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2 CLHIA REPORT ON LONG-TERM CARE INTRODUCTION The face of health care in Canada is changing. Shorter hospital stays, more outpatient treatment and an aging population with longer life expectancy are increasing the need for continuing care for many Canadians. Long-term care is most appropriately thought of as a continuum of care. It starts from the point where an individual requires regular assistance with aspects of their day-to-day living and can include medical and non-medical care. Long-term care can range from periodic support in the home through to more formalized institutional care. The types of specialized care could include weekly assistance getting to and from appointments or buying groceries to more formal housing, medical, nursing, social or therapeutic treatments. Often, we think of the need for continuing or long-term care as applying to the elderly and the need for care in a nursing home. While the majority of individuals requiring assistance are seniors, this represents only part of the picture. 2 There may also be circumstances in a younger person's life when long-term care could be required. The development of an unexpected debilitating illness or an accident could result in the need for around-the-clock care for a person of any age. That being said, the bulk of the stress on Canada's long-term care infrastructure will come from our aging demographics. Canada is facing a growing challenge with respect to how best to provide quality long-term care support to its citizens. The aging demographic is critical to understanding the future pressures on long-term care in Canada. Last year marked the year that baby boomers 3 began to retire. This group currently accounts for 33 per cent of the population in Canada. There are currently about 14 per cent of Canadians that are over the age of 65. An analysis of today's demographics suggests that by the year 2036, 25 per cent of the entire population will be over the age of 65. Even though we are living longer, the older we get, the more likely we will be managing a chronic disease and the more likely that we will need some degree of support - either in the home or in an institutional setting. According to Statistics Canada, the chances of requiring long-term care are one in ten by age 55, three in ten by age 65 and five in ten by age 75. 4 The following examples illustrate the importance of age-related health issues and put the aging of our population in context. Currently: • 225,000 Canadians turn 65 each year; • about 7 per cent of Canadians over the age of 65 reside in health care institutions; • one in 11 Canadians over the age of 65 is affected by Alzheimer's disease or a related dementia; 2 Data reported by the Canadian Healthcare Association in New Directions for Facility Based Long-term Care shows that over 95 per cent of those in special care facilities (i.e., nursing homes, residences for senior citizens, and chronic and long-term care and related facilities) were over the age of 55. 3 Baby boomers are those individuals born between 1946 and 1962. 4 Statistics Canada: Health Expectancy in Canada.