Is Canada ready for an increasingly diverse senior population? Here's what health experts say
Share
As a graduate student nine years ago, Dr. Saskia Sivananthan spent a couple of weeks living in an Ontario long-term care home as part of a research project. While there, she was able to interact with patients from different ethnic backgrounds, including one man who would hardly speak to staff members.
After noticing Sivananthan was South Asian, the man began speaking to her in Tamil, and she learned he had lost his ability to speak English following the onset of dementia. It’s common for older patients living with dementia to lose their ability to speak the most recent language they’ve learned, she said.
Sivananthan discovered the man was a member of the Brahmin caste, the social caste in Hinduism from which priests have historically been drawn. She learned he followed strict traditional protocols calling for married and unmarried men to generally abstain from touching women. This helped explain the trouble he had co-operating with female personal support workers (PSWs) when taking a shower or eating a meal, Sivananthan said.
“He wasn't used to women touching him and providing personal care to him,” she told CTVNews.ca in a telephone interview. “So he would struggle when female personal support workers would come to help him, and he couldn't communicate in English anymore as his dementia had progressed.”
After additional conversations with staff members, a male PSW was assigned to the man, and daily tasks were translated into Tamil to help bridge gaps in communication, Sivananthan said. Although this interaction happened years ago, it remains a common experience for older immigrants today, she said.
“I continue to visit long-term care (and support family members dealing with this), and see the same lack of supports,” she wrote in an email to CTVNews.ca.
WHY IT'S 'CRUCIAL' TO TAKE CULTURE INTO CONSIDERATION
A person’s cultural background is “crucial” to consider when providing care for older adults in diverse communities, said Sivananthan, who is now an affiliate professor in the department of family medicine at McGill University. Not doing so can have a significant impact on their ability to access health-care services at all, she said.
“If (health workers) aren’t trained to think about that beforehand … sometimes, they’ll end up providing care that can be detrimental because it might scare the person and they don’t want to come back,” Sivananthan said.
Along with gaps in the provision of cultural competency training for health workers, there is also a lack of health data related to visible minority groups, she said, which raises questions about whether Canada’s health-care systems are ready for an increasingly diverse senior population.
New statistics from Environics Analytics, a marketing and analytical services company owned by Bell Canada, show the country’s senior population is projected to surpass 11 million by 2043. The data, based on a special analysis for CTV News, paints the senior population as the fastest-growing age group in the country.
As the number of seniors in Canada grows, so will the population of visible minorities, according to estimates released by Statistics Canada in 2022. Data from the agency shows the total number of seniors in racialized groups is expected to reach 2,950,000 in 2041, up from 1,020,000 in 2021. This represents an increase of 190 per cent over the span of 20 years.
DATA AT A GLANCE:
Nearly two million immigrants were aged 65 or older in 2021, according to the latest census data from Statistics Canada, representing approximately 30 per cent of Canada’s senior population
Based on this data, 45 per cent of immigrants aged 65 and older were originally born in Europe, while 36 per cent came from Asia. The remaining proportion of immigrants settled in Canada from the Americas (14 per cent), Africa (4.5 per cent) and Oceania (one per cent)
The latest census data from 2021 also shows approximately one in seven seniors is a visible minority in Canada
Visible minority groups expected to have the highest populations by 2041 are South Asian, Chinese and Black, according to Statistics Canada
A recent report published by the organization shows approximately 570,000 Canadian seniors were living with dementia in 2020, making up 8.4 per cent of the senior population at the time. Fast forward to 2050, and projections show nearly 1.7 million seniors are expected to be living with dementia.
As Canada’s senior population grows, along with the number of people living with dementia, it is especially important that health-care systems have programs and supports adequately set up to help diverse communities, Sivananthan said.
In addition to language barriers, a lack of awareness around certain health conditions is another unique challenge facing visible minorities aged 65 and older, Sivananthan said. Languages such as Punjabi, for example, do not have words that directly translate to “dementia.”
There is also limited data on the needs and experiences of people living with dementia in Canada, experts say, particularly those in visible minority groups. But research has suggested that members of these groups face additional challenges due to the lack of culturally appropriate health-care options.
A 2012 study looking at South Asian Canadians living with dementia, for example, highlights concerns around the potential for discrimination by staff members in health-care settings, as well as gaps in knowledge around dementia itself and support programs and services.
In some communities, there’s also a stigma associated with dementia, said Dr. Roger Wong, a clinical professor of geriatric medicine at the University of British Columbia. Some may feel a sense of shame or embarrassment when diagnosed with dementia, viewing their symptoms as a sign of weakness, he said.
