Community Needs Assessment Report -...
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Prepared by Danikloo Consulting – October 2016 1 Community Needs Assessment Report
Transcript of Community Needs Assessment Report -...
Prepared by Danikloo Consulting – October 2016
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Community Needs
Assessment Report
Prepared by Danikloo Consulting – October 2016
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Table of Contents
1. Introduction …………………………………………………………………………………………………………………...…………………………….. 3
2. Background……………………………………………………………………………………………...……………………………………………………3
2.1 The Lending Cupboard ……………………………………………………………………………………..………………….………………………. 3
2.2 Central Alberta………………………………………………………………………………………………...…………………………………………. 4
2.3 Purpose of the Project ………………………………………………………………………………………..…………..……………………………. 5
2.4 Questions to be answered ………………………………………………………………………………………………..……..…………………….. 5
2.5 Methodology …………………………………………………………………………………………..………….……………………………………... 6
3. Key Findings …………………………………………………………………………………………………..…………………………………………………… 7
3.1 Central Alberta Demographics ……………………………………………………………………………………………..….…………………….… 7
3.1.1 Current Population & Age Demographics ……………………………………………………………………………………..…………..... 7
3.1.2 Projected Population Growth ………………………………………………………………………………………………….……………...13
3.1.3 Socio-Economic Conditions in Central Alberta ….………………………………………………………………………………………....14
3.1.4 Minority Groups ……………………………………………………………………………………………………………………………..... 20
3.1.5 Geographical Makeup of Central Alberta ………………………………………………………………………………………………...... 24
3.2 Central Alberta Economy ……………………………………………………………………………………………………………………………... 27
3.2.1 Current Economic Conditions ……………………………………………………………………………………...…………………………. 27
3.2.2 Multi-Generational Work Force………………………………………………………….………………………………………………………31
3.2.3 Government Funding Opportunities……………………………………………………………………………………………………………31
3.3 Central Alberta Health…………………………………………………………………………………………………………………………………..35
3.3.1 Orthopedic Disorders…………………………………………………………………………………………………………………………….36
3.3.2 Other Diseases, Disorders & Health Conditions……………………………………………………………………………...………………40
3.3.3 Injuries & Accidents……………………………………………………………………………………………………………………...……....44
3.4 Alberta Health Services (AHS) Policies and Practices………………………………………………………………………………………………46
3.4.1 Post-Surgery Release Times……………………………………………………………………………………………………………………47
3.4.2 Home Care……………………………………………………………………………………………………………………..…………………48
3.4.3 Physiotherapy/Occupational Therapy…………………………………………………………………………………….……………………49
3.4.4 Self-Referrals and Other Referrals…………………………………………………………………………………….……………………….49
3.4.5 Long-Term Care…………………………………………………………………………………………………………….……………………49
4. Priorities for the Next Decade………………………………………………………………………………………………………...…………………………….52
4.1 Regional Capacity……………………………………………………………………………………………………………………………………….53
5. Conclusion……………………………………………………………………………………………………………………………………………………………..53
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1. Introduction
Welcome to The Lending Cupboard Society’s Community Needs Assessment.
The information in this document will provide you with a “snap shot” of elements of
Central Alberta life, as well as a glimpse into what the next few years may hold for our
region, as related to the potential impact for the services provided by The Lending
Cupboard. However, there is information in this document that will be of interest and
relevance to municipal governments, not-for-profit (social profit) organizations, community
groups and businesses.
The conclusions and key findings are the result of interpretation of the information and
data gathered, and may be subjective in some instances. Readers are also welcome to
draw inferences and conclusions from this report, and to reference this material for use in
any organizational planning efforts as appropriate. Additionally, there may be initiatives
and community or government responses in development or in existence of which we
were unaware during this project. We welcome any additional information the reader has
to offer.
2. Background
2.1 The Lending Cupboard
In 2006, Jacqui Joys founded The Lending Cupboard Society of Alberta, a few years
after personally experiencing barriers to accessing affordable medical equipment
during her husband’s cancer. Her vision, which is now a ten-year reality, was to offer
medical equipment to everyone who needs it, at no cost, for as long as it’s needed.
In its first year of operation, the Cupboard lent out 330 pieces of equipment and had
a total client interaction of 456. In its 2015-16 fiscal year, 16,000 pieces of equipment
were lent out to 4,300 clients, with a total of 8,800 clients in and out of the Lending
Cupboard doors – a staggering 800% increase. This exponential growth, all while
operating out of the same facility, reveals the importance of the Cupboard to Central
Albertans, but represents a number of pressures for Cupboard operations.
While many of the Cupboard’s clients are referred by Red Deer’s Hip and Knee
Clinic, Red Deer Home Care or the orthopedic unit of the Red Deer Regional
Hospital, a great number of Cupboard clients are referred from clinics, home care
and hospitals as well as being self-referred, for any number of reasons, from all
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around the region. The Cupboard has seen clients come from as far away as
Lethbridge.
TJA = Total Joint Arthroplasty
The Lending Cupboard operates with 4 part-time staff and a full time Executive
Director, and relies on a strong team of 80 volunteers, in addition to the volunteer
Board of Directors, and members of various committees. The Cupboard is currently
open Mondays, Wednesdays and Fridays from 10:00AM until 3:00PM. The staff and
volunteers assist clients to find and be fitted with the equipment they require; the
volunteers also operate a sanitation room as well as conducting regular maintenance
and repairs.
2.2 Central Alberta
The geographical parameters of Central Alberta region are differently defined by
many agencies and authorities. For the purposes of the Community Needs
Assessment (CNA), the steering committee chose the following:
● Red Deer as the central hub ● North to Wetaskiwin ● East to Stettler (with that health centre serving communities east to
Coronation) ● South to Drumheller/Carstairs ● West to Rocky Mountain House
These boundaries result in the inclusion in the Lending Cupboard’s catchment area
of about 65 communities of various sizes.
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Central Alberta is the most densely populated rural region in Alberta, with a
population of 313,0001. The Queen Elizabeth II Highway, Western Canada’s busiest
and most economically vibrant corridor, is a major trade route, as part of the
CANAMEX corridor, which stretches from the coast of Alaska to the Gulf of Mexico.
The major industrial drivers in Central Alberta are energy (specifically oil and gas)
and agriculture2. While there is a sizable seniors’ population, the largest population
group is aged 50-64. A more in depth description of the region, as it relates to the
purpose of this project, is detailed in Section 3.
2.3 Purpose of the Project
When the Board of Directors and staff team met in the fall of 2015 to undertake their
strategic planning for the next 3 years, the pressures of growth facing the
organization were top of mind. Although the organization maintains a full show floor,
has been making use of a sea-can in the parking lot, and also has an overflow
warehouse, roughly 80% of its equipment is out on loan at any given time. The
organization is well aware that a decision about its space is needed; but how to
grow? Where to grow? Move or stay? In order to make responsible, informed
decisions about its facility needs, the organization decided it needed to learn from
the community about current and future demand for its services.
The information gathered and the conclusions drawn from The Lending Cupboard’s
Community Needs Assessment will inform its:
● Decisions about facility & space needs (location, size, specific requirements) ● Staffing plans ● Budget ● Hours of operation ● Fund Development Strategy ● Volunteer Recruitment and Retention Strategy
2.4 Questions to be answered
The Community Needs Assessment (CNA) sought, through research, interviews and community conversations, to answer the following questions:
● What is Central Alberta’s current demographic makeup, and where are the demographics headed?
1 Town of Sylvan Lake, Economic Profile 2015.
2 https://en.wikipedia.org/wiki/Central_Alberta
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● What present or emerging lifestyle trends in Central Alberta may impact demand for The Lending Cupboard?
● What is the current state of the Central Alberta economy, in the aspects that may impact Lending Cupboard use, and what are the economic projections for our region?
● What is the present and ten-year projected socio-economic makeup of Central Alberta?
● What diseases, conditions, and other health issues that require medical equipment are prevalent in Central Alberta? Are these growing or declining problems?
● What Alberta Health Services policies and practices may impact demand for The Lending Cupboard?
● What other government (municipal, provincial, federal) current or anticipated policies may impact demand for The Lending Cupboard?
● How can urban/rural communities across the region ensure that their residents have access to affordable medical equipment?
“Thank you so much for your assistance in helping my mother with a walker, necessary for mobility at this time. Very friendly, professional staff, and extremely
helpful!”
2.5 Methodology
The Community Needs Assessment relied upon interpretive methods of research
and data collection, focusing on examining the feedback and information gathered
through a comprehensive, holistic lens. Because of the number of variables and
broad applications intended for this report, qualitative and quantitative data were
given equal weight, and anecdotal information was considered as meaningful as
measurable data.
The project began in early May of 2016, and concluded on October 6th, when The
Lending Cupboard Board of Directors approved the CNA at their October 6th
meeting. The steps involved in the project were as follows:
1) Understand, from the organization, the objectives and intended outcomes for the project;
2) Develop “current state” benchmarks (done during the strategic planning process) for The Lending Cupboard;
3) Strike a steering committee for the project; 4) Develop the Scope of Work (SOW) and Work Plan; establish questions for
research;
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5) Identify subjects for interview, focus groups and community conversations; 6) Conduct interviews; host focus groups and community conversations;3 7) Conduct research; 8) Analyze data, identify key findings, which include “current state” benchmarks
as well as projections, where possible, for up to the next 10 years; 9) Write report; revise according to Steering Committee and Board feedback;
finalize.
3. Key Findings
The conclusions and key findings are the result of interpretation of the information and
data gathered, and may be subjective in some cases. Readers are also welcome to draw
additional, or different, inferences and conclusions from this report, and to reference this
material for use in any organizational planning efforts as appropriate.
