Key Messages
What Is the Issue?
- Canada is experiencing an important demographic transition toward an increasingly diverse aging population with an increased need for care and support during the later stages of life.
- Despite older adults’ strong preferences to live in their home or community for as long as possible, health systems are challenged to keep up with growing demands for home care, community care and support services to support conditions to age in place, when appropriate.
What Did Canada’s Drug Agency Do?
- Canada’s Drug Agency prepared an Evidence Assessment report that identified and described the current context of aging and hinderances to aging in place in Canada, considerations relevant to aging in place for equity-deserving groups, strategies and initiatives intended to address unmet needs and improve outcomes, and systemic considerations related to implementing initiatives supporting aging in place.
- The Health Technology Expert Review Panel (HTERP) used the Canada’s Drug Agency Evidence Assessment report to inform deliberations and to develop objective, impartial, trusted pan-Canadian guidance for decision-makers when considering evidence-informed aging-in-place initiatives to support equitable aging in place in jurisdictions in Canada.
What Is HTERP’s Position on Aging in Place?
- Everyone has the right to age with dignity. Aging is a normal part of life and may be accompanied by changes in health status and/or abilities to complete everyday self-care tasks.
- Older adults comprise a heterogenous population with a continuum of health care needs and risks, including people living with vitality, those with moderately complex care issues, and those with complex care issues.
- Health and social systems were originally designed to meet the less complex acute care needs of a younger population and operate largely in silos. They cannot adequately or proactively address the continuum of needs of many older adults and their caregivers.
- Aging in place is a dynamic and complex experience that occurs within a larger context that is not limited to health systems.
- Older adults’ autonomy and preferences for care are realized by the active role of informal unpaid caregivers.
- The population of older adults in Canada is diverse with varying needs, risks, and cultural norms and values related to aging in place.
- Barriers to aging in place may disproportionately affect members of equity-deserving groups that experience multiple and often intersecting historical, social, cultural, medical, structural, institutional, and environmental barriers to care and support. There must be equity in access to safe, appropriate, and ongoing care to support dignity in living in a place of one’s choosing for older adults as they age.
What Is HTERP’s Guidance to Support Aging in Place?
- foster a system that prioritizes integrated models of care to address current and future unmet needs and bridge gaps in and between services
- identify interventions that are aligned within an integrated model of care and are responsive to the unique and complex needs of older adults and their unpaid caregivers
- ensure culturally appropriate and equitable opportunities for positive outcomes
- standardize core measures or indicators to guide data collection, analysis, use, and reporting that support robust evaluation and cross-jurisdictional comparisons of interventions.