There may be assumptions that dementia is a normal part of aging, even though it is not, said Wong. Yvonne Appah, a nurse practitioner with Alberta Health Services, said this mentality can be common among members of different Black communities in Canada.
“I do think that there is a perception that the issues that happen during dementia, such as memory loss, depression, some of the behaviour issues, may be associated with normal aging in our community,” she told a virtual roundtable organized by the Alzheimer Society of Canada in February. “(Or) that it might be a flare of a personality as well, so there’s some misconceptions of what this disease looks like.”
This stigma and lack of awareness can discourage people from seeking a diagnosis, Wong said. By the time these patients talk to a specialist, their dementia may have progressed much further than if they sought care earlier, he said.
“You can imagine if there's a later diagnosis (and) later access to health care, it can lead to more health-related problems down the road,” he said.
TAKING HEALTH RISKS INTO ACCOUNT
Additionally, people of different ethnic backgrounds can have an increased risk of developing dementia compared to other groups, Sivananthan said. She points to several studies conducted in the U.K. and the United States in recent years that show people from African, Caribbean and other Black communities are at higher risk of developing dementia than white men and women.
As part of a study released last year, researchers in the U.S. looked at instances of racism among nearly 1,000 middle-aged Black, Hispanic and white adults. Results from the study showed Black participants experienced the most exposure to racism, and that these experiences were linked to cognitive decline due to the trauma they inflicted.
These are all factors that medical professionals should take this into consideration when interacting with patients, Sivananthan said. As a result, culturally specific care should go beyond dementia, and apply to all forms of health care, Wong said.
This type of care should also include efforts to recruit candidates from diverse communities for clinical trials, Wong said. Historically, medical studies performed in Canada have not always been representative of the diverse populations seen across the country, so the results may not be applicable to those in various ethnic groups, he said.
Sivananthan agreed.
“You’re taking study results and applying them to a general population, but we actually don’t know if those drugs might react differently in people who have different genetic risks,” Sivananthan said. “When you don’t look at the diversity of populations in your research, it becomes problematic when you're trying to apply it.”
Studies have also shown that various racial groups face differences in the risk of developing chronic conditions such as cardiovascular disease and obesity.
Additionally, candidates from diverse communities are not always recruited for clinical trials, so the results may not be applicable to those across various racialized groups, Wong said. Historically, medical studies performed in Canada have not always included the same kind of diverse populations seen across the country, he said.
“Ideally, the individuals who participate in medical and health research should be reflective of the populations whom we serve,” he said. “All of us need to do a lot better in terms of making sure that we include the diversity of individuals who are participating in these research studies.”
“You’re taking study results and applying them to a general population, but we actually don’t know if those drugs might react differently in people who have different genetic risks,” Sivananthan said. “When you don’t look at the diversity of populations in your research, it becomes problematic when you're trying to apply it.”
CULTURALLY APPROPRIATE CARE IN ACTION
From a health perspective, it is “absolutely important” to provide older Canadians with culturally sensitive care that is personal to them, said Ito Peng, a professor of sociology at the University of Toronto and a Canada Research Chair in global social policy. This is done by taking into account their language and cultural background, as well as the kind of assumptions they may have around how care should be provided and who should provide it, she said.
One of her PhD students currently works at Yee Hong Centre, a facility that provides Chinese and Japanese residents with culturally appropriate long-term care. Built in 2004, the Yee Hong Centre’s Scarborough Finch site has 250 beds for Chinese and Japanese residents, and offers 24-hour care for patients with severe health conditions.
As a recreation worker at the centre’s Scarborough Finch location in Toronto, Izumi Niki organizes different activities in Chinese, Japanese and English, some of which are planned around major holidays such as Lunar New Year.
Izumi Niki is a recreation worker at Yee Hong Centre, a facility that provides Chinese and Japanese residents with culturally appropriate long-term care. Niki helps organize a variety of activities for residents in Chinese, Japanese and English. (HANDOUT / University of Toronto)
Activities can include concerts, during which residents sing songs in their native language, as well as exercising and crafts. Niki will also help residents cook foods they are already familiar with, such as onigiri, which are Japanese rice balls.
These types of experiences are what separate the home from other long-term care facilities, and help to create an increased sense of belonging, Niki said.
“I hear very positive things from the residents, that they are valued and they feel attached because they can see other people who are in a similar situation,” Niki told CTVNews.ca in a telephone interview. “Some of the seniors don’t have a family here, so feeling like a member of society is sometimes difficult.”
Residents at one of Yee Hong's centres celebrate Canada Day. (@yeehongcentre / Instagram)
Niki hopes to see the creation of more facilities such as Yee Hong Centre in the future, to better service members of minority communities.