3.1 Central Alberta Demographics
3.1.1 Current Population and Age Demographics4
According to the 2012 report Highlights of the Alberta Economy, Alberta has the
youngest population of all the Canadian provinces, with a median age of 36.5,
substantially lower than the Canadian median age of 40.6.5 There are roughly
770,000 children aged 1-14, 487,000 seniors, and 3 million people in the
working age range of 15-64 living in our province6. While it’s more difficult to find
statistics by age category for the region, there is individual municipal data
available.
From an Alberta standpoint, it is clear that, while both ends of the age spectrum
are growing, the baby boom of 1946-1964 is still the largest population group.
3 Author’s note: Although organizations and community stakeholders from every community in the catchment area were contacted to
participate in the community consultation portion of the project, not all responded. As such, there may be, in this report, more information about some communities or organizations, and very little about others. 4 Author’s note: The results of the 2016 Canada census will not be available until February of 2017; most of the statistics in this
section are based on 2011 data, except where individual municipal censuses collected applicable information. 5 Alberta Enterprise and Advanced Education, 2012. Highlights of the Alberta Economy. Edmonton, Alberta.
6 Statistics Canada, 2015. Population by sex and age group, by province and territory. Government of Canada.
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Imagine the shifting of the numbers in the above graph, moving the numbers
from 2009 figures to today, in 2016. The large group at the age 50 mark would
today be 57. Here is the projection of ages from 2015-2041:
According to the Government of Alberta, over the next 25 years, the population
in this province will:
● Reach 6 million, an increase of roughly 1.8 million people from 2015.
● Be older, with a median age of 40.3 years, up from 36.2 years today.
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● Be increasingly diverse, as arrivals from other countries account for
about 46% of the expected growth.
● Be even more concentrated in urban centres, especially along the
Edmonton-Calgary corridor; by 2041 almost 8 in 10 Albertans are
expected to live in this region.7
Other government projections suggest that Alberta will remain one of the
youngest provinces in the coming years. It is estimated that between 2011 and
2021, the number of seniors will increase from 413,100 (already increased from
this 2011 number, to 487,000) to 642,100. In that time, the percentage of
seniors will increase from approximately 11% to 15% of the total population. By
2036, it is projected that there will be more than one million seniors in Alberta, or
about one in five Albertans. The aging of the population began to accelerated
starting in 2011 as baby boomers began to turn 65. The accelerated growth of
this age group is expected through to 2031, when all baby boomers will be over
age 65. The aging population, in general, will continue to characterize
demographic trends in the following decades.8
Following is the population data for communities of 5,000+ population within the
catchment area of this project:
Blackfalds
Population: 9,510
Ages:
● The average age of a resident in the community is 29, significantly younger
than the provincial median average of 36.
● Over 75% of those living in Blackfalds are 40 years of age or younger, with
32% being under the age of 18.
● 18% of the population is between that ages of 46 and 71+.9
7 Government of Alberta, June 2016, Population Projection, Alberta Treasury Board and Finance
8 Alberta Seniors Ministry, A Profile of Seniors, September 2010
9 Town of Blackfalds, 2016 Census, 2016
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Didsbury
Population: 4,957
Ages:
● Youth (0 to 17 years old) account for 29.91% of the population.
● Young Adults (18 to 44 years old) account for 31.62% of the population.
● Middle Age (45 to 65 years old) account for 28.1% of the population.
● Old Age (65+ years old) account for 17.12% of the population of Didsbury.10
Drumheller
Population: 8,029
Ages:
● Youth (0 to 17 years old) account for 24.8% of the population
● Young Adults (18 to 44 years old) account for 37.38% of the population.
● Middle Age (45 to 65 years old) account for 28.22% of the population.
● Old Age (65+ years old) account for 16.26% of the population.11
Innisfail
Population: 7,953
Ages:
● Youth (0 to 17 years old) account for 28.68% of the population.
● Young Adults (18 to 44 years old) account for 31.85% of the population.
● Middle Age (45 to 65 years old) account for 27.35% of the population.
● Old Age (65+ years old) account for 18.21% of the population of Innisfail.12
10
Area Score, Didsbury Age Distribution Statistics, 2016 11
Area Score, Drumheller Age Distribution Statistics, 2016 12
Area Score, Innisfail Age Distribution Statistics, 2016
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Lacombe
Population: 11,707
Ages:
● Youth (0 to 17 years old) account for 32.34% of the population.
● Young Adults (18 to 44 years old) account for 35.5%.
● Middle Age (45 to 65 years old) account for 25.45% of the population.
● Old Age (65+ years old) account for 14.29% of the population of Lacombe.13
Olds
Population: 8,235
Ages:
● Youth (0 to 17 years old) account for 28.01% of the population.
● Young Adults (18 to 44 years old) account for 34.39% of the population.
● Middle Age (45 to 65 years old) account for 25.94% of the population.
● Old Age (65+ years old) account for 19.14% of the population of Olds.14
Ponoka
Population: 6,773
Ages:
● Youth (0 to 17 years old) account for 29.15% of the population.
● Young Adults (18 to 44 years old) account for 31.59% of the population.
● Middle Age (45 to 65 years old) account for 26.05% of the population.
● Old Age (65+ years old) account for 19.26% of the population of Ponoka.15
13
Area Score, Lacombe Age Distribution Statistics, 2016 14
Area Score, Olds Age Distribution Statistics, 2016 15
Area Score, Ponoka Age Distribution Statistics, 2016
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Red Deer
Population: 100,807
Ages:
● Youth (0 to 17 years old) account for 28.48% of the population.
● Young Adults (18 to 44 years old) account for 41.66% of the population.
● Middle Age (45 to 65 years old) account for 25.8% of the population.
● Old Age (65+ years old) account for 10.56% of the population of Red Deer.16
Rocky Mountain House
Population: 6,933
Ages:
● Youth (0 to 17 years old) account for 31.35% of the population.
● Young Adults (18 to 44 years old) account for 38.17% of the population.
● Middle Age (45 to 65 years old) account for 24.52% of the population.
● Old Age (65+ years old) account for 12.99% of the population of Rocky
Mountain House.17
Stettler
Population: 5,748
Ages:
● Youth (0 to 17 years old) account for 28% of the population.
● Young Adults (18 to 44 years old) account for 33.65% of the population.
● Middle Age (45 to 65 years old) account for 25.22% of the population.
● Old Age (65+ years old) account for 19.22% of the population of Stettler.18
16
Area Score, Red Deer Age Distribution Statistics, 2016 17
Area Score, Rocky Mountain House Age Distribution Statistics, 2016 18
Area Score, Stettler Age Distribution Statistics, 2016
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Sylvan Lake
Population: 14,310
Ages:
● Youth (0 to 17 years old) account for 35.09% of the population.
● Young Adults (18 to 44 years old) account for 43.03% of the population.
● Middle Age (45 to 65 years old) account for 22.55% of the population.
● Old Age (65+ years old) account for 6.51% of the population of Sylvan
Lake.19
Wetaskiwin
Population: 12,525
Ages:
● Youth (0 to 17 years old) account for 27.97% of the population.
● Young Adults (18 to 44 years old) account for 32.12% of the population.
● Middle Age (45 to 65 years old) account for 25.3% of the population.
● Old Age (65+ years old) account for 20.31% of the population of
Wetaskiwin.20
3.1.2 Projected Population Growth
The Government of Alberta, through the formerly named “Finance and
Enterprise” ministry, developed population projections for 2010 to 2050. Some
of the key projections include:
● The population of Alberta, by 2050, could fall somewhere between 4.7 and
7.6 million people (This is quite a broad range of speculation, especially
considering that Alberta’s current population is 4.146 million people).
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Area Score, Sylvan Lake Age Distribution Statistics, 2016 20
Area Score, Wetaskiwin Age Distribution Statistics, 2016
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● Future population growth is expected to be mainly attributable to migration,
particularly international migration. Net migration, accounting for inter-
provincial migration and international migration, is projected to account for
70% of Alberta’s growth, with the remaining 30% coming from internal
population growth.
● Average life expectancy is anticipated to continue increasing, going from
the 2009 rate of 82.6 years for females to 85.0, and from the 2009 rate of
77.5 for males to 81.2.
● The share of seniors’ population is expected to grow, from the 2009 level
of 10.4% to an anticipated 25.7% of the total population by 2050.
● The proportion of “older seniors” is also expected to rise sharply, with 1 in
13 Albertans being over the age of 80 by the year 2050.21
“Borrowing from The Lending Cupboard saving my husband from having to take
sick days at work.”
3.1.3 Socio-Economic Conditions in Central Alberta
21
Government of Alberta, 2010, Alberta Population Projections, Alberta Finance and Enterprise
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Relatively speaking, Alberta is a prosperous province, even given the recent
economic turmoil. In 2014, the median household income for Alberta was
$100,750, second only, nationally speaking, to the Northwest Territories22. In
Central Alberta specifically, Sylvan Lake residents maintain the highest median
household income, followed by Olds, Lacombe, Innisfail and Red Deer23.
However, the cost of living in Alberta is also higher than many other parts of the
country. Housing costs have softened as a reflection of the soft economy, but
appropriate, affordable housing is still out of reach for many Central Albertans.
The current state of the economy has exacerbated financial struggles for many,
putting even basic household needs like transportation, food security, and
adequate housing out of reach.
Poverty has increased in Alberta in 2015-16. The most recent available data suggests that 7-9.5% of Albertans live in poverty (depending on which metric is used) – this translates to between 259,000-354,000 people.
