Parent Care: The Latest, Greatest Challenge for Baby Boomers

William G. Whittaker, QC, Partner, Lette Whittaker and 3rd Vice-President, The Empire Club of Canada; The Reverend Vic Reigel, Christ Church, Brampton; Steve Rudin, Executive Director, Alzheimer Society of Canada; Marion Walsh, President and CEO, Bridgepoint Health; Joel Weiner, Region Director General, Ontario and Nunavut Region, Health Canada; Frederic L.R. Jackman, CStJ, PhD, LLD, President, Invicta Investments Incorp. and Past President, The Empire Club of Canada; Susan Donaldson, CEO, Ontario Association of Community Care Access Centres; and Geoffrey, C. Mitchinson, Vice-President, Public Affairs, GIaxoSmithKline.

Introduction by Ann Curran

Today's guests are going to discuss one of the baby boomer's greatest challenges--parent care.

Millions of aging Canadians are now faced with a challenge, for which they're mostly unprepared: caring for their elderly parents or other loved ones. The resulting pressures impact on how baby boomers live and work.

We will hear from John Wright, Senior Vice-President of Ipsos-Reid, on the results of a special national poll and other relevant data that examines how Canadians are coping with eldercare and the issues they say are pressing.

Following John's research and comments, we will hear from Bart Mindszenthy--co-author of "Parenting Your Parents: Support Strategies for Meeting the Challenge of Aging in the Family."

Bart will share some of his observations and discuss the six key lessons all boomers should embrace as they help their parents while trying to balance their own lives.

For those of you who may not know John or Bart's background, let me share it with you now.

John Wright is a Senior Vice-President for the Canadian Public Affairs Division of lpsos-Reid Corporation.

In addition to his client responsibilities, involving strategic and tactical communications research, John has been the lead media spokesperson for the company for the last 13 years on politics, policy and consumer trends.

He also hosts a weekly radio show for Canada's largest NewsTalk station, Toronto's CFRB, called "Your Opinion Counts."

A graduate of the University of Toronto in 1980, he served as an Ontario parliamentary intern and an executive assistant to a provincial cabinet minister.

John's two decades in public affairs have included terms as Senior Co-ordinator of Government Relations for Manufacturers Life Insurance Company, vice-president of a leading advertising firm and executive vice-president of a media and public relations company.

Mr. Wright is a Founding Director and Past President and named a "Life Member" of the Public Affairs Association of Canada, a Founding Member and Member of the Advisory Board of the American Chamber of Commerce in Canada, an author of the Carswell Public Affairs Handbook and he has shared in the prestigious International Association of Business Communicators'

Jake wittmer awards in 1995 and 1997 for outstanding research communications programs.

John served on the Board of Directors of the Clarica Life Insurance Company of Canada from 1999 to 2002. He is also a member of the Advisory Board of the Dominion Institute of Canada and is on the Canadian Advisory Board of the Washington D.C.-based Woodrow Wilson Center.

Ladies and gentlemen please welcome John Wright.

John Wright

Madam President, distinguished head table guests, members of the Empire Club, ladies and gentlemen: I stand here in the footsteps of Dr. Angus Reid, our founder, who addressed this body in 1991.

While our company name today is well known across this country, it wasn't always the case. In fact, Angus's speech, that dealt with the Constitution, Quebec separatism and the Quebec Referendum, was actually the very first time he appeared in Toronto, and arguably to the nation, on a dais that would propel his remarks so extensively into the public domain.

That speech was commented on far and wide and signalled not only the insights of one of Canada's most renowned public-opinion thinkers who would soon evolve into the renown that he justifiably bears today, but also was the prologue of one of Canada's most defining moments in the twentieth century.

My presentation today deals with "Parent Care: The Latest, Greatest Challenge for Baby Boomers." While being here marks another landmark for our company, on the surface parent care may not sound as important as the nation's constitution. But I have learned never to underestimate the power of social trends in changing the very backbone of our country. And I believe that parent care is one of those issues.

I share this podium today with Bart Mindszenthy who has co-authored an insightful book on the dynamics of "parenting your parents." This dual format means that I have half the time usually allotted to an address (which means that he does as well) and so in the next 10 minutes or so I want to give you a peek at, as opposed to a journey through, some of the key findings of public opinion on attitudes concerning this issue. The challenge for me is to keep my remarks brief (My wife is quick to note that I can't even say hello in 10 minutes).

On the other hand, this is a prologue for what will play out over the course of the next two decades and will have such an impact on our society, its institutions, its health-care dimensions and literally millions of Canadian families that it will change the way we think about ourselves--and act with each other--forever.

