Dr. Samir Sinha shares his 2023 wishes long-term care and older adults in Global News.

NIA's new survey exploring perspectives on growing older in Canada is discussed in Insurance Portal.

Dr. Samir Sinha, NIA Director of Health Policy Research, discusses the NIA's new survey exploring perspectives on growing older in Canada on Global News Hamilton.

Dr. Samir Sinha, NIA Director of Health Policy Research, discusses the NIA's new survey exploring perspectives on growing older in Canada on Zoomer Radio.

The NIA's research on COVID-19 is discussed in a University of Alberta article about what COVID has taught us about ageing. 

NIA's new survey exploring perspectives on growing older in Canada is discussed in Benefits Canada.

NIA's new survey exploring perspectives on growing older in Canada is discussed on Tricity News.

More than half of Canadians over the age of 50 are feeling positive about ageing, according to a new NIA survey, but those who are struggling financially or have poor health were far more likely to struggle with their expectations of ageing, Alexandra Mae Jones writes for CTV News. 

“There are still challenges to ageing in Canada, and certain segments of Canada’s older population are especially vulnerable,” Natalie Iciaszczyk, Policy Analyst at the NIA and report co-author, said in the release. “Conducting this survey annually will allow us to more quickly identify areas of growing concern and respond to them before they get worse.”

Healthcare Quarterly speaks with Dr. Samir Sinha about developing new LTC standards, as part of its new special issue on the theme of Strengthening Pandemic Preparedness in Long-Term Care. 

Dr. Samir Sinha comments on CBC's The National about the early signs of dementia, available treatment options and how to support caregivers.

Dr. Samir Sinha speaks to CityNews about the Ontario government's lack of messaging about the importance of flu shots as influenza cases rise in the province.

Dr. Samir Sinha speaks to Canadian Press' Nicole Ireland about the how this "tripledemic" will impact older adults and how vaccination can help to protect against respiratory viruses. 

Dr. Samir Sinha speaks to CBC Radio's Cross Country Checkup about how this "tripledemic" of COVID-19, RSV and seasonal influenza will impact older adults and how vaccination can help to protect against respiratory viruses.

Dr. Samir Sinha speaks to Ottawa Citizenabout how this "tripledemic" of COVID-19, RSV and seasonal influenza will impact older adults and how vaccination can help to protect against respiratory viruses.

Keith Ambachtsheer, NIA Senior Fellow, authored this article about how Peter Drucker revolutionized Canada's public sector pension system in the Harvard Law School Forum on Corporate Governance.

CTV News discusses the NIA's recent report on how to improve the uptake of influenza vaccinations in Canada.

Dr. Samir Sinha speaks to The Canadian Press about how this "tripledemic" of COVID-19, RSV and seasonal influenza will impact older adults and how vaccination can help to protect against respiratory viruses.

Dr. Samir Sinha speaks to CTV News about a new experimental drug that can be used to treat dementia. 

Dr. Samir Sinha speaks to CBC Ottawa about a new experimental drug that can be used to treat dementia. 

Dr. Samir Sinha speaks on the Green House Project's podcast, Elevate Eldercare, about creating change in long-term care homes. 

The NIA's new report on how to improve the uptake of influenza vaccinations in Canada is discussed in this Globe and Mail opinion piece written by Dr. Samir Sinha, NIA Director of Health Policy Research. 

The NIA's new report on how to improve the uptake of influenza vaccinations in Canada is discussed in Saltwire.

Dr. Samir Sinha discusses Ontario's Bill 7, which requires hospitals to either send patients to long-term care or charge them $400 a day, and its consequences for older adults with CBC News' Jonathan Migneault.

The NIA's new report on how to improve the uptake of influenza vaccinations in Canada is discussed in CTV News.

Amid a “triple threat” of COVID, respiratory syncytial virus (RSV) and influenza that’s been pummelling the health-care system, the NIA's new report has raised concerns about vaccination rates for the flu failing to reach the Public Health Agency of Canada’s coverage goal for older adults, Alessia Passafiume writes for the Toronto Star.  

“As Canada enters what is expected to be our worst flu season in recent years while still in the midst of the COVID-19 pandemic, it is more important than ever that Canadians get vaccinated against influenza,” the report reads. 

Dr. Samir Sinha discusses Ontario's Bill 7, which requires hospitals to either send patients to long-term care or charge them $400 a day, and its consequences for older adults with CTV News' Angie Seth.

Dr. Samir Sinha speaks to the CBC's Jennifer Lee about the how this "tripledemic" will impact older adults and how vaccination can help to protect against respiratory viruses. 

Dr. Samir Sinha discusses Ontario's Bill 7, which requires hospitals to either send patients to long-term care or charge them $400 a day, and its consequences for older adults with Globe and Mail's Carly Weeks and Dustin Cook. 

Dr. Samir Sinha speaks to  Toronto Star's Alessia Passafiume about the how this "tripledemic" will impact older adults and how vaccination can help to protect against respiratory viruses. 

“Ultimately living with COVID means there will be people who get infected. These people will most likely be marginalized and vulnerable citizens, in particular older people,” says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "helping the elderly live longer in their own homes by providing home care is the only time government can give people what they want and simultaneously spend less money."

Dr. Samir Sinha, NIA Director of Health Policy Research says, "the existing levels of vaccination in long-term care homes resulted in the lower death rate during the Omicron wave. However, the “collateral damage” that did occur, including isolation and other issues, stemmed from understaffing during outbreaks. This could have been prevented with a more robust vaccine rollout."

"How do you staff these homes to efficiently get people bathed, washed, and fed? Sometimes we forget that these are people who are living in their home and who are often living with really complex conditions like dementia which requires extra attention as well as a high level of training," says Dr. Samir Sinha, NIA Director of Heath Policy Research.

"I think the timing is a bit too early to lift all restrictions. Right now, we are seeing that a number of people have not had access to the booster shot, including older adults across the country. About 74% of older adults have been boosted versus 94% that have only gotten their first and second doses. This 20% gap is the group of people that are most likely to die from COVID," says Dr. Samir Sinha, NIA Director of Health Policy Research.

The COVID-19 pandemic highlighted serious systemic problems with infection prevention and control as well as other issues inside long-term care residences across the country. Data gathered by the National Institute on Ageing finds 16,345 long-term care residents had died of COVID-19, as of Feb. 8, since the pandemic began.

According to the National Institute on Ageing's latest numbers, more than 16,000 residents of long-term care homes in Canada have died because of COVID-19. Thousands of staff members in long-term care facilities have been infected as well, and more than two dozen of them have died as a result.

Dr. Samir Sinha, NIA Director of Health Policy Research, says that the HSO requirements will be used to accredit nursing homes, but could also provide the foundation for new laws, including the Liberals’ promised "Safe Long- Term Care Act."

Dr. Samir Sinha, NIA Director of Health Policy Research, says many older adults also want restrictions to end, but feel conflicted. “They are also very clearly aware that there are a number of older people who are not being supported, or are not necessarily being protected in the way that is needed, for society to reopen safely.”

"Loosening these restrictions is going to allow residents to make sure that their social well-being is being met and their care needs can be better attended to while cases are declining," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"We can change long-term care by really reorienting the way we provide care to be what we call having a resident care focus. This fundamentally changes the way we provide care to asking first and foremost what do residents want? By asking a resident when do they want to eat, for example, or when they want to bathe. Then all of a sudden you can provide more individualized care that's more in line to what residents want or need," says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "there are a number of vulnerable individuals who still haven't been able to get access to a booster dose. For example, amongst our older people who represent 90% of our COVID deaths to date, we've done a good job of getting over 94% of them their two doses. However, only 80% have received three doses and it is the third dose that makes the difference. Without it, these folks are being left highly vulnerable."

