We are running out of time. Toronto needs a dementia-friendly action plan to provide concrete support for affected residents and their families.

Although there is a need for action in all parts of Canada, it’s particularly acute in Toronto and Ontario. Solutions enacted here could be a model for the rest of the country.

Ontario is expected to experience the highest surge in dementia cases in Canada, with projections of a 202-per-cent rise in the next 30 years, culminating in 1.5 million new instances of Alzheimer’s disease as the most common cause of dementia by 2050.

The situation is particularly dire in Toronto because the proportion of its population over age 65 is projected to grow to 21.2 per cent by 2041. This aging population also means Toronto will need to deal with a rising tide of people affected by dementia.

Due to the progressive nature of dementia and insufficient community health support from provincial and federal governments, the City of Toronto must turn to the real stakeholders for solutions in this affair – its communities, networks, businesses, resources and social capital.

There are several sensible, low-cost strategies for the city to implement that would address its challenges with fiscal responsibility in mind.

Training is one key

Toronto should adopt a comprehensive approach to educating public servants as well as those in businesses and sectors directly interacting with the public such as Service Ontario, post offices, banks, police forces, fire departments, grocery stores, pharmacies and dental offices.

It should also mandate that all city staff complete a short certificate course on how to serve and accommodate people with dementia as part of Toronto’s priorities regarding accessibility, inclusivity and equity.

This course can be offered in collaboration with the Alzheimer Society of Toronto, which has the personnel, technical infrastructure and course content.

The course can be tailored to different audiences of various abilities across multiple platforms – in-person, virtual and distance (self-study) courses. The training of the entire city staff can be accomplished in six months.

Toronto should also encourage financial institutions, corporations and businesses to include a similar mandate in their accessibility and training programs.

Make improving accessibility for people with dementia a priority

In addition, the city can foster accessibility for people affected with dementia via several initiatives.

Public buildings and spaces can be easily enhanced with little cost by adopting in bylaws the basic principles of designing dementia-inclusive spaces.

For instance, implementing straightforward interventions like using signage, wayfinding aids, appropriate wall colours and adequate lighting in settings such as community centres, churches, museums and subway stations can greatly benefit individuals with dementia who often experience altered visual perception affecting colour, depth and distance.

Additionally, ensuring that items such as toilet paper are easily visible can significantly enhance the inclusivity of these environments for people with dementia.

The city can help launch adult day programs and re-evaluate existing ones, with community centres, associations and parks used as hosts.

Adult day programs can eliminate several modifiable risk factors such as social isolation and physical inactivity associated with dementia. Tackling these risk factors can reduce the prevalence of dementia by 40 per cent. They can also contribute significantly to our seniors’ and their families’ quality of life.

They are financially significant both for the individual and the city. The cost of providing care is high and family caregivers spend an average 26 hours per week doing so. Delaying the significant impact of dementia can reduce the number of caregiving hours as well as help relieve stress on health-care providers in hospitals and nursing homes.

However, current adult day programs cater – not exclusively but predominantly – to individuals with English-speaking backgrounds.

According to Toronto’s seniors strategy 2.0, approximately “15 per cent of senior Torontonians cannot speak English.” It is also important to note many patients revert to their mother tongue as dementia progresses.

Therefore, the city must gear adult day programs for people with dementia to different socioeconomic conditions, abilities, gender, sex and racial groups. It must also avoid a one-model-fits-all strategy. Each culture understands dementia differently and deals with a unique set of challenges. There is always a risk of violating community principles, goals and values.

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Therefore, it must consult with community members as well as dementia and cultural specialists to ensure the viability, equity, inclusivity, accessibility and efficacy of its programs.

For example, active consultation is necessary with First Nation communities and leaders because their understanding of dementia, cultural practices and needs are radically different from the standard definitions of care in the West.

The city should also consult various stakeholders such as colleges, universities and health-care networks to engage students and future leaders as volunteers or in co-op programs.

Conduct an active awareness campaign

The findings from The Royal Society of Canada’s Task Force on COVID-19 shed light on a concerning issue: The marginalization of residents and workers in Ontario’s long-term homes has undermined possibilities for recognition of their personhood.

In this light, the city must launch an active awareness campaign to foster recognition of the personhood of people affected with dementia. This campaign can be implemented via various platforms and strategies:

  • Use story signage in public spaces such as metros and parks. Story signage, strategically placed in public spaces, harnesses the power of narrative techniques such as character development and plot arcs to evoke emotions, engaging and educating viewers effectively.
  • Install artworks produced by people affected with dementia across city landmarks in collaboration with its public art strategy.
  • Build partnerships with communities to launch festivals, events and intergenerational social interactions such as dementia cafés as non-judgmental spaces for individuals with dementia and their families.
  • Allocate dementia-specific awards to researchers, nurses, personal support workers and community centres.
  • Use social media platforms to promote and facilitate access to the provisions provided by the city.
  • Build parentship with various stakeholders to enhance campaign impacts and initiatives such as financial institutions, provincial and federal governments, the Alzheimer’s Society of Toronto and local sports salons.

The estimates about the higher number of individuals living with dementia in the near future indicate a pressing need to increase levels of health and social care.

A dementia-friendly action plan would have a positive impact on struggling individuals and families. It would also improve their quality of life and contribute significantly to their safety, health, social and economic well-being and inclusion.

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Farzad Shahinfard
Farzad Shahinfard is an adjunct professor of English and social science at Sheridan College. He is interested in the intersections between critical theory and AI ethics, AI governance, the arts, education and health-care policy.

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