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Suicide Rates Can Be Reduced

By on June 13, 2018 in Health, Psychology
Photo Credit : Huffington Post

Photo Credit : Huffington Post

Two recent celebrity suicides sparked off a lot of discussions about mental health issues. Both Kate Spade and Anthony Bourdain were unlikely victims of suicides because they appeared happy, perky and financially sound. Yet, both of them had suffered from depression and addiction for a long time and they both chose to hang themselves to end their “misery”.

Their deaths coincided with a new report released last week by the U.S. Centers for Disease Control and Prevention. Suicide rates rose in all but one state between 1999 and 2016, with increases seen across age, gender, race and ethnicity. In more than half of all deaths in 27 states, the people had no known mental health condition when they ended their lives.

Increasingly, suicide is being viewed not only as a mental health problem, but a public health one. Nearly 45,000 suicides occurred in the U.S. in 2016 – more than twice the number of homicides – making it the 10th leading cause of death. Among people aged 15 to 34, suicide is the second leading cause of death.

In Canada, the situation is equally stark. According to The Globe and Mail, about 3,000 people worldwide die by suicide every day – including 125 in the United States and 10 in Canada. Statistics Canada figures indicated that in 2009, there were 3,890 suicides in Canada, a rate of 11.5 per 100,000 people. The suicidal rate for males was three times higher than the rate for females (17.9 versus 5.3 per 100,000). Although suicide deaths affect almost all age groups, those aged 40 to 59 had the highest rates. Married people had a lower suicide rate than those who were single, divorced or widowed.

For seniors, the situation is even worse. Over 10 seniors (60+) die by suicide every week in Canada and approximately 1,000 older adults are admitted to Canadian hospitals each year as a consequence of intentional self-harm. Seniors are, in fact, one of the most at-risk demographic when it comes to suicide. Of that demographic, men over the age of 65+ are the most at risk.

For older adults, in particular, depression is the most common mental health problem due to loss of family and friends, debilitating sicknesses or disease, and a loss of independence and the isolation that can ensue. In an interview with CTV, Dr. Leon Kagan, the director of Geriatric Psychiatry at the University of Alberta, suggests that isolation is a key factor in driving thoughts of suicide among seniors. “These older individuals are having everything taken away from them in terms of their work, their health, their families and finding their role diminished. For some of them, taking their own lives seem to be the only option that they have.”

But suicide rates can be reduced by confronting and talking about depression and offering help to those suffering from prolonged sadness. The Globe and Mail pointed out one of the saddest aspects of the stories about Kate Spade was the revelation that she hesitated to get help for her crushing depression because she worried it would hurt her brand, built on cheerful and brightly-coloured handbags and clothes. Depression is often hidden behind a front of happiness. There is also the stigma of mental illness – victims and family members often feel ashamed of talking openly about their condition. Although this stigma has gradually been fading, the greatest barrier for many is not fear of seeking treatment, but access to treatment.

In Canada, the waits for psychiatric care are disturbingly long. The barriers to accessing psychological services tend to be financial – psychotherapy is not covered by publicly-funded health insurance and private insurance tends to offer limited coverage. The media should tell people that mental illnesses are treatable and instead of glorifying celebrity suicides, they should report on cases in which mentally-depressed patients have recovered by seeking proper treatment. Many people who consider or attempt suicide do get help and they get better.

For older adults, the magnitude of death by suicide is a fact that is under-reported and needs to be discussed more openly so that caregivers and families of older adults can better understand the warning signs of depression and suicide and offer up the help they need.

According to the Canadian Association of Suicide Prevention (CASP), the events that trigger suicide thoughts in seniors are unique and can differ from those that might lead to depression or mental health struggles within a younger demographic. While sadness is the most obvious system of depression, depression can actually exist without sadness.

