Chapter 2: Finding Your Way Through the System

Getting organized

Most people have a lot of information about their health and their affairs and legal matters. Make sure the personal information of your loved one is up to date. You will need this information when talking to health care providers and in an emergency.

Medical information

Keep a list of your loved one's medicines. Write down how much they take, how often and when they take them. Keep the list up-to-date. Ask the pharmacist to print out a list for you. The list should include any non-prescription drugs, such as vitamins, minerals and natural remedies. Keep this list with you and show it whenever you meet with a health care provider.

Emergency contact information

Place emergency information near the phone where it is easy to find. Keep the emergency phone number for your area (example: 911) and the names and phone numbers of health care providers. Include names and phone numbers of people you can call after hours. Also, have a list of people to call if your loved one has a change in their health.

Make two copies of this information; put one in your wallet and give a copy to your loved one.

Banking

Your loved one may need help taking care of their personal affairs, like paying bills or making a will. You may want to think about hiring a financial planner, a lawyer or both to help you.

Make a list of your loved one's important papers and write down where they are stored. This list should include the following:

identification - birth certificate, marriage certificate, passport, proof of citizenship, social insurance number
bank account information - bank accounts, mortgages, credit cards, lines of credit, loans
investments - RRSPs, pension plans, mutual funds, stocks, bonds, RESPs, etc.
wills, Power of Attorney for Care and Power of Attorney for Property and any documents related to funeral arrangements
key assets or income - details of vehicle ownership, property ownership, income sources, most recent tax returns, insurance policies, utility payments, post office box key and safe deposit boxes
phone numbers for any lawyers, financial planners or accountants

Tips

Do not rely on your memory. It is best to know where to find the papers before you need them.

Your loved one may not want to share personal, banking or legal information with you. If this is the case, tell them that you are worried about an emergency. You want to make sure you know all their wishes. You do not need to see the papers - you only need to know where to find them in an emergency.

To make things easier, you might need to change the way your loved one does their banking. You might want to set up some of the following:

joint access to safe deposit boxes
automatic payment of regular bills
power of attorney documents
direct deposit of pay cheques and benefits
joint bank accounts so that bills can be paid and money taken out in an emergency

Remember that the person you are caring for is still in charge of decisions unless he or she becomes mentally unable to do so.

If you need help, you can find free or low-cost sources of financial advice. Some associations, membership groups and non-profit organizations offer such services. See the Resources list at the end of this section for more information.

Do not forget to ask your own family and friends - you may know someone who is a financial expert!

It is a good idea to talk to your loved one about fraud or defrauds. Some con artists try to sell things to older people or take advantage of them. Tell your loved one to call you if they do not trust what a person is telling them. You may need to report it to the police.

Government Programs and Benefits

Some federal government policies and services may help you as a caregiver or your loved one. Here is a list of some programs you may be able to use.

Old Age Security Program
Canada Pension Plan
Employment Insurance (EI) Compassionate Care Benefits

Services for Veterans

Veterans Affairs Canada
Veterans Independence Program

Income Tax Deductions and Credits

Caregivers can get a number of income tax deductions and credits. You can find information about what you can claim at the Canadian Revenue Agency.

You may want to look up the following items on the Canadian Revenue Agencies web site to see if these credits can help you:

caregiver credit infirm dependant deduction
personal disability credit
medical expenses credit
basic personal credit
age credit
spousal credit
eligible dependant credit
spousal transfer credit
registered disability savings plan
child disability benefit (CDB)

Legal affairs

All of us should be ready for what might happen if or when we get sick and eventually die. It is important to have the right legal papers in place to protect you, your property and your loved ones.

As a caregiver, you should also make sure your loved one has the following legal papers in place:

Advance directives (Living will)

When your loved one is still well, they will prepare "advance directives". Use these instructions for future medical care when he or she can no longer communicate with anyone.

As a caregiver, know your loved one's wishes. Ask them to share their thoughts so you can make sure that everyone (health care provider and family members for example) follows their wishes.

Powers of attorney

Powers of attorney are legal papers giving someone you trust the power to make decisions for you while you are alive if you cannot make the decisions on your own. This might happen in situations where you are unconscious; have a stroke or get Alzheimer's disease and cannot take care of yourself. You must be of sound mind and capable to name your powers of attorney. If not, you will not be able to complete these.

