It's common for Canadians to hold on to unwanted holiday gifts for up to five years

Canadians may hold on to more than five million unwanted gifts this year

TORONTO, December 23, 2011 /Canada NewsWire/ - New research reveals that, based on past behaviour, 75 per cent of Canadians may hold on to their unwanted holiday gifts this season - considered a burden by most - even though they are comfortable with the idea of re-gifting. In fact, compared with last year, more Canadians think re-gifting is acceptable (55 per cent versus 47 per cent) once the presents are unwrapped.

So what's causing Canadians to hold on? According to the annual research commissioned by Canada's largest online classifieds site, Kijiji.ca, nearly half of Canadians continue to hold on to unwanted holiday gifts out of guilt and shame. In fact, a comparison with 2010 data reveals that one third of Canadians feel guilty about not keeping an unwanted gift and slightly less (two-in-10) would be ashamed to admit to the gift giver that they gave away or sold their present.

"Canadians continue to let their emotions get in the way," said Allyson Smith, a comedian and Kijiji Canada's gift-giving therapist. "We're too concerned about the gift giver's feelings. Our research shows many of us will go to extreme lengths to pretend we like a gift by displaying it every time the gift giver is present, sending a photo of the gift being used to the gift giver, and even buying a similar item for the gift giver to show our appreciation."

Most commonly, Canadians hold on to unwanted gifts for up to five years before getting rid of them. However, Canadians are quick to admit that if the gift giver never found out, they'd ideally exchange the item, re-gift or re-sell it, or give it to charity. Only eight per cent of Canadians would still store the item but never use it.

"It's a fact that the overwhelming majority of Canadians have never been caught giving away an unwanted holiday gift," added Smith. "At the end of the day, not using the unwanted gift is simply worse than giving it away or selling it."

With more than 60 per cent of Canadians indicating that they could use some extra cash after the holidays to pay off their debts, there's even less reason to hold on. Selling the unwanted gift also means the gift giver's money doesn't go to waste, according to nearly 6-in-10 Canadians.

The survey revealed some other interesting information about holiday gifting:

...The most common characteristics of a bad holiday gift are based on the recipient's personal taste. Some of the most common items include clothing, like a sweater in the wrong size, and home accessories, including a toaster and a vase, that can easily be sold for cash.

...Nearly two-in-10 Canadians have considered giving an unwanted gift back to the gift giver.

...The majority of Canadians (56 per cent) say that unwanted holiday gifts become a burden after the holidays are over.

...When it comes to immediate family, in-laws tend to be the worst gift givers.

When it comes time to let go of unwanted holiday gifts, Canadians should visit www.kijiji.ca to get started.

Methodology

These are some of the findings of an Ipsos Reid poll conducted between December 20 and 21 on behalf of Kijiji. For this survey, a sample of 1,007 adults from Ipsos' Canadian online panel was interviewed online. Weighting was then employed to balance demographics and ensure that the sample's composition reflects that of the adult population according to Census data and to provide results intended to approximate the sample universe. A survey with an unweighted probability sample of this size and a 100% response rate would have an estimated margin of error of +/- 3.1 percentage points, 19 times out of 20, of what the results would have been had the entire population of adults in Canada been polled.

About Kijiji Canada

Kijiji, which means "village" in Swahili, is the number one classifieds site in Canada, connecting ten-million buyers and sellers each month. Kijiji.ca offers Canadians a free, easy, and local way to buy, sell, and trade goods and services in their community. With local sites for more than 100 cities and towns across the country, Kijiji makes it easy for Canadians to find exactly what they're looking for in their own community. Kijiji Canada is part of the eBay Classifieds Group, the global leader in online classifieds with a global presence in more than 20 countries and 1,000 cities.

Government of Canada Adds 41 Hazardous Substances to Emergency Regulations

OTTAWA, December 21, 2011 /Canada NewsWire/ - Canada's Environment Minister, the Honourable Peter Kent, today announced the addition of 41 unique substances to the Environmental Emergency Regulations. The substances include styrene, an explosive chemical used to make polystyrene plastic containers, and ammonium nitrate, a fertilizer.