David Foot's seminal work "Boom, Bust and Echo" which outlined the impact of a growing and aging population in Canada, is upon us as a nation. Indeed, our national grey boom will affect all of the touchstones that we have--advertising, consumer goods and services, tourism and travel, accommodations and housing, and health care--in the years to come. Even this past weekend, Canada's Minister of Citizenship and Immigration, Denis Coderre, pointed out that over the next five years Canada will need at least one million more skilled workers, drawn mainly through immigration, not only to keep up with our pace of growth, but particularly to replenish the places left by those in the work force who are retiring.

Given this, it should also be no surprise that the Ontario government last week announced its intention to rid barriers of mandatory retirement for those over the age of 65 in the province. The workplace, employers and benefit plans for employees will all be predictably affected over the next number of years as 15 per cent of our current work force will be within 10 years of retirement by the end of this decade. Not to be subtle, boomers who are now between 37 and 55 years old currently make up 47 per cent of the work force and in 10 years, half of them will be over 55.

Today in this country, there are more people over the age of 55 than under age 15. Two and a half million Canadians are currently between 60 and 69 and 2.7 million Canadians are currently over 70. When you comprise these two groups, it makes up 5,250,000 adults or 22 per cent of the adult Canadian population--well over two out of you at every table here today.

Finally, by 2006, three million Canadians will be over 70 and in 2011 one million will be over 80.

Those are a lot of numbers to digest in terms of demographics. But they underscore that in a country where we're living longer and where the boomer bulge is leaving a deep wake behind it, it is about to have an enormous impact on our health-care system and will challenge our long-term care plans. And those plans are on the cusp of an explosion--ranging from long-term-care insurance and home-care services to new public and private care and housing facilities to name a few. Even health-care workers will face dwindling ranks as upwards of 25 per cent of physicians indicate that they themselves will want to retire in the next decade. More SARS, more West Nile and fewer health-care workers to combat them--not a pretty picture.

And we will have choices to make on public funding levels and the role of private and public sectors. The impact will likely be felt most by families as they cope with not only the social and financial assistance that might be required to address eldercare issues, but also the complex feelings that can often overwhelm individuals in terms of comfort and caring for their loved ones.

What we can start with are the polling results done two weeks ago by Ipsos-Reid for this event today and over the last couple of months for our clients, RBC Financial, The Alzheimer Society of Canada and Aventis Pharma, all of which was publicly released.

As of two weeks ago, 73 per cent of adult Canadians told us that they have living parents or in-laws.

Of this group, over half (55 per cent) believe they will have to provide some form of care for their parents or in-laws in the future. This represents 9.6 million adults, or 40 per cent of Canada's adult population who feel this way right now.

What's more, 42 per cent of those with parents or in-laws are actually concerned that they'll have to care for them when they get older. This is evident in every part of the country, more so in Atlantic Canada and in Ontario and among younger Canadians as one-third of Canadian adults with parents or in-laws believe that their parents will need social or financial assistance.

In short, that's 24 per cent of the adult population or almost 5.8 million Canadian adults who believe that, in the future, they will have to step up to the plate and help care for their parents.

The fact is, of course, for some, this might not happen. Those between 18 and 34 years of age have the greatest level of anxiety about the future, but a lot can change over the next many years depending upon the accumulated retirement wealth of that boomer group and what they can buy in terms of their extended care or what is provided through the public health-care system.

In some respects, the future has already begun with 25 per cent of Canadian adults indicating that Alzheimer's disease has already been diagnosed for someone in their family circle. As a backdrop to this, 88 per cent of all Canadians believe that as the population ages, the effects of this disease on the Canadian health-care costs will be dramatic--not to mention their own personal, emotional and social costs within their own families.

We are also starting to see the effects of aging not only in the workplace as older workers begin to retire, but in terms of those who are increasingly dealing with elder-care. A study done by us for Aventis recently of employees with benefit plans (approximating 71 per cent of the Canadian work force) identified that one-third (32

per cent) are responsible for eldercare and 12 per cent are responsible for children under the age of 18 and elder-care responsibilities.

The survey also revealed that the one-third of these workers who care for elderly family members average 23 hours of care-giving per month and 17 per cent (or one in six of these workers) indicate they'll have to take more time off in the next two years for those responsibilities.

The impact becomes clear when 35 per cent of plan members agree that it's becoming harder to balance their work, home and life because of caring for young and old alike, and it's a recognition of the future when over half (53 per cent) of that work force indicates that they would be willing to pay higher premiums for eldercare health coverage.

