Cathy Arnold and Sarah Oosman
What’s the issue?
Over the next 20 years, Canada’s population of adults over the age of 65 years is expected to rise by 68% reaching 10.4 million by 2037 with the number of adults 75 years and older doubling in most provinces, including Saskatchewan (Infographic: Canada’s seniors population outlook: Uncharted territory, CIHI, 2017). Health status changes with aging are highly variable, but when they occur they can quickly and drastically impact quality of life. Many adults entering their older years are keenly interested in optimizing their health, maintaining their mobility and independence, and finding ways to age well and in place. This will increase the need for community care and services including local clinics, exercise classes, fall prevention education, family-caregiver support, and home care. It is expected that the number of seniors accessing physical therapy will triple in 16 years (Canada Facing Growing Need for Physiotherapy as Canadians Get Older; Conference Board of Canada, 2018). Physiotherapy in Canada is ill-equipped to meet this future demand with many areas already facing shortages.
Our take on things
As physical therapists we are keenly aware of the services and care we have the potential to provide amidst the rising older adult population in our country, our provinces and our communities. Yet, the province of Saskatchewan has not yet formalized an aging strategy to meaningfully pave the way forward to support healthy aging and aging well for our older adult population.
This ‘Rep’ is an opportunity for us to share stories of our research and community engagement, the successes and the setbacks, that are unique to our province of Saskatchewan and relevant to our nation. We want to highlight the important need for professional physical therapy advocacy that is necessary to support healthy aging initiatives. We hope that what we share will be relevant and applicable for other provinces and provincial professional associations and that this ‘Rep’ will open dialogue with others doing work within the healthy aging realm so we can learn from one another and make positive impacts to aging well for individuals across Canada.
What are we doing?
Falls and risk of injury from falls are detrimental to optimizing and maintaining health and mobility among older adults, significantly impacting quality of life and rate of decline along the aging trajectory. Dr. Cathy Arnold and her research team at the University of Saskatchewan and the Saskatchewan Health Authority have been researching the efficacy of fall prevention exercise and education in community-dwelling older adults. Recently she has embarked on a more novel approach to determining ways to decrease risk of injury, recognizing that we can’t prevent all falls from happening. This research has led to an exciting collaboration with the Saskatchewan Health Authority to augment their successful ‘Staying on Your Feet’ Program. Her research teams have been exploring how older adults fall through simulated falling experiments and computer simulation and what reasons attract and detract people from attending fall prevention programs. They have found a positive impact on fall and injury reduction factors by adding in specific training to prevent injury called FAST (Fall Arrest Strategy Training). They have also found through focus group discussions that participants highly value the leadership provided by physical therapy in these programs. ‘Staying on Your Feet’ continues to be offered to community dwelling older adults but the reach is small, focusing on senior residences willing to offer the program primarily in the urban site of Saskatoon. Spreading, scaling up and exploring factors that influence sustainability of such programs as ‘Staying on Your Feet’ in other urban, rural and remote communities in Saskatchewan, and beyond, will be key to supporting older adults to age well and in the place of their choice.
Furthermore, older adults living in rural and remote locations in Saskatchewan experience augmented health disparities in comparison to older adults living in urban contexts. These challenges are particularly true among First Nations, Inuit and Métis communities and older adult populations where the trend towards aging is also on the increase. This brings in the importance of Dr. Sarah Oosman’s research, in partnership with the northern Métis community of Île-à-la-Crosse and the University of Saskatchewan, revealing the experiences and aspirations of aging well, and living well across the generations, among older Métis adults and youth living in a rural and remote northern Saskatchewan Métis community. These projects, “Wuskiwiy-tan! (Let’s Move!) Aging Well in a Northern Saskatchewan Métis Community” and “Tah-Nighaniwhak! (They will be leaders!) Growing Up Well in a Northern Saskatchewan Métis community”, connect perspectives of Elders and youth in the community. The connection between seniors and youth is strongly grounded in an Indigenous worldview and recognizes community perspectives of health within, between, and across generations as foundational aspects of the research. Through this research, Elders are starting to talk more about the use of traditional medicine and practices, highlighting that healing is grounded in the balance between the emotional, physical, spiritual and mental spheres. Sharing this knowledge and talking about how people can incorporate it into their experiences within the health system will continue to support everyone in achieving optimal health and well-being. Elders and youth explain what works for them, applying their experience, knowledge base and Métis practices, thus honouring historical Métis knowledge with the potential to improve health across the lifespan. This collaborative research project emphasizes the importance of community engagement and outsider practice of cultural humility to inform healthy aging program and policy change that is meaningful for Métis community members. Older adults, Elders and youth are involved in driving what happens, ensuring that intergenerational relationships are highlighted throughout everyone’s life and health journey. Sarah is part of a research team that also includes community researchers Ms. Liz Durocher and Mr. TJ Roy (community of Île-à-la-Crosse), university scholars Dr. Sylvia Abonyi (University of Saskatchewan) and Dr. Amanda Lavallee. What our team learns about healthy aging from this work will not only be relevant to other Indigenous communities throughout Canada but can directly inform healthy aging strategies for non-Indigenous, rural and remote communities in Saskatchewan and Canada.
Considering that the province of Saskatchewan does not presently have an aging strategy in place for our aging population, there are a growing number of initiatives and exciting events in Saskatchewan taking place. For example, a provincial study is being conducted to develop consensus and co-ordination of fall risk screening and assessment practices across the province, an experience that can be shared with our fall prevention partners across Canada. Saskatchewan is also hosting the next National Fall Prevention Conference in 2020 in Saskatoon with a focus on how to provide important services and care to older adults in rural and remote communities. Make plans now to visit Saskatchewan and attend this event and reach out to your colleagues in Saskatchewan so we can build on successes in other communities and provinces and build a strong future for our aging populations.
Let’s hear from you:
We would like to close this ‘Rep’ with sending a couple of questions back to the profession in Canada:
- How do we take our isolated but successful aging projects to leverage enhanced opportunities that strengthen, support and broaden the reach and impact?
- What are we doing collectively, as a physical therapy profession, to address the growing and urgent need for upstream approaches for older adults to embrace a high quality of life as they choose to age well and in place?