The CASP website indicated that if an older adult is exuding the following traits, they might be at risk for depression or suicide:

  • Fatigue (difficulty falling asleep)
  • Loss of interest in hobbies or pleasurable pastimes
  • Social withdrawal and isolation
  • Loss of self-worth
  • Weight loss or loss of appetite
  • Fixation on death
  • Recent passing of a loved one
  • Lingering health problems

The most useful way to offer help to anybody suffering from depression is to to tell them that they are not alone. Let them know that there are people who want to help, and that with the right support, they can find hope again. In addition to having an open conversation about depression and suicide, you can suggest a change in routine by encouraging the people at risk to be involved in activities within their community. Some people need to talk regularly about how they feel in order to shift perspectives, so you can help them out by doing the research on professionals to talk to and, if possible, offer to drive them to and from appointments. When someone knows that others need them to live, it can discourage them from taking their own life. You can organize family time whenever possible and surround the person at risk with love, affection and reassurance that they are not alone.

We also need to tackle the societal problems that can fuel and trigger mental illness and suicidal thoughts – sexual and physical abuse, bullying, trauma, isolation, poverty and more. Anyone can help and little gestures matter. There is hope and we CAN reduce suicide rates if we try harder.

 

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Personal Support Workers In High Demand

By on April 5, 2018 in Health, Politics
Photo Credit: Canadian Career College

Photo Credit: Canadian Career College

The New York Times reported recently that according to the Bureau of Labor Statistics analysis, among the 10 occupations expected to grow the most through 2026, personal care and home-health aides will require the most new workers, with 1.2 million new positions between them. About 10,000 baby boomers turn 65 every day, and more than half will need long-term care, according to the Pew Research Center.

Home-care agencies and elderly-care facilities are apparently struggling to recruit. Last year, 26 percent of personal-care aides and home-health aides in the U.S. were foreign born, according to the Conference Board. In New York, 62 percent of home aides were foreign born. In California, Massachusetts and New Jersey, foreigners represented nearly half of them. That is why a recent bill introduced by the Republicans and supported by the White House to create a point system for admission based on factors including education, English skills and job offers in the U.S., which would cut the overall number of green cards awarded each year by half, worries employers who rely on immigrant labour. Senior-care agencies particularly are worried because many are dependent on Medicaid and Medicare and so cannot easily raise wages to make their jobs more attractive to native-born workers. According to a Washington think-tank, the Center for Global Development, the U.S. needs far more new low-skilled workers than high-skilled workers. Only three of the 10 occupations expected to grow in demand require university degrees, all of them digital or data-focused: software developers, statisticians and mathematicians.

In Ontario, Canada, to meet the increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Findings from a recent review of home-care service user charts in Ontario, Canada, indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex-care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. As the population ages in Ontario, the demand for PSWs performing more complex tasks is only going to increase substantially.

That is why the Liberal government in Ontario is creating a new provincial agency called Personal Support Services Ontario that could eventually serve hundreds of thousands of patients in the province. CBC News reported that this move would mean PSWs will become provincial employees. It also has the potential to take a significant portion of the $2.5 billion in annual publicly-funded home care away from the for-profit and not-for-profit agencies currently providing it. The government says creating the agency would give home-care clients more choice in selecting a PSW and more control in determining their care schedule. As with other new government policies, there are supporters and naysayers.

The plan is laid out in a Ministry of Health document dated October 2017 which says  Personal Support Services Ontario will be created soon to deliver home care in the spring. It also says the new provincial agency will directly recruit, screen and employ PSWs. Some 729,000 people received provincially-funded home care services in 2015-16. Nearly all of that care was delivered by nurses and PSWs employed by outside agencies, both for-profit and not-for-profit. The document says that the new provincial agency would initially provide PSWs to clients who need a high volume of home care –  at least 14 hours per week.

We all know that in 2015, the auditor general criticized the regional agencies that coordinated home-care services, the Community Care Access Centres (CCACs). Critics also questioned how much of the CCAC budget went into administration instead of home care and found that nurses employed directly by the CCACs were paid more than those employed by agencies. This all prompted the government to eventually dismantle the CCACs effective as of April last year.

While the creation of Personal Support Services Ontario seems to be a good idea, more time and work should be dedicated to providing better training to the PSWs and improving the efficiency of home-care delivery. We do not need a new provincial agency to reinvent the wheel and recreating a similar bureaucracy to the CCACs while thousands of seniors continue to be on the waiting list for the services of PSWs. With the upcoming provincial leadership elections, it would be interesting to see how the Wynne government would tackle this important new policy.

