium’s national partner organizations: AGE-WELL NCE, the Canadian Association of Gerontology, the Canadian Network for the Prevention of Elder Abuse, and United Way Centraide Canada. These organizations helped plan the event, contributed their knowledge and expertise on the 4 themes, shared best practices and innovations, and participated on the speaker panels (for a full list of speakers, see Annex A).

Following this was a third and final panel, where partner organizations reflected on the lessons they learned over the past year and their visions for the future of aging in Canada. They discussed how Canadians rose to the occasion amid a global pandemic to keep older adults safe. They also acknowledged that more work must be done to make sure every senior in Canada can age well at home and in their communities.

The Symposium closed with a call to action for participants: share their knowledge, expertise, and ideas about aging in Canada with the FPT Forum of Ministers Responsible for Seniors. This Report highlights what was heard, both from partner organizations and from Canadians, regarding the 4 themes of the Symposium and how Canada is innovating to improve the future of aging. For a detailed list of organizations who provided submissions to inform this Report, please see Annex B.

Partner organizations

The Virtual Stakeholder Symposium on the Future of Aging in Canada was made possible with support from the following national partner organizations.

AGE-WELL NCE

AGE-WELL NCE

AGE-WELL NCE was launched in 2015 through the federally funded Networks of Centres of Excellence (NCE) program. It is a pan-Canadian network of over 5000 older adults, caregivers, researchers, partner organizations and future leaders working together to accelerate the delivery of technology-based solutions that make a meaningful difference in the lives of Canadians.

Canadian Association of Gerontology

Canadian Association of Gerontology

The Canadian Association of Gerontology is a national, multidisciplinary scientific and educational association established to provide leadership in matters related to the aging population. Founded in 1971, their mission is to improve the lives of older Canadians through the creation and dissemination of knowledge in gerontological policy, practice, research, and education.

Canadian Network for the Prevention of Elder Abuse

Canadian Network for the Prevention of Elder Abuse

The Canadian Network for the Prevention of Elder Abuse is a pan-Canadian charity made up of individuals and organizations who care about older adults and the prevention of harm in later life. Their mission is to connect people and organizations, foster the exchange of reliable information, and advance program and policy development on issues related to preventing the abuse of older adults in Canada.

United Way Centraide Canada

United Way Centraide Canada

United Way Centraide Canada is a federated network of 76 local United Way Centraides serving more than 5,000 communities across Canada. Together, their mission is to create opportunities for a better life for everyone in our communities. United Way Centraide’s broad support focuses on 3 key pillars: moving people from poverty to possibility, helping kids be all they can be, and building strong and healthy communities.

Technology to support seniors aging in community

In this section

The first theme explored at the Symposium was the role of technology in helping seniors age at home and in their communities. For many, the word technology evokes thoughts of virtual reality or artificial intelligence. However, AgeTech includes everything from eyeglasses, hip protectors, and wheelchairs to wearable devices like smart watches and more high-tech tools like sensors, robots, and smart homes. These technologies benefit older adults in many ways; they can increase access to necessary health and social services, monitor and improve physical and cognitive function, and help seniors maintain their mobility and independence as they age (AGE-WELL, nd; Stanley, 2015).

64% of Canadians aged 65+ believe that technology advances can help to lessen the impact of COVID-19 on their daily lives (AGE-WELL NCE, 2020).

Like the rest of Canadians during the pandemic, older adults turned to technology to help them stay active, healthy, and connected to their communities. A poll done by AGE-WELL in 2020 found that 88% of Canadians aged 65 and over are using the internet every day and 65% own a smartphone (AGE-WELL, 2020). Over the first year of the pandemic, seniors nearly doubled their use of video calls as a way to communicate with their families and friends (AGE-WELL, 2020). In addition, nearly three-quarters of older Canadians are confident using the technologies currently available to them, and 66% are willing to pay out-of-pocket for AgeTech that will help them live safely and independently at home for longer (AGE-WELL, 2020).

As the interest in technology-based solutions to aging in place increases, so too has the development of AgeTech to meet seniors’ needs. The Forum asked partner organizations and Symposium participants to share with them examples of innovations that can help seniors age in community. Here are some of the technologies and programs that were identified:

“Technology is not going to take over person to person connections - the type that really matters. [I hope to learn] that technology will somehow allow more face-to-face and 1-on-1s.”

Coalition of senior-serving organizations

Although AgeTech is an important tool in the toolbox, it is not meant to replace human touch and will not, on its own, solve the complex challenges Canada faces to supporting seniors who want to age in place.

At the Symposium, speakers expressed that equitable access to technology is a human right. Nonetheless, Canada faces a digital divide between those who have the knowledge and resources to use technologies, and those who do not. These resources are often referred to as the “digital determinants of health.”

Digital determinants of health interact with, and are influenced by, the social determinants of health. They consider factors like reliable high-speed internet access, digital literacy, and access to technology devices as critical components of an individual’s health and well-being, alongside traditional social determinants like income and geography (Crawford & Serhal, 2020). Symposium participants indicated that, when it comes to technologies that support seniors to age in place, proactive measures must be taken to address the digital divide among Canadians. The biggest barriers to overcome are as follows.

