The Regional Municipality of Waterloo s Seniors Services Planning Report

Transcription

1 The Regional Municipality of Waterloo s Seniors Services Planning Report The Regional Municipality of Waterloo s Seniors Services Planning Report i

2 The Regional Municipality of Waterloo s Seniors Services Planning Report Social Planning, Policy, and Program Administration Regional Municipality of Waterloo, 2010 This material has been prepared for specific use by The Regional Municipality of Waterloo. When referencing this document please use the following citation: The Region of Waterloo. (2010). The Regional Municipality of Waterloo s Seniors Services Planning Report. Waterloo, ON: Social Planning, Policy and Program Administration. Should you have any questions about this document, please contact: Regional Municipality of Waterloo, Social Services 99 Regina Street South, 5 th Floor, Waterloo, ON N2J 4G6 Tel: TTY: Fax: This document is available online at: This document is available in alternative formats upon request. DOCS#: The Regional Municipality of Waterloo s Seniors Services Planning Report ii

3 Acknowledgements The Regional Municipality of Waterloo s Seniors Services Planning Report was made possible with the help of many contributors across the Regional Municipality of Waterloo (the Region). This planning document has been prepared to inform future seniors planning work in Waterloo Region and will support the Region of Waterloo in continuing to make a difference in the lives of older adults and other community members. Region of Waterloo Contributors Report Prepared By: Brandie Steeves Leigh Golden Social Planning Associate, Social Planning, Policy and Program Administration (SPPPA) Manager, Social Planning, Research, and Evaluation With Contributions From: Michael Schuster Commissioner, Social Services Lynn Randall Director, SPPPA Gail Kaufman Carlin Director, Seniors Services Helen Eby Acting Director, Seniors Services Karen Weber Social Planning Associate, SPPPA (to October 2009) Fazilah Shariff Masters of Social Work Student, SPPPA Tyla Fullerton Social Planning Associate, SPPPA Asma Razzaq Epidemiologist, Public Health Stephanie Ellens-Clark Public Health Planner, Public Health Social Services would like to thank the many individuals who provided information for the inventory component of this report including representatives from Corporate Resources; Planning, Housing and Community Services; Public Health; Social Services; Transportation and Environmental Services; and the Waterloo Region Crime Prevention Council. The Regional Municipality of Waterloo s Seniors Services Planning Report iii

4 SENIORS SERVICES PLANNING REPORT Report Overview... 1 Canadian Context... 1 Defining Seniors... 2 Seniors in Waterloo Region... 3 Seniors & Health... 5 Seniors Living with Low Income Seniors & Disability in Waterloo Region Legislative Requirements for the Regional Municipality of Waterloo Current Regional Services & Planning Seniors Services Division Inventory of Internal Services and Planning Promising Practices Innovative Findings Summary of Promising Practices Discussion Recommendations Summary References Glossary & Acronym Definitions Appendix A Inventory of Programs and Services Appendix B Inventory of Planning Appendix C Inventory of Promising Practices Appendix D WHO Checklist of Essential Features of Age-friendly Cities List of Tables & Figures Contacts The Regional Municipality of Waterloo s Seniors Services Planning Report iv

5 REPORT OVERVIEW In the Corporate Strategic Plan Objective 4.4, the Regional Municipality of Waterloo (the Region) formally committed to enhance programs and services to address the growing needs of seniors (Region of Waterloo, 2007, p. 9). To facilitate this objective, three strategic actions were identified: a) build the Supportive Housing Project at Sunnyside Home, b) develop a Region-wide planning body for seniors services, and c) develop a Regional Strategy for seniors that ensures a healthy quality of life in communities (Region of Waterloo, 2007, p. 9). Seniors Services, whose role is to work collaboratively with the community to plan, support, and operate long-term care and community programs for seniors in Waterloo Region, successfully opened Sunnyside Supportive Housing in the Spring of In order to implement the remaining two strategic actions, additional background research was required to inform both a future Regional planning body for seniors and the development of a Regional strategy for seniors. The Regional Municipality of Waterloo s Seniors Services Planning Report provides such background information and a snapshot of current Regional planning and service provision related to seniors. It outlines the legislative requirements of the Region, and compares current activities to these requirements as well as promising planning practices within Canada. Finally, this report recommends that the Region proceed with the creation of a Regional planning/advisory body for seniors and the development of a Region-wide seniors strategy. Canadian Context Canada and Waterloo Region alike are experiencing dramatic changes in population demographics. The Canadian population is aging at a rate that has never been seen before, primarily due to the aging of the Baby Boomers (individuals born between 1946 and 1964) (Region of Waterloo Public Health, 2010a). Not only is the Canadian population aging, but the growing population of seniors is significantly different from seniors in the past. In general, seniors today are more educated, enjoy a higher socioeconomic status, are more ethno-culturally diverse, and are living longer with fewer disabilities than seniors in previous decades (Public Health Agency of Canada, 2009; Ontario Professional Planners Institute, 2009). Anticipated population changes due to the increasing age of the Canadian population will result in a simultaneous change in demand for many community services such as housing, social services, transportation, and health and wellness The Regional Municipality of Waterloo s Seniors Services Planning Report Page 1 of 65

6 services (Ontario Professional Planners Institute, 2009). Appropriately planning for these population changes from a municipal perspective is crucial. Changes in community demographics and the impending increase of seniors should be considered from a proactive and innovative standpoint. Understanding the realities of anticipated population changes, the Region of Waterloo conducted research on current and projected changes locally, and has developed a number of documents to aide local planning and service provision. For example, the Regional Growth Management Strategy (2003) (required under the Places to Grow Act, 2005), the Human Services Plan (2006), and the Regional Official Plan (2009) all provide extensive evidence and guidance for current and future planning in Waterloo Region. As a first step towards better understanding the role of the Region in seniors service provision and local planning, this report provides an overview of Regional services and planning that have a direct or indirect impact on seniors in the community. Following this internal review, external research, partnerships, and plans are identified. Before continuing the discussion about seniors in Waterloo Region, it is important to distinguish how the term seniors was defined and selected for this report. Defining Seniors For the purposes of this report, a senior is defined as a person aged 55 and older. This definition is consistent with the definition of older adults in the Region of Waterloo Public Health department s Older Adults Health Status Report (2010). The term senior has been selected for this report, and will be used with the deepest respect. From the perspective of the contributors to this report, a senior is thought of as someone of long tenure, a person who has survived obstacles and lived many years. In addition, a large number of influential bodies (e.g., Government of Canada, the Public Health Agency of Canada, and the Government of Ontario) use the term senior, affirming the use of the term in a similar context. When reflecting on seniors issues, it is important to consider the many varying characteristics that seniors exhibit. The population of seniors in Canada, and similarly in Waterloo Region, is widely varied in terms of health status, cultural origins, financial situations, living arrangements, physical activity levels, social engagement, etc. (Statistics Canada, 2007). Seniors are a significantly diverse group with many interests and needs, and as such, caution and consideration should be taken when planning for service provision for seniors in Waterloo Region. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 2 of 65

7 SENIORS IN WATERLOO REGION Approximately 11.6% of the Waterloo Region population was over the age of 65 in 2006 (approximately 55,000 seniors) this percentage will increase dramatically in the next few decades as the Baby Boomers continue to age. building vibrant urban places, the Region will aim to develop safe communities with adequate and appropriate housing for individuals of all ages, including seniors. The RGMS also promotes greater transportation choice in order to improve access to employment and services, improve air quality, and increase physical activity, all of which would be particularly beneficial to seniors in Waterloo Region. As noted in the Region of Waterloo s Human Services Plan (2006a), the seniors population in Waterloo Region is expected to grow more than any other age group. In 2006, seniors aged 65 and older accounted for approximately 11.6% of the Waterloo Region population (approximately 55,000 residents) (Region of Waterloo, 2006b). This percentage is growing as the Baby Boomer generation continues to age. Figure 1 depicts the age distribution for the Waterloo Region in 2008 and projects population changes in 2018 and Figure 1 illustrates that the largest growth in the population will be seen in the over 65 age groups. Waterloo Region is one of the fastest growing communities in all of Canada. With a current population of 534,900 (Region of Waterloo Planning, Housing, and Community Services, 2010), Waterloo Region is expected to grow to approximately 730,000 people by 2031 (Region of Waterloo, 2006a). The 2003 Regional Growth Management Strategy (RGMS) advocated for a balanced approach to growth management that fundamentally changed the way planning occurs within the Region (Region of Waterloo, 2003). Many of the goals and key elements are particularly relevant to seniors in Waterloo Region. By focusing on Figure 1 Population Distribution, by Sex and Age Group, Waterloo Region, 2008, 2018, 2028 Population (as cited in Region of Waterloo Public Health, 2010a) The Regional Municipality of Waterloo s Seniors Services Planning Report Page 3 of 65

