A Growing Health System Challenge
The burden of frailty in Canada is steadily growing. Today, approximately 25% of people over age 65 and 50% past age 85 – over one million Canadians – are medically frail. And in 10 years, well over two million Canadians may be living with frailty. Frail elderly Canadians are over-represented in all parts of the healthcare system: primary care, community and residential care, acute care and end-of-life care.
Frailty is also linked to higher consumption of healthcare resources. Of the $220 billion spent on healthcare annually in Canada (11% of GDP), 45% is spent on people over 65 years old, although they are only 15% of the population. Canadian seniors account for 40% of acute care services and occupy 85% of acute care beds.
This growing population is both under-recognized and under-served, challenging the healthcare system to improve the quality and quantity of care delivered.
Currently, we have little evidence to guide the care of our frail elderly. We don’t know if current therapies are beneﬁcial or cause harm, are cost-eﬀective or waste scarce healthcare resources.
As well, the healthcare system is ill equipped to deal with frailty:
- Healthcare systems are organized to manage illness based on single body systems and diseases, not the complex multi-system problems of frail people.
- Frailty is poorly understood, pervasively under-recognized, and under-appreciated by healthcare professionals and the public.
- Few healthcare professionals have expertise in caring for the frail elderly.
- Poor system integration causes poor outcomes for frail people.
“Without evidence, aggressive and expensive technologies are often overused without improvement in outcomes, causing undue suffering to patients, undue distress to their families, caregivers and health care practitioners, and wasted health care resources.”
-- CFN Scientific Director Dr. John Muscedere