“We have to cater to the needs of each individual,” said Niki, whose PhD focuses on elder care. “Not feeling isolated (and) feeling like you belong in society is the most important thing when you are aging.”
CTV News is a division of Bell Media, which is part of BCE Inc.
Edited by Mary Nersessian, graphics produced by Jesse Tahirali
An infant and the child's grandparents – aged 55 and 60 – were all killed when a vehicle being pursued by police in the wrong direction on Highway 401 in Whitby, Ont. caused a crash involving at least six vehicles, the Special Investigations Unit says. The driver of the suspect vehicle also died.
Donald Trump was held in contempt of court Tuesday and fined US$9,000 for repeatedly violating a gag order that barred him from making public statements about witnesses, jurors and some others connected to his New York hush money case. If he does it again, the judge warned, he could be jailed.
A new cancer treatment recently approved in Canada promises to cut treatment time down to just minutes, but experts have differing opinions on whether it's what's best for patients.
Surmising even the physical appearance of a dinosaur - or any extinct animal - based on its fossils is a tricky proposition, with so many uncertainties involved. Assessing a dinosaur's intelligence, considering the innumerable factors contributing to that trait, is exponentially more difficult.
An ongoing municipal strike, court battles and revolt by half of council has prompted the province to oust the mayor and council in Black River-Matheson.
A new Canadian dental care program is offering the hope of free care to millions, but while 1.7 million people have signed up for the plan, only about 5,000 dentists have done the same.
A man wielding a sword attacked members of the public and police officers in a east London suburb early Tuesday, killing a 13-year-old boy and injuring four others, authorities said.
London Drugs says it is working with third-party security experts as the company tries to reopen dozens of stores across Western Canada that were shuttered by a cybersecurity incident Sunday.
Five men are facing a total of 47 charges after a police investigation in Delta that resulted in the seizure of more than $1 million worth of drugs last year, local police say.
An infant and the child's grandparents – aged 55 and 60 – were all killed when a vehicle being pursued by police in the wrong direction on Highway 401 in Whitby, Ont. caused a crash involving at least six vehicles, the Special Investigations Unit says. The driver of the suspect vehicle also died.
A new video has surfaced showing a vehicle pursued by police in the wrong direction on Highway 401 moments prior to a fatal crash that killed four people, including an infant and grandparents.
Researchers at Ottawa's CHEO Research Lab are calling for a national surveillance strategy on eating disorders in Canada, as new statistics show a rise in the social and economic costs associated with the issue in children and youth.
Mike Tarnowski will be the new mayor of the Township of Russell, after council in the town east of Ottawa decided not to hold a byelection to fill the vacant position.
The Treasury Board of Canada will only say it is “committed to hybrid work,” as reports suggest federal workers may be required to spend more time in the office.
Transit riders, take note: the Montreal-area regional transit authority, the ARTM, is changing its fare structure on July 1. Prices are going up by an average of 3 per cent.
There may be hope for Winnipeggers as they try to dodge numerous potholes on their daily commute. The city is testing out a new product known as Road Soup, which would be used to help fill the craters during the early spring.
The Saskatchewan NDP's recent criticism of political lobbyists has backfired. During question period on Monday, the government revealed an NDP email in which the party requested sponsorship from a lobby firm that it had previously criticized.
Aggressive international recruitment has brought in a flood of new money, but questions are also being raised within the institution about the sustainability of that growth, and the motivations behind it.
The City of Waterloo is moving forward with a plan to try and rezone 25 acres of city-owned land near RIM Park to allow for affordable and attainable housing.
An ongoing municipal strike, court battles and revolt by half of council has prompted the province to oust the mayor and council in Black River-Matheson.
A new cancer treatment recently approved in Canada promises to cut treatment time down to just minutes, but experts have differing opinions on whether it's what's best for patients.
A London woman has been arrested after police were called by somebody who was woken up around 11 p.m. at a city hotel. According to the person who called 911, a woman was seen banging on doors of the hotel while allegedly holding a gun.
The Huron Perth Public Health Unit has issued 1,557 suspension orders to students in elementary and secondary school whose immunization records are considered incomplete.
‘Project Déjà Vu’ was launched in October 2022 after a financial institution reported fake accounts created by a former employee. Toronto Police describe the crimes as “synthetic-identity credit fraud scheme.”
The intersection of University Avenue west and Church Street as well as a one-block radius in each direction will remain closed until at least 5 p.m. on Wednesday.