Accessibility

Technologies and the infrastructure needed to support them have to be available and affordable for all seniors in Canada. Many rural and remote communities still do not have access to high-speed internet. While Canada’s Connectivity Strategy aims to get 100% of Canadians connected to reliable internet access by 2030 (Innovation, Science, and Economic Development, 2020), infrastructure support needs to go further. Older Canadians want 1-on-1 support and training, recommendations on what applications to use, and help to identify how they can get more out of being online. Moreover, technology devices and internet subscriptions need to be affordable for seniors who live on fixed or low-income. All technologies, from assistive devices like hearing aids to computers and smart phones, need to be priced affordably and support is required for device maintenance that reduces the need for regular upgrades.

Usability

Technologies developed for seniors in Canada need to be user-friendly. Research should be leveraged to better understand the needs and perspectives of older adults when it comes to using technologies: how do they navigate the tools they are using, what frustrates and excites them about the technology, and what are their concerns when it comes to safeguarding their personal information. Older adults also face unique challenges when using technologies. By involving seniors in technology development, challenges can be addressed or overcome during the solution design process. For example, while a senior may be confident using their smartphone, some of the applications they use may have font sizes that are too small for them to read. Engaging with seniors during the technology development process will ensure that usability issues are addressed and solutions are developed that best meets their needs.

“The pandemic has been a catalyst for more older adults getting involved; they have embraced technology when they have the means to.

Canadian Network for the Prevention of Elder Abuse, Symposium Speaker

Digital literacy

New forms of technology can be confusing and frustrating to use, even for people with high levels of digital competency. For older adults, who did not grow up with the types of technologies that are used regularly today, such as social media, smart phones, tablets, etc., limited digital literacy can become a complete barrier to participation. Concerns about privacy and online security intensify the challenge, as information about how to stay safe online is not always accessible. Developing a deeper understanding of how seniors use and navigate technological tools is necessary in order to create tailored support programs that can increase literacy and reduce the digital divide for older Canadians.

“When technologies are available, for example being able to FaceTime with grandchildren, it will be helpful to know how these means of connecting compare to genuine face-to-face time spent together. Are there some technologies that can significantly reduce the harms of social isolation [for Elders in communities?]”

Advocacy Organization (Indigenous Peoples)

As more and more services go digital, overcoming these barriers will be critical to preventing further systemic inequities. Particular equity concerns were raised regarding low-income seniors, seniors living in rural and remote communities, older seniors who are hesitant or resistant to technology adoption, and seniors from different cultural and ethnic backgrounds whose first language is not English or French. Moreover, targeted action will need to be taken on connectivity for Indigenous communities. Given limited broadband in many First Nations, Inuit and Métis communities, more research is needed to understand to what extent Indigenous Peoples are using technologies, how technologies can be aligned with the needs of seniors in the community, and what readily available technologies can be deployed to improve wellness and aging for Indigenous Peoples.

Research and innovation in healthy aging

In this section

Research on aging plays a critical role in informing the decisions made at a policy, health service delivery, and community level in Canada. It generates a deeper understanding of the experiences, needs, and challenges associated with aging and supports the design of innovative solutions to aging in place. Research in aging has been more important than ever over the course of the past year as Canadians came together to respond to the COVID-19 pandemic.

As a means of fostering research and collaboration, several Canadian organizations have leveraged their resources to form networks for aging research. Some of the innovative networks we heard about include:

Given the crucial role that research plays in supporting informed decision-making, Symposium participants were asked to share their top priorities for an aging research agenda. Responses from partner organizations, as well as people from all corners of the country, suggested that Canada’s aging research agenda should focus on equity, diversity, and inclusion for seniors, meaningful engagement of older Canadians in research activities, and best practices for supporting aging in place.

Ageism and the impacts on equity, diversity, and inclusion for seniors

Older Canadians are not a homogeneous group of people. Every senior in Canada has a unique lived experience that is shaped by their culture, values, ethnicity, language, community, and other socioeconomic influences on their lives.

Ageism refers to the “use of stereotypes, prejudice, or discrimination to categorize and divide people in a way that leads to harm, disadvantage, or injustice on the basis of their age”.

World Health Organization

Nevertheless, public discourse often places everyone over the age of 65 in the same group. In fact, some of the public health messaging during the pandemic reinforced this ageist belief. Older Canadians were often portrayed as frail and vulnerable because of the disproportionate impacts of COVID-19 on their physical and mental well-being. This portrayal fails to consider the intersectional identities of older Canadians and acknowledge the worsened impacts of COVID-19 on people of colour, individuals living with disabilities, and low-income seniors (Statistics Canada, 2021).

When asking research questions, Canadians want to ensure that the unique experiences of older adults are considered. In particular, research should include seniors who are First Nations, Inuit, and Métis, seniors who live with disabilities, have low incomes, are part of the LGBTQIA2S+ community or visible minority groups, and more.