"The Government of Canada continues to meet its commitment to protect Canadians and safeguard our environment," said Minister Kent. "These amendments to the Environmental Emergency Regulations will further protect Canadians where it matters most: at work, in their homes and in their communities."

Thirty-three substances in use in Canadian commerce, in several physical states, and some substances classed in their different forms are now added to the Environmental Emergency Regulations, for a total of 41 unique listed additions.

Facilities that handle these 41 listed substances at or above regulated quantities are required to develop environmental emergency (E2) plans, if they are not already in place.

E2 plans require that individuals and industrial facilities using or storing regulated hazardous substances listed in the regulations have plans for and can manage the consequences of an unintended release of the substance into the environment.

The amendments include an exemption that reduces administrative burdens for some facilities in the propane gas sector. Facilities with propane in storage containers are excluded from the E2 regulations if their storage containers of less than 10 tonnes are located at least 360 metres from their property boundaries.

Other uses of propane are already controlled under the existing Environmental Emergency Regulations.

The complete list of substance and details of the amendments to the Environmental Emergency Regulations can be found here.

Health & Safety Watch - Button batteries pose a serious hazard to children and the elderly

Severe injury can occur within 2 hours of ingestion

December 19, 2011 - Health & Safety Watch - Button batteries pose a serious hazard to children and the elderly - Should be treated as an emergency

Health Canada and other health authorities report that cases of people swallowing button batteries reported to manufacturers and health officials that result in serious internal injury and death are on the rise. These small disc-shaped button batteries store lots of energy in a tiny space. They are commonly found in a wide range of products around the home that children have access to, such as remote controls, musical greeting cards, watches, calculators, flashing jewellery and shoes, key fobs, books, and other small electronic devices.

The size, shape and energy storage properties of button batteries make them hazardous if swallowed. A swallowed button battery can block an airway or can cause serious internal chemical burns in the oesophagus in as little as two hours. The 20 to 25 mm diameter lithium button batteries result in the most serious injuries, especially where young children are involved. In cases of swallowing, the batteries were found loose on the floor by young children, in garbage bins, or on countertops, taken directly from a package, or removed from household products. Even adults, particularly seniors, have unintentionally confused button batteries with pills or food and been injured.

Children who swallow "button" batteries, commonly found in toys and consumer products around the home, can suffer internal injuries within two hours of ingesting one, according to a recent U.S. study.

A review of button battery safety by the Winnipeg Regional Health Authority summarizes the risks and provides parents and caregivers with advice on what to do if a child swallows a battery or places one in the ear or nose, and how to best protect children from small batteries. Highlights of the WRHA article and the original US study are provided here.

A U.S. study reported that in the past 18 years there have been over 8,500 cases reported to the American Battery Ingestion Hotline, with 73 cases of serious injuries from battery ingestion and 13 deaths. Sixty-two percent of these cases occurred in children who were younger than 6 years of age. Injuries (e.g., severe burns, esophageal stenosis, bilateral vocal cord paralysis) occurred as soon as 2 hours after ingestion. The study also found that at least 27% of serious outcomes and 54% of fatal cases were initially misdiagnosed, usually because of nonspecific presentation.

[Foreign body lodged in oesophagus] Injuries typically occur when a battery becomes stuck in a child's oesophagus. Once lodged, the battery can create an electrical current that burns the surrounding tissue. Children have also put small batteries in their noses and ears. This can also cause a burn and so they need to have the battery removed immediately. Button batteries that are not removed and remain in the oesophagus can cause burns and even perforation of tissues, causing life-threatening and sometimes fatal injuries. Depending on where the battery is lodged, it may be removed either using a scope or surgery.

"Our advice is to go immediately to go to Emergency and have an X-ray taken. If the battery is in the oesophagus, it needs to be removed as soon as possible," says Dr. Lynne Warda, a medical consultant with Impact, the Winnipeg Health Region's Injury Prevention Program.