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22
Government of Canada, 2014, Median total income, by family type, by province and territory, Statistics Canada 23
Red Deer Advocate, September 13, 2015, Median income highest at Sylvan, Susan Zielinski 24
Central Alberta Economic Partnership, 2014, Alberta Economic Indicator Report, Data developed by Environics Analytics
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These are the key industries in Alberta:
25
Albertans are employed in the following occupations:
26
Despite being one of the wealthiest provinces in Canada, currently in Alberta:
● 77,595 children – one in ten – live in poverty
● Low-income children in Alberta live in deeper poverty than children in
other provinces.
25
Central Alberta Economic Partnership, 2014, Alberta Economic Indicator Report, Data developed by Environics Analytics 26
Central Alberta Economic Partnership, 2014, Alberta Economic Indicator Report, Data developed by Environics Analytics
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● A job is no longer a ticket out of poverty – 24,695 children living in
poverty have one or both parents working full-time, full-year.
● Roughly 15% of Red Deer’s population lives below the poverty line.
● Aboriginal children are more than twice as likely to live in poverty.
● Recent immigrant and visible minority families experience higher
unemployment rates placing them at greater risk of living in poverty.
● Alberta’s living costs, especially for housing, are amongst the highest in
Canada, placing additional burden on low income children and their
families27.
The Broadbent Institute’s February 2016 report, An Analysis of the Economic
Circumstances of Canadian Seniors, offers a dismal picture of the financial
prospects for seniors in Canada. According to the study:
● “The Old Age Security (OAS) and Guaranteed Income Supplement (GIS)
guarantee levels are falling behind: For single seniors, these have fallen
from 76% of median incomes in 1984 to about 60% now. For senior
couples, the OAS/GIS maximum benefits have declined from 53% to
40% of median incomes.
● “Trends in income sources for seniors suggest that poverty rates will
increase rather than decline into the future because OAS and GIS
benefits are indexed to the Consumer Price Index (CPI), while average
earnings rise faster than the CPI over extended periods.
● “The spread between the OAS/GIS guarantee levels and the LIM for
2015—the spread that seniors need to fill using the Canada Pension
Plan/Quebec Pension Plan (CPP/QPP), private pensions and private
savings—is about $5,600 for single seniors and $4,700 for couples28.
● “The proportion of the population receiving the GIS is higher for single
seniors than couples, and higher for single women (between 44% and
48%) than for single men (between 31% and 37%).
● “Roughly half (47%) of those aged 55–64 have no accrued employer
pension benefits. The vast majority of these Canadians retiring without
an employer pension plan have totally inadequate retirement savings.
For example, roughly half have savings that represent less than one
year’s worth of the resources they need to supplement OAS/GIS and
CPP/QPP. Fewer than 20% have enough savings to support the
supplemented resources required for at least five years.
27
Make Poverty History Canada, 2010, Why does Alberta need a plan? 28
Throughout this paper when we refer to single seniors we are not referring to their marital status, but the fact that they live alone.
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● “The overall median value of retirement assets of those aged 55–64 with
no accrued employer pension benefits is just over $3,000. For those with
annual incomes in the range of $25,000–$50,000, the median value is
near just $250. For those with incomes in the $50,000–$100,000 range,
the median value is only $21,000.
● Only a small minority (roughly 15–20%) of middle-income Canadians
retiring without an employer pension plan have saved anywhere near
enough for retirement. The vast majority of these families with annual
incomes of $50,000 and more will be hard pressed to save enough in
their remaining period to retirement (less than 10 years) to avoid a
significant fall in income.”29
Community services front line workers report that the economic pressures have
led, in many cases, to the combining of households, wherein adult children and
their families are returning to live with their parents in an effort to conserve
resources. Lack of adequate financial resources and the accompanying stress
can contribute to:
● Delays in receiving medical treatment, where cost may be involved
● Lack of access to medication
● A loss of access to transportation, particularly in rural communities
● Reduced quality of health
● A rise in domestic violence30 and elder abuse31
Ample evidence confirms a direct link between socio-economic standing and
health status. One in seven children in Canada are born into poverty, and may
experience at-birth health issues such as low birth weight, asthma, type 2
diabetes, and malnutrition. Children who grow up in poverty are more likely to
experience physical disabilities, chronic health conditions and premature
death.32 Financial inequity impacts health, and is over-represented within the
health system; estimates place the cost of socioeconomic disparities in the
health system to be 20% of all healthcare spending.33
29
Broadbent Institute, February 2016, An Analysis of Canadian Seniors, Richard Shillington, Tristat Resources 30
Psych Central, 2016, Is Financial Stress a Factor in Domestic Violence?, Traci Pedersen, University of Iowa 31
Edmonton Police Service, 2016, Why Elder Abuse Happens 32
The Battlefords News-Optimist, April 2015, The relationship between poverty and health in Canada, Carolyn Shimmin, Troy Media 33
Canada without Poverty, 2016, Poverty – Just the Facts
http://www.edmontonpolice.ca/CommunityPolicing/FamilyProtection/ElderAbuse/WhyElderAbuseHappens.aspx
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Seniors in Central Alberta live in varying conditions, according to their
geographical location, economic circumstances, and family and community
support systems. Health and seniors’ services providers report that, in Red
Deer, Central Alberta’s largest urban centre, seniors living independently are
more open to the notion of moving into an assisted living facility, or long-term
care, as needed. However, in the more ‘rurban’ and rural communities, seniors
are more ardently committed to remaining in their homes, even if there is a
substantial lack of local services and support systems, and even if their living
conditions are less than optimal. This can contribute to compounded health
problems and premature or expedited aging.
There is a strong intersection between persons with disabilities and poverty. In
Canada, the poverty rate for people with disabilities is 14.4%, comprising nearly
600,000 people.34 According to the Council of Canadians with Disabilities, low
income and income insecurity is a longstanding issue for persons with
disabilities, and can include human costs such as “poorer health, premature
mortality, psychological distress and suicide.”35
From a socio-economic and health-quality standpoint, life in urban Central
Alberta versus life in rural areas is markedly different. During the community
consultation phase of the Community Needs Assessment project, it was
repeatedly expressed that the further a community is from the QEII corridor, the
more challenging it is for people to access health services and supporting
resources, such as medical equipment. These challenges may include:
● Lack of access to local health services
● Lack of transportation
● Lack of community or family support
● Isolation
● Financial constraints
34
Council of Canadians with Disabilities, 2006, Demographic profile 35
Council of Canadians with Disabilities, December 10, 2014, Disabling Poverty and Enabling Citizenship: Understanding the
Poverty and Exclusion of Canadians with Disabilities, Cameron Crawford
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3.1.4 Minority Groups
In general terms, there are some specific minority groups that may have a
greater need for the services of The Lending Cupboard. These groups include
First Nations people, Hutterites and immigrants/refugees.
First Nations
Nearly one of six First Nations people living in Canada live in Alberta, with
116,670 First Nations people, 96,870 Métis, and 1,985 Inuit, and the rest
reporting other Aboriginal identities (3,300) or more than one Aboriginal identity
(1,875). About 51% of First Nations people in Alberta live on reserve. Central
Alberta rests on the line between Treaty 6 and Treaty 7, and is home to 17 First
Nations communities. While the Aboriginal population is younger than the non-
Aboriginal population in Alberta, with a median age of 28.8 as opposed to
Alberta’s median age of 36.2, Aboriginal Albertans are more likely to live in
poverty than their non-Aboriginal counterparts, and nearly one-third of First
Nations people (30%), 12% of Métis and 8% of Inuit lived in homes in need of
major repairs; the rate was highest for First Nations people living on a reserve
(54%).36 According to the 2011 census report from Statistics Canada, Aboriginal
populations in Canada are projected to continue to grow; urbanization, in which
36
Government of Canada, Aboriginal Peoples: Face Sheet for Alberta, Statistics Canada, March 2016
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Aboriginal people move off reserve into other communities, is also trending
upward.
During the community consultations phase of the Community Needs
Assessment, health care providers in health centres close to First Nations
communities reported an increase in chronic health conditions such as diabetes,
heart disease and tuberculosis37, amongst First Nations Albertans. It is
important to note, however, that the majority of First Nations people in Alberta
self-rate their health as good or very good.38 Furthermore, Health Status reports
have consistently indicated much higher rates of injury among First Nations
populations, over non-Aboriginal populations.39 The on-reserve federally
provided health care versus the off-reserve provincially provided care can
sometimes lead to individuals ‘falling between the cracks’ when it comes to
accessing services and supports. In Central Alberta, the health centres in
Ponoka and Rocky Mountain House in particular reported an increase in chronic
health conditions in First Nations people and communities.
Adding to the health problems for First Nations people is the HIV/AIDS outbreak,
which, in some locales, is reaching near epidemic status. Although the
Indigenous population make up only 3% of Canada’s population, this people
group makes up 6-12% of new HIV infections. This alarmingly increasing issue
is most prevalent among Saskatchewan First Nations people; in Alberta, it is
currently being studied among youth in Treaty 8 territory (Lesser Slave Lake
area). Concerning to Central Alberta is the growth pattern: some 40% of new
infections among First Nations people are occurring in people under the age of
30.40 If this growing health concern is not addressed, it can be assumed that the
numbers of infected people in Central Alberta will also grow. With treatment,
people living with HIV/AIDS can now live longer than was expected when the
diseases first came on the radar. However, there are mobility impacts related to
the disease itself, and aside effects from the medications. As young people are
being affected, they may require mobility aids over long periods of time. At this
time, however, it is unknown how much of a demand there will be in Central
Alberta as a result of this health issue.