"Why would our government right now, only a few months from an election, want to call in the military? Because that could be a sign of failure. Any home in Ontario can actually call the Red Cross and ask for their support, but why would you want to be that home that admitted that you might not be able to provide the care that you're residents needed?" says Dr. Samir Sinha, NIA Director of Health Policy Research.

Earlier in the pandemic, Dr. Samir Sinha, NIA Director of Health Policy Research, helped create a COVID-19 Risk Assessment tool for people who are looking to visit friends and family, but also looking to be safe and ensure the risk of spreading the virus is low. His tool gained noticeable traction during the holidays, when there were no official restrictions while Omicron was spreading.

Dr. Samir Sinha, NIA Director of Health Policy Research and chair of the HSO’s technical committee, said Ottawa has supported the standards, but he is concerned jurisdictional issues will slow “desperately” needed progress, including legislation.

“I don’t know of any Canadian who is impressed with our current standards of long-term care in any province or territory,” Dr. Sinha said in an interview.

Thought leaders from across Canada have joined forces to raise awareness and educate the Canadian community on the risk of shingles. In a lifetime 1 in 3 people, particularly those over 50 will develop shingles. This moderated discussion, featuring NIA's Executive Director, Michael Nicin, is framed by a set of questions that reflect the key messages of the campaign and how each organization can help to dispel common conceptions such as “I won’t get it”, “I have a healthy lifestyle”, and “I already had shingles in the past”.

Over the course of his career, Keith Ambachtsheer, NIA Senior Fellow, has conducted research on the effectiveness of various governance and decision-making structures in public pension plans. His studies, among others, have shown that better governance strongly correlates with objective measures of better long-term strategic investment decisions.

For those with compromised immune systems, the reopening of Canada is not so easy. "It could absolutely be deadly, especially if we're not putting in the right safeguards, other than just hermitically sealing these individuals off from the rest of society," said Dr. Samir Sinha, NIA Director of Health Policy Research.

A draft report released last week on improving conditions for long-term care residents should be seen for what it represents: a sidebar to a discussion this country has put off for far too long, and which the COVID-19 pandemic made clear can no longer be avoided.

Dr. Bonnie-Jeanne MacDonald is the director of financial security research at the National Institute on Ageing (NIA), Ryerson University. Bringing together leading industry experts and building on academic best practices coupled with innovative ideas, Dr. MacDonald’s work aims to improve retirement financial security for Canadians through practical insights, industry innovations and government solutions. This interview dives into Canada’s current and future retirement challenges.

"Sometimes depending on the severity of your infection, it might also translate into the immune response that you might create. If someone had a severe infection that might have been prolonged as well, they might have a much more robust immune response and potentially a higher level of immunity," said Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha said continuing to use the term fully vaccinated for two doses is a “huge disservice” not only to seniors who derive enormous benefit from three doses, but people of all ages, “who don’t know how essential and important a third dose is.” Sinha is Director of Health Policy Research at the NIA.

"There are some long-term care homes that are going overboard in my view, by limiting residents to their rooms, not having any activities, or not even allowing them to wander the halls safely," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"It's just so sad when you think that in the last few weeks we've lost over 300 residents and just how unforgiving this pandemic has been, especially to those people living in our long-term care and retirement homes," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"We had a treatment, we had a booster shot that this person wanted, that her family wanted," said Dr. Samir Sinha, NIA Director of Health Policy Research. He said the family was "doing all the right things they were supposed to do. Yet this is where our system failed."

Dr. Samir Sinha, NIA Director of Health Policy Research, believes several new criteria in the proposed standards would have saved thousands of lives in long-term care homes during the pandemic.

During a technical briefing this week, Dr. Samir Sinha, NIA Director of Health Policy Research, said he hopes it will lead to meaningful change. Accreditation Canada, which accredits 68 per cent of long-term care homes across the country, has agreed to use these standards in its process, but there’s no requirement for provinces and territories to adopt them or change legislation accordingly.

The Health Standards Organization draft standards will be open to public review for 60 days. The Canadian Standards Association's proposed standards, expected to be revealed next month, also will be subject to public input for 60 days. The final standards are expected this fall.

"We just made history by having more than 16,000 people die in our long-term care and retirement homes because of this pandemic. Wave after wave we continue to see record numbers of homes entering outbreak. We've got some fundamental, long-standing issues that we really need to address. This became an opportunity for us to take a look at what the existing standards are that led us into this mess in the first place and what can we do to strengthen them so that they speak to what resident-centred care really looks like," says Dr. Samir Sinha, NIA Director of Health Policy Research (starts at minute 24).

Special to Financial Post by Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research: By 2050 the costs of long-term care will take up more than a quarter of all income tax revenues

Dr. Samir Sinha, HSO’s long-term care services technical committee chair, said he is hopeful this will provide a “clear blueprint” to enable the federal government, provinces and territories to move long-term care “to where all Canadians are demanding it to go.”

"I'm hoping. My God, I'm hoping that this will be a clear blueprint that really can enable provincial and territorial and federal action to move long-term care to where all Canadians are demanding it to go," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"Thousands of Canadians said, 'We want long-term care to feel like home to be home-like.' So we asked, 'What does that mean to you?' The standard can become the basis for new legislation for new regulations," says Dr. Samir Sinha, NIA Director of Health Policy Research.

“If you want to enable the standard, you have to fix issues of funding. You must have better staffing. We must have better levels of accountability,” says Dr. Samir Sinha, NIA Director of Health Policy Research.

"The previous standards didn't have much to say about the [long-term care] workforce. But we know that our conditions of work are the conditions of care. And unless we actually make sure we have a well supported, resilient and competent workforce, then you can't even provide good care at all," says Dr. Samir Sinha, NIA Director of Health Policy Research.

“I think a lot of the standard has been written in that line of thinking, about what have we experienced and what further things we need to do in the standard to have avoided a lot of what we had been witnessing over and over again during this pandemic,” Dr. Samir Sinha said in a media briefing ahead of the document’s release.

“These standards can be so much more than just the basis of accreditation programs,” said Dr. Samir Sinha, NIA Director of Health Policy Research.

"I'm hoping that this will be a clear blueprint that really can enable provincial, territorial and federal action to move long-term care to where all Canadians are demanding it to go," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"Once you have that framework in mind, it is actually pretty easy to start framing everything else in a way that respects the rights of residents," says NIA Director of Health Policy Research, Dr. Samir Sinha.

You should still get a booster even if you’ve just had COVID, according to Dr. Samir Sinha, NIA Director of Health Policy Research. Dr. Sinha recommends getting a booster – or even a fourth shot if eligible.

“We don’t know how strong your level of natural immunity will be in response to a recent infection with COVID. And we don’t necessarily know how long it will last,” Sinha tells Global News.

How can you bring up peri- or menopausal issues with a manager who you don’t think will be supportive?

"When deciding how to approach this with your employer, it’s important to first consider what kind of workplace you are in. Some organizations have fostered cultures where you can have all kinds of open conversations. Other organizations don’t have that type of open culture, so when you encounter an issue – whether it’s menopause or another wellness-related health issue – those conversations can become really difficult," said Lisa Taylor, NIA Associate Fellow and Founder and President at Challenge Factory.

NIA Director of Health Policy Research, Dr. Samir Sinha, says there was already a shortage of staff in long-term care homes across the province. "Right now, two years into the pandemic, we just don't have the resilience in our system in terms of the adequate amount of staff and supports that we can actually provide in a crisis."

"Sometimes children of elderly parents bully them into giving up driving," says Dr. Samir Sinha, NIA Director of Health Policy Research. Rather than having a family member shut down driving, he recommends a thorough conversation with the person who is driving to determine their driving fitness and views around driving.