Continuing Power of Attorney for Property:
A Continuing Power of Attorney for Property lets you name a person to make financial choices for you. If you do not have a power of attorney for property and you can no longer make your own choices, the government will assign a guardian to make these choices for you.

Power of Attorney for Personal Care:
A Power of Attorney for Personal Care lets you name a person to make decisions about your care.

The Power of Attorney's job is to make sure they follow your wishes. A lawyer can make these documents for your loved one. You can also use a do-it-yourself kit.

For information about Power of Attorneys and Advance Directives in Ontario, visit the Ministry of the Attorney General's website.

DNR (Do not resuscitate) order

This is a doctor's order written in the chart that tells the medical staff not to revive a person if their heart stops or they stop breathing. The doctor writes this order after talking to the person or their Power of Attorney for Personal Care. The person or their Power of Attorney for Personal Care can change this order at any time. Talk to your health care provider for more information about DNR orders.

Wills

A will is a legal paper that lets everyone know how you want to divide up your estate after death. An estate is everything that you own or partly own. A will makes sure everyone follows your wishes about your estate.

If your loved one does not have a will, talk to them about making one. It can prevent problems in the future. You can get a lawyer to help, or use a do-it-yourself kit. Go to your province or territory's website and link to the Ministry of the Attorney General for information about wills. You can also check your local bookstore for kits.

Preplanning funerals

Many people plan for their funeral ahead of time to make it easier for their families when they die. Ask your loved one if they have made any arrangements. If not, you can ask what they want done when they die. Some questions you can ask: What type of funeral do they want? Do they want to be cremated? Where do they want to be buried?

Tips

It may be hard to talk about these things with your loved one, but it is important to know what they want. Tell them that you need to talk about their wishes so that you can make sure you know what to do for them in the future.

Give us your feedback

Please share your comments or concerns on this section of the Guide. Your comments are important to us. We appreciate and thank you for taking the time to complete this short Feedback Survey. If at any time, you wish to speak with a nurse at Ottawa Public Health please call 613-580-6744 TTY/ATS: 613-580-9656 or email us at healthsante@ottawa.ca

Talking with Health Care Providers

As a caregiver it can be hard to know when to talk with health care providers and when not to. Be clear with your loved one and tell them that you are trying to help but do not take control. Here are some ideas to find out if your loved one needs your help:

ask your loved one if they can get the information that they want
ask if they are comfortable talking with health care providers
ask them if it is ok for you to help

Tips

You can help your loved one stay in control by looking at them when a health care provider asks questions. Let your loved one answer first.

Questions for health care providers

It can be hard to talk to health care providers, especially when you do not know some of the words they are using. Here are some common questions you might want to ask:

Tests

The doctor might order tests to find out what could be wrong with your loved one, or to see if they are getting better, worse or staying the same.

Ask questions about:

why the test is being done
how a test will be done and how it will affect the person
what the test will show
what will happen if the test is not done

Illness

Ask questions about:

causes
what to expect with the illness as time goes on
if the illness can be passed on to others
how to stop the illness from being passed on to others

Treatment choices

There might be more than one way to treat an illness. There are also times when no treatment is available.

To help your loved one make the best decision about treatment, make sure they understand all the types of treatment. This will help them feel less anxious.

Ask questions about:

how the treatment will affect the illness
how the treatment will help with the symptoms
how the treatment is done
what are the side effects of the treatment - physical, mental and emotional
what will happen if no treatment is done
what are non-medical options for treatment

Medications

The health care provider might give your loved one new medication when you go for an appointment.

Ask questions about:

why does your loved one need the medicine
how should they take the medicine and for how long
what are the side effects of the medicine
what should they do if they have a side effect
is the medicine safe to take with other medicines or dietary supplements
should they have any foods or drinks with the medicine
should they stop certain activities and do others
do they need to take any tests...like blood test or x-rays...while taking this medication

Remember: Make sure you can read the prescription if the doctor writes it by hand.

You can ask a health care provider if they have any written information about the medicine.

Health care and supportive care services for you

Primary care

Primary care is usually the first step to enter the health system. This is where people get care for most of their everyday health needs. Primary care means care given by family doctors, nurses, dieticians, mental health professionals, pharmacists, therapists, and others. In Canada, you usually start with visiting a family doctor or a general medical practitioner. They focus on finding out what is wrong and treating the illness or injury.

