1. Executive Summary 1

2. Executive summary 2 Canada’s demographic realities are not unique. Understanding how to meet the growing health care needs of an aging population—and how to deliver high-quality care in a cost-efficient fashion—is a challenge that many other nations are trying to address. When comparing the experiences of older people in Canada with those of older people in other countries, this report shows significant variation across the country and mixed results overall.

3. Executive summary (cont’d) 3 Access to care Timely access to primary and specialist care remains a significant challenge for older Canadians. While almost all older Canadians (55 and older) have a regular doctor, 53% waited at least 2 days for care the last time they were sick or needed medical attention, and 25% waited at least 2 months to see a specialist. Canada had the longest waits for primary and specialist care of all 11 countries, and every province had significantly longer waits than the international average. Half of older Canadians found it very or somewhat difficult to get medical care in the evenings and on weekends or holidays without going to the hospital emergency department (ED). Consequently, 37% of individuals responded that the last time they went to the ED, it was for a condition that could have been treated by their regular doctor. While cost was not a barrier to medical services for most older Canadians, a significantly higher proportion (7%) than the average of countries said they were prevented from filling a prescription or skipped a medical dose because of the cost. For 15% of older Canadians, cost was also a barrier for dental care.

4. Executive summary (cont’d) Caregiving and planning for end-of-life care Older Canadians spent more time on average as informal caregivers; they also spent more time planning for their own end-of-life needs. Almost 1 in 5 older Canadians provided care at least once a week to a person with an age-related problem. Nearly half of them (47%) provided care for at least 10 hours a week, a greater proportion than the international average (40%). Nearly 1 in 4 (23%) Canadian caregivers needed help to provide care but did not receive it, and 34% said they had experienced distress, anger or depression while providing care. Older Canadians were significantly more likely than older people in other countries to have discussions (61%) about their end-of life wishes or to have written plans (39%). 4

5. Executive summary (cont’d) Quality of care Generally, older Canadians reported having positive experiences with their providers that were on par with or better than the international average; however, continuity of care between providers can be improved. Older Canadians were more likely on average to be encouraged to ask questions (70%) by their regular doctor and to be involved in treatment plans (79%) by their specialists than older people in other countries. Most older Canadians were taking multiple medications, and they were significantly more likely to report having medication reviews (80%) with their care providers than the international average. Older Canadians with chronic conditions were also more likely to have discussions about treatment goals (60%) and adopting healthy lifestyles (e.g., diet, exercise) with their providers than older people in other countries. However, only 37% had a written plan to self-manage their conditions. A higher proportion of older Canadians (13%) said that specialists did not have basic information or test results from their family doctor. Similarly, 25% said their family doctor did not seem to be informed and up to date about the specialist care they had received. These results varied widely across the country, however. 5

6. Executive summary (cont’d) Perceptions of health and health care While older Canadians were more likely to feel good about their health, they were not as optimistic about their health system. Slightly more than half of older Canadians said their health was very good or excellent, which was significantly higher than the international average. More than half also believed that fundamental changes are required to fix the health system. While perceptions of the health system had improved slightly in the previous 7 years, they were still among the lowest of reporting countries. 6