CHASIcast: Dr. Shelley Canning discusses Canada’s aging population, nursing, and her dream course

After a brief hiatus, the CHASIcast returns with Dr. Shelley Canning. As an associate professor in nursing, director of the Centre for Education and Research on Aging (CERA), member of UFV’s Board of Governors, and a CHASI Faculty Associate, Dr. Canning brings considerable knowledge to our podcast.

Dr. Shelley Canning sits on a couch in a radio studio opposite Dr. Martha Dow. They speak into microphones, with a glowing orange “on air” sign on the wall above Dr. Canning. A quote superimposed on the lower third of the image reads: “I think we lost our way. So we lost our focus, and we lost our place at the bedside, and we lost our passion for that hands on nurse. Nurses, we do bodily care, we work with our hands, and there’s great pride, I think, in doing that. But we kind of turned away from that work. And what I think the last couple of years of COVID has shown us is that that work is what’s needed.” The quote is attributed to Dr. Shelley Canning.

Dr. Canning’s efforts recently contributed to UFV becoming the first university in B.C. to receive Age-Friendly University status. Alongside celebrating that accomplishment, Dr. Canning and host Dr. Martha Dow discuss Canada’s aging population, how the nursing profession has perhaps lost it’s way, and Dr. Canning’s dream of aging education that reaches across disciplines.

To hear more about Dr. Canning’s work, follow her on Twitter at @shelley_canning.

Hosted by CHASI’s director Dr. Martha Dow and recorded in CIVL Radio’s studio at the University of the Fraser Valley, the CHASIcast is available to stream below, or on Spotify, Apple Podcasts, , Stitcher, Google Podcasts, Amazon Music/Audible, and other platforms!

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Dr. Shelley Canning: I think we lost our way. So we lost our focus, and we lost our place at the bedside, and we lost our passion for that hands on nurse. Nurses, we do bodily care, we work with our hands, and there’s great pride, I think, in doing that. But we kind of turned away from that work. And what I think the last couple of years of COVID has shown us is that that work is what’s needed.

Intro: Based out of the University of the Fraser Valley on unceded, traditional lands of the Sto:lo people we are the Community Health and Social Innovation Hub, or CHASI for short. We support the social, mental, emotional, physical, and economic health of those living in our communities by bringing together experts from across disciplines. Those experts have some incredible stories and insights. To share those with the communities we serve, we bring you the CHASIcast, a monthly program where we drill down on a current topic and chat about how it impacts our lives.

Dr. Martha Dow: So it’s my pleasure today to welcome Dr. Shelley Canning to the CHASIcast. And Dr. Canning is an associate professor in nursing, director of the Center for Education and Research on Aging, member of UFV’s Board of Governors, and most importantly from our perspective, a faculty associate at CHASI, so welcome.

Dr. Shelley Canning: Thank you. I am actually delighted to do a CHASIcast. I’ve listened to all of the previous ones.

Dr. Martha Dow: Oh, that’s great. And often we do this on my porch with a glass of wine, so I appreciate that it’s the morning and we’re not doing that

Dr. Shelley Canning: Yes, we do do those casts.

Dr. Martha Dow: So I’m wondering actually if we can start with a really exciting initiative that you spearheaded and that is the Age Friendly University. And I wonder if you could tell us a bit about what it is and why it’s important to you.

Dr. Shelley Canning: So the Age Friendly University initiative is, I think a critically important initiative across institutions in countries like Canada where we are anticipating a significant demographic change. And so I teach about aging to my nursing students and I always try to talk about that demographic change, not in a fearful way, because in fact we are looking at our current students at, the peak of their careers, working and living at a time where Canada will have a large proportion of people over the age of 60 and 65.

And in fact, an increasing proportion of Canadians over the ages of 90 and over the ages of 100, our centenarians are actually a rapidly growing population group. So it speaks to all kinds of things about healthcare and society, but the, it’s just simply a numbers fact. So if we are to prepare our students, to be good social citizens and to understand they live in a time where there will be a lot of people in that older age demographic.