Button batteries do not all pose equal risk. The smaller batteries may be ingested and passed without a person knowing it. It's the bigger ones that are more likely to become lodged and cause permanent tissue damage - or even death.

Parents are encouraged to look for toys that help protect children from batteries by having a compartment for the battery that may only be accessed with a tool or screwdriver. But button batteries are everywhere. A glance around your house will show the common ways they may be found, in household products like remote controls, garage door openers, cameras, calculators, key chains, jewellery with flashing lights and even greeting cards. And they're much easier to access in these types of products.

With the elderly, poor vision may contribute to mistaking the button batteries for other objects - a hearing aid, medication or food, for example. A surprising 15% of people who ingested a button battery mistook it for a pill, according to a US study. There are accidental reasons adults may ingest button batteries - using your mouth to hold a battery, putting the battery in a glass that you drink out of before properly disposing of it and drinking from the glass to name a few. Store button batteries away from food and medicine. Take care when changing the button batteries in a product that they do not get mixed in with any pills, medicine or food. Realize that to anyone with poor eyesight, button batteries look just like pills or candy.

...read more story at Health and Safety Watch

Vision loss the most feared complication of diabetes, patient poll reveals

About 70,000 Canadians affected by vision loss resulting from diabetic macular edema

DORVAL, Quebec, December 19, 2011 /Canada NewsWire Telbec/ - A new poll of persons with diabetes across Canada shows that vision loss is the most feared complication of the disease.

The poll found that almost half (46%) of persons with prediabetes or diabetes feared vision loss the most as a complication of their disease. This was more than twice as many (21%) who said they feared losing limbs and three times as high as the 15% who said they most feared cardiovascular complications.

Most Canadians, 84%, are aware that vision loss can be a complication of diabetes. The poll also found that 78% of Canadians consider themselves very or somewhat familiar with the disease and 70% say they either have or know someone with prediabetes or diabetes. Four in 10 Canadians (40%) say they are very or moderately concerned they will develop diabetes, but this ranges from three in 10 (30%) in British Columbia to nearly half (49%) in Quebec. Ontario is close to the national average at 39%.

Vision loss is an important complication of diabetes because of the impact of the disease on the small blood vessels at the back of the eye. Longtime, elevated blood sugar levels can result in fluid leaking from these vessels in the macula at the back of the eye which is responsible for central vision. The fluid causes swelling, referred to as diabetic macular edema (DME) which can result in steadily deteriorating vision over time. It is estimated that vision loss resulting from DME affects approximately 70,000 Canadians, making it one of the major causes of adult-onset vision loss.

"Ophthalmologists previously used laser to treat DME to reduce the vision loss," said Dr. David Wong, a retina specialist at St. Michael's Hospital in Toronto. "The newer treatment that's been approved by Health Canada is different from the older treatment in that it is a needle injected into the eye and it is effective in stabilizing and improving vision in diabetic macular edema."

A patient who has recently received the new treatment for vision loss from DME is Kashiram Joshi, who lives in the Toronto region. Diagnosed with diabetes in 1994, several years ago he started having troubles with blurry vision, which continued even after cataract surgery, until he received the new treatment.

"I noticed an improvement after the first injection, and it's kept on getting better," he said. "I had given up reading, except for short times with a magnifying glass. Now my eyesight is almost 20/20 and I read and do everything else without a problem. The difference is like night and day."

The key to preventing such vision loss in diabetes is getting an early diagnosis of the disease and ensuring treatment brings blood sugar levels under control, added Dr. Wong.

"Patients with diabetes or at risk of getting diabetes should control their blood sugar, blood pressure and cholesterol and live an active normal healthy lifestyle to reduce the risk of diabetic complications."

About diabetic macular edema

Diabetes prevalence in Canada is growing at epidemic levels. Currently, one in four Canadians have diabetes or prediabetes and if trends continue this will rise to one in three by 2020.