37
The Star, October 8, 2015, First Nations Health Crisis is a Canadian Problem, Jean-Victor Wittenberg, Michael Dan, Cindy
Blackstock, Isadore Day 38
Government of Canada, March 24, 2016, Aboriginal People: Fact Sheet for Alberta, Statistics Canada 39
Health Co-Management Secretariat, 2010, Health Determinants for First Nations in Alberta 40
The Anisnabe Kekendazone Network Environment for Aboriginal Health Research, Canada: Aboriginal youth resilience to
HIV/AIDS (ACRA), 1998-present
Prepared by Danikloo Consulting – October 2016
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Hutterites
Alberta is home to 109 Hutterite colonies. These colonies are all strictly rural,
and mainly dependent on agriculture, though some have diversified into
manufacturing and trucking. Though little is known about Hutterite life and
demographics, the population is growing in Canada; in 1995, the total North
American Hutterite population was counted at 30,000, but by 2011, Canadian
Hutterite population alone was 32,500.41 The health of Hutterite communities
appears to be, in general, very good, due to a diet high in fruits and vegetables.
Additionally, over 90% of Hutterites report being in the care of a regular family
doctor, compared to 81% of the non-Hutterite population.42
Some interesting health statistics of the Hutterite population are seen in this
chart:
The high “sense of belonging” factor that is a staple of Hutterite life has a
positive impact on health and health outcomes for Hutterites. Though they are
rural people, they, by virtue of the construct of their community, have a strong
support system that ensures no member of their community is lacking access to
health services and support. Due to lack of general data regarding Hutterites, it
is unknown if their work in agriculture leads them to experience higher rates of
personal or work-related injuries; however, given their ongoing population
growth, and the high level of community care and attention to health needs, it is
safe to assume that Lending Cupboard usage by this people group will continue
to rise.
41
The Canadian Encyclopedia, July 2013, Hutterites, John Ryan 42
Government of Alberta, September 2014, Alberta Hutterites: Overview of Selected Determinants of Health, Alberta Health Services
Prepared by Danikloo Consulting – October 2016
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Immigrants, Refugees and Migrants
In 2015, Red Deer committed to bringing in 250 Syrian refugees. At the time of
this report, roughly 40 refugees from Syria have arrived. Refugees from other
parts of the world are also welcomed to Canada, on an ongoing basis.
Additionally, Canada will potentially receive more than 300,000 new permanent
residents in 2016, according to Immigration Minister John McCallum.43 While
most immigrants initially land in Canada’s largest urban centres, such as
Toronto, Montreal and Vancouver, many will find their way to Red Deer and
Central Alberta through “second-wave” migration.
Virtually all refugees coming from war-torn countries will arrive with injuries of
some kind, according to representatives from the Central Alberta Immigrant
Women’s Association (CAIWA). While they have access to Alberta Health Care
and doctor attention, most refugees come without financial means of any sort,
have barriers such as language, transportation, finances and lack of awareness
of wrap-around health support services like The Lending Cupboard.
Immigrants and refugees may also be more vulnerable to illness and injury.
Research shows that “newness”, which includes young workers, temporary
workers, and recent immigrants, share an elevated risk of occupational injury.
Factors contributing to this include:
● Recent immigrants are more likely than Canadian-born individuals to be
in physically demanding occupations;
● There are potential language barriers;
● They may not be aware of their rights as workers, may not have access
to information on safe work practices, and may not be aware of their right
to refuse unsafe work;
● They may be underemployed and thus willing to take on more risky
tasks, for which they may not be qualified.44
When it comes to inter-provincial migration, there have been a number of
reports that, due to the economic downturn, people are leaving the province of
Alberta, going either back to their home province or elsewhere in search of work
prospects. While Alberta did see nearly 17,600 people move away in the first
43
The Globe and Mail, March 8, 2016, Canada on track to receive more than 300,000 immigrants in 2016, Michelle Zilio 44
Institute for Work and Health, Newness” and the risk of occupational injury
Prepared by Danikloo Consulting – October 2016
24
three months of 2016, the perception that Alberta is losing population is
incorrect. More people moved to Alberta than left in that first quarter of the year,
giving us a net gain of 6,700 people. The population growth is expected to
continue, if at a somewhat slower pace until the economy rebounds for the
foreseeable future.45 See section 3.1.1 for general population growth
projections.
3.1.5 Geographical Makeup of Central Alberta
With a population of roughly 313,000, Central Alberta is characterized by the
Queen Elizabeth II (QEII) highway, which runs down the center of the region like
a spine. Red Deer acts as the central hub for the region, with several smaller
‘rurban’ centres, such as Sylvan Lake, Innisfail, Blackfalds and Lacombe
clustered close by. The further one travels away, to the east or west, from the
QEII, the more rural the landscape becomes; as well, the distance between
communities increases and population decreases.
45
Canadian Broadcasting Corporation, June 21, 2016, More people moving out of Alberta this year
Prepared by Danikloo Consulting – October 2016
25
46
The boundaries established for the Community Needs Assessment project
were:
● North of Red Deer to Wetaskiwin ● East of Red Deer to Stettler ● Southeast of Red Deer to Drumheller ● Southwest of Red Deer to Olds ● West of Red Deer to Rocky Mountain House ● Northwest of Red Deer to Rimbey
46
County of Ponoka, 2013
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Why these demographic findings matter to The Lending Cupboard
Seniors are the largest user group of Lending Cupboard equipment. As people age, they require
increased health services, including orthopedic surgeries. The largest age group of people
requiring hip and knee surgeries in Canada are between age 45 and 74.1
The Lending Cupboard needs to be aware that this population group is growing, which means that
the Cupboard can expect a correlating growth in demand.
The growing population in Alberta, in general, and Central Alberta specifically, will continue over
the next ten years, but, until the oil and gas industries recover or a new economic driver emerges
that draws major numbers of people to the province, growth will be slower than it has been over
the past 15 years. However, with continued immigration, continued growth in Hutterite populations,
and an anticipated return to economic stability and growth within the next 2-3 years, The Lending
Cupboard needs to plan for a moderate growth in demand due to general population growth.
The recession in Alberta is leading to increased poverty. Central Albertans will have less
disposable income and less capacity to pay for health supports such as medical equipment
purchases or rentals. This will put increased pressure on The Lending Cupboard, as people look
for more affordable options to meet their health needs.
More First Nations people are moving off reserve, and more immigrants and migrants are moving
to Central Alberta. Their unique health challenges will mean increased demand for Lending
Cupboard equipment.
Prepared by Danikloo Consulting – October 2016
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3.2 Central Alberta Economy
3.2.1 Current Economic Conditions
Although the province has been in a recession for the past 1.5 years, largely due to
its heavy reliance on the energy resource sector, Alberta has still led the country in
economic growth over the last 20 years.47 However, in mid-2016, the struggling
economy was further impacted by the Fort McMurray wildfires, leading to an
expected overall economic contraction for 2016 of -2.9%.
The economic woes have had a significant impact across Alberta. In 2015,
unemployment numbers, which reached 62,480 in December, had nearly doubled
from the same month in the previous year. Food bank usage increased by almost
25% in 2015, and Albertans relying on income support from Alberta Works rose by
roughly 20% from the previous year48. In Central Alberta, unemployment reached a
concerning 8.6% in July of 2016.49
Economic forecasts are a mixed bag. Though RBC projects a positive GDP growth to return in 2017 at a rate of 2.3%50, and the Provincial Government has invested significantly in social programs, and has made a commitment to economic diversification, Alberta is still an oil and gas dependent economy, and will be for the foreseeable future. Even though there has been recent OPEC movement to restrict oil production, which will drive prices up, the speculation exists that this is a temporary move.51 Many economists anticipate 5-10 more years of low oil prices (roughly $50bbl)52. As a result of the economic volatility, poverty can arrive in an individual’s life quickly and profoundly, but it can and often does take much longer to dig out.
47
Government of Alberta, January 2016, Highlights of the Alberta Economy 48
Edmonton Social Planning, April 2016, The Path Forward – Opportunities to End Child Poverty 49
Government of Alberta, 2016, Economic Dashboard – Unemployment 50
RBC Economics, September 2016, Provincial Outlook, Robert Hogue 51
Calgary Herald, September 30, 2016, After two years of trouble, OPEC strikes a deal – but don’t bet on lasing truce, Chris Varcoe 52
World Economic Forum, February 2016, Will oil prices stay this low for the next decade? Keith Breene
Prepared by Danikloo Consulting – October 2016
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Unemployment rates, by demographics of youth, Aboriginal, and overall employment, from 2007-2015 were:
According to the Alberta Economic Dashboard, current unemployment statistics are:
Current unemployment by gender and youth demographic:
53
53
Chart shows comparative 2015 and 2016 unemployment rates for males, females & youth. 2015 is blue; 2016 is orange.
Prepared by Danikloo Consulting – October 2016
29
Current Aboriginal unemployment statistics:
54
Though earlier in 2016, several economists were predicting the beginning of an economic
turnaround in the third quarter (Q3) of 2016, the May wildfires in Fort McMurray dashed
those hopes. The Conference Board of Canada reported that up to $1B was lost in oil
sands production alone, as a direct result of the fires. 55 Though some upswing can be
expected due to reconstruction efforts in Fort McMurray, this is not projected to a long-
term, general return to growth. ATB economist Todd Hirsch adjusted his economic
projection for 2016 and 2017, predicting an overall economic retraction of -1.9% for 2016,
and a modest return to growth of possibly up to 2% for 2017.56
RBC also forecasts a return to growth for 2017, predicting 2.3%.
57
54
Government of Alberta, August 2016, Labour Force Statistics 55
Huffington Post, May 5, 2016, Fort McMurray Fire’s Economic Impact: $1Billion in oil sands production lost, Dan Healing,
Canadian Press 56
Canadian Broadcast Corporation, July 12 2016, Alberta Economy to shrink by 1.9% in 2016, forecasts ATB, Robson Fletcher 57
RBC Economics/Research, September 2016, Provincial Outlook, Robert Hogue, Senior Economist
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30
In its report on economic trends for 2016-2028, Economics and Revenue Forecasting, the
Government of Alberta’s Treasury Board and Finance, paints a dismal picture, reporting
that oil prices are expected to remain “subdued”, the outlook for exports will be
weakened, and investments, earnings, and consumer spending will remain low.