“We know that the number of First Nations’ individuals with disabilities increases with age as over 50% of First Nations’ individuals above 50 years old report activity limitations. How can we better support First Nations seniors with disabilities?”

Advocacy Organization (Indigenous Peoples)

Asking questions that examine the impacts of policies and programs on the diversity of seniors in our communities is critical to combating ageism. Ageism has significant negative impacts on the health, well-being, and human rights of older persons. Consequences can include shorter lifespans, poorer physical and mental health, slower recovery from disability and cognitive decline, increased social isolation and loneliness, and increased risk of experiencing some form of violence (World Health Organization, 2021). According to the World Health Organization, globally, 1 in 2 people are ageist against older persons (World Health Organization, 2021). Yet, research and data on ageism is limited. A participant submission from the Centre on Aging at the University of Manitoba shared that “ageism underlies so many issues related to older people in Canadian society, whether it is at the policy level, businesses, or within older people themselves. Right now, even Equity, Diversity and Inclusion committees and initiatives fail to delve into this as an issue.” More research is needed to ensure equity and inclusion in programs and services for the diversity of older adults in Canada as they age.

Meaningful engagement of older adults in research

Symposium participants highlighted the importance of listening to and amplifying the voices of older adults in research. Canadians want to better understand the social meaning and lived experience of being a senior, and they know that the experts in this area are seniors themselves.

Older adults need to be engaged as partners in research. Research partnerships with seniors begin with asking them directly about what their needs are, what challenges they face, what they are most concerned about, and what they want aging in place to look like for themselves and their peers. Equipped with greater knowledge of their hopes and challenges, researchers can then work together with seniors to design studies, solutions, and innovations for the future of aging in Canada. Each solution should be tested with older adults, and their feedback must be central to its evaluation as a successful support for aging in place.

“How will you engage older adults in a meaningful and collaborative way as co-designers and co-leaders of research, innovation, and knowledge translation, implementation in supporting healthy aging in a way that matters to them?”

Advocacy Organization (Seniors)

There are many ways that researchers can engage older adults and amplify their voices and experiences. From consultations and focus groups to leadership and review committees, research partnerships with seniors can look different in every project. Some innovative examples that were shared include:

Research to support aging in place

Lastly, partner organizations and Symposium participants highlighted research on supports and best practices for aging in place as the biggest priority for Canada’s future of aging agenda. Access to appropriate care still acts as a barrier for many seniors who want to age at home. For First Nations, Inuit, and Métis communities, supporting seniors to remain in the community, where they are surrounded by the land and their families and friends, is especially challenging. There are few long-term care resources in rural and remote areas, which increases the pressure on unpaid and formal caregivers to meet the complex medical care needs of seniors in their lives.

Innovation: My BINGO Hub team

“When it comes to aging in place, many supports are already available; however, seniors and family caregivers are often not aware of them when they need it the most. The process of finding reliable information and connecting to the right program or services is both time consuming and inefficient. In an effort to help bridge these gaps, we took on this initiative and created an easy-to-use practical tool that serves as the 1-stop shop for our end users to better address and coordinate different needs related with aging in place. The goal is for mature adults and family members to be able to find reliable up-to-date health and social information, get connected to different programs and vetted service providers as well as register for events and sign up as a member of different groups all under 1 platform.”

Community-based seniors serving organization

Canadians want to know more about innovations in formal supports, like home care, and informal supports, like intergenerational connections, that can enable seniors to age in place. For First Nations in particular, there is added emphasis on the principle of Bringing Care Closer to Home and exploring innovations that will allow seniors to get the long-term care, hospice, and palliative services they need within their communities.

Furthermore, research on improved supports for unpaid caregivers was identified as a priority. Unpaid caregivers play a significant role in providing care to aging Canadians. Despite their important contributions to the healthcare system, caregiving roles often carry heavy social and financial burdens (Fast et al., 2020). Caregivers have to balance time for their work, families, and care obligations on a long-term basis. They assume costs for out-of-pocket expenses of their care recipients. Unpaid caregivers also have to navigate the complex web of health and social services for seniors, among their many other caregiving responsibilities. More research is needed to better understand the experience of unpaid caregivers, as well as to identify solutions that will alleviate the social and economic burden of caregiving for Canadians.

Addressing and preventing elder abuse

In this section

During the second half of the Symposium, the conversation shifted to focus on some of the important social issues that seniors are facing. The first issue discussed was elder abuse. Elder abuse comes in many different forms. From physical and sexual abuse, emotional harms and neglect, systemic ageism and violations of human dignity, and financial and legal manipulation or coercion, older adults can be subject to a variety of violations of their fundamental human rights (Canadian Network for the Prevention of Elder Abuse, nd). Recent data from the National Initiative for the Care of Elderly suggests that about 8.2% of Canadians over the age of 55 (over 750,000 Canadians) have experienced some form of mistreatment (National Initiative for the Care of the Elderly, 2015).

