Why many seniors hoping to age at home are forced into crisis decisions, expert says

Dementia expert Dr. Saskia Sivananthan discusses what it looks like for people with Alzheimer’s to stay at home versus getting help at a long-term care facility

Many Canadian seniors would prefer to spend as many of their remaining years as possible in their own homes, but a dementia diagnosis such as Alzheimer’s can quickly throw a wrench in those plans, a brain expert says.

“We want to stay at home because it’s a familiar place, we have our routines and there’s the independence and the autonomy,” Dr. Saskia Sivananthan, a neuroscientist and CEO of dementia-focused think tank the Brainwell Institute, told CTV’s Your Morning Thursday.

“But the fact of the matter is, with Alzheimer’s disease, as you get to those end stages, you’re going to need a lot more care, and that’s so difficult unless you have a caregiver and a whole team surrounding you to support you.”

Sivananthan said that data suggests the vast majority of Canadian seniors want to age at home. However, most of them have not taken any specific steps to ensure that they’ll be able to do that if they experience significant cognitive decline.

Ultimately, it comes down to whether an aging person has a caregiver, she said.

“It’s a caregiver and a caregiving family who are the biggest deciding factor in whether someone can remain at home and for how long,” explained Sivananthan. “There’s a lot of evidence to show that they also help support the overall quality of life and how you can live with dementia.”

That’s why it’s crucial to plan ahead, before in-home support is necessary, she said, otherwise these difficult decisions end up being crisis-driven, which makes them even harder to navigate than they already are.

Sivananthan noted that the way our health-care system is set up for aging people is partly to blame for the prevalence of crisis-driven decision making when it comes to seniors who are in the process of losing their ability to take care of themselves.

“We have not gotten a co-ordinated system in place to support people pre-emptively to remain at home and so instead, you end up going to the ER or having to move to long-term care in crisis, and that’s the worst possible way to make those decisions,” she said.