DME is a common complication of diabetic retinopathy, which is caused by damage to the blood vessels of the retina and is the leading cause of vision loss in working-aged adults in the developed world. In people with diabetes, elevated blood sugar levels can lead to problems with the blood circulatory system. These problems can result in symptoms in various areas of the body, such as extremities, but also including the small blood vessels in the retina of the eye. These vessels then leak, which causes swelling (edema) of the macula, the centre of the retina responsible for sharp and straight ahead vision. Therefore, DME can lead to significant visual impairment.

The first symptoms of DME are most often "floaters" or spots in the line of vision, then blurry vision. DME usually progresses slowly with worsening symptoms and is a lifelong condition. DME with visual impairment affects 2.6% of diabetics in Canada.

The Vision Critical / Angus Reid Forum poll

From Nov. 15 to 16, 2011, an online survey was conducted among 2,215 randomly selected Canadian adults, including 168 individuals with diabetes or prediabetes, who are Angus Reid Forum panelists. The margin of error for the whole sample, which measures sampling variability, is +/- 2.08% 19 times out of 20. The results were statistically weighted according to the most current education, age, gender and region census data to ensure a sample representative of the entire adult population of Canada.

Novartis Pharmaceuticals Canada Inc.

Novartis Pharmaceuticals Canada Inc., a leader in the healthcare field, is committed to the discovery, development and marketing of innovative products to improve the well-being of all Canadians. In 2010, the company invested close to $100 million in research and development in Canada. Novartis Pharmaceuticals Canada Inc. employs more than 600 people in Canada. It was named for the seventh time as one of the "50 Best Employers in Canada" for 2011. For further information, please consult www.novartis.ca.

Disclaimer
The foregoing release contains forward-looking statements that can be identified by terminology such as "can," "commitment," "potentially," "ongoing," "will," or similar expressions, or by express or implied discussions regarding potential approvals to sell Lucentis* in additional markets or regarding potential future revenues from Lucentis* You should not place undue reliance on these statements. Such forward-looking statements reflect the current views of management regarding future events, and involve known and unknown risks, uncertainties and other factors that may cause actual results with Lucentis* to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Lucentis* will be approved for sale in any additional markets. Nor can there be any guarantee that Lucentis* will achieve any particular levels of revenue in the future. In particular, management's expectations regarding Lucentis* could be affected by, among other things, unexpected regulatory actions or delays or government regulation generally; unexpected clinical trial results, including unexpected new clinical data and unexpected additional analysis of existing clinical data; competition in general; government, industry and general public pricing pressures; the company's ability to obtain or maintain patent or other proprietary intellectual property protection; the impact that the foregoing factors could have on the values attributed to the Novartis Group's assets and liabilities as recorded in the Group's consolidated balance sheet, and other risks and factors referred to in Novartis AG's current Form 20-F on file with the US Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those anticipated, believed, estimated or expected. Novartis is providing the information in this press release as of this date and does not undertake any obligation to update any forward-looking statements contained in this press release as a result of new information, future events or otherwise.

Are you protected?

New survey shows that adult Canadians are unaware of how vaccines can help protect against serious diseases

TORONTO, December 12, 2011 /Canada NewsWire/ - A new survey conducted by Angus Reid Public Opinion, a division of Vision Critical, reveals that adult vaccinations are not on the radar of most Canadians and that many Canadians are unaware that some serious diseases can be prevented through routine adult vaccinations. Despite the benefits of vaccines for the good of society, only about half of those surveyed (55%) feel that it is critical to keep up-to-date with their vaccinations and even less (46%) feel vaccines are as important as diet and exercise in maintaining their overall health.1

"Parents are advised of the benefits of vaccinations for their children, but adults don't generally think about vaccines for themselves," says Dr. Vivien Brown, family physician from the University of Toronto. "Adults, especially individuals over 65, or those who have underlying medical conditions, should consider vaccinations as an important component of their overall health management, alongside diet and exercise."