Then the idea of an age friendly institution becomes increasingly important, and we have seen out of the WHO this initiative for age friendly cities, communities, and a group of academics in the, about 10 years ago, in 2012 at the University… University of Dublin City or Dublin City University I think it is.

They got together and were thinking about this idea of this population change and what it means to be age friendly and embrace that demographic. They decided that hey, universities are the perfect place to take on some of that load, and came up with nine principles that are age friendly and started this global network of age friendly universities. So that’s a long answer to a clean question, Martha. But in short, we have now become the ninth Canadian University who are who have a designation as an age friendly university. We’re the first in BC which I think is a… a lovely a lovely place to start as the first, So I think it gives us all kinds of ways to partner with other universities and to look at, at doing some of the things we currently do better and doing some of the things that we currently don’t do.

Dr. Martha Dow: I wonder if, just on that note, if you thought about sort of your top of your wishlist, what, what do you envision that gets you really excited about those possibilities?

Dr. Shelley Canning: I would love every student at UFV to have some education on aging and what it’s like to live with dementia, because that’s the other piece of an aging society is that we see increasing numbers of people living with what are often typical or common types of health challenges.

And the one that can be often the most misunderstood and present a lot of challenges is dementia, so I would love it if every student that left here, regardless of discipline, had had some of their myths and misconceptions squashed and had less ageist attitudes.

Dr. Martha Dow: That really intrigues me because we often talk about doing something across the curriculum. Writing across the curriculum, right? You know indigenizing across the curriculum, those sorts of things. What does that look like for aging, I wonder?

Dr. Shelley Canning: I think when you look at across the curriculum and, and you think about aging, aging is so cleanly pigeonholed in the health sciences or the, the practice professions where folks like a nurse, a social worker, are going to be trained to work with older people.

So it’s a very specific kind of education that we provide. But the thing is aging is, aging intersects everything. So it, it extends beyond issues of gender or race or ethnicity or community. It simply, it belongs to all of us. So I think if we look at how do we then take it across widely, across curricula, There’s ways to think about how aging impacts each of the disciplines.

I think a lot about business. I know there are there’s certainly lovely intersections between health and business and if you look at what will happen in the next decade, some of these folks that are aging into that older adulthood stage, there will be much a much greater percentage of them that actually.

Had worked and, and entered that time with, with pensions. So they have a different kind of financial portfolio than in decades past where you would see a large number of the older population would be widowed women who had never worked outside their home. So they enter older adulthood and their financial portfolio is government pensions, so subsidized pensions.

But there will be a large group of people now who have more money and and, and then more agency. So they want to be part of that decision making and they want to be , they’ll want to be treated like full citizens regardless of the fact that they might be 80 and look like a little old lady or a little old man.

So it’s easy to stereotype them as being less able. But in fact they won’t be. So I, I think there is I think there’s opportunity across every discipline to think about how the students we educate today are going to interface with that particular demographic.

Dr. Martha Dow: I’m excited to watch that your vision unfold and support it, and yeah, I’m, I’m really intrigued to see what that looks like. You talked obviously about, we’re used to it being housed in the health sciences nursing. I’d love for us to talk a bit about nursing. We’ve talked, you and I, about sort of the state of, if you will. I’d love you to talk about the work that is nursing, I, I find that really inspiring quite honestly, to hear you talk about it in those ways.

And I wonder if you could, could share a bit about, you know, what, what are your thoughts? Where are we at with this discussion?

Dr. Shelley Canning: We are at a place that I never imagined we would be at. So I’ve been a nurse for over 30 years. And I’ve seen us as a profession move in some ways that have been, I think, progressive and I think some ways that have complicated our work in unanticipated ways, and we have kind of hit this nexus at this particular time where so many things have happened at the same time and we didn’t pay attention to the little cues that we were starting to see or the hints of erosion that we were starting to see, and, and this is, is why we have, it seems like suddenly a, a huge nursing shortage or a huge primary care physician shortage, but we saw these things coming in the decades leading or the years leading up to this particular point.