On the home front, a third of Canadians are worried about where they'll live when they get older. But on the flip side, you'll be delighted to know, almost as many (31 per cent) think they would enjoy living with their children and their family. While this may be an admirable sentiment, recent numbers compiled by us for the Royal Bank's 10th annual housing survey released last month put that hope in today's context--5 per cent of the adult population currently have parents or in-laws living with them, of which one in six made renovations or modifications to their homes, while another 12 per cent of the adult population expects that their parent or parents will live with them as they get older. Roughly 17 per cent of the adult population thinks that the noise they either hear or will hear at the refrigerator late at night will come from their parents, not their adolescent teenagers arriving home late and looking for munchies.

The impact on the housing community is apparent. If the move-in factor comes to fruition, a quarter of this group says they'll have to buy a bigger home, with another quarter renovating their current home. The Royal Bank study showed that when it comes to renovations, ground floor accessibility for wheelchairs and bathrooms may top the list inside the house, but outside the house may be equally crucial with trying to find the right balance between being in neighbourhoods that are close to friends and relatives as well as health and medical facilities.

But the pressure with respect to these changes shouldn't just be viewed among those who will be compelled to care for parents or in-laws. Almost half of Canadian adults (47 per cent) are concerned that they're going to be a burden to someone when they get older.

Let me close off then with two clear statistics that I think must be considered over the next few years. The first is that only 36 per cent of Canadians have discussed with their parents or in-laws their long-term care plans so that they know what to do if they should need assistance as they age.

I am reminded that a few years ago, the prostate cancer issue was one that very few of us ever talked about; yet, today, it is very much more out in the open with people speaking of survivors and those afflicted by the disease in a way that compared to a decade ago is truly astonishing.

In that light, I believe strongly that what this country needs is to be able to start talking about long-term-care plans within the family setting. There is no question that policy mentors and other health-care professionals have already been engaged in scenario planning and have identified many of the issues for some time. But it seems to me that the place to start is at home and making it "o.k." to discuss these matters among parents and children alike.

Frankly, if I can drive to work every day and hear radio commercials about preplanning my funeral and how to talk about it, there should be equal time given to this station in life before I get there.

We're all sensitive to the subject and our financial and emotional boundaries. I can't imagine sitting down with my dad 20 years ago and saying: "So what do you want to do when you're infirm and how much is in the bank to carry you forward?" But I should have, because 20 years later, my brother and sister-in-law are living the very care scenario that many others are today in looking after my mother under their roof. It sure would have been easier to plan for, even 10 years ago, if we had bridged the information gap that existed then.

The dialogue has to start somewhere and perhaps Bart's book should be required reading for every household in order to at least understand the dimensions of what many in this country will truly face in the future.

It does not have to be a worrisome venture if many Canadians come to grips with the issue and at least do some rudimentary planning. But while the price will be measured in not only personal dollars and the avenues of care in our health-care system to meet this new reality, perhaps the most unwarranted measurement is that today two-thirds (63 per cent) of Canadians say they will feel guilty unless they can adequately provide their parents or in-laws either help or social assistance when the time comes.

Clearly, guilt solves nothing and creates a level of anxiety and false expectations that can be alleviated well in advance if the dialogue begins so the care can be shared and structured on a basis between those who may need help and those who will provide it.

Almost 10 million Canadian adults believe they will have to help care for their parents or in-laws, almost six million may have to provide financial or social assistance, and four million currently are or will experience eldercare in their own home.

What is compelling about these public opinion numbers, is that the effects are already washing up on the shores of people's lives, ranging from homes to workplaces to guilt.

And what is perhaps the largest challenge is not to solely put pressures on our leaders to prepare and respond to these matters, but to begin at home--a national challenge to begin the dialogue between parents, in-laws, and other family members as to what plans, desires and needs should be considered for the future.

And to begin that journey, let us turn to Bart Mindszenthy author of "Parenting Your Parents" who will provide you with some guidance.

Thank you.

Introduction by Ann Curran

Bart Mindszenthy is a partner of Mindszenthy & Roberts Communications Counsel. His firm has specialized in major change, conflict and crisis communication management since 1990. He is the co-author of the 1988 best selling book, "No Surprises: The Crisis Communications Management System," the first Canadian practical guide to developing and planning organizational crisis communications plans and processes.

As well, Bart co-authored "Leaders hip@Work: How to be an Effective Team Leader Anywhere, Anytime, with Anyone," with Dr. Harvey Silver, which was 2001's fifth-best selling business book in Canada.