According to the Canada-wide survey, very few (16%) of Canadians aged 45 to 74 feel that they know a lot about adult vaccination and only two-in-five (41%) report ever speaking with a doctor about them. Even more astonishing is that when asked about pneumococcal disease, almost half of Canadians surveyed don't know what adult vaccines they need to protect themselves against this disease, despite how serious it is.2

"I am 65 and I have had pneumococcal pneumonia several times," says Deborah Douglas, patient from Toronto, Ontario. "Two winters ago I was deathly ill and was hospitalized for weeks with pneumonia. This was the first time I had heard of this disease - I had no idea I was at risk because of age and my diagnosed weak immune system. I was not aware there were adult vaccines options to help protect me."

The most common form of pneumococcal disease in adults is pneumonia. In Canada, pneumonia and influenza were the eighth leading cause of death in 2006, according to Statistics Canada. Not surprising, only 55 per cent of Canadians surveyed knew that pneumococcal disease is a serious illness that can cause hospitalization and death, 67 per cent5 reported that they had not been or were unsure if they had been vaccinated against pneumococcal disease, and 29 per cent reported that they had never heard of the disease. Lack of familiarity with the vaccine (49%) is the most commonly reported reason for not getting vaccinated among those who have not been vaccinated against pneumococcal disease.6 The seasonal flu and H1N1 vaccines do not protect Canadians against pneumococcal disease. Confusion is common since it is not always clear what these vaccines protect you against.

Being able to diagnose and treat pneumococcal disease quickly will help reduce the severity, duration and potential long-term complications. The signs and symptoms of pneumococcal disease vary depending on severity and can include; fever, shaking, chills, headache, productive cough, muscle pain and weakness.7

"Although pneumococcal disease can affect people at any age, older adults and children have a higher risk of contracting the disease than others," says Dr. Brown. "If you are 65 years of age or older, or have underlying medical conditions, such as a suppressed immune system due to treatment or illness, chronic heart, liver or kidney disease, or diabetes, speak to your doctor about pneumococcal disease vaccination and other adult vaccines that are right for you."

While vaccines are an important element that works with your immune system to help ensure serious diseases are prevented; many people are not aware that childhood immunization does not provide lifelong immunity against some diseases, such as pneumococcal disease (pneumonia, meningitis, sepsis, bacteraemia).

Vaccination can help prevent pneumococcal disease; however, it is also important to live a healthy lifestyle, especially as you get older. Below are some tips that can help you live life to its fullest:

...Eat well.
...Be active and include others in your activities.
...Get enough sleep.
...Don't forget to take your medication(s) regularly.
...Talk to your doctor on a regular basis and don't skip your check-ups.
...Talk to your loved ones or caregiver about how you're feeling. It's important to let others know if you aren't feeling well. They can help determine if you need to seek medical advice.

Alzheimer Society Of Ontario Welcomes Proposed Caregiver Leave Legislation

Number of family caregivers to increase with dementia prevalence

TORONTO, December 8, 2011 /Canada NewsWire/ - The Alzheimer Society of Ontario applauds the Ontario Government's introduction of legislation to create a Family Caregiver Leave as announced today by Minister of Labour Linda Jeffrey and Minister of Health and Long-term Care Deb Matthews.

"Today's legislation, if passed, would be a welcome solution for many caregivers and families living with Alzheimer's disease and other dementias," says David Harvey, Chief Public Policy and Program Initiatives Officer at the Alzheimer Society of Ontario.

Ontarians with dementia will require more and complex care as the number of cases increase by 40 per cent in the next 10 years. The responsibility of care falls largely on the shoulders of family members who will provide 144 million hours of unpaid care per year by 2020. Many caregivers are forced to give up their jobs to care for someone full time at home or develop health issues as a result of the pressures of caregiving.

"The Alzheimer Society has been working diligently with all political parties on behalf of caregiver rights," adds Harvey. "Today's announcement is a positive step towards strengthening caregiver support but other measures such as flexible respite and non-refundable tax credits would further ease the burden."