8 As can be seen in Figure 2, seniors live in all areas of Waterloo Region with the highest percentage choosing to live in North Cambridge (33.8%), Central Waterloo (31.5%), North-Eastern Kitchener (29.7%), and North Wilmot (29.3%) (Canadian Social Data Strategy, 2006). When considering service provision and planning for seniors throughout Waterloo Region, it is important to recognize the geographical distribution of seniors and the varying needs of those in the urban and rural areas. For example, individuals in urban areas will have better access to community services than individuals living in the rural areas. Collaboration with local area municipalities and other service providers Figure 2 Distribution of Seniors in Waterloo Region, 2006 will help to address the needs of seniors from all areas across the region, and to harmonize local and Regional service provision. In addition to the current population of Waterloo Region aging, migration (from both abroad and within Canada) to Waterloo Region will account for a large proportion of population increases. Of all urban areas in Canada, Waterloo Region has the fifth highest per capita immigrant population, accounting for approximately 22.3% of the total population, many of whom are seniors (Region of Waterloo, 2006a; Region of Waterloo, 2006c). In 2006, approximately 37% of seniors over the age of 55 years were immigrants to Waterloo Region (Region of Waterloo Public Health, 2010a). When planning for seniors in Waterloo Region, it is imperative that both spatial and population growth, as well as demographic and labour force changes, be considered. Waterloo Region will require services that are specifically tailored to the growing segments of the population, such as seniors and new immigrants. (Canadian Social Data Strategy, 2006) The Regional Municipality of Waterloo s Seniors Services Planning Report Page 4 of 65

9 Seniors & Health Seniors today are living longer, healthier lives than seniors in the past; however, most seniors tend to have at least one chronic health condition (Public Health Agency of Canada, 2009). With increasing age, individuals can experience challenges such as an increase in negative health conditions and potential co-morbidities (i.e., having more than one negative health condition at one time). Focusing, however, on healthy aging can delay and minimize the negative health effects of aging and the development of chronic diseases (Public Health Agency of Canada, 2009). The Public Health Agency of Canada (2010) emphasizes that a longer, healthier life can be actualized by committing to eating healthfully, increasing physical activity, staying socially connected, refraining from smoking, and minimizing falls. A community can play a significant role in the ability of individuals to age healthfully and actively. To provide a better understanding of the health status of seniors in Waterloo Region, the Region of Waterloo Public Health Department released the Older Adults Health Status Report (OAHSR) in April 2010, which provides a broad snapshot of the health of older adults in Waterloo Region. This comprehensive report provides an overview of population demographics, general health, mental health, sexual health and blood-borne infections, infectious disease, chronic disease, lifestyle and health behaviours, health care utilization, independence, safety, employment, and social engagement. Brief summary information from the OAHSR is included below to provide a profile of the general health and health implications to social service provision in Waterloo Region. For more details, please see the full report. Note: All statistics in this section of Seniors & Health have been summarized entirely from the 2010 Older Adults Health Status Report (Region of Waterloo Public Health, 2010a) unless otherwise noted. General Health In Waterloo Region, 79.6% of older adults rate their general health as good or better, which is higher than the provincial average of 77.5%. A higher percentage of males reported having good or better general health compared to females (81.0% vs. 78.5%). Life expectancy at birth in Waterloo Region is 82.5 years for females and 78.9 years for males, with a health expectancy of 75.0 years for females and 72.9 years for males. The most common cause of death in males in Waterloo Region in 2005 were cancer, heart disease, diabetes, chronic lower respiratory diseases, and cirrhosis. Females, conversely, had higher rates of cerebrovascular disease, dementia and Alzheimer disease, influenza, pneumonia, and heart failure causing death than males. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 5 of 65

10 Lifestyle and Health Behaviours Nutrition Food security refers to having physical and economic access to sufficient, safe, and nutritious food that meets the dietary needs and preferences for an active and healthy life. Most older adults households in Waterloo Region are food secure; however approximately 4.0% were food insecure in , which accounts for approximately 4,406 older adults households. Physical Activity and Weight Physical activity can have significantly positive effects on health and well being throughout the entire lifespan, including into older adulthood. In , 39.6% of older adults in Waterloo Region reported being moderately active or active. This proportion is lower than the provincial percentage of 43.7% and corresponds to higher levels of obesity and individuals who are overweight in the Region. Approximately 65.6% of older adults in Waterloo Region were overweight or obese in compared to 60.5% of older adults provincially. Independence As a means of describing the independence of older adults in Waterloo Region, the authors of the OAHSR, with input from Social Services, outline various statistics regarding housing and transportation within the Region. Housing According to 2006 census data, most (78%) older adults in Waterloo Region live in family households, while very few live with extended relatives or non-relatives. However, for individuals aged 85 and older, approximately 59.8% of females live on their own, whereas only 27.8% of males live alone. In addition to health requirements and care needs, housing affordability can have a major impact on quality of life and the ability for older adults to age in their home comfortably. With increasing age, older adults in Waterloo Region spent more of their pre-tax income on housing. According to Statistics Canada, 30.4% of individuals age spent over 30% of their income on housing; whereas nearly half of those aged 75 and older devoted more than 30% of their pre-tax income to housing costs. In Waterloo Region, there are various housing options for older adults that are suited to accommodate a range of needs. In addition to private ownership or rental housing units, community housing is available for individuals and families who find it difficult to afford housing in the private market. Community housing includes rental housing that is either subsidized or offered at an affordable market rent. Thirty-six buildings in Waterloo Region have community housing units dedicated The Regional Municipality of Waterloo s Seniors Services Planning Report Page 6 of 65

11 % to individuals over the age of 50, some of which provide support services to those who need assistance to live on their own. Units allocated to older adults are in high demand; with 686 individuals on the waiting list. The wait time for housing tends to be one to two and a half years. Sunnyside Supportive Housing, recently opened in the spring of 2010, combines affordable housing with services that help older adults in their day to day activities enabling individuals to age in place as long as possible. Finally, collective dwelling housing options such as retirement homes and long-term care (LTC) homes are also available. As estimated by the CMHC, approximately 5% of Ontarians aged 75 and older lived in retirement homes in 2009 and paid an average of $2500 per month for room and board. In 2009, there were approximately 1727 retirement home spaces in Waterloo Region with a vacancy rate of 7.7% (5.6% lower than the provincial rate). With regard to LTC homes in Waterloo Region, there are approximately 2486 LTC beds operated by a range of profit and not-for-profit operators (L. Plume-Campbell, WWCCAC, personal communication, October 13, 2010). Wait lists are lengthy in all homes. The Region is responsible for operating Sunnyside Home, the largest LTC home in Waterloo Region (more information on Sunnyside Home is provided below). In line with the Region of Waterloo 2007 Homelessness to Housing Stability Strategy, the authors of the OAHSR emphasize the importance of housing, income, and supports for preventing homelessness in the Region. Locally, adults 50 years of age and older use a variety of services aimed at assisting individuals at risk of homelessness, including longer term housing with support ( %), emergency shelters (17.0%), street outreach or drop in services (30.0%), shorter Figure 3 - Proportion of Adults with a Driver's License, by Sex and Age Group, Waterloo Region, Age Group Males Females (Region of Waterloo Public Health, 2010a) term housing (26.0%), or transitional or time-limited housing (8.0%). It is estimated that the proportion of older adults experiencing homelessness will increase more than other age groups due to the aging Baby Boomer population. This increase will likely result in larger usage of the human services listed above as well as a greater need for more age-appropriate services for individuals over the age of 55. Transportation Most older adults in Waterloo Region prefer to use private automobiles both for work and personal use more than any other form of transportation. In 2006, approximately 82% of local older adults possessed a driver s license; however, this percentage decreased with age (Figure 3). When traveling to and The Regional Municipality of Waterloo s Seniors Services Planning Report Page 7 of 65