“This is the highest number we have ever had, and we haven’t even reached the peak,” Dr. Samir Sinha, NIA Director of Health Policy Research, said in an interview. “It’s the ultimate letdown to have one of the government’s smartest ministers put in charge of tackling this file resign on a day when Ontario has never seen so many long-term care homes in a COVID-19 outbreak.”

If Toronto succeeds with its plans to transform all city-operated nursing homes, it will become a North American municipal leader in long-term care, said Dr. Samir Sinha, co-chair of Toronto’s seniors’ accountability group and NIA Director of Health Policy Research.

Sinha said the city has a seniors strategy that elevated community support for older adults and focused on long-term care. Still, he said, the possibility of extra staff in nursing homes does not immediately mean Toronto will succeed with high-quality emotion-centred care.

"What we've seen across the country — and in Alberta as well — is just an explosive growth in the number of continuing care environments that are actually experiencing outbreaks just because Omicron is that contagious," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"And as it spreads widely in the community, it's only a matter of time before it gets into the home via people coming into the home, like workers or potentially visitors as well."

Dr. Samir Sinha, NIA Director of Health Policy Research, told CTV News that it seems long-term care homes are following the right steps from a public health standpoint in having close contacts isolate.

“We don't know even which of the double or triple vaccinated people might get seriously ill and might end up dying,” he said.

"The protocols that have been approved in this home will and have certainly greatly improved the quality of life of the home’s residents," said Dr. Samir Sinha, NIA Director of Health Policy Research.

But Dr. Sinha cautions that with increased activity, there may be a higher risk of COVID-19 transmission among residents and staff, since Omicron can still infect those who are fully vaccinated.

Dr. Samir Sinha, NIA Director of Health Policy Research, said while a fourth shot may provide benefit in certain vulnerable populations who are at risk of waning immunity, it still remains to be seen if a mass rollout among the general population is needed going forward.

“Side effects often tell us that our immune systems are actually working and are responding as they should to the vaccine,” said Dr. Samir Sinha, NIA Director of Health Policy Research.

“When it comes to financial planning, people really can’t think long-term,” says Bonnie-Jeanne MacDonald, who researches financial security issues at the National Institute on Ageing, a think tank associated with Ryerson University. “We are hard wired to be optimistic and to react to short-term problems."

Dr. Samir Sinha, NIA Director of Health Policy Research, said he will “tear a strip off” medical students who use the “poor historian” reference when speaking of older adults. “It ties into the notion of ageism,” he said.

The province has not mandated vaccinations for personal care home staff, and has not released vaccine uptake information for the sector. That was a mistake, says Dr. Samir Sinha, NIA Director of Health Policy Research.

New care home outbreaks could have been prevented with mandatory vaccination for staff and better investments in retaining and recruiting workers, he said Friday.

Dr. Samir Sinha, NIA Director of Health Policy Research, told CTV News that it seems long-term care homes are following the right steps from a public health standpoint in having close contacts isolate.

“We don't know even which of the double or triple vaccinated people might get seriously ill and might end up dying,” he said.

A recent survey by the National Institute on Ageing found that almost 100 per cent of Canadians aged 65 and older planned to live in their own home for as long as possible. Yet Canada spends 87 per cent of long-term care dollars on institutionalizing people in nursing homes rather than at-home assistance. Moreover, few options exist for older Canadians between the home alone and institutional care ends of the housing continuum.

“The biggest concern is, are we going to have enough beds available even to provide basic levels of care for COVID patients coming in that don’t necessarily require an ICU bed, but require a bed nonetheless? The worry is that we might not have enough of those,” said Dr. Samir Sinha, NIA Director of Health Policy Research.

NIA Director of Health Policy Research Dr. Samir Sinha described allowing health-care workers to return five days after a positive result as a bet the majority will not be infectious.

"You are going to have people who are infectious, who are back at work, who are tired, who are exhausted and in a low-staffed environment," Sinha said. "And this is exactly how the virus can prey, it’s how it’s preyed in long-term care settings, and it can explode like wildfire."

The new buildings would incorporate aspects of the so-called Green House model, doing away with large, institutional-type facilities.

Dr. Samir Sinha, NIA Director of Health Policy Research, said that besides appropriate staffing, smaller living quarters need adequate government funding, beyond the traditional formula for the current, higher number of residents per unit.

Applying for your pension early can be very expensive

“Deferral of QPP and CPP payments is the most underused and poorly understood disbursement solution in the country,” says Bonnie-Jeanne MacDonald, Director of Financial Security Research at the University's National Institute on Ageing.

Reducing mortality risk

“The No. 1 issue [that affects mortality risk] is the presence of chronic illnesses,” Sinha said. “But, if you do survive those and manage to live healthy and not develop things [such as] diabetes or cardiovascular disease, and you luckily don’t get accosted by cancer along the way, then there are other illnesses that are likely to catch up with you over time, such as dementia,” says Dr. Samir Sinha, NIA Director of Health Policy Research.

The best dividend stocks for a retirement portfolio

A recent survey conducted by Ipsos for Ryerson University’s National Institute on Ageing and HomeEquity Bank revealed that many Canadians are nervous about their retirement prospects. That survey saw 75% of respondents nearing or in early retirement say that the COVID-19 pandemic had them more concerned about their family’s financial security and well-being. A previous survey conducted by Ipsos revealed that nearly a quarter of respondents were delaying retirement due to the pandemic. Today, I want to look at the best dividend stocks to hold in a retirement portfolio right now.

Unvaxxed loved ones? How to handle tense family gatherings over the holidays

The holiday season is just a month away, and unlike last year when gatherings meant video calls and quiet celebrations with household members, this year promises to be a little less muted. The National Institute on Ageing has a COVID-19 Visit Risk calculator online that can help people assess how safe a visit or gathering will be.

With fewer outbreaks, some Saskatoon care homes loosening visitor restrictions

According to the National Institute on Ageing at Ryerson University in Toronto, which has been tracking the virus in care homes across the country, there have been 694 cases and 123 deaths in about 164 long-term care homes in the province since the beginning of the pandemic.

Worried about running out of money in retirement? A new type of pension plan may soon solve that problem

Dr. Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research, hopes government will move quickly on the necessary regulatory changes and that Canada’s first stand-alone DP pools will be introduced in a year or so.

“It’s a way to democratize pensions,” she said. “To make a lifetime income available to any Canadian who wants to have one.”

Amid soaring prices, retired Canadians are staying in their homes: ‘This is a wake-up call for all of us’

Ninety-six per cent of Ontario seniors over age 55 currently plan to remain in their own homes for as long as possible. The reasons are clear. Many have watched with panic as long-term care residents bore the brunt of the pandemic, with thousands dying and many forced to isolate for months. “The pandemic has created an opportunity to rethink a number of different approaches to aging,” says Dr. Samir Sinha, Director of Health Policy Research at the National Institute on Ageing. “They’re thinking: ‘I don’t want to be one of those statistics on the news.’”

Care as we age: Transforming long-term care

In this episode, Dr. Samir Sinha talks about long-term care and how we can better support individuals as they age. Cracks in the long-term care system in Canada were visible long before the pandemic. COVID just further amplified the failures in a system meant to support and care for the most vulnerable. The question is: Will this finally be the impetus need for real change to happen? And if so, what will it look like and how do we get there?

Peter Chow: No Monoclonal Antibodies in Sault Ontario – But We Have Fluvoxamine

“When we’re hearing about some individuals who are dying who happen to have been fully vaccinated, it starts creating doubt in the minds of others about whether the vaccine is even worth it at all,” said Dr. Samir Sinha, NIA Director of Health Policy Research at the NIA.

