The Future of Aging (WMT2-V34)

Transcript: The Future of Aging

[00:00:01 The CSPS logo appears onscreen.
00:00:06 The screen fades to Neil Bouwer.
00:00:14 Text appears on screen 'Neil Bouwer, Visiting Professor at the Max Bell School of Public Policy' and 'Ottawa, ON'.]

Neil Bouwer (Visiting Professor at the Max Bell School of Public Policy): Good afternoon, everybody. My name is Neil Bouwer. I'm going to be your moderator for this Canada School of Public Service event. We're in front of a live audience here. So, if you hear cheering in the background, you know why.

Dr. Zayna Khayat (Rotman School of Management, University of Toronto): (laughs) Or crying.

Neil Bouwer: So, that's fantastic, and then we've got the rest of you online.

[00:00:22 Dr. Zayna Khayat is shown sitting next to Neil Bouwer.]

So, thanks so much for joining us. Many of you are buried deep in snow. Some of you will be multi-tasking and so forth, but we've got a really lively discussion here for you today on a really important topic.

So, before we get started, I just want to acknowledge that we are on the traditional and unceded land of the Algonquin Anishinaabe Nation. And in the spirit of reconciliation, I can say I'm really pleased to be able to be having this event and these conversations on Algonquin land. And at the same time, I'm also very proud to be a Canadian and that we can celebrate our Canadian-ness and our Canadian sovereignty in these times where that's being questioned by some. So, anyway, it's great to have some time here today and we can reflect on all that as we go forward.

So, the topic for this afternoon is aging. So, we're all doing it, and moreover, we've been talking about it, it seems like, for ages. We've been talking about the demographic period. We've been talking about the stresses that aging is going to cause on our social programs, on our society, the changes, the profound changes it's going to have on us. So, now, we can have some real talk today about the subject of aging and we've got a really amazing guest here with us today from the University of Toronto and elsewhere. Zayna is an expert in aging. She's a friend of the Canada School of Public Service and of the public service, and she's helped us to kind of think through the implications of aging across sort of a wide spectrum of society. So, we're really happy to have you here. Thank you so much for joining us.

We are speaking English for this service but we also have French translation and your questions are welcome in French and in English.

So, this will be mostly an English event but we are welcome to have questions in French, in the official language of your choice.

So, with that, maybe we can sort of get things rolling, Zayna. I know you've got a deck presentation that you want to take us through. We're going to pause periodically and see if there's hands shooting up in the air or chins being scratched or eyebrows being raised. We'll check in periodically online to see what kind of questions you have but we'll also have time afterwards for a discussion.

Dr. Zayna Khayat: Perfect. Thank you.

[00:02:35 Dr. Zayna Khayat gets up and walks over to a podium.]

Thank you. I also speak French, but slowly.

Okay, so I'm going to kind of start by spewing some facts just to set the stage for why this is a really important topic. I've been doing this… I'm doing this in a three-part futurism series with you. This is the second, and there's a reason why this topic was picked. So, two thirds of the people over the history of the world that ever made it past 65 years old are alive today, okay? This is a very rare phenomenon to be alive this long. In the 1950s, most people didn't age. It wasn't really language we used. They died. So, most of our institutions, almost all of them, were based on a construct of, when you became old, three to five years later, you were no longer here. You all are now living about 10 years longer than your parents' generation and almost 20 years longer than your grandparents' generation.

There are some futurists that if you look at science, like longevity science, improvements in kind of geopolitical contexts, they think a child born today is likely to live past 150 years. There are other scientists, narrower but still whose life's work is longevity, that actually think, this is going to be your dorky word of the day when you go out for Valentine's tonight to talk to people about, that we are entering an era of what's called longevity escape velocity. So, you know when we send a rocket ship up, there's a point where gravity no longer pulls it down and we don't need the rocket fuels. It's an escape velocity. So, escape velocity from longevity is where for every year you're alive, a combination of science and social policy keeps you alive for 1.1 years. That implies mortality.

And this kind of… experts think that the conventional definition, again, since the 1950s of when you're called young and when you're called old, will be obsolescent by 2030, and a big driver of that is that's when millennials start to turn 50. So, the whole construct of what's old changes by then. And then, the last factoid is if you combine the purchasing power of the segment of our population globally over 50, this is a massive wealth transfer that we've never seen, the combined economic force of the over 50 would be the third largest economy in the world after China and the United States, yet nearly every institution of society is designed for that 1950s paradigm. So, that's why we're going to talk about this today.