58
Though most economists are loathe to make predictions too far into the future, there are
reports that indicate that somewhat brighter days lay ahead. The Conference Board of
Canada says that although “the plunge in oil prices will restrain growth over the medium
term, but the long-term prospects remain bright.”59 It does, however, also predict that
58
Alberta Treasury Board and Finance, August 2016, Economics and Revenue Forecasting, Wade Tymchuk and Catherine Rothrock 59
The Conference Board of Canada, May 17, 2016, Provincial Long-Term Economic Forecast for Alberta: 2016, Executive
Summary
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Alberta’s economy will continue to be increasingly reliant upon the oil sands, either
directly or indirectly. The report also states that Albertans will continue to earn more than
the national average over the next 20 years, but that the aging population will limit growth
in household consumption/consumer spending.
3.2.2 Multi-Generational Workforce
We hear a lot about the aging Baby Boomers, and it’s true. Over the next 20 years,
virtually all of the Boomers will have retired. Kristen Cummings, of Cantos Performance
Management, explains that today’s workforce may consist of Baby Boomers, Gen Xers,
Gen Yers and Millennials, as well as the now emerging Gen Z, all at the same time.
Motivators and drivers are different for each generation. As such, young people working
today are, for all intents and purposes, working in a completely different economy than
baby boomers. Where boomers were and are more inclined to fit themselves into the
structure of a corporation, and more interested in interpersonal relations, the “iGen” (as
the Millennials and Gen Zers are sometimes called) workforce are more entrepreneurial,
independent and tech-driven. Boomers and Busters built their networks through local
service and community volunteerism; the iGen builds a global network through social
media, and give their time and money to global social causes that meet with their
passions and convictions.60
“The Grey Shift” is an emerging reality in Canada. With baby boomers retiring, there will
be a significant loss of knowledge and capacity in the workforce. For the first time in our
history, there may be more people in their retirement years than there are in the
workforce.61 The short-term reprieve is that people are staying in the workforce longer.62
This may be motivated by financial concerns, since research indicates that Canada’s
household debt-to-income ratio continues to balloon, and the majority of people poised to
reach retirement age have not amassed sufficient savings.63
These factors all have an influence on community volunteerism and charitable donations.
3.2.3 Government Funding Opportunities
With any economically challenging time comes a reduction in the availability of funding
opportunities for not-for-profit (now called ‘social profit’) organizations. However, both the
United Way of Central Alberta and the Red Deer & District Community Foundation, two of
60
Cantos Performance Management, 2016, Bridging the GAP: Demographics at work in school, Kristen Cummings 61
The Globe and Mail, November 8, 2015, Boom, Bust and Economic Headaches, Parkinson, D., McFarland, J., McKenna, B. 62
Financial Post, February 18, 2015, Canadians facing longer wait for retirement, Critchley, B. 63
The Globe and Mail, February 16, 2016, Many Canadians entering retirement with inadequate savings, study says, McCarthy, S.
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Central Alberta’s major local granting organizations, have continued to see an increase in
their year-over-year fundraising efforts. This speaks to the generosity of the Central
Alberta community, and bodes well for the future of funding opportunities through these
avenues.
Though the new Provincial Government has made a commitment to raise the profile of
social needs in Alberta, their expenditure targets over the next 3 years indicate that there
is unlikely to be increased funding through any ministry, because there will be no
increase in budgets beyond basic cost increases. Though the population is expected to
grow by 3% each year, the government’s projected rate of growth in operating expense
will average 2% per year.64
In addition to the potential for less government funding to be available, there is the
absolute certainty that less corporate sponsorship will be available for the next 2-3 years.
When the economy improves, the generosity of Alberta’s business sector will no doubt re-
assert itself.
64
Government of Alberta, April 14, 2016, Fiscal Plan 2016-2019, Hon Joe Ceci, President of Treasury Board and Minister of Finance
Prepared by Danikloo Consulting – October 2016
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Why these economic findings matter to The Lending Cupboard
Sustained economic pressure may force more people to look for low/no cost options when
sourcing medical equipment. The longer the recession continues, the more people are forced into
financial struggles. This will put increased demand from across the region onto The Lending
Cupboard’s resources.
The Lending Cupboard is heavily reliant upon community volunteerism, and currently has over 80
volunteers who donate roughly 8,000 man hours per year to the organization. The majority of
these volunteers are of retirement age; if The Cupboard continues to successfully engage
Boomers, the level of volunteerism for the organization will likely remain stable for the next 10 or
more years. However, in the longer-term, it behooves The Lending Cupboard to consider
developing strategies to engage younger generations in volunteerism and local giving.
As demand for the services of The Lending Cupboard grows, so does the need for more staff,
extended hours of operation, a larger facility, and thus, a larger budget. If traditional government
funding sources are not accessible and corporate sponsorships are less available, The Lending
Cupboard will need an innovative fund development strategy and a strong community engagement
strategy to build its capacity and resources to meet the demand.
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3.3 Central Alberta Health
The kinds of illness, injury, diseases and conditions that require one or more pieces of
medical equipment found at The Lending Cupboard include (but are not limited to):
● Diabetes ● Heart and Stroke ● Cancer ● Multiple Sclerosis ● Muscular Dystrophy ● Arthritis ● Parkinson’s Disease ● ALS (Lou Gehrig’s Disease) ● Spinal cord injury ● Brain injury ● Sports injuries ● Orthopedic conditions (hip, knee, shoulder, ACL, etc.) ● Physical disabilities ● Falls and motor vehicle crashes ● Bariatric patients ● Elderly patients
The kinds of medical equipment that The Lending Cupboard lends, that is needed by
people with the above-noted health issues includes:
● Walkers and rollators (wheeled walkers) ● Wheel chairs ● Knee walkers ● Canes & Crutches ● “Air boot” (reusable splint/cast) ● Commodes ● Raised toilet seats and toilet arm rests ● Bath bars ● Neck braces ● Reachers/grabbers ● Shower chairs/bath benches ● Hydraulic bath lifts ● Slings/hoyer lifts ● Hand-held shower nozzles ● Bed rails ● Bed poles/Sask poles ● Cryotherapy Units ● Specialized pieces
Prepared by Danikloo Consulting – October 2016
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The Lending Cupboard also has power scooters and wheelchairs, though these items are
for sale, rather than to be lent.
Other options for accessing medical equipment around the region include:
Organization/Business Name Type of Access
Millerdale Pharmacy (Red Deer) Buy or rent
Red Cross (Red Deer) Short-term loan
Motion Specialties Buy or rent
Most pharmacies in Central Alberta Buy or rent
ALS Society Loan
On the Mend Medical Equipment (Rocky Mountain House) Buy
Alberta Aids to Daily Living (AADL) Government funding to purchase equipment (partial funding - strict criteria – income threshold)
With the possible exception of The Red Cross Society, these other options may have
limitations on the types of equipment available and the stock. The Lending Cupboard
does not lend out:
● Respiratory equipment ● CPAP machines (for sleep apnea) ● Hospital beds
3.3.1 Orthopedic Disorders
Any condition that involves one’s musculoskeletal system is orthopedic, and includes
such disorders as:
● Arthritis (Osteo and rheumatoid) ● Bursitis ● Carpal Tunnel Syndrome ● ‘Tennis’ Elbow ● ‘Golfer’s’ or ‘Baseball’ Elbow ● Fibromyalgia ● Foot pain and other foot problems ● Ligament injuries ● Fractures ● Torn meniscus, ACL ● Low back pain/spinal issues ● Neck pain and problems ● Osteoporosis
Prepared by Danikloo Consulting – October 2016
37
● Shoulder pain and problems ● Scoliosis ● Bone disease ● Soft-tissue injuries
The Lending Cupboard has equipment to lend for almost all of these health concerns.
Following are some informative statistics regarding some orthopedic disorders:
1) Arthritis: According to the Canadian Arthritis Society, “the word arthritis means
inflammation of the joint (“artho” meaning joint and “itis” meaning inflammation).
Inflammation is a medical term describing pain, stiffness, redness and swelling.
Arthritis is a disease that can involve any of the joints in the body, often occurring in
the hip, knee, spine or other weight-bearing joints, but can also affect the fingers
and other non-weight-bearing joints. Symptoms of arthritis include joint pain,
swelling, stiffness and fatigue. Untreated inflammation can eventually lead to joint
damage, destruction and disability. Some forms of arthritis can also affect the
body’s internal organs.”65 Currently, 1 in 6 Canadians has arthritis, which can strike
anyone at any age; by the year 2036, it is estimated that this number will rise to 1 in
5. More than 59% of Canadians with arthritis report having physical limitations. Joint
damage caused by osteoarthritis accounts for more than 80% of the hip
replacement surgeries in Canada and more than 90% of knee replacements.66
In 2014, Alberta had the 4th highest number of people with arthritis in Canada, with
525,715. 302,896 being female and 222819 being males.67 The Alberta Bone &
Joint Health Institute reports that the total economic burden of Osteoarthritis (OA)
and Rheumatoid Arthritis (RA) in Alberta is estimated at $3.3billion per year (a 2010
figure). As Canadians live longer and live increasingly sedentary lives, it is
anticipated that, within a generation, 1 in 4 Albertans will have one or more of these
[bone or joint] diseases.68
2) Hip & Knee Surgeries: Hip & Knee surgeries increased 13% over five years in
Canada from 2008-201369. In Alberta, hip surgeries increased by more than 20%
between 2010 and 2015:
65
The Arthritis Society, 2016, What is Arthritis? 66
The Arthritis Society, 2016, Arthritis in Canada, Facts and Figures 67
Government of Canada, 2014, Arthritis, by sex, province and territory, Statistics Canada 68
The Alberta Bone & Joint Health Institute, 2015, $3.3Billion economic burden in Alberta 69
Canadian Institute for Health Information, 2013 Annual Report
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Knee replacement surgeries in Alberta, over that same period of time, increased by
almost 27%.