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National PharmaCare On The Horizon

By on March 21, 2018 in Health, News, Politics

DR.-ERIC-HOSKINS

I have more than once advocated the support of a national pharmacare program for Canada on this blog. It, therefore, gave me hope when the Trudeau Government recently plucked Ontario’s Health Minister, Eric Hoskins, to chair a special Federal Commission to look into the introduction of a national pharmacare program for the nation. Yesterday, Ontario Premier Kathleen Wynne said that her budget will include a blueprint to expand Ontario’s pharmacare program, known as OHIP-plus, which currently covers people up to the age of 25. She said she will move forward without the federal government for now and beginning August 1, 2019, seniors will no longer have to pay a deductible or co-payment for more than 4,400 prescription drugs.

Skeptics immediately said that both the Federal and Ontario Liberal Governments made these promises to win votes in the upcoming elections. For the highly unpopular Kathleen Wynne, in particular, this is obviously a campaign promise to woo the votes of the boomer and senior populations. She says the program will cost $575 million a year when it is fully operational in 2020-21. Drugs covered in the program include medications for cholesterol, hypertension, diabetes and asthma. Campaign promises can be broken but this latest announcement has won my vote.

Health care ranks highly among voter concerns in national polls, so it did not surprise me when Finance Minister Bill Morneau introduced the feasibility study of a national pharmacare program when he unveiled the Federal budget last month. The budget announced the creation of an advisory council, headed by Dr. Eric Hoskins, that would investigate whether public health-insurance plans could be expanded to cover prescription drugs. A national pharmacare plan had been previously proposed by the New Democratic Party (NDP).

The appointment of Dr. Hoskins, in itself, is already a step in the right direction. Dr. Hoskins, while in office as Ontario’s Health Minister, has always been a strong advocate for a national pharmacare program. In his new role, he will study the options, their costs, explain the trade-offs and determine which is the most feasible. Currently, about 26 million Canadians have private drug benefits, largely through employers. There are 102 public drug insurance programs, but that still leaves 700,000 people with no drug coverage, and an estimated 3.6 million with inadequate coverage, according to the Parliamentary Budget Officer.

A national pharmacare plan could save anywhere from $4 billion to $11 billion on the $28.5-billion prescription drug bill (from 2015). These savings could come from joint buying, more strictly regulating drug prices, more aggressive use of generics, and limiting the list of drugs that are covered. The Globe and Mail reported that while a single, national plan would theoretically save money on drug purchases, it would also mean a large-scale shifting of costs from the private sector to the public sector. The single biggest obstacle to pharmacare is the unwillingness of federal, provincial and territorial governments to absorb those costs and then increase taxes to pay the bill.

National pharmacare means insuring that every Canadian has access to necessary prescription drugs regardless of ability to pay. This philosophy has very few detractors, but there are many technical, financial and political impediments. But the appointment of Dr. Hoskins to chair the advisory council suggested the government’s seriousness about this initiative. It is well known that Dr. Hoskins, a physician himself, is a long-time proponent of an ambitious national pharmacare program. He has publicly backed that the best way of doing pharmacare is to throw out the system we currently have. The basic idea is that medically necessary drugs would be covered under the Canada Health Act and provided by provincial health plans for everybody, including those who now have private insurance. The federal government’s bulk-buying power would drive down prices for these new plans. People who felt the public coverage was inadequate could buy supplementary insurance on the private market, just like they can under medicare.

Skeptics and the Opposition are already criticizing the Trudeau government for paying lip service. But given Dr. Hoskins’s credentials and track record, and the timing of the Federal elections next year, it will only work to the Liberals’ advantage to devise a fiscally-responsible national pharmacare plan that would work.

Judging from the latest national polls, the Federal Government seems to be on the right track. A new Nanos Research poll that surveyed 1,000 Canadian adults by phone and online between March 7 and March 12, after the Liberals tabled their third federal budget on February 27, indicated that Canadians support the idea of public health insurance that covers prescription drugs. But they don’t like running deficits nor do they want new taxes to pay for the programs. But Canadians cannot have their cake and eat it too! How will the national pharmacare program be paid for otherwise? The NDPs have not come up with a good idea for financing this program either. So we should let Dr. Hoskins do his job and come up with a sensible plan. In Canada, we have had public hospital insurance since 1957, and public insurance for physicians since 1966. It is about time that we see another large-scale national health initiative on the horizon.