And the pandemic has just tipped the scales in a really quick and dramatic fashion. But I think part of what happened was we moved away from our purpose and away from our role and identity as nurses. We got lost in the middle as we achieved maybe more respect for our role within the healthcare team.

We began to see ourselves as more autonomous, be more clear about what our role was. Certainly nurses aren’t physicians assistants. Part of our origins were there, but we’re, we’re really partners. So we have a very different work to do, but a very complimentary work. And we were able to articulate that a lot cleaner in the last part of the last century, and as we moved into, into the, the current time.

But in doing that, we, I think we lost our way. So we lost our focus and we lost our place at the bedside and we lost our passion for that hands on nurse. Nurses, we do bodily care. We work with our, our hands, and there’s great pride, I think, into doing that. But we, we kind of turned away from that work. And what I think the last couple of years of COVID has shown us is that that work is, is what’s needed.

When you watch TV and they show you what happens when you walk through an ICU you’re seeing this beautiful dance of nurses who are just coordinating. It almost looks like choreography as they prone a patient. So you see several on one side of the bed, several on the other, and they’re managing tubes and lines, and it’s all very synchronized.

And the next thing you know, this person is now on their stomach instead of on their back. It may look simple at a glance, but it’s, it’s this highly collaborative synchronized work where each of us, our, our teamwork is, is really strong and each of us knows what the next one has to do. And it’s all done in this highly stressful situation, environment, and, and the outcomes are, are often difficult, but you find your way through it because you’ve been so close and because this work is bodily work. So I’m, I’m. Hopeful. While I would honestly say we have been, I think, quite lost in the last while, I’m hopeful that maybe this actually helps us find ourselves.

Dr. Martha Dow: What do you mean by that? What’s that hope rest in and what do you see?

Dr. Shelley Canning: I hope it, it helps us find our way back to the bedside, where we look at that work, not as, beginning nursing work where we’re anxious to move on to something different where we’re in a role that we see as a leadership role because we have a different title or we we’re managing a lot of of data, we’re a step away from the patient, we’re looking at policies and processes, and we’re, we’re managing the work of other people, perhaps care aides or LPNs or, or others on the floor when really that is, our work. That’s, that’s all part of our work and we need to be there too.

So where we’ve seen nurses kind of step away from some of the bedside roles, I’m hoping that we see nurses come back. A place where it’s been I think where we’ve seen a really big change is in long term care. So the care of our older people, our most frail people, we saw nurses, RN nurses pulled away. And the bulk of the work, of course, is done by other care providers, but I think it’s time to see more nurses come back into that work.

Dr. Martha Dow: What’s the discourse like among nurses? Associations? Yeah, can you talk a little bit about where that’s at?

Dr. Shelley Canning: I think it’s a mix of perhaps hope. I’m on the board of a couple of different gerontology nurses groups, our, our provincial group and our national group.

And I think there is some hope that the devastating impact on older people that we’ve seen through COVID that in fact now more people are aware that this has been a poorly resourced piece of the healthcare pie and that we need to do much better. What has happened in long-term care is unconscionable.

And so dramatic change needs to happen. And, and of course it needs to be funded before it will be happening. So I think there’s a, a sense of hope, but I think there’s also a sense that very quickly social concerns shift to another emerging issue. And, and it will be easy to lose the focus on whether or not we need to invest in the care of older people.

So it’s about keeping that conversation going. For me, I try to inspire new nurses, so I teach in the first year of the program. I try to have them see that the care of older people is gonna be part of what they do wherever they’re working. Over half of the patients in any hospital at any given time are older, and so they need to recognize if they’re working in emergency or ICU wherever they are.