Primary care services include teaching ways to avoid illness, finding out what is wrong, treating illness and follow-up care. They might refer your loved one to a specialist or send them for more testing.

Your loved one's primary care provider is important. It is the first place to go with your questions or concerns. Keep their number in a place where you can easily find it.

Home care

Home care includes many services that help people with a wide range of health problems and disabilities to live in their home.

Services can include:

an assessment to see what your loved one needs help with
a person to coordinate the care and services (sometimes called a case manager)
nursing services
homemaking and/or personal support services
rehabilitation services: physiotherapy, occupational therapy, speech language pathology, dietician services, and social work
oxygen and respiratory therapy
respite services (a temporary break from caregiving)

The hospital, government or agency providing the home care pays for most of these services. Personal care and homemaking services might have user fees. Private insurance plans might cover some of these user fees.

Your local Community Care Access Centre will have information about these services. For more information: 613-745-5525.

Visit the government provincial and territorial site to find out about publicly funded home care programs in your area.

Respite services

Respite care is short-term care given by trained individuals that lets you take a break from caregiving. This means you can take the time to do something for yourself and renew your energy. If you are a full-time caregiver, try to get some respite on a weekly basis.

Tips

leave the names of other family members as emergency contacts
try not to focus on caregiving or the person you are caring for - they are safe
remind yourself that getting a break is important and will help you be a better caregiver
be realistic in what you expect when you return to care for your loved one - the situation itself did not change, but your ability to deal with it might have changed

Depending on where you live, you may be able to get respite services at very little or no cost. You might get services in the home, or through facilities with short-term care placements used for respite. See the Resources list at the end of this section for more information about respite.

Adult day programs

Adult day centres are one type of respite. These programs let you drop off your loved one at a centre for the day and know that they are safe. These programs are good for your loved one because they give them a chance to take part in activities and to meet other people. Adult day programs are also good for the caregiver because they give you a break. Adult day programs include some of the following services:

personal care
exercise programs
social activities and other fun activities
activities to stimulate the mind
meals
transportation to and from the program
therapies and other medical services
counselling and emotional support
information

Call 211 for a list of community and older adult centres that have adult day programs.

Other services

There are other services to help people stay in their homes and do as much as possible for themselves. Go to the Ottawa Community Support Coalition website to find a service near you.

Meal programs - services can be in the home or in one central place (such as Meals on Wheels).

Transportation services - can provide driving to and from appointments, day programs, etc.

Emergency response systems - allow a person to get help and emergency services by pushing a button on a bracelet or necklace.

Volunteer services - give many of the services for little or no charge. Trained volunteers can provide meals, driving and friendly visiting. They can give you a break from care and keep your loved one company.

Hospice/palliative care -is for people at the end of their life. The focus is on comfort and making their last few days or weeks as peaceful as possible. This service can help:

manage pain and symptoms
provide emotional, psychosocial and spiritual support
provide grief and bereavement counselling

Home care programs or other government-funded programs offer these services and can be in the home or in a facility. See Chapter 5: Providing Care at End of Life section for more information on palliative care.

Residential Care (Long-term Care, Retirement Home)

Sometimes caregivers may feel guilty about wanting to place their loved one in a nursing home. However, this type of care may be what is best for your loved one. Here are some times when you might have to place your loved one in a nursing home:

you cannot give the type of care your loved one needs
your loved one needs 24-hour care
you cannot find or pay for the help your loved one needs
the health and safety of your loved one is at risk if they stay at home
your own health is at risk if you keep taking care of your loved one at home

In the past, you might have told your loved one that you will not put him or her in a nursing home. You made this promise when neither of you could know how hard it would be to provide around-the-clock care. Consider your current situation carefully and ask yourself these questions:

can you give the care that keeps your loved one safe and comfortable? Do you have to cut corners because you cannot keep up?
can you afford to quit your job or hire the help you need?
will your loved one be afraid to stay alone for hours at a time when you cannot be there? Will you worry about your loved one being alone for hours at a time?
does your loved one lie in their bed for a long time and have to wait until you return to go to the bathroom?