During the past decade, he has counselled clients in high-profile issues and crises in Canada. His firm develops crisis communications plans for organizations in all sectors and conducts training sessions and simulations to test plans and train people. He and his partner, Gail Roberts, are frequent presenters at conferences and corporate retreats.

Bart, with 35 years of experience in public relations, is an accredited member of the Canadian Public Relations Society, an elected member of its College of Fellows and a member of the Counselors Academy of the Public Relations Society of America. He is an Associate Faculty member in the MBA program at Royal Roads University, Victoria, B.C.

Bart has won numerous national awards for his work and leadership in the field of public relations and has been widely published in Canadian and U.S. journals and magazines.

An only child, Bart was inspired to write the book "Parenting your Parents" because of his experiences with his parents and listening to many friends and acquaintances talk about the issues they faced with their own elderly parents.

In writing the book, Bart also drew on his professional expertise, observing that just as organizations manage their crises much better when they are prepared, boomers can best help themselves and their parents by planning, understanding the challenges, and being prepared. Please welcome Bart Mindszenthy.

Bart Mindszenthy

Madam President, distinguished head table guests, members of the Empire Club, ladies and gentlemen... for years I listened to important speakers stand at this podium and express what an honour it was to address the club. I never imagined I would be standing here to share my thoughts with you. But I am, and I am sincerely honoured by the opportunity.

I am still a bit overwhelmed by John Wright's intense tour of the landscape of Canadian's concerns and expectations about eldercare. His data sets off flashing yellow lights of caution and alarming red lights of concern.

He's provided a vivid snapshot of the myriad issues facing all of us boomers who have aging parents.

Our parents. Our links with the past, and our passports to the future. The people who got us from infancy into adulthood, regardless of how well we think they accomplished that. The very ones who, as they age and start to falter, now need us. Need our help and support.

But guess what--no one and no system has taught us or prepared us for parent care.

We learned about childcare; most of us attended prenatal and parenting classes and got both welcomed and unsolicited advice from our families and even friends.

But being a parent to our children was an intimate involvement in the progression of life--watching them expand and extend their universe and skills and minds. Parent care, though, is a process of regression--watching our parents' universe contract and witnessing their physical and mental decay.

So here we are on a journey of discovery. A journey we never planned to take. A journey like no other we've ever experienced.

It's a trip of joy and hurt, of anxiety and personal growth, filled with uncertainty.

It's all about watching how time is taking its toll on our parents. And there isn't a single thing that we can do to stop or even slow down the march of time and its consequences.

We used to need help walking, and now our parents do. They used to take us to the hospital emergency room in the middle of the night, and now we take them. We couldn't construct well-formed thoughts, and now our parents can't. We were once in diapers, and now many of our parents are.

And as we become absorbed by this role reversal, every step of the way we are having to learn new coping and adapting skills.

And it's not easy.

In fact, it can be rather frightening and it is most certainly intimidating.

On this journey, we'll discover many new things about ourselves and all those close to us. In some cases, we will find the kind of support we so much need. And in some cases, we'll be bitterly disappointed by the ambivalence of those from whom we expected sensitivity and caring.

And for this journey, I suggest to you that there are a number of guiding principles that can help us navigate our way through the maze of personal challenges we'll face. Let me share six of those principles with you--principles I have learned from a decade of escalating personal experience and from so many others who have found themselves likewise immersed in parent care.

Let me start with three principles with respect to our parents:

1. Slow everything down. Their sense of time and our sense of time are now running at very different velocities. Move more slowly to accommodate their slowing speed. Speak more slowly to accommodate their sluggish ability to comprehend. Understand that our parents will take twice as long to do something or to think about something or even to express something. They'll sense and internalize our impatience, and they'll react to it with a deep, inner emotion of angst and even anger. So, patience should be our watchword.

2. Treat parents with dignity and respect; their sense of independence is sacred. We can't take them for granted and should never underestimate their need to feel like they are an important and valued part of our busy lives. As long as they are able to make sound and safe decisions, we must respect those decisions. We must not "take over" just because we think they can't do the right things or because we believe we can do things better. Our aging parents want to feel in control and independent, even when they're not. So be very sensitive to their unexpressed frustration that they're now frail and failing. The day they must stop driving will be a turning point in their sense of self-confidence. The move to an assisted living or nursing facility will be another major watershed in their lives. The first fall will signal a defining moment in their decline. And each epic event will demand that we come to terms with their personal fears.