70
The correlation between age and hip or knee replacement surgery is strong. The
Canadian Institute for Health Information, in its 2013 annual report, states: “Sex
differences persisted in that, overall, females had higher age-standardized rates
than males for both hip and knee replacements, across all jurisdictions. Looking at
volumes by age group, the gender gap was greater among hip replacement
recipients: 27% of male hip replacement recipients were age 65 to 74, where nearly
half of all female recipients were age 75 and older at the time of surgery. Interesting
trends in 2010–2011 were evident for those age 45 to 64; these people made up
29.6% and 38.3% of hip and knee replacement recipients, respectively. Those aged
55 to 64 had the second-highest volume of knee replacements among both males
and females, exceeded only by those age 65 to 74. Further, the age groups 45 to
54 and 55 to 64 were the only ones that had a five-year increase in age-specific
rates, for both sexes and for both hip and knee replacements. Males age 45 to 54
and 55 to 64 who underwent hip replacement had five-year increases of 8.8% and
70
Canadian Institute for Health Information, Hip Knee Replacements 2014-2015 quick stats, Canadian Joint Replacement Registry
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11.0%, respectively; among women, increases were 5.3% and 4.6% for the same
age groups, respectively. Among knee replacement recipients, males age 45 to 54
and 55 to 64 had even higher increases, at 17.9% and 18.8%, respectively,
whereas women had increases of 14.4% and 7.1% for the same age groups. In
contrast, rate decreases were the norm for other age groups.”
Until recently, the Red Deer Hospital has been the only hospital in Central Alberta
doing orthopedic surgeries; some are now being performed in Olds, to take the
pressure off of Red Deer. Camrose, though outside the scope of this project, also
does orthopedic surgeries; The Lending Cupboard sees a substantial number of
clients coming from Camrose. Operating room (OR) wait times as well as availability
of beds on hospital units translates into ever-increasing wait times for patients
requiring orthopedic surgery of any kind. For The Lending Cupboard, this means
that more people need mobility aids in advance of their surgeries, and for longer
periods of time. Additionally, health care providers report that people waiting
extended periods of time for orthopedic surgery can often end up with compounded
mobility issues (for example, a bad hip becomes a bad hip and a bad back).
Additionally, with the tough economy, with many people unemployed and without
extended health benefits, individuals requiring physio or occupational therapy
(PT/OT) are more often choosing to wait for the publicly funded option, rather than
attending private clinics. This has lengthened wait times for this service, and again
results in an even greater need for mobility aids for longer periods of time.
3) Multiple Sclerosis (MS): Canada has the highest rate of MS in the world, with an
estimated 100,000 Canadians living with this autoimmune disease of the central
nervous system.71 The disease attacks myelin, the protective covering of the nerves,
and causes inflammation, which is accompanied by symptoms such as fatigue, lack
of coordination, weakness, tingling, impaired sensation, vision problems, bladder
problems, cognitive impairment and mood changes. The cause remains largely a
mystery, and individuals experience symptoms differently. Also a mystery is Central
Alberta’s large representation of MS sufferers. As stated, Canada is the MS capital of
the world, and Central Alberta is the MS capital of Canada. Although, like arthritis, it
is not considered a fatal disease and, as of yet, no cure has been found, MS differs
from arthritis in that “attacks” tend to be episodic. As such, the need for mobility aids
for people living with MS also tends to be intermittent; however, it is best to have
these aids on hand in the home for when they are needed. It could therefore be
expected that Lending Cupboard clients living with MS would hold equipment for
great amounts of time, possibly years.
71
Multiple Sclerosis Society of Canada, 2016, What is MS?
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4) Other Orthopedic Diseases and Disorders: There are many more types of orthopedic
health challenges, disorders and diseases, as listed above. More information on the
Canadian and Albertan statistics these disorders is available at the Canadian
Institute for Health Information (CIHI) and Statistics Canada.
3.3.2 Other Diseases, Disorders and Health Conditions
1) Parkinson Disease: Defined as “a neurodegenerative disorder that affects motor and
non-motor functions due to a lack of dopamine in the brain. Dopamine allows nerve
impulses to travel smoothly from one cell to the other”72, it is estimated that over
10,000 Albertans suffer with Parkinson Disease. Similarly to MS, Parkinson Disease
has a strong presence in Central Alberta, approximated at 400 patients. The reason
for the representation of this disease as higher in Central Alberta is unknown.
Though there are no marked stages for the disease, it is progressive, and is
characterized by impact to one’s motor systems, trouble with walking, rigidity, slowed
movement, and then tremors. It can be accompanied by cognitive impairment.
Parkinson typically presents within the age range of 55-65, but young onset can
develop as early as the 20s or 30s. The Central Alberta chapter of Parkinson Alberta
estimates that upwards of 75% of people living with the disease require one or more
mobility aids and daily living aids. Incidents of falls are higher in the Parkinson
population, due to the motor impairment and tremors, and elderly Parkinson sufferers
are at even higher risk of fall-related injuries.73
Within roughly a year, a new neurology clinic will be opening in the Red Deer
Hospital, to respond to the growing Parkinson numbers as well as other neurological
disorders. The presence of this clinic will undoubtedly lead to more referrals to The
Lending Cupboard.
2) Bariatric: Health Canada and Statistics Canada define obesity by Body Mass Index.
Using this measurement, StatsCan reports a year-over-year increase in overweight
and obese Albertans as follows:
72
Parkinson Alberta, 2013, About Parkinson Disease 73
Parkinson Alberta, 2016, Interview with Central Alberta Executive Director Moira Cairns
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According to the Alberta Physician Learning Program, over 90,000 Albertans are
considered morbidly obese.74 Despite evidence that behavior modification
techniques may achieve, though rarely sustain, an overall reduction in weight by
10%, referrals to the province’s bariatric programs continuously fall below Alberta
Health Services (AHS) targets. This means that people struggling with extreme
obesity may not receive direct treatment, and may experience serious comorbidities
such as diabetes, heart disease, gout, hypertension, arthritis, some cancers, and
mobility issues75. Health practitioners from around the Central Alberta region
reported, during this project’s information gathering phase, that more and more
specialized equipment is needed, to accommodate the needs of larger patients.
Additionally, the Red Deer Regional Hospital Centre has a well-subscribed bariatric
program. Surgical wait times for those in the bariatric program, though targeted for 5-
9 months, can, in reality, be in excess of 2+ years. As referrals to this program are
targeted for increase, it can be expected that the demand for specialized equipment
will also rise.
3) Diabetes: Incidents of diabetes, a metabolic disease in which the body’s inability to
produce any or enough insulin causes elevated levels of glucose in the blood, has
actually gone down in Alberta over the last few years. Numbers reached an all-time
high of 195,440 in 2012, reducing to 175,686 in 2013 and further falling to 171,906 in
2014.76 However, despite these promising numbers, most experts predict that
diabetes is indeed on an upward trajectory.
77
74
Physician Learning Program, Bariatric Surgery Referral 75
US Institutes of Health, 1999, Obesity and its comorbid conditions, Khaodhiar L1, McCowen KC, Blackburn GL., US National
Library of Medicine 76
Government of Canada, 2014, Diabetes, by sex, province and territory, Statistics Canada 77
Canadian Diabetes Association, 2010, The Cost of Diabetes in Alberta
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Diabetes is characterized by sores that will not heal, particularly on the feet, which
can sometimes lead to amputation. While The Lending Cupboard does not maintain
diabetic supplies such as needles or testing kits, The Cupboard must be positioned
to support the daily living and mobility aids required by people living with diabetes.
4) Aging: The aging process is not a disease, disorder, nor even a problem. Living
longer is a good thing! And people in Alberta are doing so, and with better health
than ever, thanks for medical advances and a great quality of life. The number of
seniors aged 65 or older is expected to more than double from about 490,000, or
about 11%, of the total population in 2015, to just over 1.1 million. Almost one in five
Albertans, is projected to be aged 65 or older in 2041.78 Statistics Canada reports
that as of July 1, 2015,” preliminary estimates show that, for the first time, there were
more persons aged 65 years and older in Canada than children aged 0 to 14 years.
Nearly one in six Canadians (16.1%)—a record 5,780,900 Canadians—was at
least 65 years old, compared with 5,749,400 children aged 0 to 14 years (16.0%).”79
Aging does, for some, present health challenges, many of which require the support
of daily living and mobility aids. Unsteadiness on one’s feet is a common issue
among older people, which puts them at risk of falling. Falls are the number of cause
of injury in seniors. The Public Health Agency of Canada says that between 20 and
30% of seniors who live in the community experience at least one fall each year. Up
to 95% of all hip fractures are caused by this, and death results in 20% of cases.80
Spinal Cord Injury Alberta reports: “In Alberta, there was an estimated additional 186
new spinal cord injuries in 2010. It is estimated that by 2030, the number of
Canadians living with spinal cord injury is expected to climb to 121,000 due to the
aging of the Canadian population and more accidents occurring as a result of falls.”
Additionally, seniors, or those approaching age 65, account for the majority of hip
and knee replacement surgeries in Alberta, as noted in section 3.3.1-1. More
information on age demographics is offered in section 3.1.1.