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Wellness Travel Popular Among Boomers

By on September 8, 2017 in Health, Travel

Bullhead Lake-hikers-mountain-L

I recently conducted an interview with a freelance journalist who was drafting an article on the latest boomer-travel trends for publication in a newsletter for Manulife Financial. I told her that wellness and slow travel will become a major trend for this demographic for the next decade or so.

According to the Canadian Tourism Research Institute (CTRI), an offshoot of the not-for-profit Conference Board of Canada, baby boomers will be the main pleasure-travel market over the next 10 years, spending more than CDN$35 billion annually. Because boomers are healthier and living longer than their parents, they want to maintain their good health to enjoy life and their new-found freedom after retirement. This explains why they want wellness and fitness programs, not only in their daily lives, but also when they travel.

Research by the Global Wellness Institute (GWI) confirms that wellness is one of the world`s fastest-growing, most resilient markets – clocking double-digit growth while the global economy shrank by -3.6 percent. According to data released by GWI in October 2016, the global wellness industry grew 10.6 percent in the last two years, from a US$3.36 trillion market in 2013 to US$3.72 trillion in 2015. Among the 10 wellness sectors analyzed, fitness and mind-body (+21 percent), and wellness tourism (+14 percent) were among the top five fastest-growing from 2013 to 2015. Wellness tourism now accounts for 15.6 percent of total tourism revenues – amounting to almost one in six of total tourist dollars spent. One of the major contributors to this growth is the baby boomers who are seeking experiences rooted in meaning, purpose, authenticity and nature.

Wellness incorporates fitness, mental and physical health improvement, as well as eating healthy. Over the past decade, boomers are looking for healthy hotels, wholistic cruises, hiking, cycling, mindfulness and yoga retreats, medical tourism and more. Everyday commitments, particularly for those who are still working, prevent boomers from participating in fitness activities or attaining health goals. So, vacations focusing on wellness – adventure, exercise, self-improvement or volunteerism – become more and more compelling.

I always remind people that due to the almost 20-year-gap between the youngest Canadian boomers born in 1966 to the oldest ones born in 1947, we cannot lump all boomers together. For the younger boomers, who are probably still working, exercise, fitness and cycling vacations may be more appealing. According to Forbes Magazine, slow-travel programs that bring people to national parks and forests for one- or two-week guided backpacking adventures seem to be an ideal exercise and fitness vacation for younger boomers who want to unplug, de-stress and recharge. Canada`s Fitz and Fowell based in Montreal and Cycle Treks in Victoria, B.C., also offer cycling tours, whale watching, culinary tours or a seaside trek.

For the older boomers, also called leading-edge boomers, mindfulness or yoga retreats may be the way to go. The Omni La Costa Resort and Spa in Carlsbad, California, which also houses the Chopra Center  for Wellbeing, helps groups incorporate wellness into their workplace and personal lives. Mindfulness, offered by Miraval Resort and Spa in Tucson, Arizona, includes programs that cover healthy lifestyle changes, self-discovery and transformation. Apart from spas, more and more hotels are joining the wellness bandwagon. Westin Hotels recently launched a US$15 million well-being campaign for both employees and guests to smile and listen more, worry less and sleep better.

Although cruise lines have recently begun to lure millennial travellers, boomers remain their most stalwart customers. Celebrity Cruises emphasizes on well-being centred on mind, body and spirit. The cruise line has a special program dedicated to seven different types of yoga. Passengers can also enjoy other fitness classes such as Pilates, indoor cycling as well as personal training focusing on blood pressure, bone health and more. With the current huge interest in ballroom dancing, cruise lines such as Cunard and Crystal receive accolades on their devotion to ballroom dancing. Professionals teach waltz, tango, samba and other dances during the day, and passengers can practice their moves at themed formal balls held in the evenings. Crystal also provides gentlemen hosts present on every cruise to make sure single ladies do not turn into wallflowers.

Oceania, Regent Seven Seas and Cunard`s Queen Mary 2 all integrate the Canyon Ranch Spa dining menu on board. Each cruise line offers the specialty spa cuisines in select restaurants throughout their ships. The menu includes organic foods and dishes high in protein, fibre and healthy fats, as well as vegetarian options.