Ageism is discrimination too: 3 important takeaways from Generous Futures — Addressing Ageism

The season 2 premiere Addressing Ageism highlights how charitable giving is carving new pathways for seniors. The panel, moderated by Michael Nicin, Executive Director, National Institute on Ageing features experts in the field, Dr. Samir Sinha, Mitch Frazer, Chameli Naraine, and Delores Lawrence.

Provinces’ top doctors reject COVID booster shots for all, for now

Dr.Samir Sinha, the Director of Health Policy Research at NIA, told QP Briefing that the science shows a booster shot is a "likely necessity," particularly among more vulnerable groups. The question to Sinha is more about when to deploy the booster shot, and which populations to prioritize. "How do we equitably distribute booster shots?" he asked, identifying what he saw as a critical question on the issue. He identified the British Columbia case study as a good one, in which seniors, front-line health-care workers and Indigenous people are prioritized for booster shots. These groups were also among the first to have access to the initial vaccine, making the timing gap suitable for them to have their booster shots soon.

Ageing and thriving in the 21st century

An Ontario study by the National Institute on Ageing found that, at minimum, 8% of newly admitted long-term care residents could have avoided admission with the right home-based supports. As well, too may seniors then get bounced around from facility to facility, especially if they ‘break the rules’, or are in and out of hospital, factors which accelerate decline.

Dr. Celeste Pang discusses NIA and Egale report, Coming Out and Coming in to Living with Dementia: Enhancing Support for 2SLGBTQI People Living with Dementia and their Unpaid Carers.

“Part of the challenge, both within government circles and in the broader society, is that health and finances are often treated as separate domains working in separate silos,” says Michael Nicin, NIA Executive Director. 

Dr. Samir Sinha, NIA Director of Health Policy Research, says the need for home care in Toronto is vast. “The whole system is strapped right now.”

The Fixing Health Care series, authored by NIA Senior Fellow Dr. Robert Bell, Anne Golden, Paul Alofs, and Lionel Robins, addresses 10 common problems faced by patients in the public health system across Canada.

“We have to remember that good, high-quality day programs can do a lot to stimulate a person’s, body, mind and spirit. Just because you have dementia doesn’t mean you have to stop living," says Dr. Samir Sinha, NIA Director of Health Policy Research.

According to the National Institute on Ageing, 2,225 Ontario long-term care residents died during the second wave compared to 2,072 in the first wave.

Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research, says preparing for old age is a necessity, given that we are living longer. She added, in the article in the Financial Post, that they leave these decisions about ageing to the last minute, which puts a strain financially and physically on loved ones.

The “MyCOVID-19 Visit Risk Calculator” asks users about 20 questions, from a person’s vaccination status to the type of transportation they intend to use, to estimate their risk of infection.

“There are so many elements that go into [a decision], from how many people you are visiting with, to how are you going to get there, and you realize it’s not a simple yes-no answer, which everyone would like,” said Dr. Samir Sinha, who developed the tool and is Director of Health Policy Research at the NIA. He said he continues to mask in public places.

With an election newly underway in Ontario, have the parties learned the right lessons from the COVID-19 crisis in long-term care? Dr. Samir Sinha, NIA Director of Health Policy Research, joined TVO’s The Agenda with Steve Paikin for a panel discussion on the issue.

Keith Ambachtsheer, NIA Senior Fellow in Retirement Income Security, says a pension system will only keep working if two things are kept in mind: legitimacy – retirement savings have to be managed in the best interests of participants – and good governance.

"We’re at a situation where [almost] a quarter of Canada’s population is now on the brink of retirement. They’re facing a very different situation than retirees have in the past, because a lot of them are going to be [retiring] without a pension plan and post-retirement benefits have declined all around,” says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

"One 2020 survey from the National Institute on Ageing found that almost 100 per cent of people wanted to live independently and in their own homes for as long as possible."

One of the biggest issues for Canadians is that they continue to leave their choices on ageing to the last minute. This winds up putting strain on loved ones, both financially and physically, says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

Geriatrician and NIA Director of Health Policy Research, Dr. Samir Sinha, says more investment in home care is needed to avert a financial long-term care crisis a decade from now.

"Right now we have a system that is geared towards building more beds. What I am proposing would actually save us billions of dollars and it would provide people with what they actually want and need," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"This is our time to start getting eldercare right in this country and really looking at how we can support more people to age in their communities and homes, because we know we are underspending compared to other OECD countries when it comes to care services for older people. This is why we have a challenged healthcare system as a result," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"Canada is now is at the tip of the demographic iceberg and the one program that has been ignored is the long-term care system. As we have seen during the pandemic, the long-term care system is not adequate and also not financially sustainable," says Bonnie-Jeanne Macdonald, NIA Director of Financial Security Research.

Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research, says the impact could be particularly devastating because Canada's future elders have not had as many children as previous generations.

"We don't have anything like the Generation House in Denmark anywhere in Canada that I know of but we could totally do this here. We just need the political will that we've seen in this community and we have living proof that this can actually work," says Dr. Samir Sinha," NIA Director of Health Policy Research.

"Right now there are about 200,000 Canadians living in long-term care homes. About a third of them, could have actually stayed in their own homes, with proper home care support," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"Now that we are ageing rapidly, we also see that compared to the other major G7 countries, we tend to spend 30% less on providing forms of long-term care. Therefore, we shouldn't be surprised that it took a pandemic to really show all of Canada how fragile our long-term care system is, especially when we underfund it so much," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"We've known about the data for a long time. I think we have always decided to prioritize other populations and other needs earlier. I don't blame us as a country - when we created Medicare in 1966, the average Canadian was 27 years of age and most Canadians didn't live beyond their 60s. So while other countries started realizing that their populations were ageing, Canada kept prioritizing other things and now we need to play a game of catch up," says Dr. Samir Sinha, NIA Director of Health Policy Research.

The retiring population will impact the cost of older adults’ social programs in Canada, says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research. "They’re really facing a perfect storm in retirement."

"Rather than build more long-term care homes, Atlantic Canadian governments should focus on prevention and awareness, and tap into the close-knit feeling in the region’s communities so older adults can age at home in their care," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"We knew in 2011 when our baby boomers started turning 65 that this is going to be our future that we need to be prepared for," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"Last year, the oldest baby boomers turned 76, and they most probably live independently. They haven't started hitting these critical ages that are usually associated with needing care and support," says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

“We need to make sure we are building the ageing infrastructure we will need and we need to think about how we adapt to being what we call an ‘age-friendly city'," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"Baby boomers aren't just the largest generation, they're also the first generation to have relatively few children. So they're not going to have the same family support that's existed since basically the beginning of time," says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

“[Baby boomers] haven’t started hitting these critical ages that are usually associated with needing care and support but it’s really something that’s now very clearly on the horizon,” says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

"A decade from now, where one in four of us will be an older person, there's no time like the present to start fixing the underfunding of our long-term care systems," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"I'm hoping that we're not just thinking about fixing long-term care but also thinking about how we can support more older Manitobans to thrive in their own homes and communities," says Dr. Samir Sinha, NIA Director of Health Policy Research.

“Ultimately living with COVID means there will be people who get infected. These people will most likely be marginalized and vulnerable citizens, in particular older people,” says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "helping the elderly live longer in their own homes by providing home care is the only time government can give people what they want and simultaneously spend less money."

Dr. Samir Sinha, NIA Director of Health Policy Research says, "the existing levels of vaccination in long-term care homes resulted in the lower death rate during the Omicron wave. However, the “collateral damage” that did occur, including isolation and other issues, stemmed from understaffing during outbreaks. This could have been prevented with a more robust vaccine rollout."

"How do you staff these homes to efficiently get people bathed, washed, and fed? Sometimes we forget that these are people who are living in their home and who are often living with really complex conditions like dementia which requires extra attention as well as a high level of training," says Dr. Samir Sinha, NIA Director of Heath Policy Research.