A retirement or nursing home can be the best choice, but, not always the easiest choice to make. It is a good idea to involve everyone in the discussion, and to take time to find out about all your choices. It is important to know that waiting lists can be very long for nursing home beds, especially for government-funded facilities. You may not be able to choose where you place your loved one in an emergency. That is why planning can be very helpful.

If you are not sure a nursing home is the best choice, you might want to think about trying a respite or short-term placement. With stays ranging from two to six weeks, this will allow your loved one to try out the place. You will also be able to see if this is a good place for your loved one.

There are different types of nursing homes available. The government funds or partially funds some of them. Public programs cover some of the costs of services in these facilities, but residents pay other costs.

Other nursing homes are privately owned and do not get any government funding. This means that residents pay for the services provided.

You may want to look for the nursing home that best meets the needs of your loved one because the types of services offered will be different in different homes.

Here is how you can find out about residential care options:

visit the Ministry of Health and Long Term Care¹website to get more information on residential care facilities.
your local Community Care Access Centre will have information about these services. You can call them at 613-745-5525
look at local directories in your community for older adults' residences
ask health care providers for ideas
seek advice from friends and colleagues
look in your phone book, the Yellow Pages or online under headings such as:
- homes for elderly
- nursing homes
- rest homes
- retirement homes
- long term care facilities

Give us your feedback

References

Ontario Ministry of Health and Long Term Care [Internet]. Toronto (ON): Queen's Printer for Ontario; c2009-2010 [last modified 2013 Jul 05]. Home, Community and Residential Care Services for Seniors: c2008 [last modified 2012 Aug 31]; [cited 2013 Jul 18]; [about 2 screens]. Available from http://www.health.gov.on.ca/en/public/programs/ltc/

Tips to Find Your Way

Taking care of someone else can be very hard. You need to learn new skills as well as learn all about the health care system. This can feel like too much at times. This section of the guide gives you tips to help you find your way.

Tips

learn as much as you can about your loved one's illness. This will help you to plan for changes that might happen.
keep your loved one's health, legal and banking information all together and make copies of everything. Always take their health care information to appointments.
find out where to get help. Start with your primary health care provider. You can call the Ottawa Public Health Information Line at 613-580-6744, search the Internet or go to the Resources listed at the end of this section.

Understanding common illnesses

The next few pages give you some facts about common illnesses and links to places where you can get more information.

Alzheimer's disease

Alzheimer's disease is a type of dementia. The risk of developing Alzheimer's doubles every five years after the age of 65. The risk reaches almost fifty percent after the age of 85.¹ Alzheimer's disease causes a slow decline of brain functions. Signs include:

memory loss
poor judgment and reasoning
extreme changes in mood and behaviour
loss of ability to care for themselves

Even though there is no cure for Alzheimer's disease, the sooner that you find it, the better the medications and treatment will work. Early warning signs can be:

forgetting how to do the things they do every day
having a hard time doing things they normally do every day like washing their face
problems with language
not knowing what time it is and where they are
poor or less judgment
problems with planning ahead for things
losing things
changes in mood or how they are acting
changes in personality
loss of interest, not wanting to do anything²

For more information: Alzheimer Society of Canada

Arthritis

The term arthritis comes from the Greek "arthro" which means joint and the Latin "itis" which means inflammation. The term refers to over 100 conditions that affect people's joints.

Arthritis can affect anyone, no matter his or her age, physical condition or ethnic background.

The most common symptoms are joint pain, stiffness and swelling. These symptoms can often get in the way of a person's daily activities.

There are two main types of arthritis:

Inflammatory arthritis happens when a person's immune system attacks the joints, causing inflammation, swelling and pain. The most common form is rheumatoid arthritis. Other forms include lupus and gout.

Osteoarthritis happens when there is damage in and around the joints that the body cannot repair. It can be caused by injury or other factors. When the tissue protecting the ends of bones begins to wear away, there can be pain, stiffness, swelling and bone-on-bone movement in the joint.³

People living with arthritis can face disability and poor quality of life. However, they can lead active lives, avoid permanent damage if they notice the arthritis, and seek treatment early.

For more information: The Arthritis Society

Cancer

Cancer is a disease that starts in the body's cells. Millions of cells make up our bodies. Groups of cells make up our tissues and organs, like muscles and bones. Genes inside each cell make the cell grow, work, reproduce and die. Most of the times our cells do what the genes tell them and that is why we stay healthy. When messages to our cells are mixed up, cells start to form lumps or tumours.