In addition to ocean cruise vacations, leading-edge boomers are also increasingly attracted to river cruises which offer slow and leisurely travel. A Rhine or Danube river cruise offers passengers cycling tours through the countryside and cities, or even encourages cruisers to  ride along the river, catching up with the ship in the next port. River cruises also offer culinary cooking classes which can include a visit to the local market with the chef, shopping for fresh seafood and produce at ports of call.

Last, but not least, solo travel has become a growing trend. Whether they have just lost a loved one or going through a divorce, boomers refuse to stop travelling. According to Visa`s Global Travel Intention Study 2015, the number of affluent adults, who vacation on their own, has more than doubled to 32 percent, up from 14 percent in 2013. Travel companies, cruise lines and the wellness industry are already adjusting their travel offers to better accommodate solo travellers.

With longer lifespans and a greater emphasis on health and fitness, boomers will continue to be interested in wellness travel for many more years to come. Marketers and the travel industry stand to win big if they pay greater attention to and focus more efforts on offering new and meaningful experiences for this affluent demographic.

 

 

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Increase In Cancer Rates Shocks Canadians

By on July 5, 2017 in Health

Cancer-Treatment

A new report released last month by the Canadian Cancer Society, in partnership with the Public Health Agency of Canada and Statistics Canada, predicted that almost one in every two Canadians is expected to be diagnosed with cancer in their lifetime and one in four Canadians will die from the disease. The charitable organization indicated that the latest statistics show that cancer is now the leading cause of death in Canada.

According to the Society’s epidemiologist and one of the report’s authors, Dr. Leah Smith, currently every year there is an increase in the number of cancer cases in Canada. “So between now and 2030, for example, we expect to continue to see a dramatic increase in the number of cancers diagnosed in Canada. The lifetime risk (an individual’s likelihood of being diagnosed with cancer at some point in their lives) for Canadian men is 49 percent, while it sits at 45 percent for women.

Dr. Smith also said that these statistics are a reflection of the aging and growing population. “About 90 percent of all the cancers that we expect to be diagnosed in 2017 will be among Canadians 50 years of age and older.” About 45 percent of those cases will occur in people aged 70 and older, said Dr. Smith, noting that as more people move into old age, the number of cancer cases will rise.

The Cancer Society’s report also showed that lung cancer is the most commonly-diagnosed cancer overall, making up 14 percent of all diagnoses, followed by colorectal, breast and prostate cancers. Lung cancer is also the leading cause of cancer deaths among Canadians. Of the four top cancer killers, pancreatic cancer has the lowest survival rate at only eight percent. It’s anticipated to be the third-leading cause of cancer deaths in Canada.

Canadians, both young and old, were shocked to hear this bad news. According to a report by Global News, the numbers seem shocking and alarming but it’s reminding Canadians how many people will be touched by cancer. The Cancer Society also said that it takes a huge toll on individuals who have a cancer diagnosis, on their loved ones and on the healthcare system.

In the past three years, I’ve lost at least three boomer friends to cancer. In spite of the sobering statistics, the good news is that overall cancer survival rates have increased: in the 1940s, only 25 percent of Canadians survived their diagnoses, but now 60 percent do. Some cancers, like thyroid and testicular, have five-year survival rates of over 90 percent.

What can we do to reduce our risk of cancer? In addition to regular check-ups and cancer screens, we can focus on a healthier lifestyle by avoiding tobacco, excessive drinking, eating well, exercising, maintaining a healthy body weight and practising sun safety.

We can only do our best because unfortunately some cancers are just unavoidable. According to a new research at the Johns Hopkins Kimmel Cancer Center, only about 42 percent of cancers are preventable. Using health records from 69 countries, the scientists of this study concluded that 66 percent of cancer-causing genetic mutations arise from the “bad luck” of a healthy dividing cell making a random mistake when it copies its DNA. About 29 percent are due to the environment and the remaining five percent are due to heredity. These numbers also vary depending on the type of cancer, the authors of this research found. At least 60 percent of mutations triggering skin and lung cancer are due to the environment, they calculate, compared with 15 percent or less in prostate, bone, brain and breast cancers. The bad news is that most mutations arise naturally and there is nothing people can do. The causes of cancer are complex and until more breakthrough research results tell us more, let’s try to maintain a healthy lifestyle and live life to its fullest.

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