"I think the timing is a bit too early to lift all restrictions. Right now, we are seeing that a number of people have not had access to the booster shot, including older adults across the country. About 74% of older adults have been boosted versus 94% that have only gotten their first and second doses. This 20% gap is the group of people that are most likely to die from COVID," says Dr. Samir Sinha, NIA Director of Health Policy Research.

The COVID-19 pandemic highlighted serious systemic problems with infection prevention and control as well as other issues inside long-term care residences across the country. Data gathered by the National Institute on Ageing finds 16,345 long-term care residents had died of COVID-19, as of Feb. 8, since the pandemic began.

According to the National Institute on Ageing's latest numbers, more than 16,000 residents of long-term care homes in Canada have died because of COVID-19. Thousands of staff members in long-term care facilities have been infected as well, and more than two dozen of them have died as a result.

Dr. Samir Sinha, NIA Director of Health Policy Research, says that the HSO requirements will be used to accredit nursing homes, but could also provide the foundation for new laws, including the Liberals’ promised "Safe Long- Term Care Act."

Dr. Samir Sinha, NIA Director of Health Policy Research, says many older adults also want restrictions to end, but feel conflicted. “They are also very clearly aware that there are a number of older people who are not being supported, or are not necessarily being protected in the way that is needed, for society to reopen safely.”

"Loosening these restrictions is going to allow residents to make sure that their social well-being is being met and their care needs can be better attended to while cases are declining," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"We can change long-term care by really reorienting the way we provide care to be what we call having a resident care focus. This fundamentally changes the way we provide care to asking first and foremost what do residents want? By asking a resident when do they want to eat, for example, or when they want to bathe. Then all of a sudden you can provide more individualized care that's more in line to what residents want or need," says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "there are a number of vulnerable individuals who still haven't been able to get access to a booster dose. For example, amongst our older people who represent 90% of our COVID deaths to date, we've done a good job of getting over 94% of them their two doses. However, only 80% have received three doses and it is the third dose that makes the difference. Without it, these folks are being left highly vulnerable."

"Why would our government right now, only a few months from an election, want to call in the military? Because that could be a sign of failure. Any home in Ontario can actually call the Red Cross and ask for their support, but why would you want to be that home that admitted that you might not be able to provide the care that you're residents needed?" says Dr. Samir Sinha, NIA Director of Health Policy Research.

Earlier in the pandemic, Dr. Samir Sinha, NIA Director of Health Policy Research, helped create a COVID-19 Risk Assessment tool for people who are looking to visit friends and family, but also looking to be safe and ensure the risk of spreading the virus is low. His tool gained noticeable traction during the holidays, when there were no official restrictions while Omicron was spreading.

Dr. Samir Sinha, NIA Director of Health Policy Research and chair of the HSO’s technical committee, said Ottawa has supported the standards, but he is concerned jurisdictional issues will slow “desperately” needed progress, including legislation.

“I don’t know of any Canadian who is impressed with our current standards of long-term care in any province or territory,” Dr. Sinha said in an interview.

Thought leaders from across Canada have joined forces to raise awareness and educate the Canadian community on the risk of shingles. In a lifetime 1 in 3 people, particularly those over 50 will develop shingles. This moderated discussion, featuring NIA's Executive Director, Michael Nicin, is framed by a set of questions that reflect the key messages of the campaign and how each organization can help to dispel common conceptions such as “I won’t get it”, “I have a healthy lifestyle”, and “I already had shingles in the past”.

Over the course of his career, Keith Ambachtsheer, NIA Senior Fellow, has conducted research on the effectiveness of various governance and decision-making structures in public pension plans. His studies, among others, have shown that better governance strongly correlates with objective measures of better long-term strategic investment decisions.

For those with compromised immune systems, the reopening of Canada is not so easy. "It could absolutely be deadly, especially if we're not putting in the right safeguards, other than just hermitically sealing these individuals off from the rest of society," said Dr. Samir Sinha, NIA Director of Health Policy Research.

A draft report released last week on improving conditions for long-term care residents should be seen for what it represents: a sidebar to a discussion this country has put off for far too long, and which the COVID-19 pandemic made clear can no longer be avoided.

Dr. Bonnie-Jeanne MacDonald is the director of financial security research at the National Institute on Ageing (NIA), Ryerson University. Bringing together leading industry experts and building on academic best practices coupled with innovative ideas, Dr. MacDonald’s work aims to improve retirement financial security for Canadians through practical insights, industry innovations and government solutions. This interview dives into Canada’s current and future retirement challenges.

"Sometimes depending on the severity of your infection, it might also translate into the immune response that you might create. If someone had a severe infection that might have been prolonged as well, they might have a much more robust immune response and potentially a higher level of immunity," said Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha said continuing to use the term fully vaccinated for two doses is a “huge disservice” not only to seniors who derive enormous benefit from three doses, but people of all ages, “who don’t know how essential and important a third dose is.” Sinha is Director of Health Policy Research at the NIA.

"There are some long-term care homes that are going overboard in my view, by limiting residents to their rooms, not having any activities, or not even allowing them to wander the halls safely," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"It's just so sad when you think that in the last few weeks we've lost over 300 residents and just how unforgiving this pandemic has been, especially to those people living in our long-term care and retirement homes," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"We had a treatment, we had a booster shot that this person wanted, that her family wanted," said Dr. Samir Sinha, NIA Director of Health Policy Research. He said the family was "doing all the right things they were supposed to do. Yet this is where our system failed."

Dr. Samir Sinha, NIA Director of Health Policy Research, believes several new criteria in the proposed standards would have saved thousands of lives in long-term care homes during the pandemic.

During a technical briefing this week, Dr. Samir Sinha, NIA Director of Health Policy Research, said he hopes it will lead to meaningful change. Accreditation Canada, which accredits 68 per cent of long-term care homes across the country, has agreed to use these standards in its process, but there’s no requirement for provinces and territories to adopt them or change legislation accordingly.

The Health Standards Organization draft standards will be open to public review for 60 days. The Canadian Standards Association's proposed standards, expected to be revealed next month, also will be subject to public input for 60 days. The final standards are expected this fall.

"We just made history by having more than 16,000 people die in our long-term care and retirement homes because of this pandemic. Wave after wave we continue to see record numbers of homes entering outbreak. We've got some fundamental, long-standing issues that we really need to address. This became an opportunity for us to take a look at what the existing standards are that led us into this mess in the first place and what can we do to strengthen them so that they speak to what resident-centred care really looks like," says Dr. Samir Sinha, NIA Director of Health Policy Research (starts at minute 24).

Special to Financial Post by Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research: By 2050 the costs of long-term care will take up more than a quarter of all income tax revenues

Dr. Samir Sinha, HSO’s long-term care services technical committee chair, said he is hopeful this will provide a “clear blueprint” to enable the federal government, provinces and territories to move long-term care “to where all Canadians are demanding it to go.”

"I'm hoping. My God, I'm hoping that this will be a clear blueprint that really can enable provincial and territorial and federal action to move long-term care to where all Canadians are demanding it to go," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"Thousands of Canadians said, 'We want long-term care to feel like home to be home-like.' So we asked, 'What does that mean to you?' The standard can become the basis for new legislation for new regulations," says Dr. Samir Sinha, NIA Director of Health Policy Research.

“If you want to enable the standard, you have to fix issues of funding. You must have better staffing. We must have better levels of accountability,” says Dr. Samir Sinha, NIA Director of Health Policy Research.

"The previous standards didn't have much to say about the [long-term care] workforce. But we know that our conditions of work are the conditions of care. And unless we actually make sure we have a well supported, resilient and competent workforce, then you can't even provide good care at all," says Dr. Samir Sinha, NIA Director of Health Policy Research.