Speaking on AM800's The Morning Drive, Mayor Drew Dilkens said the hub will be located on the city's near wet side in the 700 block of Wellington Avenue near Wyandotte Street west.
London Drugs says it is working with third-party security experts as the company tries to reopen dozens of stores across Western Canada that were shuttered by a cybersecurity incident Sunday.
British Columbia's highest court has ordered the Green Party of Canada's deputy leader to be released from custody pending her appeal of a 60-day jail sentence for her role in old-growth logging protests on Vancouver Island.
Out of more than 9,000 entries from over 2,000 breweries in 50 countries, a handful of B.C. brews landed on the podium at the World Beer Cup this week.
Search and rescue crews have been called in after a vehicle belonging to a missing senior was located near a rural intersection outside of Kelowna Tuesday.
Legendary sportscaster Bob Cole was a Newfoundlander through and through, and his daughter says his connection to the province was 'everything' to him.
A police officer on Montreal's South Shore anonymously donated a kidney that wound up drastically changing the life of a schoolteacher living on dialysis.
Out of more than 9,000 entries from over 2,000 breweries in 50 countries, a handful of B.C. brews landed on the podium at the World Beer Cup this week.
The lawyer for a residential school survivor leading a proposed class-action defamation lawsuit against the Catholic Church over residential schools says the court action is a last resort.
Mounties in Nanaimo, B.C., say two late-night revellers are lucky their allegedly drunken antics weren't reported to police after security cameras captured the men trying to steal a heavy sign from a downtown business.
When identical twin sisters Kim and Michelle Krezonoski were invited to compete against some of the world’s most elite female runners at last week’s Boston Marathon, they were in disbelief.
The federal government says the task force it created to monitor and investigate grocery retailers' practices has not conducted any probes and doesn't have a mandate to take enforcement action.
Most federal programs aimed at reducing plastic waste are working, but the government isn't measuring its progress toward its overall goal of zero plastic waste by 2030, according to a new audit from Canada's environment commissioner.
Researchers at Ottawa's CHEO Research Lab are calling for a national surveillance strategy on eating disorders in Canada, as new statistics show a rise in the social and economic costs associated with the issue in children and youth.
Norovirus is spreading at a 'higher frequency' than expected in Canada, specifically, in Ontario and Alberta, according to the Public Health Agency of Canada.
Surmising even the physical appearance of a dinosaur - or any extinct animal - based on its fossils is a tricky proposition, with so many uncertainties involved. Assessing a dinosaur's intelligence, considering the innumerable factors contributing to that trait, is exponentially more difficult.
Anyone who has a Gen-Z person in their life is likely familiar with the popular social media app TikTok, but a new bill in the U.S. may soon take it off of the American market.
Britney Spears and her father Jamie Spears will avoid what could have been a long, ugly and revealing trial with a settlement of the lingering issues in the court conservatorship that controlled her life and financial decisions for nearly 14 years.
Taylor Swift continues to dominate in the week following the release of her 11th album, "The Tortured Poets Department." The 31-track album has hit No. 1 on the Billboard 200 chart, tying Swift with Jay-Z for second-most No. 1 albums at 14. Only The Beatles, with 19 No. 1 albums, have had more.
Rachel McAdams has been nominated for a Tony Award for best actress in a play for her Broadway debut, while Canadian choreographers Rick Kuperman and Jeff Kuperman earned a nod for their work on "The Outsiders."
Canada's GDP rose 0.2 per cent in February, driven by a rebound in transportation and warehousing, which saw the largest recorded month-to-month rise in over a year at 1.4 per cent.
London Drugs says it is working with third-party security experts as the company tries to reopen dozens of stores across Western Canada that were shuttered by a cybersecurity incident Sunday.
The clock is ticking ahead of the deadline to file a 2023 income tax return. A personal finance expert explains why you should get them done -- even if you owe more than you can pay.
A police officer on Montreal's South Shore anonymously donated a kidney that wound up drastically changing the life of a schoolteacher living on dialysis.
One of the winners of a historic US$1.3 billion Powerball jackpot last month is an immigrant from Laos who has had cancer for eight years and had his latest chemotherapy treatment last week.
French police evicted migrants from a makeshift tent-camp next to Paris City Hall early on Tuesday, the latest clear-out of people without homes that aid groups allege is a campaign to beautify the French capital ahead of the Summer Olympics.
The Toronto Blue Jays rested all-star shortstop Bo Bichette and key relievers Yimi Garcia and Jordan Romano weren't available, so it fell to Justin Turner to step up.
Rolls-Royce is vastly expanding its factory in Chichester, England. The BMW subsidiary is adding five new buildings with construction planned to start next year.