12 from work in Waterloo Region in 2006, over 90% of adults aged 55 and older traveled by automobile either as a driver or passenger, whereas only 10% used other modes of transportation (e.g., public transportation, taxi, cycling, or walking). On a typical day, approximately 77% of older adults traveled as a driver of a private automobile, and only 5% used other modes of transportation. Overall, less than 3% of older adults in Waterloo Region own a transit pass, which is similar to those aged 25 to 54 years of age (2.5%). Safety According to the 2008 Kitchener-Waterloo Metropolitan Survey, more than half of local older adults felt unsafe walking in parks at night. Respondents also reported feeling unsafe at night in the downtown areas (45%) and in their local neighbourhood (28%). During the day, older adults were less likely to feel unsafe; however, 26% felt unsafe walking in the park in the daytime and 22% felt unsafe in downtown areas. The prevalence of abuse against older adults can only be estimated as many victimizations are never reported. In Canada, it is estimated that between 4-10% of older adults have experienced some form of abuse. Locally, the Elder Abuse Response Team (EART) receives calls from concerned citizens regarding elder abuse in the Region. Of the 202 calls received in 2008, the most common form of abuse reported was financial abuse, followed by notifications of neglect, psychological, physical, and self-neglect offenses. In most cases, callers to EART were family members calling on behalf of their loved one. Similar to national data, adult children were most often the perpetrators of the abuse in these calls. Social Engagement & Work Social engagement is associated with having a sense of belonging to the community, 71% of seniors in Waterloo Region feel a strong or very strong sense of belonging in their community. volunteerism, and/or working with or without pay. Social engagement was said to positively correspond to survival, good cognitive function, and less disability with increasing age. In , the majority of older adults in Waterloo Region (71.1%) stated that they had a strong or very strong sense of belonging to their community, which was comparable to the Ontario average of 71.3%. Nearly half of all Waterloo Region older adults volunteered in 2003 (48.9%), which is associated with lower morbidity, longer survival, lower rates of depression, less health care service utilization, and greater life satisfaction. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 8 of 65

13 Many older adults are actively employed. Based on 2006 Census data, approximately 30,530 individuals aged (64.0%) and 5,515 individuals aged 65 and older (10.6%) were employed in the workforce in Waterloo Region in 2006 (C. Simpson, Workforce Planning Board of Waterloo Wellington Dufferin, personal communication, September 24, 2010). With the elimination of the mandatory retirement age in Ontario in 2006, participation of older adults in the workforce is increasing. It is noted that in , 75.3% of individuals aged and 16.9% of those aged 65 to 75 reported working in the last 12 months. In general, more males were in the workforce than females (62.0% vs. 43.5% respectively). Of those who worked during the previous week, 84.3% worked full time and 15.8% worked part-time. These figures change with age: the proportion of older adults who worked part-time increased from 11.4% for individuals aged years to 53% for those aged Local older adults also support friends and family with child care (26.7%), and assist other older adults (29.2%). Figure 4 depicts the percentage of older adults working in Waterloo Region by various categories (e.g., age group, sex, part-time or full time work, and unpaid work). In addition to those who reported working, there were also older adults who reported being available for work, but were without or looking for employment. Unemployed older adults in Waterloo Region constituted 3% of the older adult population which is lower than the provincial value of 4.7%. Seniors Working by Age Groups Seniors Working by Gender Seniors Working in Previous Week (FT/PT) Seniors Providing Unpaid Work Figure 4 - Percent of Seniors Working by Various Categories Percent years years Females The Regional Municipality of Waterloo s Seniors Services Planning Report Page 9 of 65 Males Part-Time Full Time Housework Child Care Seniors Care (Region of Waterloo Public Health, 2010a)

14 Seniors Living with Low Income Waterloo Region is an area in Southern Ontario that is well known for its affluence. However, it is essential to consider those residents in the region that are struggling with low income and its associated life challenges. Inadequate income can have a negative impact on quality of life and well being, which in response, can lead to negative effects for the community at large. In 2006, the average income for older adults in Waterloo Region between the ages of 55 and 64 years was $45,695, whereas the average income for those over the age of 65 was $32,022 (these values do not include net worth or an estimate of accumulated assets) (Region of Waterloo Public Health, 2010a). Locally, female older adults tend to have a lower income than males, and most have an income that is less than $35,000 per year (Region of Waterloo Public Health, 2010a). Similar to Ontario, most income for older adults in Waterloo Region is derived from employment (40.7%) as well as the Canada Pension Plan, private pensions, and old age security (40.4% combined) (Region of Waterloo Public Health, 2010a). There is a % Figure 6 - Percent of Individuals with Low Income in Waterloo Region and Ontario, Before Tax, Waterloo Region Ontario All Individuals Individuals over 65 years (Region of Waterloo Public Health, 2010b) $40,000 $30,000 $20,000 $10,000 considerable income gap in Waterloo Region that has been increasing steadily for both the general population and the population of seniors in the community. In 2006, there was an income disparity between all seniors and seniors with low income of $17,517, nearly $6,400 more than the disparity of $11,147 in 1996 (Region of Waterloo Public Health, 2010b) (Figure 5). In addition, based on before-tax incomes, approximately 7.9% of individuals 65 years and older in Waterloo Region lived with low income in 2006 (Region of Waterloo Public Health, 2010b) (Figure 6). Although the proportion of seniors living in low income in Waterloo Region was less than that of seniors living in low income in all of Ontario, this figure represents over 4,000 seniors (Region of The Regional Municipality of Waterloo s Seniors Services Planning Report Page 10 of 65 $0 Figure 5 - Total income for all individuals and individuals over 65 years, Waterloo Region and Ontario, 2006 Waterloo Region Ontario All Individuals Individuals over 65 years Individuals living with low income Individuals over 65 years living with low income (Region of Waterloo Public Health, 2010b)

15 Waterloo Public Health, 2010b), 69% of whom are female (Region of Waterloo Public Health, 2010a). In addition to women, people who tend to live in poverty more than others include individuals who are single or unattached (especially females), recent immigrants who have worked less than 10 years, Aboriginal peoples, children, and persons with disabilities (Region of Waterloo Public Health, 2010b; Standing Committee on Social Affairs, Science, and Technology, 2009; Laurie, 2008). Table 1 Ontario Works Caseload by Age, Kitchener CMA, 2008 & 2009 The Government of Canada provides an Old Age Security pension to eligible 1 seniors and an additional Guaranteed Income Supplement for eligible 2 seniors with low income. Due to this fixed income, some seniors may have difficulty paying for life s necessities such as bills, property tax, etc. For some seniors who own a home, property taxes and associated home ownership costs can be overwhelming. In 2001, approximately 11% of seniors who owned a home in Waterloo Region (Kitchener Census Metropolitan Area data) spent more than 50% of their income on housing costs, which is considered a severe affordability problem, placing them at risk of homelessness (Region of Waterloo Social Services, 2007). Age 2008 Caseload 2009 Caseload Percent Category # % # % Change 0-6 2, , , , , , , , , , , , , , Over Total 11, , (Region of Waterloo, 2010a) The number of seniors living in low income is likely greater today due to the global economic recession and can be demonstrated by increased use of social services such as Ontario Works. Table 1 illustrates that approximately 616 individuals 55 years of age and older were participants of Ontario Works in 2009, which is a 30% increase from 2008 (Region of Waterloo, 2010a). With the potential negative impacts of the recent economic recession, in addition to the growing proportion of seniors in the population, the importance of planning and addressing the needs of seniors in low income in Waterloo Region is even more imperative. Not only will Waterloo Region have more seniors living in the community, but there may also be a higher 1 Eligibility for the Old Age Security pension includes an age requirement of 65 years or older, Canadian citizenship or legal residency at the time of application, and residency in Canada for at least 10 years after the age of 18; or if a senior lives outside of Canada, they must have lived in Canada for at least 20 years after the age of 18, and was a legal resident or citizen at the time of application (Service Canada, 2010). 2 Eligibility for the Guaranteed Income Supplement is based on a number of variables. For specific details, go to: The Regional Municipality of Waterloo s Seniors Services Planning Report Page 11 of 65

16 number of seniors who are at risk of living in low income (e.g., unattached individuals, new immigrants, Aboriginal peoples, and persons with disabilities) (Region of Waterloo Public Health, 2010b). As previously mentioned, seniors tend to acquire additional, and often interacting, health issues with increasing age. These health effects can be compounded when an individual lives in low income or poverty. In some cases, having poor health can lead to poverty and low income, but in most cases, poverty leads to negative health effects (Laurie, 2008; Region of Waterloo Public Health, 2008). Moreover, poverty has been seen as the primary determinant of poor health in Canada (Region of Waterloo Public Health, 2008). Poverty not only affects individuals living with low income, but also has significant impacts on the society at large. For each household in Ontario, this figure equates to approximately $2,300 per year, which presents itself in health care costs, crime, social assistance, lost tax revenue, and intergenerational poverty (Laurie, 2008). Thus, for seniors living with low income, it is even more important to prevent and address their health and social needs in order to improve their quality of life, and to minimize the societal costs associated with the combination of poverty and poor health. Seniors & Disability in Waterloo Region As individuals age, their likelihood of experiencing a disability increases (Region of Waterloo, 2010b). In 2006, approximately 1.85 million people in Ontario (15.5%) reported having a disability (Region of Waterloo, 2010b). In 2006 approximately 47.2% of Ontarians over the age of 65 and 56.3% over the age of 75 reported limitations in daily activities (as cited in Region of Waterloo, 2010b). In , approximately 45.0% of older adults in Waterloo Region experienced activity limitations sometimes or often, which is less than the provincial average of 50.3% (Region of Waterloo Public Health, 2010a). As required by provincial legislation, ensuring accessibility to Regional services is a major focus of the Region, and has been incorporated into the Corporate Strategic Plan. The following section describes the key pieces of provincial legislation that impact the Region with respect to accessibility and senior-specific service delivery and planning. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 12 of 65