Elder abuse is often underreported. Lack of awareness, social isolation, and family relationships are all barriers that may prevent someone from reporting abuse. Because of these barriers, it is estimated that up to 10% of older Canadians are actually silent victims of 1 or more kinds of elder abuse (Justice Canada, 2015).

Innovation: In Hand: A mistreatment of older adults intervention ethical decision-making framework

In Hand was designed to support health and social service practitioners in their ethical reflection during the intervention process in a situation where an older adult has suffered mistreatment. This decision-making framework targets various competing values arising in a situation of mistreatment and introduces various suggestions for practice.

This situation worsened during the pandemic. As Canadians were asked to remain at home, many seniors became further disconnected and socially isolated. An isolated senior may lack access to basic necessities like groceries, be more vulnerable to scammers, or be trapped at home with their abuser. At the same time, the services that are usually provided to seniors by community-based organizations were disrupted. As a result, older adults living at home during COVID-19 reported higher rates of isolation and mental health struggles (Canadian Red Cross, 2020).

Combatting elder abuse requires collaboration and collective action. Action needs to be taken at individual, organizational, community, and policy levels. Some of the critical areas for further action that were identified by Symposium participants include improved data collection, training and education resources, and knowledge sharing on interventions and best practices to prevent and address elder abuse.

Improved data collection

Canada lacks important data about the experience and prevalence of elder abuse. The most recent pan-Canadian elder abuse study was conducted 6 years ago. This study did not provide a detailed outlook into the prevalence of elder abuse at the provincial and territorial levels. It also did not capture the intersectionality of older adult identities. Thus, more research and improved data collection on the prevalence and impacts of elder abuse in Canada is needed. Further, data collection should be disaggregated, or broken down, by sociodemographic factors like age, sex and gender, sexual orientation, culture and ethnicity, etc. to improve understanding of how diverse groups of seniors experience elder abuse.

Training and education resources

Canadians need more education and training resources that raises awareness on how to recognize the signs of elder abuse and what to do about it if they see it happening. Symposium participants shared the belief that more training and education resources should be deployed at all levels of society. General awareness campaigns can be used to inform the public about how to recognize the signs of elder abuse. Curriculum on elder abuse and ageism can be incorporated in schools and post-secondary institutions to increase societal awareness of the issue.

“Training that is not geared to social services or health professionals is needed, and resources in French are scarce.”

Advocacy Organization (Seniors living in official language minority communities)

Additionally, training has to be provided to professionals and volunteers who work with seniors on a regular basis, such as nurses, social workers, personal support workers, and community-based organizations. It should also be provided to professionals that interact with seniors in areas where abuse is prevalent: lawyers, banking staff, and police officers can all play a role in preventing and identifying elder abuse in communities. An innovative training program identified by Symposium participants was the “It’s Not Right: Neighbours, Friends and Families for Older Adults” pilot. This bystander intervention training program was deployed in every province and territory in Canada and provides training on how to recognize and address signs of elder abuse in community.

Interventions and best practices

Lastly, Symposium participants wanted to know more about existing best practices to prevent and address elder abuse. More information is needed on effective interventions, educational resources, and training activities to determine what should be invested in and scaled to other communities. The Canadian Network for the Prevention of Elder Abuse (CNPEA) is taking the lead on this work through their Roadmap to Increase Elder Abuse Prevention. Together with their partners at the Centre for Research and Education on Violence Against Women and Children, Elder Abuse Prevention Ontario, CanAge, the Canadian Centre for Elder Law, NICE, Egale Canada, and the International Longevity Centre Canada, CNPEA is working on a tool that stakeholders can use to figure out where the gaps are in their community and what they can do to improve their approach to elder abuse prevention. The Roadmap will outline what works, what does not, what the gaps are, and how they can best be filled to meet local needs. Through this Roadmap, individuals and communities will be empowered to take action and work together to address elder abuse at a local, regional, and national level.

Emerging best practices in supports for seniors and responding to social isolation

In this section

The final theme explored during the Symposium was social isolation of older Canadians. Social isolation can be defined as a lack of meaningful interactions with others (HelpAge Canada, nd). It has important physical and mental health impacts including depression, anxiety, and physical and cognitive decline (Statistics Canada, 2020). Even before the pandemic struck, the International Federation on Ageing had declared social isolation as the number 1 issue facing seniors in Canada (Employment and Social Development Canada, 2021).

Over the last year, as Canadians were asked to stay home and limit in-person interactions to prevent the spread of COVID-19, instances of social isolation worsened for older adults. Seniors living in rural areas or long-term care facilities, those who have lower incomes or decreased mobility, and seniors who have limited digital literacy skills were all identified as individuals at higher risk of isolation.

Symposium participants indicated they want to know more about the strategies used to identify people living in isolation, as well as the innovations that were applied and tested during the pandemic to keep older adults connected. Participants also highlighted that social isolation is a mainstream term that may not reflect the experiences of Indigenous Peoples. Further engagement is needed with First Nations, Métis, and Inuit peoples to better understand their cultural needs as it relates to connection with their lands, youth, families, and communities.

