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Price: $19.95

Format:
Paperback 208 pp.
20 tables, 12 figures, 6" x 9"

ISBN-10:
0195447662

ISBN-13:
9780195447668

Publication date:
July 2013

Imprint: OUP Canada

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Aging in Canada

Neena L. Chappell and Marcus J. Hollander

Series : Issues in Canada

Canada, like other countries, is aging. The media has reported on a "grey tsunami," a demographic change reflecting longer life expectancy and the retirement of the so-called baby boomer generation. The numbers and percentages of older adults within our population continue to increase. In 2010, 15.3 percent of Canada's population was over 65; in 2030, it will be 24.1 percent. Many commentators have risen alarm about this flood of adults potentially bankrupting our health care system.

This book gives us the facts in a clear, concise, and balanced way. It is true that our population is aging; however, this is not a crisis. We learn that the actual cost drivers are technology, labour, and increased service utilization across all ages - not uncontrollable demographic factors like population growth. The perceived crisis in the sustainability of our health care system should be framed in terms of challenges related to the reorganization and management of health services, particularly for older adults. Cost effectiveness is the key.

Two experts on aging review the latest information. They explore topics such as how our health changes as we age and how our health care needs change as a consequence; how the needs of older adults are currently met; and how we can improve in the future. From discussion of informal caregiving to a cost-benefit analysis of continuing care, this fascinating and informative book provides an eye-opening look at the realities of our aging population.

Readership : The market for this volume includes the disciplines of sociology, particularly the sociology of aging, and social work. It will also be of interest to policy makers, health care professionals in the field of gerontology, and research analysts. General readers interested in issues associated with our aging population will also be a key market.

List of Illustrations
Acknowledgements
1. Introduction
2. A Profile of Our Aging Population
Introduction
More Older Canadians
Dependency Ratios: Cause for Concern?
Interpreting Dependency Ratios
The Health and Well-Being of Older Canadians
Chronic Conditions
Functional Disability
Self-Perceptions of Health
Summary of Physical Health in Old Age
Well-Being
Frailty
Subpopulations
Summary of Health and Well-Being
Health Promotion and Disease Prevention
Chapter Summary
3. Informal Care
Introduction
Social Support and Caregiving
Caregiving in the West
Caregiver Stress and Burden
Caregiver Stress and Burden
Other Directions in Caregiving Research
Caregiving in the Future
Caregiving in Summary
Social Policy and Caregiving
Caregiving Policies and Programs in Canada
International Experience
The Need for Care for Caregivers
Looking Forward
4. The Evolution of Continuing Care for Older Adults
Introduction
Defining Continuing Care
The Historical Evolution of Continuing Care
The Emergence of Social Security in Canada (1700s-1945)
The Consolidation of Social Security (1945-early 1970s)
Fiscal Retrenchment (early 1970s-early 1990s)
Reform and Retrenchment (early 1990s-present)
Current Concerns
Discussion
5. The Economic Evaluation of Continuing Care
Introduction
An Overview of Economic Analysis
The Cost-Effectiveness of the Maintenance and Preventive Function of Home Care
Home Care as a Substitute for Residential Care
The Cost-Effectiveness of Home Care Compared to Acute Care Hospitals
The Cost-Effectiveness of Other Continuing Care Services
Discussion
6. Models and Frameworks for Integrated Care
Introduction
Examples of Successful Integrated Systems of Care
Larger Provincial and State Models
Smaller Models with Home, Community, and Residential Care Components
Smaller, Integrated Community-Based Models
The Chronic Care Model
Frameworks to Inform the Development of Integrated Systems of Care Delivery
Three Highly Regarded Frameworks
The Enhanced Continuing Care Framework
Discussion
Conclusion
7. A Path Forward
Introduction
A Critical First Step
Twenty Years of Policy Drift
A Response to the Skeptics
"The Cost-Effectiveness Data No Longer Apply"
"Actual Savings Are Not Possible"
"Large Scale Change Is Not Feasible"
Getting It Right
Scope of the Book
Conclusions
Notes
References
Index

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Neena L. Chappell is professor of sociology at the University of Victoria. She has served as president of the Canadian Association on Gerontology (2008-2012) and is president of Academy II (Social Sciences) of the Royal Society of Canada, 2011-13. Her awards include the Craigdarroch Award for Excellence in Communicating Research, University of Victoria, 2006; the Canadian Sociology Association Outstanding Contribution Award; and the 2001 Claude P. Beaubien Medal for Excellence in Research.

Marcus J. Hollander is president of Hollander Analytical Services Ltd., a national health services and policy research company headquartered in Victoria, BC, and has over 30 years of experience in health services research, evaluation, and administration, including working as the director of the Health Network of the Canadian Policy Research Networks. He is a recipient of the Distinguished Member Award of the Canadian Association on Gerontology (2012), their highest award; the Queen Elizabeth II Diamond Jubilee Medal for contributions to gerontology (2012); and the Alberta Premier's Award of Excellence (Silver, 2000).

Understanding Health, Health Care, and Health Policy In Canada - Neena L. Chappell and Margaret J. Penning
Aging Our Way - Meika Loe
The Overselling of Population Aging - Edited by Ellen Gee and Gloria Gutman
The Oxford Handbook of Work and Aging - Edited by Jerry W. Hedge and Walter C. Borman
Aging As a Social Process - Barry D. McPherson and Andrew Wister
Poverty in Canada - Raghubar D. Sharma

Special Features

  • Topic of ongoing media interest. We hear often of the coming "grey tsunami" that may bankrupt our health care system. The facts are here.
  • Authors provide a rounded approach. As well as issues such as ageism, chronic conditions, and frailty, this book considers overall well-being, happiness, and disease prevention.
  • Summarizes the latest research from Canada and elsewhere. The latest information on topics such as informal care, caregiver burden, and <"the sandwich generation.>"
  • Up-to-the-minute data. Contextual summaries of the latest data help to distinguish fact from myth.
  • Comparative approach. Considers how Canada compares in the treatment of its elderly population to European countries with a similar health care system.
  • Addresses Canadian diversity in aging. There is considerable heterogeneity to aging in Canada, with many different personal experiences, health requirements, and expectations.
  • Explores the multi-layered field of continuing care. Our current system has a history, a future, a range of experiences, and various price tags. All are evaluated here.
  • Forward looking. Authors argue that an aging population is manageable, but governments must take action now.