17 Legislative Requirements for the Regional Municipality of Waterloo Six main Acts guide service delivery and planning pertaining to seniors at the Region: the Ontario Disabilities Act, 2001 (ODA); the Accessibility for Ontarians with Disabilities Act, 2005 (AODA); the Long-Term Care Homes Act, 2007; the Homemakers and Nurses Services Act, 1990; the Ontario Public Health Standards (OPHS); and the Excellent Care for All Act, Brief summaries of each Act are listed below. Ontario Disabilities Act, 2001 (ODA) The Ontario Disabilities Act, 2001 (ODA) requires that all municipalities with more than 10,000 residents prepare a public annual accessibility plan that includes an update on progress to identify, prevent, or remove barriers, and outline actions for future progress (Region of Waterloo, 2010b). In addition, municipalities with more than 10,000 residents are also required to appoint an Accessibility Advisory Committee to help guide accessibility planning. The four barrier themes addressed in the ODA include: policy, practice, and attitudinal barriers; information or communication barriers; physical or architectural barriers; and technological barriers. Accessibility for Ontarians with Disabilities Act, 2005 (AODA) The Accessibility for Ontarians with Disabilities Act, 2005 mandated the Province to develop a set of accessibility standards for both private and public sectors. The first set of standards formalized was the standard for accessible customer service, which includes goals for: the development of policies, practices, and procedures related to accessible customer service provision; the development and implementation of staff training programs on accessible customer service; and accessible communication of the progress on achieving these goals (Region of Waterloo, 2010b). Additional standards will be released in the areas of transportation, information and communication, employment, and the built environment. Long-Term Care Homes Act, 2007 The Long-Term Care Homes Act, 2007 outlines a new governance system for LTC homes in Ontario, and replaces the Nursing Homes Act, the Charitable Institutions Act, and the Homes for the Aged and Rest Homes Act. The Long-Term Care Homes Act, 2007 is based on the principle that a LTC home is primarily the home of its residents and is to be operated so that it is a place where they may live with dignity and in security, safety and comfort and have their physical, psychological, social, spiritual and cultural needs adequately met (Long-Term Care Homes Act, 2007). Section 119 of the Long-Term Care Homes Act, 2007 states that every southern municipality that is an upper or single-tier municipality shall establish and maintain a The Regional Municipality of Waterloo s Seniors Services Planning Report Page 13 of 65

18 municipal home and may establish and maintain municipal homes in addition to the home that is required (Long-Term Care Homes Act, 2007). Sunnyside Home is the LTC home owned and operated by the Region and is described in detail below. Homemakers and Nurses Services Act, 1990 (HNSA) The Homemakers and Nurses Services Act, 1990 (Regulation 634, amended to O. Regulation 174/95) guides the delivery of the Homemakers and Nurses Services Program, a program that the Region has discretion to deliver. The Homemakers and Nurses Services program provides homemaking and nursing services support to individuals with low income to help maintain their health and live independently in the community (Region of Waterloo Social Services, 2009). Clients are normally individuals over the age of 65 or individuals who have a physical or mental disability. More information about the Homemakers and Nurses Services Program is described below in the summary of Seniors Services. Ontario Public Health Standards (OPHS) The OPHS guide the provision of mandatory health programs and services in Ontario as required by the Ministry of Health and Long-Term Care (MOHLTC) and the Health Protection and Promotion Act, R.S.O. 1990, c. H.7 (Ministry of Health and Long-Term Care, 2008). The OPHS include direction to Ontario boards of health in the areas of assessment and surveillance, health promotion and policy development, disease and injury prevention, and health protection (Ministry of Health and Long-Term Care, 2008). Seniors are influenced by many of the programs and services delivered by boards of health across Ontario; however, the OPHS do not provide specific direction for seniors service provision or planning with the exception of their definition of falls prevention across the lifespan. As the local board of health for Waterloo Region, the Region s Public Health department is responsible for epidemiologic analysis of falls across the lifespan, with specific attention to children, youth, adults, and seniors. Excellent Care for All Act, 2010 (ECAA) The Excellent Care for All Act, 2010 ensures the improved quality and value of the patient experience through evidence-based health care (Ministry of Health and Long-Term Care, 2010). It aims to improve the current health care system, while ensuring quality health care for future generations. Requirements include quality committees, annual quality improvement plans, continual feedback and evaluation from clients/patients/caregivers/ staff, and a declaration of organizational values (Ministry of Health and Long-Term Care, 2010). As the provider of health care at Sunnyside Home, the Region is directly influenced by the ECAA, and must commit to continual quality assurance and improvement. The next section of this report describes services and planning currently taking place within the Regional Municipality of Waterloo that address the needs of seniors in the Waterloo Region community. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 14 of 65

19 CURRENT REGIONAL SERVICES & PLANNING As a mid-sized, upper-tier municipality, the Region is responsible for abiding by a number of legislative mandates that relate to seniors in the community as described above. In addition to fulfilling its legislated requirements, the Region provides and supports many additional services and planning initiatives that directly and indirectly influence the seniors population in the community. This section provides a summary of current services and planning delivered through the Regional Municipality of Waterloo. For more details on Regional services and planning, please refer to Appendices A and B. Seniors Services Division Seniors Services provides a range of services for seniors in Waterloo Region. Sunnyside campus, located in Kitchener, Ontario, is the main geographic hub for the Region s seniors service provision (Figure 7). Seniors Services is committed to providing quality social and health care services, and as such, Sunnyside Home has been accredited by Accreditation Canada since Seniors Services has also been an active member of the Ontario Association of Non-profit Homes and Services for Seniors since With approximately 400 staff and over 200 active volunteers, there is a consistent commitment to providing the many valued services provided at Sunnyside campus. Since 1998, the Sunnyside Foundation, a charitable organization that fund-raises for the division, has raised over $1.5 million, supplementing funding from the Region and the MOHLTC. In addition to accessible and aesthetic renovations, the Sunnyside Foundation funded the development of the Seniors Wellness Centre, which opened May The Seniors Wellness Centre also serves individuals living in Sunnyside Home and on the Sunnyside campus as well as seniors living in the community. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 15 of 65

20 Current Programs and Services in Seniors Services Long-Term Care Sunnyside Home provides residential care to 263 residents, including 10 convalescent beds and two respite beds. As stated its mission, Sunnyside Home excels in the provision of compassionate long-term care services. [They] lead through innovation and responsiveness to community needs (Region of Waterloo, 2010c). The vision of Sunnyside Home is to be recognized as a leader in advancing exemplary standards of compassionate and professional LTC. Convalescent Care Convalescent care is temporary care for individuals who have fallen ill, or who are preparing for, or recovering from a surgical procedure. The MOHLTC provides funding for this program which includes professional care, therapy, accommodation, and meals. Respite Care Caregivers often require a break from caring for a family member or friend at home to take some time for themselves. Two private respite rooms are available at Sunnyside Home for up to 30 consecutive days with a total annual maximum of 90 days. Homemaking and Nursing Services Program The Homemaking and Nursing Services Program at the Region is delivered by Seniors Services and funded by the MOHLTC and the Region. The main aim of the program is to help individuals living with low income maintain their health and live in the community as long as possible (aging in place). Of the approximately 200 program clients, 50% are frail seniors and 50% are individuals with mental health issues (Region of Waterloo Social Services, 2009). Community Alzheimer Programs Seniors Services operates a range of Community Alzheimer Programs at Sunnyside campus, which are subsidized by the MOHLTC. Programs include a Day Program, Overnight Stay Care Program, Dinner Club Program, as well as a Caregiver Support and access to a Community Recreation Therapist. Most programs focus on enhancing the abilities of individuals with Alzheimer disease or a related dementia. Education and support for family members and caregivers is also available (e.g., respite care). The Regional Municipality of Waterloo s Seniors Services Planning Report Page 16 of 65