In a 2009 caregiver poll conducted by the Alzheimer Society, 62 per cent of respondents said direct payments and tax credits would best help reduce some of the financial burden and other challenges they face in their role.

Alzheimer's disease is the most common form of dementia. It is fatal brain disorder that impairs memory, language and day-to-day function. As the disease progresses, the person diagnosed will require 24-hour care.

While dementia is not a natural part of aging, age remains the biggest risk factor. After 65, the risk doubles every five years. According to Statistics Canada, 9.6 million Canadians will be at least 65 by 2029.

The Alzheimer Society of Ontario is the province's leading care and research charity committed to helping people with Alzheimer's disease and other dementias. With a network of 38 local Societies, it offers Help for Today through programs and services and Hope for Tomorrow…® by funding research to find the cause and the cure.

First Ever Blood Glucose Meter to Help Patients Identify Blood Glucose Patterns On-Screen

Now Available in Canada:

BURNABY, British Columbia, December 6, 2011 /Canada NewsWire/ - Research indicates that the majority of patients on insulin self-report not achieving glycemic control. While regular self-monitoring of blood glucose (SMBG) is an integral part of diabetes management, obtaining a single reading helps people using insulin make adjustments in the moment and does not help them identify trouble spots over time. Pattern management is a key practice that helps people living with diabetes - especially those taking insulin - identify these trouble spots, interpret, and act on high and low blood glucose patterns to make more informed adjustments and achieve better control. Canadians living with diabetes can now feel empowered to easily spot high and low blood glucose patterns with the new OneTouch® Verio™IQ System, now available in Canada. This features the first meter ever with PatternAlert™ Technology that looks for patterns of highs and lows and provides alerts right on screen, when it finds them.

The OneTouch® Verio™IQ System includes the Test Smart® Pattern Guide, a quick reference tool to help people living with diabetes interpret and resolve high and low patterns.

"Patterns in blood glucose control can be identified when three or more tests are done at the same time of day over several days. It is particularly important to address blood glucose patterns that are above or below target as these patterns identify areas of concern that need to be addressed," says Lori Berard, RN, CDE, Winnipeg Regional Health Authority, Health Science Centre Winnipeg, Diabetes Research Group. "The new OneTouch® Verio™IQ System now affords people living with diabetes - especially those taking insulin - the ability to easily identify their blood glucose patterns and will also provide guidance on what actions can be taken to enhance their glucose control."

The new OneTouch® Verio™IQ System works exclusively with OneTouch® Verio Gold Test Strips with SmartScan™ Technology. The meter also features a colour LCD screen with large, easy to read numbers and strip port light and automatic backlight for testing in the dark.

People living with diabetes can find out more about the new OneTouch® Verio™IQ System by talking to their pharmacist or healthcare professional and by visiting www.OneTouch.ca.

About LifeScan Canada Ltd.

LifeScan, the manufacturer of OneTouch® blood glucose monitoring products, is dedicated to creating a world without limits for people with diabetes. For information about diabetes care and OneTouch® products and services, visit www.OneTouch.ca.

Canadians want strategic approach based on common principles to improve health care

OTTAWA, December 1, 2011 /Canada NewsWire/ - The results of a new public opinion poll conducted for the Canadian Medical Association (CMA) show overwhelming support (85%) for inclusion of the principles developed by the Canadians Nurses Association (CNA) and the CMA in discussions around a new agreement between federal and provincial/territorial governments on health care.

The CMA and the CNA together have defined a set of principles to guide health care transformation in Canada (www.cma.ca/advocacy/hctprinciples). To date, over 60 organizations have endorsed the principles, the goal of which is to guide the discussions that will lead up to a new health care accord between federal, provincial and territorial governments. The principles outline direction for the creation of a high quality, patient-centred health care system that is universal, equitable and sustainable.

"Governments have begun negotiations in advance of the looming end of the 2004 health accord and Canadians clearly support using the CMA/CNA principles to guide those discussions," said Dr. John Haggie, CMA President.