Could be an exciting context, but it’ll also be a context that they have to use a gerontology lens because the majority of their patients will be older. So having a passion for that will help them in that work.

Dr. Martha Dow: What do you see with incoming students?

Dr. Shelley Canning: Mm, it’s a different student. Well, in the first year, everybody’s pretty excited, I have to say.

I don’t think they lose that. So they come in excited and they want to do the work. They don’t usually know much about what nursing really is because media presents stereotypes that aren’t, they’re just not accurate. I think that they are needier in some ways. I think that they’re also surprisingly resilient in other ways.

So it’s, yeah, it’s, it ebbs and flows. I think it, it changes a bit all the time, but I, I think at the heart actually, they’re not much different than they would be all along., There’s a group that are really keen that do have some sense of nursing and they just go forward no matter what and excel.

And then there’s a group that started and they’re maybe not too sure, and it’s up to us to, I think, have presented in a way that they can actually see themselves successful in that role. And then for others, it’s maybe not the best choice either. They realize that, it’s not a job for everybody.

Dr. Martha Dow: It’s like so many as you describe it that you think it’s one thing, but how can you really know? Because we only have these other images. I wonder as we close a little bit here curriculum, you know, as you bridge, we started with the age friendly university and sort of your, your aspirations to think about, you know, all students having. Attention around that. You talk about nursing students, particularly in terms of their knowledge around it, you know, I guess two angles into that, you know, is it how do you feel about the curriculum in doing the kinds of things you describe?

Dr. Shelley Canning: The curriculum within nursing… there’s so much that has to be covered in a four year program. So it’s really difficult sometimes for others to understand that at the end of four years, we’ve only made a beginner. We can’t do more than that because each area carries such a… they’re, they’re all quite different. So whether you’re teaching about pediatrics or surgery or advanced medical units or aging, each one of them is kind of a unique area.

There’s crossover for sure. There’s nursing concepts and, and theories that apply to all areas of nursing, but there’s a lot of specific learning that students have to do all along the way. Aging has always been given short shrift though, in nursing, much like anywhere else. So there’s tremendous ageism within the healthcare professions.

And so we, we never have given a lot of value to that education around an aging patient. We’ve at times had specific aging courses, and at other times we’ve thought we could just thread aging content through the whole program. That’s pretty much been given up because it just ends up being lost.

If you don’t have an aging champion on your faculty, then threading it through the curriculum, it just, it’s gone. So we’re back to most schools having a discrete course, like the course that I teach, the gerontology course in nursing. I think the problem is if you only touch on it early though, so it’s gotta be both in my mind.

You need to have a discreet aging course, but you also have to have opportunity to thread that content through so folks don’t forget about it.

Dr. Martha Dow: Great. Last question from me. And I think it’s a nice way to cap given your nursing experience, your teaching experience, all the other things that you do that inspire so many, what would be the course you haven’t been able to teach yet, but that you’d love to teach?

Dr. Shelley Canning: Oh, well this is a course that I have been thinking about with one of my CERA colleagues, Dr. Leslie Jessiman, who has recently shifted back to the UK. But we are in the throes of planning a dementia course. And so a course it would be targeted to any student in any discipline at the university, not those who are already aiming at a a healthcare profession type role.

So it would be to better understand the experience of people who live with dementia better understand what a long term care environment really is. Better understand the risks, better understand the interventions. All we see about dementia is the worst case scenario. And honestly, it is so wrong. So when I talk about systemic ageism, neatly right in the center is systemic dementiaism.

So we have all kinds of really negative and really harmful attitudes towards folks who live with dementia. And I would love the opportunity to get to teach that course.

Dr. Martha Dow: I’ll look forward to it.

Dr. Shelley Canning: You’ll be helping me.

Dr. Martha Dow: *Laughs* Well, thank you so much for taking some time with us. We really appreciate it.

Dr. Shelley Canning: Thank you for having me, I hope I made some sense here.

Dr. Martha Dow: Much more than that. Thanks.