3. Stay close to health-care providers and ask lots of questions. Geriatric medicine is growing and maturing at a rapid pace. Our health system is doing ever more to address eldercare. But in reality, the fact is that unless we advocate on behalf of our parents, they may simply get lost in the system. That's why we should ask lots of questions. Why are we taking this course of action? Why can't we try that? How does this medication interact with that one? How can we get physiotherapy for my mother? How can we get my father into a seniors' social group? Should we have another opinion on this? Ask, ask and ask. And keep records of what is being done with and for your parents.

And now, three principles for yourself:

1. Plan ahead. My day job is all about crisis and issues management and communications. What we tell clients is that it isn't a question of "if" they'll have crises or issues, but rather, when and how large. In the same sense, it's not a question of if our parents will become frail and ill and eventually die, but when and how. So as difficult as it is to initiate these conversations, I urge you to talk to your parents while they are still mentally sound. Talk to them about their own future expectations and needs and desires, right through to end-of-life decisions. This means putting in place everything from power of attorney to living wills, from knowing how and where they've structured their finances to deciding which sibling will take a lead role in their care. Believe me, please, there are so many things to decide and consider. And these decisions are sounder when the family plans ahead. In the state of emotion that accompanies a crisis very few decisions will be good ones.

2. Find day-to-day balance in your own life. As our parents continue in their inevitable decline, recognize that the pressures on you will increase. We'll have to do more for them while still trying to spend time with our spouse and children. And still doing our job at peak performance. And still enjoying some semblance of a social life. And even finding some "me" time. All to say: we need to strive to balance our lives and the demands on it through the years of escalating parent care. Sure, we need to help and support our parents, but not at the cost of our other important relationships, or our own well-being. So you need to plan how to balance your own life. Some enlightened organizations have support programs in place. For example, our sponsor today, GIaxoSmithKline, is the first Canadian company to launch an extended paid leave for

employees caring for terminally ill family members or for dealing with other critical family situations. And then, consider how you can continue to support your parents without shorting out yourself. My co-author, Dr. Michael Gordon, taught me that if I become ill from the stress of parenting my parents, I won't be good for anything or to anyone.

3. Dump the guilt. From the thousands of people I've spoken to during the past year in church basement meetings, on radio talk shows, and at social gatherings, the hot button that consistently emerges is guilt. Guilt about not doing enough for our parents. I suggest to you that there are two kinds of guilt associated with parent care. There is inflicted guilt. That's the guilt dump we get from our parents. It's when they say things like, "If you really cared about us, you'd be here more often." Inflicted guilt is our parents' way of trying to reel us in to help them face their fears and insecurities and needs. It's their way of trying to exercise their fading reigns of control and continue to connect with us. The other kind of guilt is self-induced. It's when we try to second-guess ourselves. It's when we spend a lot of time wondering what we did or didn't do right, what we should or could have done, and what we ought to do next and why. Let me tell you something. Dump the guilt. If you can look at yourself in a mirror and state with absolute certainty that you're doing the best you can for your parents, then there is no reason to feel guilty. And doing the best will be a different and very personal definition for each one of us.

So, ladies and gentlemen, there is nothing simple or easy about this journey of discovery.

Our resilience will be tested time and again. There will be drama and trauma we can't even imagine.

That's all the more reason to plan ahead. It's not easy, but it is essential.

However, that's just one piece in the complex jigsaw puzzle of eldercare, and self care.

The challenges we face are very personal. Yet we share similar experiences that transcend our families, and span provincial boundaries and language and culture and politics.

John's polling numbers speak for themselves. Now we boomers must speak out on the issue. We must unify our voices in passion and persuasion.

I echo John's call for dialogue--dialogue that starts in our homes and reaches across the country.

I have been parenting my parents for a decade. I've co-authored a book about it. But I'm just one voice. And I'd like to see millions more voices join in a national chorus of concern about the two distinct aspects of eldercare. One is about the safety, dignity, comfort and quality of care every single aging Canadian deserves. The other is about the understanding and support we, who are now parenting our parents, so very much need.

I believe the time has come to create a national council of government, private sector and not-for-profit organizations--a council charged with exploring and establishing responsible policies and realistic procedures that deliver the support desperately needed by the elderly and increasingly needed by the adult children who are now so involved in their care.

Because while parent care starts at home, its consequences impact every government and every company and, inevitably, every one of us.

Thank you for your attention.

The appreciation of the meeting was expressed by William G. Whittaker, QC, Partner, Lette Whittaker and 3rd Vice-President, The Empire Club of Canada.