21 Community Programming In addition to the Community Alzheimer Programs, there are many other programs and services available at the Sunnyside campus that are open to seniors from the public, such as the K-W Seniors Program, Sandhills Café, the Sunnyside Auxiliary Tuck Shop, hairdressing services, and the Sunnyside Gift Shop. Sunnyside Wellness Centre The Sunnyside Wellness Centre is designed to promote healthy living with a vision to promote physical, mental, and social health of seniors in Waterloo Region. It provides supervised exercise programs designed for seniors; clinic rooms for health professionals; a therapeutic spa; educational programs on health, wellness, and nutrition; and social areas for interaction and relaxation. The Sunnyside Wellness Centre offers a new affordable, accessible option for seniors health and wellness activities in Waterloo Region. Supportive Housing Sunnyside Supportive Housing is operated by the Region with support service funding from the MOHLTC and funding provided through the Canada-Ontario Affordable Housing Program and the Region's Housing Reserve Fund. The facility opened in March 2010 and offers 30 units of apartment-style living with services to help individuals remain independent as long as possible. Sunnyside Supportive Housing offers a range of services including assistance with personal care (including hygiene and bathing), medication reminders, safety checks, housekeeping, 24/7 emergency response, social and recreational activities, as well as support for booking appointments and arranging transportation. Rental fees enable individuals with varying levels of income to benefit from supportive housing in the Region. Sunnyside Seniors Housing There are also 151 other Regional seniors apartments (Affordable Housing) located in two complexes on the Sunnyside campus. Various rental programs apply to the units four of which are wheelchair accessible. The Sunnyside Priority allows access to these two buildings for family members who have a relative living at Sunnyside Home. Services onsite include affordable housing, security, property management, and social activities. Assisted living services are also available to qualifying tenants. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 17 of 65

22 Inventory of Internal Services and Planning In addition to the information presented on Seniors Services, an internal inventory of services and planning pertaining to seniors was conducted to determine the current role that the Region as a whole plays in addressing the needs of local seniors through service provision and planning. Information on all services and planning detailed in the inventory can be found in Appendices A and B. There is a great deal of activity within the Region that is focused on services for seniors in the community and some planning occurring for future initiatives. Table 2 presents a summarized list of services for seniors currently offered through the Region of Waterloo. Table 3 lists the names of programs or groups within the Region that are currently planning for future services that may directly or indirectly impact seniors. In total, 29 examples of services and 10 examples of planning are described. Many (45.9%) services and planning specifically target seniors or subgroups of seniors (e.g., seniors with low income or seniors with Alzheimer disease or a related dementia) as their population of interest. However, services and planning initiatives that focus on broader populations, but have a direct or indirect impact on seniors are also included in the inventory. For example, some service and planning initiatives that target the general population, volunteers, persons with disabilities, individuals at-risk or experiencing homelessness, or research and planning for seniors-related topics were included in the inventory. As illustrated above, most of the services and planning occurring at the Region pertaining to seniors takes place in the Social Services department, and most notably, the Seniors Services division. Other services that have a primary focus on seniors include the Elder Abuse Response Team and Housing for seniors. However, as seen in Tables 2 and 3, many other Regional departments and divisions deliver services and conduct planning that have a direct or indirect impact on seniors in the local community. For example, Grand River Transit s MobilityPLUS and Travel Talk PLUS focus on ensuring that persons with disabilities are able to use accessible transportation. Although these programs are not specifically targeted to seniors, a large proportion of their client-base is seniors in Waterloo Region. Also of note is the provision of customer service training at the Region. Currently, Grand River Transit, Citizen Services, and Emergency Medical Services all provide forms of customer service training related to seniors and/or persons with disabilities. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 18 of 65

23 Table 2 Regional Programs and Services Related to Seniors Social Services Seniors Services Sunnyside Home (Long-Term Care Home) Homemaking and Nursing Services Program Community Programming Community Alzheimer Programs Sunnyside Supportive Housing Sunnyside Wellness Centre Sunnyside Home Volunteer Coordination Social Services Social Planning, Policy, and Program Administration Domiciliary Hostel Program Emergency Shelters Homelessness to Housing Stability Strategy Housing Options for Older Adults Living in Waterloo Region Social Services Children s Services Mitten Tree Volunteer Coordination Transportation and Environmental Services Grand River Transit (GRT) Grand River Transit General Services Customer Sensitivity Training MobilityPLUS Travel Talk PLUS Education and Training Sessions Regional Chair s Office Crime Prevention Council Elder Abuse Response Team (in partnership with WWCCAC, Waterloo Regional Police Services) Talk Local Safe Cities Series: Seniors and Crime Planning, Housing and Community Services Housing Waterloo Region Housing The Regional Municipality of Waterloo s Seniors Services Planning Report Page 19 of 65

24 Sunnyside Seniors Apartments Planning, Housing and Community Services Community Services Continued Waterloo Region Museum (WRM) General Information WRM Seniors Days WRM Volunteer Coordination Region of Waterloo Library (RWL) Volunteer Coordination Corporate Resources Citizen Services Accessible Customer Service Training (internal) ACCESS Facts Newsletter (internal) Public Health Emergency Medical Services (EMS) Customer Training Program Statistics and Data Provision The planning occurring across the Region is mostly focused on the development of specific programs or resources, rather than collaborative, strategic planning that would serve seniors from a Region-wide perspective. The absence of a coordinated planning body related to seniors issues within the Regional Municipality of Waterloo is also noted. Developing a coordinated body to synchronize activities within the Region would enable the Region to plan and prepare for the population and demographic changes expected for Waterloo Region. In addition, while some planning listed in the inventory included engagement of seniors in the planning process (e.g., in the development of the OAHSR), a seniors planning body could facilitate ongoing meaningful engagement of seniors in Regional planning and program initiatives. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 20 of 65

25 Table 3 Regional Programs and Services that Conduct Planning for Seniors in Waterloo Region Social Services Seniors Services Collaborative Seniors Planning with Stakeholders Social Services Social Planning, Policy, and Program Administration Domiciliary Hostel Program Chief Administrator s Office Crime Prevention Council Safety Issues Fact Sheet Corporate Resources Citizen Services Corporate Accessibility Planning Public Health Emergency Medical Services (EMS) Community Referral Program Home Safety Residential Audit Program Planning with WWCCAC and Local Hospitals Public Health Epidemiology & Health Analytics Older Adults Health Status Report Public Health Healthy Living, Planning and Promotion Falls Prevention Planning Group Transportation and Environmental Services Grand River Transit Grand River Transit General Services The need for corporate planning is substantiated by the breadth of departmental services that both directly and indirectly involve seniors, combined with the anticipated impact of the growing seniors demographic. To help determine the appropriate next steps for seniors service provision and planning at the Region, a scan of promising practices and activities across Canada was conducted. The following section describes a number of commonalities in the documents collected and innovative ideas that may be of interest within the Region. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 21 of 65

26 PROMISING PRACTICES A scan was conducted to determine current activities and promising practices related to planning for seniors at the municipal level. With the aging population, there has been an engaging and increasing focus on planning for seniors across Canada, especially within the past three years. Appendix C provides details on a number of reports and plans. Some common themes found in the documents include: Aging in Place, the need for accessible services and communities, efficient transportation services, housing requirements, the importance of social and civic engagement, elder abuse prevention and awareness, and understanding the diversity of the seniors population. As illustrated by the inventory of current services and planning described above, the Region is actively involved in providing services and planning related to these common topics. The importance of collaboration with various stakeholders was also emphasized, with specific mention of collaboration with various levels of government, community groups, and particularly seniors themselves from the community. Improving linkages between these important players will allow for better knowledge transfer and exchange, and for the sharing of promising practices. Innovative Findings Municipalities across Canada are participating in creative methods of serving their senior populations and ensuring a healthy and active quality of life for their residents. Some examples found in the scan of promising practices are listed below. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 22 of 65

27 The World Health Organization s Age-Friendly Cities Initiative Both a common theme and innovative initiative found in many of the documents was the World Health Organization s (WHO) Age-Friendly Cities initiative. This initiative has sparked a global movement towards age-friendly communities of all shapes and sizes (the WHO refers to the term city as an urbanized area, and does not distinguish between municipal jurisdictions, but simply encourages governments, voluntary organizations, the private sector, and citizens groups to use the WHO s tools to help develop age-friendly environments). In Canada, the City of London was the first community to officially participate in the WHO s program. In addition to the City of London, Niagara Region, Halton Region, the City of Calgary, the City of Hamilton, the City of Waterloo, the City of Cambridge, and others have also developed plans for making their communities more age-friendly based on the WHO s Age-Friendly Cities initiative. According to the WHO, an age-friendly city encourages active ageing by optimizing opportunities for health, participation and security in order to enhance quality of life as people age (2007a, p. 1). The WHO consulted with approximately 1500 seniors from 33 countries to establish eight key topic areas for an age-friendly community (Figure 8): outdoor spaces and buildings, transportation, housing, social participation, respect and social isolation, civic participation and employment, communication and information, and community and health services (World Health Organization, 2007b). These eight key features span a variety of domains that fall under the jurisdiction and responsibility of a number of different players (e.g., Regional and lower-tier municipalities). Therefore, cooperation, collaboration, and partnership with many independent groups, organizations, and residents would be necessary to develop an agefriendly community in an area such as Waterloo Region. It was data from these experts in seniors living that influenced the development of the Global Age-friendly Cities: A Guide (World Health Organization, 2007b) and the associated Checklist of Essential Features of Age-friendly Cities (World Health Organization, 2007a) Figure 8 WHO Age-Friendly City Topic Areas (World Health Organization, 2007b) The Regional Municipality of Waterloo s Seniors Services Planning Report Page 23 of 65

