Aging in Canada

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.

Marcus J. Hollander is president of Hollander Analytical Services Ltd. He has over 30 years of experience in health services research, evaluation, and administration, including working as director of the health network of the Canadian Policy Research Networks.

List of Illustrations
Preface
Acknowledgements
1. Introduction
2. Population Health and Aging
Introduction
More Older Canadians
Dependency Ratios: Cause for Concern?
Interpreting Dependency Ratios
The Health of Older Canadians
Chronic Conditions
Functional Disability
Self-Perceptions of Health
Summary
Well-Being
Frailty
Subpopulations
Summary
Health Promotion and Disease Prevention
Summary
3. Informal Care
Introduction
Social Support and Caregiving
Caregiving in the West
Caregiver Stress and Burden
Understanding Caregiver Burden
Other Directions in Caregiving Research
Caregiving in the Future
In Sum
Social Policy and Caregiving
Caregiving Policies and Programs in Canada
International Experience
The Need for Care for Caregivers
Summary
4. The Evolution of Continuing Care for Older Adults
Introduction
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. Delivering Care for Older Adults: Models of Integrated Care
Introduction Examples of Successful Integrated Systems of Care
Larger Provincial 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. Discussion and Blueprint for Action
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
Conclusions
References
Index