“There has never been a time in history that our population has experienced a loss of social interaction as we have through the COVID-19 pandemic. We must understand the severe impact this has had on seniors living in place (at home), seniors’ community centres, and for those separated from family while living in their bedrooms in long-term care homes. The health impact must be measured and acted on.”

Advocacy Organization (Retirement and Income Security)

Research demonstrates that community programming, technologies, and intergenerational interventions are all effective tools to reduce isolation among older adults. The innovations shared by Symposium speakers and participants confirms the important role that these organizations and programs play in supporting seniors, both during COVID-19 and beyond.

Senior-serving community organizations

Senior-serving community organizations play a critical role in supporting older Canadians to age in place. Community organizations provide supports like service navigation, grocery shopping, meal preparation, housekeeping, etc. and ensure seniors stay connected through wellness checks, social and physical activities, and regular programming.

“What has happened in every community across the country is that the community services sector serving seniors have really mobilized, adapted, and innovated to find new ways to connect with seniors that are struggling with isolation.”

United Way Centraide Canada, Symposium Speaker

When COVID-19 hit and physical distancing measures were put in place, senior-serving community organizations pivoted their work and stepped up to the plate to make sure that their clients got the help that they needed. They put many of their in-person programs on hold and shifted to virtual activities. They ramped up food delivery services and phone call wellness checks to see how their clients were coping with the pandemic. For many seniors, community organizations became their main point of connection to food, services, mental health support, and friends over the last year. A few of the innovative community programs identified by Symposium participants include:

Technologies to reduce social isolation

Throughout the COVID-19 pandemic, most Canadians turned to technology to stay connected with their friends and families. Older adults were no exception. Research shows that technologies that enable people to maintain meaningful connections with their communities can greatly improve quality of life and decrease loneliness and isolation (Khosravi et al., 2016; Chen & Schulz, 2016). Several organizations shared success stories of pivoting to online programming in their submissions. Many identified that digital services allowed them to reach more users and connect more people.

Nevertheless, key barriers exist for older adults turning to technology to stay connected, particularly for those who are low-income or living with a disability, and those in rural and remote communities or long-term care homes. Seniors need to have access to technologies and learn how to use them. Symposium participants shared a few examples of innovative programs and technologies that help seniors who have limited digital literacy get connected:

Intergenerational programming

Lastly, Symposium participants highlighted the importance of intergenerational programming as a means of reducing social isolation for seniors. Intergenerational activities can help seniors form meaningful relationships, learn new skills, and stay connected to their communities (Shaw & Konnert, 2014). They can also provide mentorship and connection for young people. Intergenerational programs are particularly important for First Nations, where maintaining connections with young people is an important role for elders in the community. Although many intergenerational programs had to be put on hold in the last year, Symposium participants want to see more of these best practices scaled at a local level. A few examples of innovative intergenerational programs include:

The future of aging in Canada

In this section

At the close of the Symposium, partner organizations were asked to reflect on their lessons learned over the last year while looking ahead to the future of aging in Canada. Every speaker shared that, despite the challenges that were faced, a spirit of collaboration has guided Canada’s pandemic response. Government, academia, industry, healthcare and frontline service providers, non-profit organizations, communities, and individual Canadians stepped up and worked better together to keep people safe and limit the spread of COVID-19. This “all hands-on deck” approach needs to continue forward. Symposium participants believe that the complex challenges that come with an aging population need to be tackled with the same dedication to collective action.

The future of aging in Canada is everyone’s future. Symposium speakers and participants were asked to share what they believe the experience of aging should be 20 or 30 years from now. Their responses focused on a future where aging is supported, inclusive, and celebrated.

Aging is supported

“As an older adult walks into their smart home, there may be floor tiles that collect vital signs such as heart rate, and blood pressure, and it does this automatically. They may have an intelligent mirror that helps them with tasks such as washing their hands and brushing their teeth. Motion sensors can detect falls automatically and connect the older adult to family members or emergency services…”

AGE-WELL NCE, Symposium Speaker

In the future, every senior will be supported to age the way that they want, in the places that they want to be in. Innovation will happen at the individual, community, and systemic levels to ensure seniors are better supported to age in place. Partner organizations and Symposium participants identified some key building blocks for that future as follows:

Aging is inclusive

The future of aging in Canada will also be inclusive. In 20 years from now, the diversity of experiences of aging will be better heard and understood. Every senior will be supported and respected, regardless of their age, race, ethnicity, culture, gender, sexual orientation, ability, or other intersectional identity. Ageism will be as unacceptable as racism, and the rights of older persons will be protected, preserved, and promoted, no matter who they are or where they live.

Furthermore, aging will be understood as a distinct and unique process for every person. In the future, focused efforts will be made to reach seniors in underserved communities and to provide culturally competent and safe services to Indigenous seniors. Partner organizations and Symposium participants indicated that these efforts should include:

Aging is celebrated

Lastly, in the future, aging will be an experience that Canadians celebrate. Older adults and their caregivers will be acknowledged as valued partners at every table. Partner organizations and Symposium participants shared that, in order to achieve this future, Canadians need to work together to:

The future of aging involves a paradigm shift that acknowledges seniors as valued members of every community. Together, Canadians can build this future, so that everyone can age well at home, in their communities, and surrounded by the people they care about the most.