As of the 2011 Canadian census, roughly 24.6% of seniors lived alone,
independently, which is down from the 2001 figure of 26.7%.81 In the community
conversations and focus groups conducted for this project, caregivers and
community service providers expressed a belief that, in Red Deer, where there are
more options for supported living and long-term care, seniors are more open to the
78
Government of Alberta, June 2016, Population Projections, Alberta Treasury Board and Finance 79
Government of Canada, 2015, Canada’s Population Estimates, Statistics Canada 80
Government of Canada, April 28, 2016, The Facts: Seniors and Injury in Canada, Public Health Agency of Canada 81
Government of Canada, 2011, Living Arrangements of Seniors, Statistics Canada
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43
notion of moving into an assisted living facility. It seems that the more rural the
setting, the more strident seniors are about remaining in their homes, even though
support systems are less available, and their quality of life may be significantly
reduced. Since the percentage of seniors living in these communities is, in some
cases, higher than the larger urban centres, and since falls are the number one
cause of injury to seniors, as the seniors’ population grows, so does this concern.
5) Other statistics: As was listed at the beginning of Section 3.3, there are many other
diseases, disorders and conditions that may require the use of daily living and/or
mobility aids. Following are some statistics regarding these:
Health Condition Current Statistic Projected Increase or Decline
Heart Disease 1.3 million Canadians are living with heart disease.
Health factors combined with further aging of the population will likely lead to an increase in
the number of people with Cardiovascular Disease in the
future.82
Stroke More than 400,000 Canadians are living with the effects of a stroke.
Stroke rates have plateaued since 2008 but rates are
expected to increase as the baby boomer generation
ages.83
Cancer 1 in 2 Albertans will face cancer in their lifetime and approximately 1 in 4 will die from cancer.84
In Alberta, newly diagnosed cancer cases has increased by 51% since 1996 and continues
to trend upwards.
6) Physical and Developmental Disabilities: Daily living and mobility aids are provided
through funding by Alberta Aids to Daily Living (AADL). As such, it is not common for
people living with these conditions to utilize The Lending Cupboard. However,
caregivers and program managers interviewed for this project indicated that there
are sometimes process delays in receiving funding for equipment through this
82
Heart and Stroke Foundation, 2016, Statistics 83
Government of Alberta, December 2012, The Alberta Provincial Stroke Strategy: A Legacy of Stroke Care for Alberta, Jeerakathil,
T., Burridge, D., Thompson, G., Fang, S., Hill, M. 84
http://www.documentcloud.org/documents/565954-hi-poph-surv-cancer-summary-2010.html#document/p1
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44
program, which can necessitate usage of The Cupboard as an interim measure.
Furthermore, AADL provides only partial funding, and users must be low-income,
and referred by a medical professional in order to qualify.
3.3.3 Injuries and Accidents
1) Injuries
● 5,000 Albertans are brain injured each year. Survivors of severe brain
injuries can face up to 5-10 years of intensive rehabilitation services. 50% of
brain injuries in Alberta occur in motor vehicle crashes, and 50% of those
crashes involve alcohol or drug usage.85
● In Alberta, injuries are the reason for, on average, 429,741 emergency room
visits each year. This amounts to 1,177 per day. In 2012, it was reported that
Alberta emergency wards experienced an average of 8 traumas per day,
and 14 severe head and neck injuries per day.86
● Between 2001 and 2010, falls were the number one cause of injury-related
hospital visits for children under 10. During this same period, sports injuries
were the leading cause of emergency room visits for youth aged 10-19.87
2) Motor Vehicle Accidents
● In 2014, the number of traffic injuries increased 0.5%, from 18,650 injuries in
2013 to 18,745. The number of traffic collisions increased 2.2%, from
141,638 collisions in 2013 to 144,740 in 2014.
● Male drivers between the ages of 18 and 19 have the highest involvement
rate of all drivers involved in casualty collisions.
● The five year trend from 2010-2014 shows increases in both fatal and non-
fatal motor vehicle crashes:
85
Universal Rehabilitation Service Agency, Brain Injury Facts 86
Injury Prevention Centre, Why is Injury Prevention Important? 87
Injury Prevention Centre, Children and Youth Injuries in Alberta
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88
Despite the ongoing investment in education and awareness, injury numbers and traffic
collision figures continue to rise.
The Lending Cupboard is “a wonderful establishment. My elderly parents
have benefitted greatly. Thank you for being there for us.”
88
Government of Alberta, 2014, Alberta Traffic Collision Statistics, Alberta Transportation
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3.4 Alberta Health Services (AHS) Policies and Practices
In this section, we will discuss established and emerging Alberta Health Services
policies and practices that impact demand on The Lending Cupboard.89
The pressure on the health care system in Alberta is enormous. As seen in previous
sections of this report, the population is both growing and aging; many chronic
illnesses are on the rise, along with accidents and injuries. Additionally, there is a
well-documented shortage of long-term care beds in Alberta, which necessitates
elderly patients remaining in hospital until suitable placement is found.90 The 2016
89
The policies and practices detailed in this section, while not found in publicly-available written publications, have been confirmed in
more than twenty interviews of health practitioners from around the region. 90
Public Interest Alberta, December 15, 2014, Seniors Task Force: Position Paper on Long-Term Care, Seniors Task Force
HIGHLIGHTS
1) DESPITE MEDICAL ADVANCES, NEARLY ALL THE DISEASES,
DISORDERS AND HEALTH CONDITIONS PERTINENT TO THE
LENDING CUPBOARD ARE ON THE RISE.
2) THE AGING POPULATION IS POTENTIALLY THE MOST
IMPORTANT MATTER AS IT RELATES TO THE FUTURE OF THE
LENDING CUPBOARD. THE AGE GROUP WILL CONTINUE TO
GROW OVER THE NEXT TWENTY YEARS; ORTHOPEDIC
SURGERIES ARE MOST PREVALENT IN THIS (GROWING) AGE
GROUP; FALLS ARE AN INCREASING ISSUE AMONGST THE
SENIORS POPULATION.
3) SENIORS WHO LIVE ALONE ARE MORE COMMON IN RURAL
AREAS OF CENTRAL ALBERTA, WHERE SUPPORT SERVICES
MAY NOT BE AS READILY AVAILABLE.
4) THE NUMBER OF INJURIES AND ACCIDENTS IN ALBERTA
INCREASE EACH YEAR.
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provincial health care budget, at $20.4Billion91, accounts for half of the projected
provincial revenue.92
3.4.1 Post-surgery Release Times
Post-surgery patient stays have been reducing in length of days over the last number
of years. This is the case not only in Alberta, but across health care systems in North
America. Within the health care system, it has become a widely accepted notion, and
is considered a best practice, to release people back to their homes and families as
soon as possible after surgery. The evidence is conflicting, with some studies
indicating that it does not reduce health outcomes, and results in a “modest” net cost
savings to the hospital93, while others say that there is neither cost nor patient benefit
to a reduced length of stay (LOS).94 Obviously there will be different standards and
expectations based on the patient and type of care required, and health practitioners
report that, whatever the standard, there is intrinsic flexibility in LOS standards to
account for individual patient needs.
Nonetheless, for the over 600 hip and knee surgeries performed annually at the Red
Deer Regional Hospital Centre, the length of stay used to be 4-8 days. Over the last
few years, the LOS has been reduced to 2-4 days. Alberta Health Services (AHS)
officials report that the goal for LOS for hip and knee patients to move to a hard 2-
day maximum LOS. As a consequence, family and community support resources are
more keenly relied upon to help the patient heal and recover outside of the hospital.
The Home Care system, for example, is a major factor in good post-operative, post-
hospital patient care. However, patients with family support systems are more likely
to recover more quickly and be in a better frame of mind.95 Patients waiting for hip
and knee surgery are encouraged to visit The Lending Cupboard well in advance of
their surgery date, to secure the equipment they will need while waiting as well as
after surgery. The Lending Cupboard has a contract through the AHS “Total Joint
Arthroplasty (TJA)” initiative, for $50,000 per year (15% of its total operating budget)
to provide the medical equipment needed for these patients. This contract has been
in place, at its current funding level, for the past seven years (Apr. 2009). The current
contract is in place until 2018.
91
Government of Alberta, 2016, Health Funding 2016-2017, Alberta Health 92
Global News, April 14, 2016, Highlights from Alberta budget 2016, Canadian Press Staff 93
National Institute of Health, June 2012, Acute Care For Elders Units Produced Shorter Hospital Stays At Lower Cost While
Maintaining Patients’ Functional Status, Barns, D., Palmer, R., Kresevic, D., Fortinsky, R., Kowel, J., Chren, M., Landefeld, C.S. 94 Journal of Perinatology, September 1, 2016, Demonstrating the relationships of length of stay, cost and clinical outcomes in a simulated NICU, C DeRienzo, J A Kohler, E Lada, P Meanor and D Tanaka 95
Fraser Health, A Guide to Your Surgery
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3.4.2 Home Care
Another area of health service that has a high referral rate to The Lending Cupboard
is Home Care. Home Care, which operates under the banner of Continuing Care, is
a critical function of health services in Alberta for people with disabilities, chronic
illness, and the elderly96. Home care is growing in usage across Central Alberta, as
the population grows and hospital stay time is reduced. Within the city of Red Deer,
there are 8 home care workers available to the public through AHS. Additionally,
there are private companies providing home nursing care as well as daily living
support such as shopping, housecleaning, errands and companionship. Outside of
Red Deer, there are home care services provided in a number of centres throughout
the Central Zone, including Innisfail, Olds, Rocky Mountain House, Drumheller,
Stettler, Ponoka, Wetaskiwin, and Rimbey.