Further poll results show that over three-quarters (76%) of Canadians identify improving health care as the number one priority for the federal government, ahead of issues such as reducing the national debt and deficit (62%) and reducing taxes (45%). Among other findings, a strong majority (77%) of Canadians supported the creation of a national aging strategy to address the needs of our aging population through increased support for home care and long-term care services.

"We know that 80% of the disease burden in Canada right now is chronic disease management and right now our acute services-focused health care system can't adequately meet those needs because it was not designed to do provide that sort of care," said Dr. Haggie. "Transforming health care is about doing things better - better for patients; better for quality; better for the sustainability of our system."

The Ekos Research Associates survey findings are the result of a nationally representative telephone survey of 1,001 Canadians 18 years of age and older. The margin of error for a sample of this size is +/- 3.1 percentage points, 19 times out of 20.

The Canadian Medical Association (CMA) is the national voice of Canadian physicians. Founded in 1867, CMA's mission is to serve and unite the physicians of Canada and be the national advocate, in partnership with the people of Canada, for the highest standards of health and health care. The CMA is a voluntary professional organization representing over 76,000 of Canada's physicians and comprising 12 provincial and territorial medical associations and 51 national medical organizations.

The baby boom effect: caring for Canada's aging population

New report examines how seniors use the health system and where improvements can be made

OTTAWA, December 1, 2011 /Canada NewsWire/ - As the baby boom generation begins to turn 65 this year, the aging of Canada's population will accelerate. As a result, the health care system will need to adapt to meet the future needs of a growing senior population, according to a new report released today by the Canadian Institute for Health Information (CIHI). Health Care in Canada, 2011: A Focus on Seniors and Aging shows that, while Canada's seniors (age 65 and older) are living longer and are healthier than ever, they are frequent users of the health system, costing more than any other segment of the population. Representing just 14% of the population, seniors use 40% of hospital services in Canada and account for about 45% of all provincial and territorial government health spending.

"Although the impact of population aging on health costs has remained relatively stable over time, health care planners and providers are rightfully looking at ways to meet the needs of a growing senior population," says John Wright, CIHI's President and CEO. "The number of Canadians age 65 and older is expected to nearly double to 25% of the population by 2036. Understanding where gaps exist and where efforts can be concentrated will help ensure that the system remains strong and efficient for Canadians of all ages."

CIHI's report identifies opportunities for the health system to meet these changing needs, including improved integration across the health care continuum, an increased focus on prevention and more efficient adoption and use of new technologies.

Improved integration across the health care continuum

Canada's seniors often require care from different providers across various settings, including a family doctor's office, a specialty clinic, a home care service, a pharmacy, a hospital and/or a long-term care facility. However, the study identifies gaps in the continuity of seniors' care.

As with Canadians of all ages, seniors who become acutely ill may require care in hospital, where they could encounter issues related to patient flow and appropriateness of care. Seniors who arrive at the hospital may first make contact with the emergency department, where they are likely to stay longer than non-senior adults do. CIHI's report shows that seniors spend more time in emergency departments than their younger counterparts before being admitted to hospital (3.7 hours compared with 2.7 hours in 2009-2010).

Also related to patient flow for hospitalized patients is alternate level of care (ALC) stays. Patients are considered ALC patients when they have completed the acute care phase of their treatment but remain in an acute care bed. Seniors account for 85% of all ALC patients—approximately 85,000 cases a year. CIHI data shows that nearly half of all senior ALC patients (47%) were waiting to be moved to a long-term care facility.

"Our health system can no longer afford to operate in silos. Ensuring continuity of care across the continuum will not only lead to a more efficient use of resources, it can potentially lead to better care and in turn better quality of life," explains health policy researcher Marcus Hollander. "This is particularly important in the senior population, because they receive care from many different care providers in various settings."

The study also highlights the fact that improved integration can help promote safe and appropriate drug use in seniors. Many Canadian seniors take several prescription drugs, and the number of seniors taking multiple drugs is on the rise. In 2009, almost two out of three (63%) Canadians age 65 and older took 5 or more prescription drugs from different drug classes, with close to one-quarter (23%) taking 10 or more—up from 59% and 20%, respectively, in 2002.

