Elderly and Disabled Services

Community-based supports and services (CBSS) are designed to help

community-dwelling older adults remain safely in their homes and delay
or prevent institutionalization. CBSS provide (and act as a link to)
specific resources for older adults and their caregivers that include
wellness programs, nutritional support, educational programs about
health and aging, and counseling services for caregivers, as well as
general assistance with housing, finances, and home safety. CBSS also
provide opportunities for community and civic engagement through
various volunteer programs [1] and can enhance individuals’ skills and
attitudes “to live in and gain more control over local aspects of their
communities” [2].

More than 20% of older adults (i.e., those aged 60 and above) currently
receive CBSS [3]. Older adults who use these services need them: over
90% of service users have multiple chronic conditions [4] and
corresponding activity of daily living (ADL) deficits [5]. With the rapid
aging of our population, even as overall health improves the number of
older adults who could benefit from CBSS is expected to increase
significantly in the coming years [6].

A recent nationwide survey of community-dwelling older adults found

that a substantial majority were very interested in receiving information
about CBSS [7]. However, respondents often did not know the range of
services provided or where (or how) to access them. Survey respondents
viewed health care providers as one of their major sources for
information about CBSS and were less likely to contact community-based
agencies directly [7]. Many older adults and caregivers feel most
comfortable discussing health and social issues with their health care
provider. As such, health care providers are ideally positioned to educate
older patients and their caregivers about CBSS and to refer them for
services and supports when appropriate.
There is little information in the literature about health care providers’
knowledge of and referral patterns to agencies providing CBSS. One
Canadian study published almost 25 years ago found that physicians
lacked basic information about these services; almost half (47%)
acknowledged that lack of information contributed to their failure to
refer patients for CBSS [8]. Although we did not identify any recent
studies on this topic, we suspect that most health care providers still lack
basic knowledge about the types of services provided by these agencies,
which types of patients are eligible to receive them, and how to refer
older patients (and/or caregivers) for services when appropriate.

Currently, it is estimated that 15% of the population worldwide or some 1 billion individuals live with one
or more disabling conditions. More than 46 per cent of older persons – those aged 60 years and over—
have disabilities and more than 250 million older people experience moderate to severe disability.
Looking ahead, the global trends in ageing populations and the higher risk of disability in older people are
likely to lead to further increases in the population affected by disability. According to data from World
Population Prospects: the 2015 Revision (United Nations, 2015), the number of older persons has
increased substantially in recent years in most countries and regions, and that growth is projected to
accelerate in the coming decades. Between 2015 and 2030, the number of people in the world aged 60
years or over is projected to grow by 56 per cent, from 901 million to 1.4 billion, and by 2050, the global
population of older persons is projected to reach nearly 2.1 billion. Furthermore, the higher disability rates
among older persons, as a result of an accumulation of health risks across a lifespan of disease, injury,
and chronic illness contributes to the higher disability rates among older people, urges countries to review
and further explore the complementarities between the discourses on ageing and on disability.

As the number of older persons continues to grow along with their longevity, the need for long-term
care will increase significantly for those aged 80 and over, and in particular for older women who live
longer.1 The number of older persons age 80 and above is estimated to grow from 125 million in 2015
to 434 million in 2050. Due to the rise in life expectancy and the growth in the number of older persons,
the incidence of mental health diseases such as dementia and Alzheimer’s continues to grow, leading to
a further source of increased demand for long-term care.2 The incidence of dementia is projected to
grow from 47 million worldwide in 2015 to 75 million in 2030.3 For instance, in the United States, nearly
40 per cent of the population aged 85 years and older suffer from Alzheimer’s and dementia.