28 (Appendix D). In addition to the guide and checklist, the WHO also developed the WHO Global Network of Age-friendly Cities to link participating cities; facilitate information exchange; foster appropriate, sustainable, and cost-effective interventions; and provide technical support and training (World Health Organization, 2009). It would be useful to conduct further research on experiences and outcomes of implementation of age-friendly initiatives for groups that involved Regional government, especially in a two-tiered system in Ontario. Exploring the particular roles of each stakeholder group, strategies for implementation, and lessons learned may help individuals and groups in Waterloo Region determine the potential for implementation of an age-friendly community initiative locally. Some common themes for implementation found in the study of promising practices include the leadership of an advisory committee with representation from the upper and lower-tier municipalities, community groups, volunteer organizations, and seniors themselves. Niagara Region and Halton Region are examples of two-tiered regional municipalities that have implemented age-friendly initiatives in Ontario. Both of these Regions have a high proportion of seniors; for instance, Niagara Region s population of seniors aged 65 and older is approximately 17% (Niagara Regional Housing, 2008); likewise, Halton Region has approximately 12% of their population over the age of 65 (Elder Services Advisory Committee, 2007). With a population that consists of approximately 11.6% of seniors over the age of 65, Waterloo Region may be able to learn from actions undertaken in areas such as Niagara and Halton Regions; brief information about each initiative is provided below. Regional Municipality of Niagara In June 2010, Niagara Region launched the Niagara Age-Friendly Community Initiative as part of the WHO s Age-Friendly Cities movement. Coordinated through the Seniors Citizens Advisory Committee (SCAC), the Niagara Age-Friendly Community initiative originally started with a focus on the City of Welland, but when the SCAC applied for Ontario Trillium Foundation funding, they were informed that regional collaboration would be encouraged to receive grant funding (Speck, 2010). Consequently, the City of Welland partnered with Niagara Region, the Rose City Seniors Centre Foundation, and the Niagara Research and Planning Council to develop the Niagara Age-Friendly Community Initiative. The initiative received $222,900 in Ontario Trillium Foundation grant funding for three years of project implementation (Niagara Region, 2010). In-kind contributions from community stakeholders also help fund this initiative. To begin, the Niagara Age- Friendly Community initiative will be piloted in the City of Welland, and will be expanded to other interested area municipalities as the initiative develops. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 24 of 65

29 Regional Municipality of Halton With the help of Halton s Elder Services Advisory Committee (ESAC), Halton Region is working towards becoming more age-friendly with extensive planning and collaboration with community stakeholders. The Regional Municipality of Halton is actively engaged with the ESAC by providing resource staff and committee representation. After producing The Quality of Life for Seniors in Halton guide for future planning in 2007, the ESAC has since provided the community with three update reports in 2009, and is now leading Halton Region in their Age Friendly Communities Project as of March The ESAC plans to utilize the structure of the WHO s Age-Friendly Cities initiative, including assessing the age-friendliness of Halton Region from seniors perspectives. After generating ideas for action with seniors and community stakeholders, the ESAC plans to present recommendations to Halton Regional Council, project participants, and the community at large by May Master Aging Plan Brantford and the County of Brant released a detailed plan for their aging population in 2008 titled, A Master Aging Plan for Brantford & the County of Brant. A steering committee (with representation from Brantford City Council and staff, among others) led by the Alzheimer Society of Brant directed Brantford and the County of Brant to move towards becoming an age-friendly community, but is not solely based on the WHO s initiative. Through funding from the Ontario Trillium Foundation, the Steering Committee was able to hire a consultant to provide research and planning support for the project. Various methods of stakeholder consultation led to the development of five main goals: establish and maintain a supportive infrastructure, optimize community programs and services, foster health and wellness for seniors, continuously improve support systems, and raise the profile of seniors in the community. Under each goal, specific objectives and suggested strategies are outlined. Consultations also revealed key themes regarding the needs of seniors, including: transportation, housing, social and recreational opportunities, safety, professional and retail services, and health care. Specific recommendations are listed that connect to each theme and are separated into recommendations for City and County Council, community agencies, provincial and federal governments, the community, and individuals. Further study into the development of Brantford and the County of Brant s master aging plan may be useful to help determine next steps for Waterloo Region in the development of a regional strategy for seniors. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 25 of 65

30 Summary of Promising Practices It is clear from the scan of promising practices that not only is there change taking place across Canada with regard to planning for seniors, but many groups are participating in innovative activities such as the WHO s Age-Friendly Cities Initiative, Brantford and the County of Brant s Master Aging Plan, and the City of Edmonton s Seniors Declaration. It would be helpful for the Region to further investigate the steps taken to progress towards a more suitable environment for seniors to help guide the development of a Regional seniors strategy. The following sections of this report summarizes issues and offers recommendations related to the Region s future work in seniors planning. Seniors Declaration On June 3, 2010, the City of Edmonton released a Seniors Declaration, which outlined a commitment to four ideals: individuals are respected; people of all ages are safe; transportation, urban design, and physical infrastructure allow all people to participate in full lives; and seniors have ready access to programs, employment, activities, and services (City of Edmonton, 2010). The declaration includes a statement that age is a gift to a city (City of Edmonton, 2010) and that Edmonton must retain its capacity to benefit from seniors knowledge and abilities, as well as its capacity for caring about them, both physically and emotionally (City of Edmonton, 2010). A declaration such as this is a simple, yet effective way to publicly recognize the importance of a lifecourse perspective to service provision and planning for a community. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 26 of 65

31 DISCUSSION As discussed in the section on seniors in Waterloo Region, within the next few decades, Waterloo Region is expected to see a population increase, spatial change, and demographic changes, including a dramatic increase in the seniors population. Thus, there is a significant need to monitor population changes in the area, and to plan for projected changes to ensure excellent service provision for all members of the community, including seniors. The Region s Official Plan (ROP) states that Waterloo Region needs to be a liveable community that is well-designed, [and] accommodates people at all stages of life (Region of Waterloo, 2009). The ROP also emphasizes the importance of building complete communities that provide for the needs of all residents. The Region has the opportunity to show leadership in the development of community that is inclusive of seniors in Waterloo Region. Focusing on ensuring a better quality of life for seniors not only benefits the growing seniors population, but helps to ensure a liveable community for everyone. As the City of London (2010) states in their report, an age-friendly city is a people friendly city. The Region of Waterloo has the opportunity to formally commit to developing a community that pays particular attention to the needs of seniors as an integral segment of the Waterloo Region population, and by doing so, ensures a liveable community for all. With respect to the legal requirements of the Regional Municipality of Waterloo (the Region), it was found that the Region is guided by six key documents: the Ontario Disabilities Act, 2001 (ODA); the Accessibility for Ontarians with Disabilities Act, 2005 (AODA); the Long-Term Care Homes Act, 2007; the Homemakers and Nurses Services Act, 1990; the Ontario Public Health Standards (OPHS); and the Excellent Care for All Act, 2010 (ECAA). Within these documents, the major stipulation that specifically refers to seniors is the Regional provision of LTC. While the Homemakers and Nurses Services Act, 1990 offers legislative guidance for the provision of the Homemaking and Nursing Services program, this program is delivered at the discretion of the Region. The AODA and ODA impact seniors as individuals over the age of 55 tend to have the highest proportion of disability compared to younger cohorts; The Regional Municipality of Waterloo s Seniors Services Planning Report Page 27 of 65