References

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AGE-WELL NCE. (nd). The future of technology and aging research in Canada. Retrieved from: https://agewell-nce.ca/wp-content/uploads/2019/01/Booklet_8_Challenges_English_5_final_PROOF_rev.pdf

Armitage, R. & Nellums, L. (2020). COVID-19 and the consequences of isolating the elderly. The Lancet, 5(5). Retrieved from: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30061-X/fulltext. https://www.jmir.org/2021/5/e21864

Canadian Network for the Prevention of Elder Abuse, (nd). Forms of abuse. Retrieved from: https://cnpea.ca/en/what-is-elder-abuse/forms-of-abuse

Canadian Red Cross. (2020). Red Cross COVID-19 study shows vulnerable seniors in need of more support. Retrieved from: https://www.redcross.ca/cmsctx/pv/npatel/culture/en-CA/wg/0c542570-3094-4070-abe5-abf9602a6ef5/h/29e8a148a3cdda0b463581534201e530c23d5354ce8bdb049f74786ae282011e/-/cms/getdoc/bcc851b4-3323-4870-9626-7d638fd265fc/pv.aspx

Chen, R., & Schulz, P. (2016). The effect of information communication technology interventions on reducing social isolation in the elderly: A systematic review. Journal of Medical Internet Research, 18(1). Retrieved from: https://www.jmir.org/2016/1/e18/

Crawford, A. & Serhal, E. (2020). Digital health equity and COVID-19: The innovation curve cannot reinforce the social gradient of health. Journal of Medical Internet Research, 22(6). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7268667/

Employment and Social Development Canada. (2021). Social isolation of seniors - volume 1: Understanding the issue and finding solutions. Retrieved from: /content/canadasite/en/employment-social-development/corporate/partners/seniors-forum/social-isolation-toolkit-vol1.html

Fast, J., Keating, N., Eales, J., Choong, K., & Yeonjung, L. (2020). Trajectories of family care over the lifecourse: Evidence from Canada. Cambridge University Press’ Aging and Society, 41(5). Retrieved from: https://www.cambridge.org/core/journals/ageing-and-society/article/trajectories-of-family-care-over-the-lifecourse-evidence-from-canada/55DD2050516D929AE809362A086640EE

Government of Canada. (2021). People who are at risk of more severe disease or outcomes from COVID-19. Retrieved from: /content/canadasite/en/public-health/services/publications/diseases-conditions/people-high-risk-for-severe-illness-covid-19.html

HelpAge Canada. (nd). Social isolation and loneliness. Retrieved from: https://helpagecanada.ca/resources/social-isolation-and-loneliness/

Hsu, A,, Lane, N., Sinha, S., Dunning, J., Dhuper, M., Kahiel, Z., Sveistrup, H. (2020). Understanding the impact of COVID-19 on residents of Canada’s long-term care homes: Ongoing challenges and policy responses. LTCcovid.org. Retrieved from: https://ltccovid.org/wp-content/uploads/2020/06/LTCcovid-country-reports_Canada_June-4-2020.pdf

Innovation, Science, and Economic Development Canada. (2019). High-speed access for all: Canada’s Connectivity Strategy. Retrieved from: https://www.ic.gc.ca/eic/site/139.nsf/eng/h_00002.html

Justice Canada. (2015). Crime and abuse against seniors: A review of the research literature with special reference to the Canadian situation. Retrieved from: https://www.justice.gc.ca/eng/rp-pr/cj-jp/fv-vf/crim/sum-som.html

Khosravi, P., Rezvani, A., Wiewiora, A. (2016). The impact of technology on older adults’ social isolation. Computers in Human Behaviour, 63. Retrieved from: https://psycnet.apa.org/record/2016-39370-064

Mueller, A., McNamara, M., & Sinclair, D. (2020). Why does COVID-19 disproportionately affect older people? Aging (Albany), 12(10). Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7288963/

National Initiative for the Care of the Elderly. (2015). Into the light: National survey on the mistreatment of older Canadians 2015. Retrieved from: https://cnpea.ca/images/canada-report-june-7-2016-pre-study-lynnmcdonald.pdf

Public Health Agency of Canada. (2020). Aging and chronic diseases: A profile of Canadian seniors. Retrieved from: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/aging-chronic-diseases-profile-canadian-seniors-report.html

Shaw, M. & Konnert, C. (2014). A pilot study of the impact of an intergenerational program for socially isolated seniors: Examining LINKages. Journal of Undergraduate Research in Alberta, 4. Retrieved from: https://journalhosting.ucalgary.ca/index.php/jura/article/view/30188

Stanley, R. (2015). Technology supports for community-dwelling frail older adults. The Arbutus Review, 6(1). Retrieved from: https://journals.uvic.ca/index.php/arbutus/article/view/15073

Statistics Canada. (2021). COVID-19 in Canada: A one-year update on social and economic impacts. Retrieved from: https://www150.statcan.gc.ca/n1/pub/11-631-x/11-631-x2021001-eng.htm

Statistics Canada. (2015). Population count and population growth in Canada. Retrieved from: https://www150.statcan.gc.ca/n1/pub/91-520-x/2010001/aftertoc-aprestdm1-eng.htm

Statistics Canada. (2020). Social isolation and mortality among Canadian seniors. Retrieved from: https://www150.statcan.gc.ca/n1/pub/82-003-x/2020003/article/00003-eng.htm

Submission to the Forum of Federal, Provincial, Territorial Ministers Responsible for Seniors by March of Dimes Canada.

