Bracing for the soaring dementia toll

 Many of us are going to end up needing care.

Sure, some people will be lucky and live long, independent lives before dropping dead quickly and without a fuss. Others will be less fortunate and end their days early in a car wreck.

But the rest of us will likely need care or be involved in seeking residential care for a family member.

And unless things improve, that will be a daunting prospect.

Two recent reports - one from B.C.'s ombudsman and one from the Alzheimer Society of Canada - have highlighted how difficult things could become for people needing a safe, caring place when they can't live on their own.

The society's report was called Rising Tide: The Impact of Dementia on Canadian Society. It painted a scary picture, for individuals and society.

Today in B.C., about 70,000 people have been diagnosed with dementia. Alzheimer's disease is the major, but not the only cause.

The study forecast that by 2038 the number of people afflicted with dementia would more than double to 170,000. The increase will be similar in other provinces. Across Canada, the direct costs of dementia will rise from about $8 billion a year in 2008 to $93 billion in 2038.

In this, as in so many issues, the big factor is demographics, more specifically the aging of the giant bulge of people born after the Second World War.

Today in B.C. about one in five residents is 65 or older. By 2038, one in three will be in that age bracket. About four per cent of us are 80 or older; based on BC Stats projections that will increase to 7.5 per cent.

Given the overall population growth forecasts, the number of people in the province 80 or older is forecast to increase from 191,000 today to 460,000.

Dementia is largely a disease of the old. Barring other changes, the disease will afflict many more people for a longer period.

And at the same time, the ranks of those available to provide care - or pay taxes to support it - will have shrunk.

That's critical because the study found "informal care" - that is, unpaid - is currently huge.

Spouses, other family members and friends are providing 47 million hours - more than 22,000 person years of support - caring for people with dementia before they are receiving any formal supports. They are spending something like three times that amount of time helping dementia patients who are receiving some community care supports.

Even when people are in residential care, families and volunteers are spending millions of hours helping the patients.

That's just what families have always done, you could argue. But even a generation ago people died younger, reducing the toll of dementia. Families were stable and more likely to live close to aging relatives. Often, a stay-at-home mother was available to help a parent.

That's already changed. In 30 years, it will have changed still more.

And without that support, more support and residential care will be needed. The study looked at the expected increase in the number of long-term care beds and concluded that - just in terms of dementia cases - there will be a national shortfall of 157,000 beds by 2038.

The report recommended a number of actions, starting with a national dementia plan. It urged more research and support for families in navigating the system. And it said prevention should be a focus - exercise, especially by those over 65, can delay the onset of dementia and slow its advance. (You can read the report at Alzheimer.ca.)

It should all be alarming, whatever your age. For those in the Baby Boom cohort, it is a reminder of the challenges that might lie ahead and the gaps that could make life more difficult and painful.

For those much younger, it's a warning of big health-care costs to come.

Unless we act now.

Footnote: The Alzheimer Society has an obvious special advocacy role. And the money for the study came not only from Health Canada and the Canadian Institutes for Health Research, but also from pharmaceutical companies with their own special interests.