32 however, these two acts do not specifically target seniors in the community. Similarly, the OPHS focus on falls across the lifespan, which makes note of seniors, but does not have an explicit focus on seniors as a discrete priority population. Finally, the ECAA indirectly influences seniors service provision at the Region through guidance for Sunnyside Home quality regulations. Although there are minimal legislative requirements for the Region, the inventory of services and planning at the Region outlines a number of services and planning occurring at the Region, emphasizing the Region s commitment to providing quality and innovative service to all individuals in the community, including the increasing proportion of seniors. In addition, there are also many universal programs and planning initiatives at the Region that focus on larger populations, but influence seniors in the community (e.g., many public health programs, emergency services, social services, transportation services, community services, etc.). Although there are many initiatives within the Region that effect the quality of life of seniors locally, strategic planning and coordination of services that specifically pertain to seniors are yet to be established. Existing promising practices could be instrumental in the development of a Regional integrated planning initiative for seniors. There are many municipalities across Canada that are focused on developing planning for communities that are best suited for seniors. Further analyses of such practices and sharing lessons learned could also inform appropriate approaches for the development of a strategy for seniors in Waterloo Region. In addition, it is also crucial to connect with the seven area municipalities to determine specific activities and planning for seniors that is currently taking place within Waterloo Region. As can be seen from the review of promising practices, there is a movement towards age-friendly communities as outlined by the World Health Organization s Age- Friendly Cities initiative. Age-friendly communities not only benefit seniors, but all members of society. In order for a community to be age-friendly, improvements must be made in a number of areas within a community as described by the WHO s guide (World Health Organization, 2007b). To develop a community that is age-friendly, cooperation, coordination, and collaboration is required from various stakeholders, given the various mandates. After reviewing current and projected community characteristics with respect to seniors, and considering promising practices from other municipalities in Canada, Regional staff have developed a list of recommendations to help guide the Region with respect to seniors planning. The following section of this report highlights potential next steps for the Region in maintaining an inclusive, thriving, sustainable community with appropriate attention to the growing population of seniors. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 28 of 65

33 RECOMMENDATIONS In the Corporate Strategic Plan, the Region of Waterloo aimed to promote quality of life and create opportunities for residents to develop their full potential (Region of Waterloo, 2007). Within this focus area, specific actions were outlined that included the development of a planning body for seniors services and a Regional Strategy for seniors that ensured a healthy quality of life for seniors in the local community (Region of Waterloo, 2007). This report was developed to help provide information and direction with respect to the development of a Regional seniors planning body and strategy. Detailed next steps are listed below for implementation of each strategic action. 1. Develop a Seniors Planning/Advisory Body to Inform Seniors Planning and Service Provision at the Regional Municipality of Waterloo It is important to establish an internal planning body to coordinate all services and planning at the Region that pertain to seniors. An internal planning body for seniors will provide an avenue for collaboration, knowledge translation and exchange, and consolidation across the Corporation. Next Steps: a) Develop a terms of reference. b) Invite participation from Regional departments and the community. c) Align Regional priorities related to seniors (e.g., visions, missions, goals, objectives). d) Develop a workplan that aligns with the Corporate Strategic Plan. 2. Develop a Seniors Strategy for the Regional Municipality of Waterloo If an internal planning body is developed within the Region, a major responsibility of this group could be to create a Regional seniors strategy with short-term and long-term goals for enhancing service provision and planning for seniors in Waterloo Region. An innovative multi-departmental initiative such as this would require collaboration within the Region, but would also necessitate consultation and involvement of various stakeholders as well (e.g., area municipalities, community groups, residents, and other external stakeholders). Next Steps: a) Identify the scope and framework for the development of an interdepartmental seniors strategy. b) Conduct further analysis on promising practices for Regional strategy development. c) Work with the planning/advisory body to develop the strategy. d) Collaborate with area municipalities and other stakeholders in the development of the strategy. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 29 of 65

34 Future Considerations: Pursue the interest in the development of a seniors strategy for Waterloo Region as a whole with area municipalities and community groups. After the development of an internal planning body and a Regional strategy for seniors, the Region could participate in long-term planning and strategy development for seniors within the entire Waterloo Region community. By engaging with the community in the development of a Regional strategy for seniors, the Region would demonstrate its commitment to creating a liveable community for all individuals, including the large proportion of seniors. Immediate Next Steps: Develop a budget proposal for resources required to implement the recommendations listed above. Summary The evidence presented in this report illustrates the importance of preparing and planning for the growing population of seniors in Waterloo Region. This report provides information and direction to continue with the development of a Regional planning / advisory body and Regional strategy for seniors to support planning initiatives at the Regional Municipality of Waterloo. The recommendations and next steps described above not only affect one or two departments at the Region, but all departments, which is why a multidepartmental initiative is suggested. Moreover, the implications of the recommendations on the Region and Waterloo Region as a whole not only affect seniors, but all community members; hence, the recommendation for collaboration between a wide variety of stakeholders in the community, including area municipalities, community groups, and especially seniors themselves. The Regional Municipality of Waterloo, in its efforts to build a well-designed, liveable community for all, has the opportunity to show innovative leadership in addressing the community s needs by ensuring that the Region s programs and services are best suited for all community members, including the valuable and growing population of seniors in Waterloo Region. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 30 of 65

35 REFERENCES Austin, C, Flux, D, Ghali, L, Hartley, D, Holinda, D, McClelland, R, Sieppert, J, Wild, T. (2001). A place to call home: Final report of the elder friendly communities project. Calgary, Alberta. Retrieved from Age Friendly Communities. (2010). Waterloo Age friendly Waterloo. Retrieved from Canadian Social Data Strategy. (2006). Canadian Census Data, Catalogue No XCB _OntarioCustom. Retrieved from Centre for Addiction and Mental Health. (2010). Low-risk drinking guidelines. Retrieved from City of Calgary. (2008a). Seniors services division: 2008 annual report. Calgary, Alberta: Author. Retrieved from City of Calgary. (2008b). Community and neighbourhood services: Current projects, programs, and initiatives involving older adults. Calgary, Albert: Author. Retrieved from City of Edmonton Community Services. (2007). Aging in place: A neighbourhood strategy. Edmonton, Alberta: Community Services Consulting Ltd. Retrieved from City of Edmonton. (2010). Edmonton seniors declaration. Retrieved from City of Hamilton. (2010). City of Hamilton: Hot topics. Retrieved from City of London. (2010). Age friendly London: Report to the community. London, Ontario: Author. Retrieved from City of Mississauga. (2008). Older adult project: Older adult plan. Mississauga, Ontario: Author. Retrieved from The Regional Municipality of Waterloo s Seniors Services Planning Report Page 31 of 65

36 City of Toronto. (1999). Building a city for all ages: Final report of the Toronto Seniors Task Force. Toronto, Ontario: Author. Retrieved from City of Toronto. (2002). Rebuilding respect: A progress report for seniors. Toronto, Ontario: Author. Retrieved from Edmonton Seniors Coordinating Council. (2009). Strategic plan for services to Edmonton s seniors: Towards Edmonton, Alberta: Author. Retrieved from Elder Abuse Response Team. (2007). Elder abuse response team. Retrieved from Elder Services Advisory Committee. (2007). The quality of life for seniors in Halton: Today & tomorrow. Oakville, Ontario: Halton Region. Retrieved from Elder Services Advisory Committee. (2009). The quality of life for seniors in Halton: Update #1 January Oakville, Ontario: Halton Region. Retrieved from from Elder Services Advisory Committee. (2009). The quality of life for seniors in Halton: Update #2 income and housing October Oakville, Ontario: Halton Region. Retrieved from from Elder Services Advisory Committee. (2009). The quality of life for seniors in Halton: Update #3 social and civic engagement December Oakville, Ontario: Author. Retrieved from from Elder Services Advisory Committee. (2010). Services for seniors: Age friendly communities project overview. Oakville, Ontario: Halton Region. Retrieved from Government of Canada. (2010). Seniors Canada online. Retrieved from Hamilton Council on Aging. (2010). Hamilton: A city for ALL ages. Hamilton, Ontario: Author. Retrieved from Homemakers and Nurses Services Act, R.R.O. 1990, Regulation 634, Amended to O. Regulation 174/95. Retrieved from The Regional Municipality of Waterloo s Seniors Services Planning Report Page 32 of 65

37 K.C. McCullagh Consulting Ltd. (2007). Lethbridge Community Plan for Seniors. Lethbridge, Alberta: City of Lethbridge. Retrieved from Laurie, N. (2008). The cost of poverty: An analysis of the economic cost of poverty in Ontario. Toronto, ON: Ontario Association of Food Banks. Retrieved from Long-Term Care Homes Act, S.O c.8. Retrieved from Ministry of Health and Long-Term Care. (2008). Ontario public health standards. Toronto, ON: Queen s Printer for Ontario. Retrieved from Ministry of Health and Long-Term Care. (2010). Legislation: The Excellent Care for All Act. Retrieved from Niagara Region. (2010). Age-friendly Niagara to be launched June 22. Retrieved from Niagara Region. (2009). Age-friendly communities initiative. Retrieved from Niagara Regional Housing. (2008) strategic plan. Retrieved from Ontario Disabilities Act, S.O. 2001, c. 32. Retrieved from Ontario Professional Planners Institute. (2009). Planning for age-friendly communities: A call to action. Toronto, Ontario: Author. Retrieved from Friendly%20Communities%20June%2018,% pdf Public Health Agency of Canada. (2009). Healthy aging in Canada: A new vision, a vital investment. Ottawa, Ontario: Division of Aging and Seniors, Healthy Aging and Wellness Working Group. Retrieved from Region of Peel Public Health. (2006). Seniors health report: A Peel health status report. Brampton, Ontario: Author. Retrieved from The Regional Municipality of Waterloo s Seniors Services Planning Report Page 33 of 65