Tumours can be benign (non-cancerous) or malignant (cancerous). Benign tumour cells stay in one place in the body and are usually not life threatening. Malignant tumour cells (metastases) are able to spread to nearby tissues and other parts of the body.

Cancer types get their names from the body part where they started. For example, bladder cancer with lung metastases is a cancer that starts in the bladder and spreads to the lungs.

For more information: Canadian Cancer Society

Chronic obstructive pulmonary disease (COPD)

COPD includes a number of lung diseases. The most common are emphysema and chronic bronchitis.

Emphysema is damage to the air sacs at the tips of the airways. This makes it hard for the body to take in the oxygen it needs.

Chronic bronchitis is irritated airways that make too much sticky mucus; the walls of the airways swell and partly block the air from passing through.

These illnesses together make it hard to breathe because:

the airways and air sacs in the lungs lose their shape and don't stretch well
the walls between the air sacs are destroyed
the walls of the airways become thick and swollen
the cells in the airways make more mucus than normal and block the airways

People who have a hard time breathing find it hard to care for themselves. They can get anxious, panicky or depressed. Many spend more time in the hospital.

Smoking causes 80-90% of COPD cases.⁴ Other causes are:

second-hand smoke
having lung infections as a child
dust or chemicals at work and in the environment

For more information: The Lung Association

Delirium

Delirium is a type of confusion in older adults. Dementia does not cause delirium. A medical cause like an infection or new medication can cause sudden delirium. People who have delirium might be confused and might not be able to talk normally. They might hallucinate (see, hear, feel, smell or taste something that is not there). Hallucinations can seem real and be very scary. A person who has delirium has a hard time focusing, following instructions or directions, and thinking clearly. They might be alert one moment and asleep the next. Delirium is a medical emergency that needs treatment right away.

For more information: Delirium Booklet

Dementia

Dementia, a problem in a brain, is a sign of a disease and not the name of a disease. People with dementia have trouble to:

name things and people
make decisions (safe and unsafe, appropriate and not appropriate)
plan ahead
know who you are, where they are and what time it is
recognize their family members and friends

There are different kinds of dementia and Alzheimer's disease is the most known type.

For more information: Alzheimer Society of Canada

Depression

Depression is the most common mental health problem for older adults and can deeply affect all parts of their life, their family and their community. Depression is common but it is not a normal part of aging. Common signs of depression are, less energy, less interest in things, poor sleep, and obsession with health problems.

Often these sign are mistaken as part of aging but it is possible that these signs are symptoms of a depression, which can be treated.⁵

For more information: National Institute of Mental Health

Diabetes

Diabetes is a major health problem for people across Canada. There are three types of diabetes: Type 1, Type 2 and gestational diabetes.

Type 1 diabetes happens when the pancreas cannot make insulin. Insulin is a hormone that your body needs for energy. You find Type 1 diabetes in children or adolescents. About 10% of all diabetes is Type 1.

Type 2 diabetes happens when the pancreas cannot make enough insulin or when the body does not use the insulin well. About 90% of all diabetes is Type 2. Type 2 diabetes happens mostly in adults but it is starting to happen more in children.⁶

Gestational diabetes happens during pregnancy and goes away when the woman is no longer pregnant. It happens in about 2 to 4% of pregnancies⁷, and can lead to a higher risk of diabetes for both mother and child later in life.

Helping your loved one manage their diabetes can seem overwhelming. They may need help with medications, checking blood sugar, foot care and treatment of injuries. They may also need some help to ensure they are eating well. They may experience some loss of vision. Regular eye exams and controlling blood sugars are keys to prolonging vision. There are many services available to help you and your loved one.

For more information, visit Canadian Diabetes Association and Diabetes and You. You can also visit the cnib for more information on Diabetic Retinopathy (vision loss with diabetes).

Heart disease

Heart disease is a group of diseases that affect the heart. Some illnesses include angina, arthrosclerosis, cardiomyopathy, coronary artery disease, heart attacks and valve problems. Each disease is different and so is the treatment. Coronary artery disease (CAD) is the most common. With CAD, the blood vessels in your heart become blocked. This stops oxygen-rich blood from reaching your heart and can cause chest pain or even a heart attack.

