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Seniors care: Canada can do better

An 11-nation comparison of the quality for care provided for seniors has shown Canada does not rank highly especially when it comes to access to services.

However, the Commonwealth Fund survey recently published in Health Affairs does give Canadian health care professionals good marks for discussing end-of-life care issues with their patients and shows that compared to other countries, a higher proportion of Canadian seniors have a written plan detailing end of life care and naming a substitute decision-maker.

While focused on the United States, the article reports results from a 2014 survey of 15,617 adults aged 65 years or older in Canada, the US, Australia, New Zealand and several European countries including the United Kingdom

Seniors living in nursing homes or other facilities were excluded from the survey.

In terms of access to health services, Canada ranked last in terms of the ability of seniors to get a same-day or next-day appointment when sick, have easy access to after-hours care or waiting less than four weeks to see a specialist.

Only 45% of Canadian respondent said they could get an appointment quickly when sick compared to 83% in the top-ranked countries, France and New Zealand. Only 41% of Canadian seniors said it was somewhat or very easy to get after hours care compared to 71% in the UK and 77% in the Netherlands. Forty-six percent of seniors said they waited less than four weeks for a specialist appointment, on par with the Norway, but far poorer than the 86% reported by US seniors.

“These findings validate our concerns about seniors care and access to services in Canada,” said Canadian Medical Association President Chris Simpson. “They show just why it is so important for us to develop a national strategy on seniors care.”

The survey dealt with a number of other demographic and health system issues involving seniors care and also on touched on end-of-life care. Here, Canada ranked highly compared to other countries.

Of those polled, 66% said a discussion had taken place about the treatment they wanted if they became very ill and could not make decisions for themselves. This percentage was higher than any of the other countries except the US.

In addition, 46% of Canadian senior said they had a written plan describing treatment wishes at the end of life and 62% said this written plan named someone to make treatment decisions if they were unable to do so.

“These statistics are encouraging because they suggest end-of-life care is often a topic of conversation between older patients and their physicians,” said Simpson. “The statistics also show that many seniors are doing the right thing and documenting wishes for end-of-life care.”

Forward any comments about this article to: cmanews@cma.ca.