The 148th annual CMA General Council delivered dynamic discussion and policy formation on several key health issues for Canadians. Despite the efforts of devoted physicians and policymakers, the groundwork for a national seniors’ strategy has been slow to materialize. Consequently our health care system continues to be significantly overburdened and backlogged. Essential medical services are stretched! The result: worsening surgical and consultant wait times, particularly in geriatric care, and an increasing number of “orphan” patients. This status quo, with its inadequate number of primary care physicians and long ER wait times, poses serious physical and emotional challenges for a rapidly growing elderly population. Establishing a cohesive and comprehensive seniors’ strategy has never been more urgent.
Despite these challenges initiatives exist today that would support such a strategy. For example, reductions in polypharmacy and antipsychotic use are active in the Fraser Health Authority residential care facilities, with one initiative showing a 6% reduction in antipsychotic use over 4 months. More can certainly be achieved with the elderly living in our communities. A community-centred, multidisciplinary strategy encompassing primary care, outpatient hospital services, and community services has the potential to prevent a number of elder-health issues, including fall risk and fractures, delirium secondary to polypharmacy and poor intake, and unmonitored cognitive decline. A number of strategies can curtail the continued dependence on our strained hospital health care system—outpatient preventive health care, polypharmacy reduction, community integrated EMR, and continuity of care for the frail elderly. This early preventive approach has the potential to improve quality of life, allowing seniors to thrive in their communities while reducing the burden on current hospital services. Better care for our elderly not only makes good medical sense, it changes our approach from reactive to proactive, away from temporary quick fixes toward a stable, sustainable strategy.
—Alexander Frame, MD, MHSc
I have had the pleasure of training under Dr Alfred Chafe in residential care, and the experience inspired me to write this letter.
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