Heart disease is common in Canada. In Ottawa, 28% of deaths resulted from major cardiovascular causes.⁸ In 2009, 19% of deaths in Ottawa were due to heart disease.⁹

Ninety percent of Canadians have at least one risk factor for heart disease or stroke.¹⁰ These risk factors include smoking, drinking too much alcohol, not enough exercise, obesity, high blood pressure, high blood cholesterol and diabetes.

For more information: Heart and Stroke Foundation

(Hypertension) High Blood Pressure

Your heart pumps blood. Blood pressure is the force of blood against your blood vessels (also called arteries). This force makes the blood flow throughout your body, bringing nutrients and oxygen.

High blood pressure, also called hypertension, means there is too much pressure in your blood vessels. This can damage your blood vessels and cause health problems. Anyone can have high blood pressure, but it is more common as you get older.¹¹

For more information: Hypertension Canada

Multiple sclerosis

Multiple sclerosis (MS) is a disease of the central nervous system that gets worse over time. No one knows exactly what causes MS. It is the most common disease of the brain affecting young adults (between 15 to 40 years old) in Canada and is three times more common in women than in men.¹²

MS damages the myelin (the cover that protects the brain and spinal cord).Damage is done to the myelin and blocks or changes nerve impulses. This may cause many different MS symptoms such as:

loss of balance
problems speaking
feeling very tired
seeing double

It is important to remember that your loved one's symptoms may not be the same as another person's symptoms and may not happen at the same time as theirs.

For more information: Multiple Sclerosis Society of Canada

Osteoporosis

Osteoporosis is a condition that causes bones to become thin and brittle. This leads to a higher risk of breaking a bone. The most common bones affected are the wrist, spine, shoulder and hip.¹³

Osteoporosis can happen at any age and affects both men and woman.

At least one in three women and one in five men will suffer from a fracture from osteoporosis during their lifetime.

Building strong bones during childhood and adolescence can be the best way to prevent osteoporosis later in life.

For more information: Osteoporosis Canada

Parkinson's disease

Parkinson's disease happens when certain nerve cells (neurons) in a part of the brain die or are damaged. Over time, this causes the body to make less dopamine (a chemical that helps your body to move smoothly and be coordinated). When there is a large amount of damage, the symptoms of Parkinson's disease start to show up.

Nearly 100,000 Canadians have Parkinson's disease and eighty-five percent of them are over the age of 65.¹⁴

For more information: Parkinson Society of Canada

Stroke

A stroke is a sudden loss of brain function. An ischemic stroke happens when blood flow to the brain is blocked. A hemorrhagic stroke happens when a blood vessel in the brain breaks. When a stroke happens, the cells of the brain die. The effects of a stroke depend on where the brain is hurt and how much damage there is. For example, a stroke in one area of the brain may affect how you move, and in another area, it may affect how you see, remember, speak, reason, read and write.

Stroke is the third cause of death in Canada¹⁵ and can happen at any age; but they happen more often in people over the age of 65 years.¹⁶ There are over 300,000 Canadians living with the effects of stroke.¹⁷

The five warning signs of a stroke are:

weakness - sudden loss of strength or sudden lack of feeling in the face, arm or leg, even if it only lasts a short time
trouble speaking - sudden trouble speaking or understanding or sudden confusion, even if it only lasts a short time
vision problems - sudden trouble with seeing, even if it only lasts a short time
headache - sudden, severe or unusual headache
dizziness - sudden loss of balance, especially when it happens at the same time as any of the above signs¹⁸

Watch for these warning signs and get help as fast as possible. After a stroke, a person has a 20% chance of having another stroke within two years.

For more information: Heart and Stroke Foundation

Other illnesses

Many other illnesses can affect your health or your loved one's health. See the Resources list at the end of this section for more information.

