When it comes to caring for seniors in Newfoundland's outport communities, there may be a homegrown model the provincial government can use — and it sprang from the cod moratorium imposed 30 years ago.
A program by the Canadian Mental Health Association trained community members — no matter their expertise — to help their neighbours cope with the depression, listlessness and anxiety that followed the moratorium, which wiped out jobs for more than 30,000 people.
That model of enabling people in the community to care for one another could be harnessed to help the province care for its rapidly aging rural population, says Dr. Samir Sinha, director of geriatrics at Toronto's Mount Sinai Hospital.
"I think similar models can be leveraged to really help combat social isolation and loneliness," Sinha said in a recent interview.
"If you look at countries around the world — even the United States, or in Japan, or Australia, New Zealand, in the United Kingdom — you can see a lot of initiatives that look like this kind of approach."
On July 2, 1992, as fish stocks collapsed, the federal government suspended all commercial cod fishing in the province, ending a major source of income in rural Newfoundland. Fish plants closed, small businesses shuttered and fishers laid off their crews and lost their livelihoods. Young people began moving away for jobs in other provinces, leaving behind devastated parents and grandparents.
After three decades of out-migration, Newfoundland and Labrador is home to Canada's oldest and most rapidly aging population: nearly one in four residents is 65 or older, according to the latest census data. Outside the capital city of St. Johns, many of them still live in tiny former fishing towns scattered along remote coastlines — and a long drive from the nearest doctor.
Sinha, who has advised several Atlantic Canadian provinces on senior care, says that rather than forcing seniors to move into long-term care facilities in larger towns, Newfoundland and Labrador should look at programs that empower communities to allow people to age safely and happily at home.
That was exactly the idea behind a project Susan McConnell helped launch after the moratorium, through the local Canadian Mental Health Association chapter and with its then director, Moyra Buchan.
"People in the communities were suffering, and services to communities were sparse, if existent at all," McConnell said in a recent interview. "And I think we both had a belief that we could teach people how to be more helpful to each other."
The idea was to train people in rural communities — church group leaders, Rotary Club members — in basic therapeutic practices. They were taught to listen, to ask pertinent questions and how to interpret complicated emotions. McConnell calls it "building helping skills," and she said she trained people from about 10 different rural Newfoundland communities.
Those people were then given the tools they needed to lead their own helping skills workshops, so they could train even more people.
"For years, I would run into people who told me they had taken the course in some community," McConnell said. "And they told me how it changed the way they were trying to be helpful."
Programs like McConnell's are cropping up across the world to help seniors age at home, Sinha said.
The initiatives he points to involve training community members — the postmaster or a trusted municipal official, for example — to check in on local seniors and make meaningful connections with them.
They're also taught to look for risks of falls and to ensure seniors are aware of events happening in the town and what services are available to them.
Most of all, they can be a point of meaningful contact to help stave off loneliness, he said.
Loneliness, Sinha said, can have the same health impact as smoking 15 cigarettes a day. Lonely seniors are more likely to call 911 and to have longer hospital stays, he said.
The potential to take a load off the health-care system with preventive, community-based strategies targeting loneliness is "quite significant," Sinha said. "It's actually a cost-saving measure."
Both Sinha and McConnell said involving community members in the programs has another major advantage: "They're more likely to be trusted in that community than someone like myself, who's not from there," Sinha said.
And in the case of the program McConnell led, the people who gave the training may not have had professional credentials but they were familiar faces who people were used to chatting with.
"There were a lot of people that had a lot of concerns about anybody who didn't have their master's degrees or their doctorate degrees actually trying to be helpful," she said. "And I'm thinking, 'Well, they already are."'