“I think a lot of the standard has been written in that line of thinking, about what have we experienced and what further things we need to do in the standard to have avoided a lot of what we had been witnessing over and over again during this pandemic,” Dr. Samir Sinha said in a media briefing ahead of the document’s release.

“These standards can be so much more than just the basis of accreditation programs,” said Dr. Samir Sinha, NIA Director of Health Policy Research.

"I'm hoping that this will be a clear blueprint that really can enable provincial, territorial and federal action to move long-term care to where all Canadians are demanding it to go," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"Once you have that framework in mind, it is actually pretty easy to start framing everything else in a way that respects the rights of residents," says NIA Director of Health Policy Research, Dr. Samir Sinha.

You should still get a booster even if you’ve just had COVID, according to Dr. Samir Sinha, NIA Director of Health Policy Research. Dr. Sinha recommends getting a booster – or even a fourth shot if eligible.

“We don’t know how strong your level of natural immunity will be in response to a recent infection with COVID. And we don’t necessarily know how long it will last,” Sinha tells Global News.

How can you bring up peri- or menopausal issues with a manager who you don’t think will be supportive?

"When deciding how to approach this with your employer, it’s important to first consider what kind of workplace you are in. Some organizations have fostered cultures where you can have all kinds of open conversations. Other organizations don’t have that type of open culture, so when you encounter an issue – whether it’s menopause or another wellness-related health issue – those conversations can become really difficult," said Lisa Taylor, NIA Associate Fellow and Founder and President at Challenge Factory.

NIA Director of Health Policy Research, Dr. Samir Sinha, says there was already a shortage of staff in long-term care homes across the province. "Right now, two years into the pandemic, we just don't have the resilience in our system in terms of the adequate amount of staff and supports that we can actually provide in a crisis."

"Sometimes children of elderly parents bully them into giving up driving," says Dr. Samir Sinha, NIA Director of Health Policy Research. Rather than having a family member shut down driving, he recommends a thorough conversation with the person who is driving to determine their driving fitness and views around driving.

“This is the highest number we have ever had, and we haven’t even reached the peak,” Dr. Samir Sinha, NIA Director of Health Policy Research, said in an interview. “It’s the ultimate letdown to have one of the government’s smartest ministers put in charge of tackling this file resign on a day when Ontario has never seen so many long-term care homes in a COVID-19 outbreak.”

If Toronto succeeds with its plans to transform all city-operated nursing homes, it will become a North American municipal leader in long-term care, said Dr. Samir Sinha, co-chair of Toronto’s seniors’ accountability group and NIA Director of Health Policy Research.

Sinha said the city has a seniors strategy that elevated community support for older adults and focused on long-term care. Still, he said, the possibility of extra staff in nursing homes does not immediately mean Toronto will succeed with high-quality emotion-centred care.

"What we've seen across the country — and in Alberta as well — is just an explosive growth in the number of continuing care environments that are actually experiencing outbreaks just because Omicron is that contagious," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"And as it spreads widely in the community, it's only a matter of time before it gets into the home via people coming into the home, like workers or potentially visitors as well."

Dr. Samir Sinha, NIA Director of Health Policy Research, told CTV News that it seems long-term care homes are following the right steps from a public health standpoint in having close contacts isolate.

“We don't know even which of the double or triple vaccinated people might get seriously ill and might end up dying,” he said.

"The protocols that have been approved in this home will and have certainly greatly improved the quality of life of the home’s residents," said Dr. Samir Sinha, NIA Director of Health Policy Research.

But Dr. Sinha cautions that with increased activity, there may be a higher risk of COVID-19 transmission among residents and staff, since Omicron can still infect those who are fully vaccinated.

Dr. Samir Sinha, NIA Director of Health Policy Research, said while a fourth shot may provide benefit in certain vulnerable populations who are at risk of waning immunity, it still remains to be seen if a mass rollout among the general population is needed going forward.

“Side effects often tell us that our immune systems are actually working and are responding as they should to the vaccine,” said Dr. Samir Sinha, NIA Director of Health Policy Research.

“When it comes to financial planning, people really can’t think long-term,” says Bonnie-Jeanne MacDonald, who researches financial security issues at the National Institute on Ageing, a think tank associated with Ryerson University. “We are hard wired to be optimistic and to react to short-term problems."

Dr. Samir Sinha, NIA Director of Health Policy Research, said he will “tear a strip off” medical students who use the “poor historian” reference when speaking of older adults. “It ties into the notion of ageism,” he said.

The province has not mandated vaccinations for personal care home staff, and has not released vaccine uptake information for the sector. That was a mistake, says Dr. Samir Sinha, NIA Director of Health Policy Research.

New care home outbreaks could have been prevented with mandatory vaccination for staff and better investments in retaining and recruiting workers, he said Friday.

Dr. Samir Sinha, NIA Director of Health Policy Research, told CTV News that it seems long-term care homes are following the right steps from a public health standpoint in having close contacts isolate.

“We don't know even which of the double or triple vaccinated people might get seriously ill and might end up dying,” he said.

A recent survey by the National Institute on Ageing found that almost 100 per cent of Canadians aged 65 and older planned to live in their own home for as long as possible. Yet Canada spends 87 per cent of long-term care dollars on institutionalizing people in nursing homes rather than at-home assistance. Moreover, few options exist for older Canadians between the home alone and institutional care ends of the housing continuum.

“The biggest concern is, are we going to have enough beds available even to provide basic levels of care for COVID patients coming in that don’t necessarily require an ICU bed, but require a bed nonetheless? The worry is that we might not have enough of those,” said Dr. Samir Sinha, NIA Director of Health Policy Research.

NIA Director of Health Policy Research Dr. Samir Sinha described allowing health-care workers to return five days after a positive result as a bet the majority will not be infectious.

"You are going to have people who are infectious, who are back at work, who are tired, who are exhausted and in a low-staffed environment," Sinha said. "And this is exactly how the virus can prey, it’s how it’s preyed in long-term care settings, and it can explode like wildfire."

The new buildings would incorporate aspects of the so-called Green House model, doing away with large, institutional-type facilities.

Dr. Samir Sinha, NIA Director of Health Policy Research, said that besides appropriate staffing, smaller living quarters need adequate government funding, beyond the traditional formula for the current, higher number of residents per unit.

Applying for your pension early can be very expensive

“Deferral of QPP and CPP payments is the most underused and poorly understood disbursement solution in the country,” says Bonnie-Jeanne MacDonald, Director of Financial Security Research at the University's National Institute on Ageing.

Reducing mortality risk

“The No. 1 issue [that affects mortality risk] is the presence of chronic illnesses,” Sinha said. “But, if you do survive those and manage to live healthy and not develop things [such as] diabetes or cardiovascular disease, and you luckily don’t get accosted by cancer along the way, then there are other illnesses that are likely to catch up with you over time, such as dementia,” says Dr. Samir Sinha, NIA Director of Health Policy Research.

The best dividend stocks for a retirement portfolio

A recent survey conducted by Ipsos for Ryerson University’s National Institute on Ageing and HomeEquity Bank revealed that many Canadians are nervous about their retirement prospects. That survey saw 75% of respondents nearing or in early retirement say that the COVID-19 pandemic had them more concerned about their family’s financial security and well-being. A previous survey conducted by Ipsos revealed that nearly a quarter of respondents were delaying retirement due to the pandemic. Today, I want to look at the best dividend stocks to hold in a retirement portfolio right now.

Unvaxxed loved ones? How to handle tense family gatherings over the holidays

The holiday season is just a month away, and unlike last year when gatherings meant video calls and quiet celebrations with household members, this year promises to be a little less muted. The National Institute on Ageing has a COVID-19 Visit Risk calculator online that can help people assess how safe a visit or gathering will be.