Give us your feedback

References

Alzheimer's Association [Internet]. Chicago (IL). Risk Factors: Age c2013. [cited 2013 July 29]; [about 3 screens]. Available from http://www.alz.org/alzheimers_disease_causes_risk_factors.asp
Alzheimer's Association [Internet]. Chicago (IL). 10 Early Signs and Symptoms of Alzheimer's c2013. [cited 2013 July 29]; [about 3 screens]. Available from http://www.alz.org/alzheimers_disease_10_signs_of_alzheimers.asp
The Arthritis Society [Internet]. The Arthritis Society; 2013. Arthritis Facts & Figures; 2013; [cited 2013 November 6]; [about 3p.]. Available from: http://www.arthritis.ca/facts.
Public Health Agency of Canada [Internet]. Ottawa: Public Health Agency of Canada; 2013 [modified 2013 Jul 26]. Chronic obstructive pulmonary disease (COPD); 2013 [last modified 2013 Feb 08, cited 2013 Jul 26]; [about 1 screen]. Available from http://www.phac-aspc.gc.ca/cd-mc/crd-mrc/copd-mpoc-eng.php
Buchanan D, Cappeliez P, Flint A, Frank C, Herrmann N, Janikowski P, Malach FM, Mokry J, Spanjevic L, Tourigny-Rivard MF. National guidelines for seniors' mental health: The assessment and treatment of depression. Can J Geriatr [Internet]. 2006. [cited November 19, 2013]; 9(Suppl 2):52-58. Available from http://www.ccsmh.ca/pdf/final%20supplement.pdf
National Center for Chronic Disease Prevention and Health Promotion [Internet]. Atlanta (GA). Diabetes Public Health Resource. [last modified 2011May 20]; [cited 2013 July 29]; [about 3 screens]. Available from http://www.cdc.gov/diabetes/
Life Labs: Medical Laboratory Services [Internet]. British Columbia. Diabetes: c2013. [cited 2013 July 29]; [about 2 screens]. Available from http://www.lifelabs.com/Lifelabs_BC/Patients/MedicalConditions/Diabetes.asp
Ontario mortality data 2009, Intellihealth extracted November 18, 2013, Health Planning Branch, Ontario MOHLTC Major cardiovascular diseases (ICD-10-CA: ICD I00-78)
Ontario mortality data 2009, Intellihealth extracted November 18, 2013, Health Planning Branch, Ontario MOHLTC Heart diseases (ICD-10-CA: I00-09;I11;I13;I20-I51)
Public Health Agency of Canada [Internet]. Tracking Heart Disease and Stroke in Canada, c2009. [cited 2013 July 29]. Available from http://www.phac-aspc.gc.ca/publicat/2009/cvd-avc/pdf/cvd-avs-2009-eng.pdf
Hypertension Canada. What is Blood Pressure? What is High Blood Pressure [Internet]. 2013 [cited Nov 06, 2013]. [about 1 page]. Available from: http://hypertension.ca/en/hypertension/what-do-i-need-to-know/what-is-high-blood-pressure
Multiple sclerosis society of Canada [Internet]. Toronto: the Multiple Sclerosis Society of Canada; c2011 [cited 2013 July 26]; [about 1 screen]. Available from http://mssociety.ca/en/information/default.htm
https://osteoporosis.ca/about-the-disease/fast-facts/
Parkinson Society Canada. Parkinson's disease social and economic impact. Research report. Parkinson Society Canada, 2003[cited 2013 Jul 26]. Available from http://www.parkinson.ca/atf/cf/%7B9ebd08a9-7886-4b2d-a1c4-a131e7096bf8%7D/PARKINSONSDISEASE_EN.PDF
Hakim AM, Silver F, Hodgson C. Organized stroke care: A new era in stroke prevention and treatment. Canadian Medical Association Journal 1998; 159(6 SUPPL):S1.
National Institute of Neurological Disorders and Stroke [Internet]. What You Need to Know About Stroke. [last modified 2013 June 18]; [cited 2013 July 29]; [about 3 screens]. Available from http://www.ninds.nih.gov/disorders/stroke/stroke_needtoknow.htm
Public Health Agency of Canada [Internet]. Tracking Heart Disease and Stroke in Canada, c2009. [cited 2013 July 29]. Available from http://www.phac-aspc.gc.ca/publicat/2009/cvd-avc/pdf/cvd-avs-2009-eng.pdf
Heart and Stroke Foundation [Internet]. Stoke Warning Signs c2013. [last modified 2011 October]; [cited 2013 July 29]; [about 1 screen]. Available from http://www.heartandstroke.on.ca/site/c.pvI3IeNWJwE/b.3581689/k.780C/Stroke__Warning_Signs.htm

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