38 Region of Waterloo. (n.d.). Success stories. Retrieved from DE?OpenDocument&mode=1#Sunnyside%20Seniors%20Apartments%2C%2032 Region of Waterloo. (2003). Regional growth management strategy: Planning our future. Waterloo, Ontario: Author. Region of Waterloo. (2006a). Document two: Human services and our growing community. Waterloo, Ontario: Author. Region of Waterloo. (2006b) census bulletin #2 Age and sex. Waterloo, Ontario: Planning, Housing, and Community Services. Region of Waterloo. (2006c) census bulletin #6 Immigration and citizenship. Waterloo, Ontario: Planning, Housing, and Community Services. Region of Waterloo. (2006d, November 2006). Ontarians with disabilities act: Working towards a barrier free Region of Waterloo. ACCESS Facts, pp.4. Region of Waterloo. (2007). Region of Waterloo strategic plan: Strategic focus Waterloo, ON: Author. Region of Waterloo. (2008). Human services planning action for the future: Policy framework. Waterloo, ON: Author. Region of Waterloo. (2009). Council-adopted regional official plan. Waterloo, Ontario: Author. Region of Waterloo. (2010a). Caseload profile. Data extracted from Service Delivery Model Technology dataset. Region of Waterloo. (2010b) accessibility plan: Working towards a barrier free Region of Waterloo. Waterloo, Ontario: Author. Region of Waterloo. (2010c). Sunnyside foundation. Retrieved from Region of Waterloo Planning, Housing, and Community Services. (2010). Year-end 2009 population and household estimates (Report No. P ). Waterloo, ON: Author. Retrieved from Region of Waterloo Public Health. (2004). Building healthy and supportive communities: A profile of immigrants in Waterloo Region. Waterloo, Ontario: Author. Region of Waterloo Public Health. (2008). Can money buy you health? The health impact of poverty. Waterloo, ON: Author. The Regional Municipality of Waterloo s Seniors Services Planning Report Page 34 of 65

39 Region of Waterloo Public Health. (2009). Healthy growth: Health and the built environment. Waterloo, ON: Author. Retrieved from 6E344E/$File/Final%20Healthy%20Growth%20Report.pdf?OpenElement Region of Waterloo Public Health. (2010a). Older adults health status report. Waterloo, Ontario: Author. Region of Waterloo Public Health. (2010b). A series of public health briefs on low income status: Low income status in Waterloo Region in 1996, 2001, and Waterloo, Ontario: Author. Region of Waterloo Social Services. (n.d.). Sunnyside Home Foundation. Retrieved June 7, 2010 from Region of Waterloo Social Services. (2007). Assessing risk of economic-based homelessness: Background report for Waterloo Region s housing stability system. Waterloo, ON: Social Planning, Policy and Program Administration. Region of Waterloo Social Services. (2009). Homemakers and nursing services program Transition (Rep. No. SS ). Waterloo, ON: Social Planning, Policy and Program Administration. Retrieved from 552A13/$file/SS pdf?openelement Service Canada. (2010). Guaranteed income supplement (GIS). Retrieved from Social Planning Council of Cambridge and North Dumfries. (2010). Moving towards an age friendly community. Cambridge, Ontario: author. Social Planning Council of Peel. (2010). Senior population in Peel: Trends, characteristics, and issues. Mississauga, Ontario: Author. Retrieved from Special Senate Committee on Aging. (2008). Issues and options for an aging population. Ottawa, Ontario: Author. Retrieved from Speck, M. (2010, June 24). Niagara joins global age-friendly movement. NiagarathisWeek.com. Retrieved from Standing Committee on Social Affairs, Science, and Technology. (2009). In from the margins: A call to action on porverty, housing, and homelessness. Retrieved from The Regional Municipality of Waterloo s Seniors Services Planning Report Page 35 of 65

40 Statistics Canada. (2006). Definitions of concepts and variables Census family. Retrieved from Statistics Canada. (2007). A portrait of seniors in Canada (Catalogue no XIE). Ottawa, Ontario: Ministry of Industry. Retrieved from Statistics Canada. (2009). Persons in low income after tax. Retrieved from Steering Committee, Master Aging Plan for Brantford and Brant County. (2008). A community for a lifetime: A master aging plan for Brantford and the County of Brant. Brantford, Ontario: Author. Retrieved from Turner, G. (2010, July 14). Senior-friendly London lands WHO title. The London Free Press. Retrieved from World Health Organization. (2007a). Checklist of essential features of age-friendly cities. Geneva, Switzerland: Author. Retrieved from World Health Organization. (2007b). Global age-friendly cities: A guide. Geneva, Switzerland: Author. Retrieved from World Health Organization. (2009). WHO global network of age-friendly cities. Geneva, Switzerland: Author. Retrieved from The Regional Municipality of Waterloo s Seniors Services Planning Report Page 36 of 65

41 GLOSSARY & ACRONYM DEFINITIONS Active Aging Active aging is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age (World Health Organization, 2007b). Aging in Place Aging at home for as long as possible before transitioning to an institution such as a long-term care home. AODA The Accessibility for Ontarians with Disabilities Act, 2005 (AODA) mandated the Government of Ontario to develop a set of accessibility standards for the private and public sectors in the province. Baby Boomer Individuals born between 1946 and CCAC Community Care Access Centre. Census Family According to Statistics Canada, a census family consists of a married couple and children, if any, of either or both spouses; a couple living common law and the children, if any, of either or both partners; or, a lone parent of any marital status with at least one child living in the same dwelling and that child or those children. All members of a particular census family live in the same dwelling. A couple may be of opposite or same sex. Children may be children by birth, marriage or adoption regardless of their age or marital status as long as they live in the dwelling and do not have their own spouse or child living in the dwelling. Grandchildren living with their grandparent(s) but with no parents present also constitute a census family (Statistics Canada, 2006). CMHC Canada Mortgage and Housing Corporation. CMA Census Metropolitan Area. CMSM Consolidated Municipal Service Manager. Community Group For the purpose of this report, community group is an inclusive term refering to any community agency, committee, advisory group, etc. Disability The Ontario Disabilities Act, 2001 (ODA) defines disability as: (a) any degree of physical disability, infirmity, malformation or disfigurement that is caused by bodily injury, birth defect or illness and, without limiting the generality of the foregoing, includes diabetes mellitus, epilepsy, a brain injury, any degree of paralysis, amputation, lack of physical co-ordination, blindness or visual impediment, deafness The Regional Municipality of Waterloo s Seniors Services Planning Report Page 37 of 65

42 or hearing impediment, muteness or speech impediment, or physical reliance on a guide dog or other animal or on a wheelchair or other remedial appliance or device, (b) a condition of mental impairment or a developmental disability, (c) a learning disability, or a dysfunction in one or more of the processes involved in understanding or using symbols or spoken language, (d) a mental disorder, or (e) an injury or disability for which benefits were claimed or received under the insurance plan established under the Workplace Safety and Insurance Act, 1997 (Ontario Disabilities Act, 2001) EART Elder Abuse Response Team. Elder Abuse Actions that harm an older person or jeopardize the person s health or welfare (Region of Waterloo Public Health, 2010a, p.188) and may include physical, psychological/emotional, sexual, financial, or intentional or unintentional neglect. Financial Abuse The misuse of an older adult s money or belongings by a relative or a person in a position of trust (Region of Waterloo Public Health, 2006a, p. 192). HCoA Hamilton Council on Aging. Health Expectancy The length of time that an individual can expect to live without a disability (Region of Waterloo Public Health, 2010a). Housing Affordability Canada Mortgage and Housing Corporation (CMHC) describes housing affordability as households that spend less than 30% of their pre-tax income on housing costs. MOHLTC Ministry of Health and Long-Term Care. Long-Term Care Home Long-term care homes provide a greater level of care to residents by technically trained staff (e.g., nurses, physiotherapists, occupational therapists, personal support workers, etc.). All LTC homes are regulated and funded by the provincial government. LTC Long-Term Care. OAHSR Older Adults Health Status Report. ODA The Ontario Disabilities Act, 2001 (ODA) requires that all municipalities with more than 10,000 residents prepare a public annual accessibility plan that includes an update on progress to identify, prevent, or remove barriers, and outline actions for future progress (Region of Waterloo, 2010b). The Regional Municipality of Waterloo s Seniors Services Planning Report Page 38 of 65