With fewer outbreaks, some Saskatoon care homes loosening visitor restrictions

According to the National Institute on Ageing at Ryerson University in Toronto, which has been tracking the virus in care homes across the country, there have been 694 cases and 123 deaths in about 164 long-term care homes in the province since the beginning of the pandemic.

Worried about running out of money in retirement? A new type of pension plan may soon solve that problem

Dr. Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research, hopes government will move quickly on the necessary regulatory changes and that Canada’s first stand-alone DP pools will be introduced in a year or so.

“It’s a way to democratize pensions,” she said. “To make a lifetime income available to any Canadian who wants to have one.”

Amid soaring prices, retired Canadians are staying in their homes: ‘This is a wake-up call for all of us’

Ninety-six per cent of Ontario seniors over age 55 currently plan to remain in their own homes for as long as possible. The reasons are clear. Many have watched with panic as long-term care residents bore the brunt of the pandemic, with thousands dying and many forced to isolate for months. “The pandemic has created an opportunity to rethink a number of different approaches to aging,” says Dr. Samir Sinha, Director of Health Policy Research at the National Institute on Ageing. “They’re thinking: ‘I don’t want to be one of those statistics on the news.’”

Care as we age: Transforming long-term care

In this episode, Dr. Samir Sinha talks about long-term care and how we can better support individuals as they age. Cracks in the long-term care system in Canada were visible long before the pandemic. COVID just further amplified the failures in a system meant to support and care for the most vulnerable. The question is: Will this finally be the impetus need for real change to happen? And if so, what will it look like and how do we get there?

Peter Chow: No Monoclonal Antibodies in Sault Ontario – But We Have Fluvoxamine

“When we’re hearing about some individuals who are dying who happen to have been fully vaccinated, it starts creating doubt in the minds of others about whether the vaccine is even worth it at all,” said Dr. Samir Sinha, NIA Director of Health Policy Research at the NIA.

Ageism is discrimination too: 3 important takeaways from Generous Futures — Addressing Ageism

The season 2 premiere Addressing Ageism highlights how charitable giving is carving new pathways for seniors. The panel, moderated by Michael Nicin, Executive Director, National Institute on Ageing features experts in the field, Dr. Samir Sinha, Mitch Frazer, Chameli Naraine, and Delores Lawrence.

Provinces’ top doctors reject COVID booster shots for all, for now

Dr.Samir Sinha, the Director of Health Policy Research at NIA, told QP Briefing that the science shows a booster shot is a "likely necessity," particularly among more vulnerable groups. The question to Sinha is more about when to deploy the booster shot, and which populations to prioritize. "How do we equitably distribute booster shots?" he asked, identifying what he saw as a critical question on the issue. He identified the British Columbia case study as a good one, in which seniors, front-line health-care workers and Indigenous people are prioritized for booster shots. These groups were also among the first to have access to the initial vaccine, making the timing gap suitable for them to have their booster shots soon.

Ageing and thriving in the 21st century

An Ontario study by the National Institute on Ageing found that, at minimum, 8% of newly admitted long-term care residents could have avoided admission with the right home-based supports. As well, too may seniors then get bounced around from facility to facility, especially if they ‘break the rules’, or are in and out of hospital, factors which accelerate decline.

"Right now when we look at our older population in Canada, 94% have received at least two doses but only about 80% have actually received their three doses. So we need to do a much better job of getting that third dose to those that haven't gotten it yet before we start thinking about fourth doses. However, for those who have gotten their third dose and it has been over six months, this is where we recommend getting a fourth dose, to provide them with added protection," says Dr. Samir Sinha, NIA Director of Health Policy Research.

More than a million people have turned to an online calculator that was created to help Canadians manage their COVID-19 risk. My COVID-19 Visit Risk Decision Aid, which is free online, was first created during the second wave of COVID-19 in fall 2020.

“People were starting to ask questions such as "Is it safe to visit with others?" and "Are there safer ways to visit with others?" The NIA turned it into a three-minute risk calculator in spring 2021. The tool can be a valuable resource as people navigate what appears to be a sixth wave with few restrictions," says Dr. Samir Sinha, NIA Director of Health Policy Research.

“I think all this mixed messaging is challenging because now when people hear about fourth doses, they think, well, what does it matter? Why would I get a fourth dose when I don’t even need to wear a mask?’” says Dr. Samir Sinha, NIA Director of Health Policy Research.

"The data clearly shows that for older people and those who have immunocompromised systems, the additional doses can be really helpful. Especially given that our natural immunity to the vaccine starts to wane after about three months, more so with these individuals with weakened immune systems. That's why it is recommended for these populations to be given an earlier booster dose than other populations," says Dr. Samir Sinha, NIA Director of Health Policy Research.

The Government of Canada is supporting the NIA My COVID-19 Visit Risk tools (Visit Risk Calculator and Visit Risk Decision Aid) to provide people in Canada with reliable information and tools to help them assess and reduce their individual risk of COVID-19 infection when visiting or gathering with others. This web-based tool is based on the best available scientific evidence, and contributions from a large group of public health and infectious disease experts in Canada.

"Canadians face a dual financial challenge of inflation and retirement that could last 30 or 40 years. In addition, dependable private-sector defined benefit (DB) pension plans are being replaced with defined contribution (DC) or group RRSPs that put the risk on employees," says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

This week, Liberal MP Kirsty Duncan introduced a motion in the House of Commons calling for a national conversation on how Canada can offer better solutions for older Canadians who are facing severe financial challenges as they live longer into their retirements. Motion M-45 would ask the federal government to undertake a study examining population ageing, longevity, interest rates and registered retirement income funds.

"Research by the National Institute on Ageing at Ryerson University has found that 75 per cent of all care is being provided informally by close family members. The same institute also shows the cost of publicly funded long-term care for seniors is expected to more than triple in 30 years, rising from $22 billion to $71 billion," says Duncan.

"These arrangements wouldn’t have the same payment guarantees as annuities, which leaves room for a range of providers, including large employers or groups of employers, insurers, professional associations or even provinces," says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

“We would like to see large pools across plans and across provinces, the more people the better from an actuarial standpoint because then we can provide the most efficient lifetime pension,” says Barbara Sanders, NIA Associate Fellow.

“We need to separate out what actually is age and what is performance, and we need to stop making assumptions that age leads to poorer performance in the workplace. The data does not show that,” says Lisa Taylor, NIA Associate Fellow.

"The COVID-19 Visit Risk Tool asks you to estimate what you think your risk is and then it calculates what we think your risk is. The tool provides you with education, so that you can get the latest up to date evidence and you can make any visit your planning safer," says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "These aren't pie in the sky ideas for home care. We're physically seeing them here in Denmark, and they're all practical & achievable."

"Facing a future of dire gaps in its long-term care model, Canada needs new policies and practices to address the multiple challenges and opportunities," says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

“While governments are ready to say we’re done with COVID-19 and they don’t want to talk about COVID-19 any more because frankly it’s not very great for political fortunes, the reality is you can’t monitor what you don’t measure,” says Dr. Samir Sinha, NIA Director of Health Policy.

"Close to 5000 residents haven't even received a single COVID-19 vaccine dose in in our long-term care homes. We are setting ourselves up for failure, especially if we have a new variant and as community transmission rates grow up while we prematurely relax some of the restrictions that we have in place right now," says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "smaller homes may struggle more with maintaining mandatory vaccine policies because they have fewer legal resources to defend them. The biggest concern is not really for the big chains. Ironically, it’s actually for the not-for-profit, smaller, publicly owned operations that don’t feel have the legal wherewithal to stand on their own and to defend against a claim."