Submission to the Forum of Federal, Provincial, Territorial Ministers Responsible for Seniors by the Ryerson Leadership Lab.

World Health Organization. (2020). Coronavirus disease (COVID-19): Risks and safety for older people. Retrieved from: https://www.who.int/news-room/q-a-detail/coronavirus-disease-covid-19-risks-and-safety-for-older-people

World Health Organization. (2021). Global report on ageism: Executive summary. Retrieved from: https://cnpea.ca/images/who_executivesummary_globalreportageism_eng_2021.pdf

Annex A. Virtual Stakeholder Symposium speakers

In this section

The Honourable Josephine Pon, Minister of Seniors and Housing, Alberta

Josephine Pon

Minister Josephine Pon was elected to the Legislative Assembly of Alberta on April 16, 2019 as the MLA for Calgary-Beddington, and was appointed as Alberta’s Minister of Seniors and Housing on April 30, 2019.

Pon has a wealth of work experience in banking. For more than 20 years, she has worked with 3 major chartered banks: HSBC, Royal Bank, and Scotiabank. Her experience included both personal and commercial banking. Her most recent appointment was as the Regional Manager, Business Development responsible for Multicultural Banking where she worked with more than 3,000 Scotiabank staff in the Prairie Region. During her career in the banking industry, she also worked at Canada Mortgage and Housing Corporation (CMHC), a crown corporation in mortgage insurance, as an International Trade Consultant and in the Assisted Housing department for the Prairie Region.

Prior to being elected as an MLA and being appointed as Minister, Pon was the Vice President of the Taste of Asia Group in Calgary. This executive role provided her the opportunity to enhance her corporate business experience and get personal insight into the current economic situation in Alberta, especially the challenges faced by business owners, restaurant employees, and everyday Albertans.

Pon has actively volunteered with numerous non-profit organizations in Calgary and Edmonton throughout her life. She was a member of the working group on the Edmonton Mayor’s Task Force to Eliminate Poverty, the Board Chair of Immigrant Services Calgary (ISC), Chair of the ISC Immigrants of Distinction Awards Gala, Vice President of the Hong Kong Canada Business Association, and Cultural Advisor for the Glenbow Museum.

The Honourable Deb Schulte, Minister of Seniors, Canada

Deb Schulte

The Honourable Deb Schulte was first elected as the Member of Parliament for King-Vaughan in 2015.

Minister Schulte is an accomplished community leader who served as a former and regional councillor for the City of Vaughan. In 2017, her dedication to the diversity of her community was highlighted when her Private Member’s Motion was passed, marking every June as Italian Heritage Month in Canada.

A local advocate for most of her life, Minister Schulte was appointed to the Greenbelt Task Force and served on the Board of Directors of the Oak Ridges Moraine Foundation, a non-profit organization dedicated to enhancing and preserving 1 of southern Ontario’s most distinct landscapes. Minister Schulte is a long-time member of the Humber Watershed Alliance, now known as the Regional Watershed Alliance.

Minister Schulte has a degree in mechanical and aerospace engineering from Princeton University, and 22 years of engineering and business experience with Bombardier Aerospace, now known as Bombardier Aviation. Minister Schulte lives in Vaughan with her husband, Dave, and their 2 sons.

Dr. Alex Mihailidis, Ph.D, P.Eng., AGE-WELL NCE

Alex Mihailidis

Professor Alex Mihailidis is the Associate Vice-President for International Partnerships at the University of Toronto (U of T), as well as the Scientific Director of the AGE-WELL Network of Centres of Excellence, which focuses on the development of new technologies and services for older adults. He is a Professor in the Department of Occupational Science and Occupational Therapy (U of T) and in the Institute of Biomaterials and Biomedical Engineering (U of T), with a cross appointment in the Department of Computer Science (U of T).

Professor Mihailidis has been conducting research in the field of technology and environments to support older adults or the past 17 years, having published over 200 journal papers, conference papers, and abstracts in this field. Dr. Mihailidis is also very active in the rehabilitation engineering profession, currently as the Immediate Past-President for RESNA (Rehabilitation Engineering and Assistive Technology Society of North America). He was also named a Fellow of RESNA in 2014, which is 1 of the highest honours within this field of research and practice.

