Overhaul of elder care needed as dementia rates set to skyrocket in Nunavut: report

Nunavut needs to build a long-term dementia care unit, add dozens of residential long-term care beds and consolidate elder care into one department, says a report by the territory's health department.

Those were just three of several recommendations stemming from a 2014 overview of Nunavut's residential long-term care system, which was tabled in the legislature during the winter sitting. It included consultations with elders, health professionals, the Nunavut Housing Corporation and officials from the Department of Justice, Family Services and Culture and Heritage.

The report says at least 25 beds are needed immediately to clear the waiting list for long-term care and up to 72 more beds will be needed by 2035.

Caroline Anawak, the executive director of the Pairijait Tigumivik Society, says those figures underestimate the need.

She operates an elder's home in Iqaluit and says there are currently 40 people on a waiting list to get a spot in one of its eight rooms.

"These people, by virtue of living much longer now, face all of the diseases and disorders of anyone else who gets old and I don't think there's been the planing or the recognition how many and how great those numbers are," Anawak said. 

"[Nunavut] is one of the few places that has no history of ever having to care for somebody like this."

As of July 2014, there were fewer than 150 Nunavummuit over the age of 80. The Nunavut Bureau of Statistics predicts that number will quadruple in the next 20 years, bringing a need for more residential care – and an increase in dementia patients.

Dementia rate set to rise by 600%

In February, former Health Minister Paul Okalik said the department was aware of six patients with dementia in Nunavut. All of them were referred to facilities outside of the territory.

But the report estimates the actual number of patients to be much higher and expects it to grow drastically over the next two decades.

Using data from across Canada on the prevalence of dementia in people 65 and older, the report estimates there are currently 20 people with dementia in Nunavut. Based on population projections over the next 20 years, that number is expected to grow by 600 per cent to 120 people.

The report recommends a secured dementia care unit be created in Nunavut, in part to keep residents in the territory. 

"We're not alone in Nunavut. Other provinces are now trying to deal with this issue. It's quite confusing. They need good care and the caretakers need to be fully trained," Okalik said in February.

"Therefore, we can't take on that responsibility and we are requesting a budget proposal for dementia care. We need to get support from outside of the territories because we aren't ready to take on this responsibility."

The Department of Health's business plan includes funding to address dementia care during the 2018-19 fiscal year.

Elder strategy

One Nunavut MLA doesn't want to wait that long.

In the legislature Wednesday, Pat Angnakak's motion to create a strategy for elders by the start of the fall sitting received unanimous support from MLAs.

"We need to start putting our priorities towards elders, and this government needs to do that," said Angnakak, who represents Iqaluit-Niaqunnguu.

"There's no real strategy," she said. "How do we deal with elder's properly? What is it we need to do? How should we conduct ourselves?"

Consolidating the continuing care system into the Department of Health — a recommendation in the report -— may be a start. Currently, the system is split between Health and the Department of Family Services. 

Planning for the future

Angnakak is addressing the need for more long-term care beds herself, by starting a non-profit group with the aim of building a 65-bed mixed-residential care facility in Iqaluit.

• Sailivik Society proposes new elder care facility for Iqaluit

"Twenty years from now, if I think things are expensive now, can you imagine how expensive they're going to be then?" Angnakak said.

Her proposed project includes six hospice beds and a dozen dementia beds. It's received support from three other MLAs, the City of Iqaluit, the Qikiqtani Inuit Association, Qikiqtaaluk Corporation and the Canada Mortgage and Housing Corporation.

The Nunavut Housing Corporation has committed to transferring land over to the non-profit to construct a 65,000 square foot facility, which would also include a daycare.

"The need is great and it's right now," Angnakak said.