"90% of COVID-19 deaths have happened amongst older people. This has exposed the fact that Canada spends far less than the average OECD country in terms of its long-term care home spending. Underspending and underfunding these homes has led to a high percentage of deaths happening in these settings. We haven't fixed the fundamental issues at play. We really need to end this pandemic with some true action that will fix these fundamental issues," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"Culturally safe and appropriate care really comes to the essence of who we are working with. While we might look the same, we all have different lived experiences, and we might have different cultural backgrounds and needs. Everything from the language we use, the food we serve, and the ways in which we interact with someone are ways that we can express what we call culturally safe and appropriate care," says Dr. Samir Sinha, NIA Director Health Policy Research.

"People feel more financially insecure than ever before. If you take a step back, it is pretty clear why. Retirement financial security means being able to sustain your standard of living throughout retirement. However, if we look at the Canadian retirement income system, retirees are only really getting $20 000 in pension income and the rest should be coming from private savings but right now 80% of Canadians in the private sector are not even in a workplace pension plan," says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

“This year, in particular, has demonstrated how critical it is that more older Canadians have access to virtual healthcare options that can help them to stay healthy and safe," says Dr. Samir Sinha, NIA Director of Health Policy Research.

Ageing in place is taking on new urgency for older Canadians who watched COVID-19 run rampant in nursing and retirement homes and cause 80 per cent of deaths in the first wave, according to the NIA.

"Everybody aged 50 and over should receive their shingles vaccination because we know that 1 in 3 people will be affected by this disease and this disease can be prevented by the vaccine," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"Only 29% of people aged 50 and older have received a shingles vaccine. Right now, about 94% of those individuals have gotten vaccinated against COVID, so it is not that older people are reluctant to get vaccinated. It is just that there is a huge lack of awareness that there is a shingles vaccine available and people do not know how to get the vaccine," says Dr. Samir Sinha, NIA Director of Health Policy Research.

Purpose Financial's Longevity Pension Fund, introduced in Canada last summer, is designed to provide sustainable income for life with liquidity of principal. Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research is one of the advisers to Purpose Investments.

"Food bank use has increased by a staggering 36% among Ontario residents 65 and older, in 2021 alone. Since 2008, food bank usage among seniors has ballooned by 64%," says NIA's Executive Director, Michael Nicin.

"It can be much more affordable to help people age at home where they prefer to be and where they're happier and they have better health outcomes," says Bonnie-Jeanne MacDonald, NIA Director of Financial Security Research.

"Most recently, there are roughly 2,000 LTC and retirement homes across Canada experiencing COVID-19 outbreaks," said Dr. Samir Sinha, NIA Director of Health Policy Research.

"This has resulted in an unprecedented number of residents, for example, who have had to be isolated in their own rooms. And we're now facing yet another lockdown in their own homes, another period of prolonged isolation, and we know the devastating impacts that can have," said Sinha.

“Ultimately living with COVID means there will be people who get infected. These people will most likely be marginalized and vulnerable citizens, in particular older people,” says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "helping the elderly live longer in their own homes by providing home care is the only time government can give people what they want and simultaneously spend less money."

Dr. Samir Sinha, NIA Director of Health Policy Research says, "the existing levels of vaccination in long-term care homes resulted in the lower death rate during the Omicron wave. However, the “collateral damage” that did occur, including isolation and other issues, stemmed from understaffing during outbreaks. This could have been prevented with a more robust vaccine rollout."

"How do you staff these homes to efficiently get people bathed, washed, and fed? Sometimes we forget that these are people who are living in their home and who are often living with really complex conditions like dementia which requires extra attention as well as a high level of training," says Dr. Samir Sinha, NIA Director of Heath Policy Research.

"I think the timing is a bit too early to lift all restrictions. Right now, we are seeing that a number of people have not had access to the booster shot, including older adults across the country. About 74% of older adults have been boosted versus 94% that have only gotten their first and second doses. This 20% gap is the group of people that are most likely to die from COVID," says Dr. Samir Sinha, NIA Director of Health Policy Research.

The COVID-19 pandemic highlighted serious systemic problems with infection prevention and control as well as other issues inside long-term care residences across the country. Data gathered by the National Institute on Ageing finds 16,345 long-term care residents had died of COVID-19, as of Feb. 8, since the pandemic began.

According to the National Institute on Ageing's latest numbers, more than 16,000 residents of long-term care homes in Canada have died because of COVID-19. Thousands of staff members in long-term care facilities have been infected as well, and more than two dozen of them have died as a result.

Dr. Samir Sinha, NIA Director of Health Policy Research, says that the HSO requirements will be used to accredit nursing homes, but could also provide the foundation for new laws, including the Liberals’ promised "Safe Long- Term Care Act."

Dr. Samir Sinha, NIA Director of Health Policy Research, says many older adults also want restrictions to end, but feel conflicted. “They are also very clearly aware that there are a number of older people who are not being supported, or are not necessarily being protected in the way that is needed, for society to reopen safely.”

"Loosening these restrictions is going to allow residents to make sure that their social well-being is being met and their care needs can be better attended to while cases are declining," says Dr. Samir Sinha, NIA Director of Health Policy Research.

"We can change long-term care by really reorienting the way we provide care to be what we call having a resident care focus. This fundamentally changes the way we provide care to asking first and foremost what do residents want? By asking a resident when do they want to eat, for example, or when they want to bathe. Then all of a sudden you can provide more individualized care that's more in line to what residents want or need," says Dr. Samir Sinha, NIA Director of Health Policy Research.

Dr. Samir Sinha, NIA Director of Health Policy Research says, "there are a number of vulnerable individuals who still haven't been able to get access to a booster dose. For example, amongst our older people who represent 90% of our COVID deaths to date, we've done a good job of getting over 94% of them their two doses. However, only 80% have received three doses and it is the third dose that makes the difference. Without it, these folks are being left highly vulnerable."

"Why would our government right now, only a few months from an election, want to call in the military? Because that could be a sign of failure. Any home in Ontario can actually call the Red Cross and ask for their support, but why would you want to be that home that admitted that you might not be able to provide the care that you're residents needed?" says Dr. Samir Sinha, NIA Director of Health Policy Research.

Earlier in the pandemic, Dr. Samir Sinha, NIA Director of Health Policy Research, helped create a COVID-19 Risk Assessment tool for people who are looking to visit friends and family, but also looking to be safe and ensure the risk of spreading the virus is low. His tool gained noticeable traction during the holidays, when there were no official restrictions while Omicron was spreading.

Dr. Samir Sinha, NIA Director of Health Policy Research and chair of the HSO’s technical committee, said Ottawa has supported the standards, but he is concerned jurisdictional issues will slow “desperately” needed progress, including legislation.

“I don’t know of any Canadian who is impressed with our current standards of long-term care in any province or territory,” Dr. Sinha said in an interview.

Thought leaders from across Canada have joined forces to raise awareness and educate the Canadian community on the risk of shingles. In a lifetime 1 in 3 people, particularly those over 50 will develop shingles. This moderated discussion, featuring NIA's Executive Director, Michael Nicin, is framed by a set of questions that reflect the key messages of the campaign and how each organization can help to dispel common conceptions such as “I won’t get it”, “I have a healthy lifestyle”, and “I already had shingles in the past”.

Over the course of his career, Keith Ambachtsheer, NIA Senior Fellow, has conducted research on the effectiveness of various governance and decision-making structures in public pension plans. His studies, among others, have shown that better governance strongly correlates with objective measures of better long-term strategic investment decisions.

For those with compromised immune systems, the reopening of Canada is not so easy. "It could absolutely be deadly, especially if we're not putting in the right safeguards, other than just hermitically sealing these individuals off from the rest of society," said Dr. Samir Sinha, NIA Director of Health Policy Research.

A draft report released last week on improving conditions for long-term care residents should be seen for what it represents: a sidebar to a discussion this country has put off for far too long, and which the COVID-19 pandemic made clear can no longer be avoided.