Professor Mihailidis received a B.A.Sc. in Mechanical Engineering from University of Toronto in 1996, a M.A.Sc. in Biomedical Engineering in 1998 from the University of Toronto, and a PhD in Bioengineering (Rehabilitation Engineering) in 2002 from the University of Strathclyde (Glasgow, Scotland).

Dr. Véronique Boscart, Canadian Association on Gerontology

Véronique Boscart

President, Canadian Association on Gerontology; Executive Dean, School of Health and Life Sciences, Conestoga College; CIHR-Schlegel Industrial Research Chair for Colleges in Seniors Care; Executive Director, Canadian Institute for Seniors Care, Conestoga College

Dr. Veronique Boscart has extensive gerontological experience including working as a nurse clinician, educator, manager and researcher in an international setting. Her research interests range from the substantive area of evidence-based care in gerontology and best practices in research methods with older adults to the development of gerontological education for health care professionals and care delivery models in residential care. She has published over 90 peer-reviewed manuscripts and is the lead author on the first and second Canadian edition of Gerontological Nursing and Healthy Aging (2011, 2018).

Dr. Boscart is the Executive Dean of the School of Health and Life Sciences at Conestoga College. Dr. Boscart is also the chair holder of the CIHR-Schlegel Industrial Research Chair for Colleges in Senior Care funded by the Natural Sciences and Engineering Research Council of Canada (NSERC) and Canadian Institutes of Health Research (CIHR). Dr. Boscart is the president of Registered Nurses Association of Ontario (RNAO) Waterloo Chapter. Dr. Boscart was also President (2015-2017) for the Canadian Gerontological Nursing Association and was a Section Editor for the Canadian Journal on Aging from 2014 to 2020. Dr. Boscart is involved in many research projects national and international.

Kathy Majowski, Canadian Network for the Prevention of Elder Abuse

Kathy Majowski

Kathy Majowski is a Registered Nurse in Manitoba, where she has focused the majority of her career supporting older adults in various health settings. Her current work as a Community Facilitator for the Healthy Aging Resource Team in Winnipeg provides an opportunity to support older adults by coordinating various health and social services, with the overall goal of stronger, healthier people and connected communities.

Kathy began her career in health care as a support worker while completing her nursing degree, progressing on to front line nursing at Manitoba’s largest hospital. After gaining experience in acute care, Kathy’s nursing career took her to a remote Indigenous community in northern Manitoba, where she developed additional skills and more understanding of life in a Nehiyawak community, working in a nursing station that functioned as both community clinic and trauma stabilization centre.

Current roles: Board Chair for the Canadian Network for the Prevention of Elder Abuse (CNPEA), Expert Advisory Panel member for the Canadian Femicide Observatory for Justice and Accountability (CFOJA) and Vice Chair for the Board of Klinic, a community health centre rooted in social justice and the belief that everyone deserves quality care, support, and respect.

Bénédicte Schoepflin, Canadian Network for the Prevention of Elder Abuse

Bénédicte Schoepflin

Bénédicte has been with CNPEA since 2015 and became its Executive Director in 2018. Originally from Avignon, France, Bénédicte now lives and works on the unceded and ancestral territory of the Coast Salish Peoples, including the territories of the Musqueam, Squamish, and Tsleil-Waututh Nations (Vancouver).

Bénédicte’s path took her from talent acquisition to non-profit management in the arts and culture sector, and eventually to CNPEA. Bénédicte also works for the BC Law Institute and its division, the Canadian Centre for Elder Law, as Communications Director. She is a Board member of the National Initiative for the Care of the Elderly (NICE).

Dan Clement, United Way Centraide Canada

Dan Clement

Dan Clement leads a national movement for social change as President and CEO and Secretary of the Board for United Way Centraide Canada. Dan has more than 20 years of leadership experience within the United Way Centraide network at the local, provincial, and national levels, including 11 years at United Way Centraide Canada, where his expertise is put to work on community impact and engagement, public policy, product development, and network governance.

The United Way Centraide network is comprised of a federation of 77 community-based United Way Centraides, each registered as its own non-profit organization and governed by an independent volunteer-led local Board of Directors. The United Way Centraide movement mobilizes more than 1,000 staff, 200,000 volunteers, and 1 million donors to raise and invest more than $500 million annually.

Cameron Ketchum, United Way East Ontario

Cameron Ketchum

Cameron Ketchum is a Director of Community Initiatives at United Way East Ontario, with specific responsibility for Seniors and Caregivers Issues and the Mental Health sector.

Cameron's work is focused on deploying strategies that create significant and measurable change around the key issues facing the East Ontario region, most often through collaboration with community partners and channeling resources to better address our most pressing vulnerabilities. This includes pursuing the recommendations made in 2017 Vulnerable Seniors Report and the 2020 Eastern Ontario Caregiver Strategy.

Cameron also leads the United Way East Ontario responses to community crisis, such as the ongoing COVID-19 response.

Annex B. List of submissions

The following organizations provided submissions to the Federal, Provincial and Territorial Forum of Ministers Responsible for Seniors Virtual Stakeholder Symposium on the Future of Aging in Canada.

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