It is not only the number of different medications, but also the specific medications seniors are taking that present challenges. CIHI data shows that, in 2009, 1 out of 10 Canadian seniors was taking a drug from the Beers list, an internationally recognized list of prescription drugs identified as potentially inappropriate for use by seniors. The use of these drugs has declined over the past decade. Seniors also take more over-the-counter medications and vitamins or other supplements than any other age group, possibly adding to the risks associated with multiple medications.

"As medications may be prescribed by different health care providers, without an accurate account of current treatments, seniors can be at increased risk of potential interactions or adverse events," explains Dr. Pamela Jarrett, a geriatrician in New Brunswick. "While all health care providers do their best to ensure seniors are not taking medications that may negatively interact with each other, regular medication reviews with their family doctors or pharmacists can help reduce the risk of medication interactions."

John Wright explains:

"Team-based approaches to delivering primary care may help ensure seniors are receiving appropriate care. Physicians and pharmacists working together in the same practice can lead to increased communication on prescribing and lower the risk of a senior experiencing adverse drug interactions or side effects."

An increased focus on prevention

Multiple chronic conditions—more than age—are associated with high use of the health care system. As the risk of developing chronic conditions increases with age (76% of seniors reported at least 1 of 11 major chronic conditions in 2008), prevention plays a key role in healthy aging, both to manage existing chronic conditions and to delay or prevent the onset of new ones.

Research shows that good primary health care in the community can help patients with chronic conditions—such as asthma, congestive heart failure or diabetes—avoid costly hospital admissions. The report estimates that 1 out of every 11 emergency department visits by seniors is for a chronic condition that can potentially be managed in the community. Of these seniors, nearly half (47%) are hospitalized.

Many health professionals may have a role in supporting and promoting prevention strategies. Family physicians often act as an initial contact, and although 95% of Canadian seniors have access to a family physician, some reported challenges accessing primary care. In 2009, less than half could get same- or next-day appointments, and more than one-third (34%) reported waiting six or more days for an appointment. This could result in potentially avoidable visits to emergency departments or walk-in clinics for care.

Seniors also visit other primary health care providers—such as psychiatrists, social workers and dentists—less often than younger adults, potentially reducing the amount of preventive care received. In 2008-2009, nearly half (44%) of Canada's seniors had not had a dental check-up in the previous year. Studies have shown that poor oral care can contribute to poor health in older age, affecting nutrition, body weight and the progression of many diseases.

Preventing falls is another important strategy to keep seniors healthy. Falls are the leading cause of injury hospitalization among seniors, accounting for 9% of all emergency department visits and almost 80,000 hospital admissions in 2009-2010. The study highlights an opportunity to prevent falls in several settings across the continuum of care. About 1 out of 14 (7%) seniors hospitalized in complex continuing care beds fell within a month of assessment, compared with about 1 out of 8 (12%) in residential care facilities. More than one-quarter (28%) of seniors receiving home care services experience a fall within 90 days of assessment.

Efficient use of new health technologies

The use of new health innovations and technologies can help ensure that seniors are receiving appropriate care. For example, widespread adoption of electronic health records could facilitate physician decision-making by ensuring access to complete information on patients' medical conditions and medications.

The vast majority (93%) of Canadian seniors live at home—and technological advances can allow them to stay at home for longer. For example, for seniors receiving home care services, a medication monitoring system equipped with a sensor-trigger system allows family members to monitor which medications were taken when from anywhere in the world.

"We know that the growing proportion of seniors in Canada's population is going to impact the health care system," says Jean-Marie Berthelot, CIHI's Vice President of Programs. "Collecting more comparable data, on a variety of settings across the care continuum, can help policy-makers identify and understand key issues across sectors of care and ultimately better plan and prepare for the future."

The report is available on their website at www.cihi.ca.