During the gathering phase of the Community Needs Assessment, conversations
were had with home care workers, both public and private, in Red Deer, Innisfail,
Drumheller, Stettler, Rocky Mountain House, Ponoka and Rimbey. It was learned
that medical equipment lending used to be part of the home care program, but either
has already been phased out or in the process. Reasons given for why home care no
longer lends medical equipment were first and foremost lack of storage space, but
also cost and liability. Although home care/continuing care does not fund The
Lending Cupboard, Red Deer home care services only offer equipment for fitting
purposes, and then refer to The Cupboard. The home care offices outside of Red
Deer do still refer to The Cupboard, but that is less and less likely as distance from
Red Deer increases.
While there is little question that both public and private home care programs will
grow in the coming years, no one interviewed for the project was able to provide data
in terms of numbers of patients/clients served on an annual basis in Central Alberta,
nor projected growth. Nevertheless, based on the aging population figures, growth
expectations for chronic disease and injuries/accidents, there can be no doubt that
homecare services will see an increased demand over the next decade and beyond.
Since more and more home care offices are becoming aware of The Lending
Cupboard, and making referrals, demand on The Lending Cupboard will increase in
kind. Details related to how The Cupboard can serve the region will be offered in
section 4.
3.4.3 Physiotherapy/Occupational Therapy
96
Government of Alberta, 2016, Home Care
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Physiotherapists (PT) and Occupational therapists in Red Deer frequently refer
clients to The Lending Cupboard. Many of these are working in the area of Home
Care, but there are referrals that also come through the hospital physiotherapy
(outpatients) clinic, as well as through private physio clinics.
In interviews during the gathering phase of this project, AHS officials indicated
anecdotally that the economy is having an effect on the demand for publicly funded
physiotherapy centre at the hospital. With more people having been laid off and thus
losing their extended health benefits, they are choosing to wait to receive
physiotherapy at the hospital rather than going through private physio providers. This
has led to longer wait times, which means patients may be using mobility aids longer
while they wait for physio. Additionally, the longer people wait for treatment, the more
likely they are to experience compounded health issues, which may lead to an even
more extended period of time during which they will need to rely on mobility and daily
living aids.
3.4.4 Self-referrals and Other Referrals
Over its ten years in operation, The Lending Cupboard has become widely known in
the Central Alberta region. Many community members avail themselves of The
Cupboard’s no-cost medical equipment lending program, or borrow equipment for
their elderly or infirmed loved-ones. Self-referral usage of The Cupboard has grown
over time and there is no indication it will decline at any time in the near future.
Certainly the economic factors, population growth, aging demographic, increase in
diseases and illnesses described in this report, and pressures on the health system
will all factor into a significant growth in demand on The Lending Cupboard’s
services.
3.4.5 Long-Term Care
There is a well-known, long-standing shortage of long-term care beds in Alberta.
With an estimated shortage of up to 20,000 long-term care spaces, and the
government battling a massive $10B deficit, investment in infrastructure is not likely
to come close to meeting demand over the next decade. During the 2015 election,
there was a government pledge to increase long-term care funding by $70m
annually, and while it did not include any additional funding in the 2015 budget, there
was an allocation of $60m in the 2016 budget.97 Many individuals who should be in
long-term care are living in a less than ideal state in their homes; some, who cannot
find a suitable placement in long-term care, but cannot be at home, are being
charged $52.50 per day to “live” in the hospital – meaning a month’s stay would
result in a bill for $1575.00. More long-term care facilities are being built in the
97
Government of Alberta, Health Funding 2016-2017, Alberta Health
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province, most under a P3 (public/private partnership) model. Many of these are only
suited to seniors in higher wealth categories, however, with some monthly rents as
high as $6,000. Patients who cannot afford to pay this can apply for subsidy or
waiver, but there is little doubt this is still a challenge for many elderly people. The
risk of falling through the cracks for seniors without family support is worrisome.
HIGHLIGHTS
1) REDUCING THE LENGTH OF STAY FOR PATIENTS AFTER
SURGERY HAS BEEN AN ALBERTA HEALTH SERVICES
(AHS) POLICY FOR THE LAST NUMBER OF YEARS. FOR
ORTHOPEDIC SURGERIES, SUCH AS HIP AND KNEE, A 4-8
DAY POST-SURGERY STAY HAS NOW BECOME 2-4 DAYS;
AHS PLANS TO FURTHER REDUCE THE LENGTH OF STAY
TO A TWO-DAY MAXIMUM.
2) THE HOME CARE PROGRAM IN ALBERTA IS RAPIDLY
GROWING AND EXPANDING. THOUGH THIS AREA OF AHS
DOES NOT PROVIDE ANY FUNDING TO THE LENDING
CUPBOARD, HOME CARE IS ONE OF THE HIGHEST POINTS
OF REFERRAL FOR THE LENDING CUPBOARD.
3) INCREASED UNEMPLOYMENT HAS AFFECTED EXTENDED
HEALTH BENEFITS; AS SUCH, PHYSIOTHERAPY PATIENTS
ARE WAITING FOR THE HOSPITAL PHYSIO CLINIC RATHER
THAN UTILIZING PRIVATE PHYSIO CLINICS. THIS HAS
INCREASED WAIT TIMES FOR PHYSIO, AND MEANS THAT
PEOPLE WILL LIKELY BE RELYING ON MOBILITY AND DAILY
LIVING AIDS FOR LONGER PERIODS OF TIME.
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Why these Health Findings Matter to The Lending Cupboard
In the case of virtually every disease and disorder relevant to The Lending Cupboard and explored for this report, numbers of patients in Alberta are on the rise. This will increase demand on The Cupboard.
Reduced post-surgery lengths of stay in hospital means people need to be more reliant on family and community support and resources. The Lending Cupboard is a critical component of community support for patients who need mobility and daily living aids after discharge.
Demand on Alberta’s health care system continues to grow, along with costs. The Provincial budget is stretched, with a $10B deficit, and Health representing a large portion of that budget. Cost is increasingly a priority – possibly the priority – in decisions being made within the system. This leads to a reduction in the services available through the system, an increase in wait times for services, and, as stated, a need to rely heavily on community resources, as the system cannot bear more demand.
The Lending Cupboard does not lend hospital beds, because of the logistical difficulties in finding, storing, and maintaining these specialized beds. As evidenced by the growing numbers of people with chronic disease and the need to have people served through home care rather than in hospitals or long-term care facilities, there will be an increased need for hospital beds along with the equipment that The Cupboard does offer.
The Lending Cupboard is a critical component of community support
for patients who need mobility and daily living aids after discharge.
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4. Priorities for The Next Decade
The growing pressures facing Alberta, as relevant to The Lending Cupboard, are many and varied, as described throughout this report. These pressures include:
● A conservative economic forecast; ● A continued rise in unemployment (and/or steady rates for the next 2-3
years); ● A large Provincial deficit which will decrease investment in health care and
further delay infrastructure projects; ● An aging population; ● A growing population; ● Escalating disease levels; ● Growing wait times for surgery and treatment.
Each of these pressures in and of themselves would translate into growth in demand for
The Lending Cupboard’s services. Together, these elements mean that The Lending
Cupboard should expect to double the ten-fold growth it has experienced in its first ten
years. As such, the ten-year plan for The Cupboard must include these priorities:
● A Larger Facility ● Improved Systemization and Efficiencies ● Extended Hours of Operation ● Increased staff hours ● Volunteer Attraction and Training ● Partnerships with the Community ● Advocacy to Government ● Building Independent Regional Capacity ● Substantially Increased Community Support
Given all of the pressures facing government, business, and the social profit sector, it will
be increasingly important to organizational sustainability for community stakeholders to
adopt an adaptive leadership model, exploring new social innovation and partnership
opportunities. If we keep doing what we’ve always done, we’ll keep getting what we’ve
always gotten. The challenges identified in this study have real financial, social, and
human consequences, and the community must employ new ways of thinking and
working together if we are to turn these tides.
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4.1 Regional Capacity
The Lending Cupboard does not turn away anyone who enters its doors needing
medical equipment. Albertans have come from outside the Central Alberta region and
have received the equipment they requested. Still, roughly 75% of the equipment lent
is to residents of Red Deer, and about 24% goes to individuals from around the
region. During the community consultation phase of this project, it became abundantly
clear that the obstacles and challenges faced by rural communities in the region are
tremendous. Seniors are more likely to remain in their own homes and less likely to
have transportation options. Health care providers have enormous territories, larger
seniors’ populations and stretched resources.
The communities of Rocky Mountain House and Wetaskiwin are currently developing
local medical equipment lending initiatives similar to The Lending Cupboard. While
this will be an excellent addition to the community supports in those centres, and will
help alleviate the pressure off of The Lending Cupboard in Red Deer, the findings in
this report make it clear that more regional capacity is needed. Stettler, for example,
is a hub community whose health centre serves rural communities as far east as
Coronation. Rimbey, Ponoka and Innisfail all have large seniors’ populations and
active seniors’ resource centres. The Lending Cupboard can help communities that
wish to develop a local medical equipment lending initiative, which will grow to
become a great need in the coming years in Central Alberta.
5. Conclusion
Readers of this report may feel the need, at this point, to have their blood pressure
checked! The need is great, and certainly there is much cause for personal and collective
concern. The systemic pressures and community pressures are great, and mounting.
There are many issues in our province that require the attention and deserve the concern
of all levels of government, community organizations, businesses, and all Albertans. The
bottom line is that The Lending Cupboard is needed, now and more than ever going
forward.
Ultimately, the issues identified in this document are not Lending Cupboard issues; they
are community issues. The health, safety and vibrancy of our friends, neighbours and
family belong to all of us. It is to everyone’s benefit that The Lending Cupboard and other
community supports remain strong and well-positioned to meet the needs of Red Deer
and Central Alberta.