[00:05:47 A slide for the presentation titled The Future of Aging is shown with a cartoon image of Dr. Zayna Khayat next to logos for Rotman University of Toronto, Deloitte, Talk Boutique, Teladoc Health, Quadrivia, Association of Professional Futurists, and a QR code below the text Connect! The email address Zayna.Khayat@Rotman.Utoronto.ca is also shown.]

So, I think you've got a bit of my bio. So, I currently have a lot of attributions and maybe some of these are my, let's say, conflicts. I work with a lot of different companies, including as Deloitte's in-house health futurist, but where this work that I'll be talking about came from was my one job ago which was as the first ever futurist in home care, so seniors care in Canada with SE Health. And so, we kind of had to figure out what is the future of aging so we could do our work properly, and we co-authored a book called The Future of Aging and that's where I'm going to draw a lot of my remarks from. I wanted to bring a few copies. We've run out. We did a 1,000 print production and they're all gone, so shameless plug. You have to go to Amazon to get the book or some other bookseller.

[00:06:22 A slide is shown with the text:
Futurism 101: Explore plausible & possible futures 5-10 years out
A diagram showing a point labelled Aging in Canada, marked on a timeline as 'Today'. As the timeline progresses, the diagram expands in a conical shape to a broader array of topics at the point on the timeline labelled as '~2035'. These topics are listed as:

• Possible – May happen based on early signals
• Preferred
• Probable – Likely to happen, current drivers, shifts play out
• Predicted – Straight line forecasts from today
• Plausible – Could happen given current knowledge + precedents underway.]

You've got… what? Did I sign that one? Okay, I will sign it after. There's a book in the room. Some people who got a copy of my book read it, re-sold it on Amazon. They can buy a signed copy for a little cheaper.

Okay, so what I want to anchor us in is a futures mindset and I introduced this framework in the policy horizons shop here in the federal government. This is kind of their body of work, is this idea that when you've got currents of change and vectors of change that have a lot of uncertainty about how they're playing out, the way you do policy, the way you do strategy and planning, whether that's long-range planning or even for three to five years from now, it's got to start with the end and work backwards versus looking at today and planning out. So, typical planning and a lot of planning around our demographic shift takes what we have today and predicts really what demographic drivers… what might play out, and then we plan for that. We largely look at volume going up and demand for services and implications and then we absorb that demand with new supply.

Futurists start with all the possible ways society may emerge as some of these drivers happen, and then you come back today and you say, what policy do we need to put in place to maybe fit with that future better, to maybe direct that future? What's our preferred future for what Canada looks like in an aging society? Or maybe to avoid some possible futures that may play out that we do not want to see, and that's kind of the spirit of this work and some of this training.

[00:08:06 A slide is shown with the text:
Policy development increasingly must be future-orientated
Strategy: Present-Forward

• Considers the current state, recent past & internal/external scans to plan into the future … limited to the near future (3-5 years)
  Strategic Foresight: Future-Back
• Enables you to look further into the future [5-10 yrs out] … empowers decision makers to use new ways to develop (and implement) the near-term strategy … that are compatible with the unfolding future.

A citation is provided on screen Gluck, Frederick W., Stephen P. Kaufman, A. Steven Walleck. Strategic Management for Competitive Advantage: How some large companies infuse their planning process with new entrepreneurial vigor, maintaining market leadership over the long haul. Harvard Business Review, 1 July 1980. https://hbr.org/1980/07/strategic-management-for-competitive-advantage.]

[00:08:08 A slide is shown with a graph of world life expectancy rising next to a graph of the global population rising sharply.]

Okay, so as I kind of set up in my facts, if you step back to a really, really long time ago, that's the horizontal axis here, and vertical is age, aging is actually on an exponential curve. It doesn't feel like it in our lifetime, over 70, 80 years, but for 99.9% of the time, our species has been our species. We didn't make it past 20, 25 years. So, of course, our biology is not designed for this level but really, no construct of society is ever ready for this kind of exponential growth.

[00:08:47 A graphic of The world's super-aged societies is shown, with Switzerland, South Korea, Canada, Romania, and Taiwan highlighted as new in 2025. Text states that Countries where over 20% of the population are aged 65+ are classified as 'super-aged' societies.]

And then, to add on top of that for Canada, this year, 2025, we enter the super-aged society. So, it's been a group of countries that have more than 20% of their population over 65. We've been talking about when Canada enters, and we enter this year along with these four or five other countries. Countries like Japan, of course, we always talk about. I think Monaco is the oldest society in the world, 36% of their population over 65. So, we are… I think when you get to Taiwan, there's about 40 countries are now in this kind of super-aged category, and again, kind of unprecedented for our species.

[00:09:34 A slide is shown with The Future of Aging book cover and the text:
Why this book

• Aging is a universal experience
• It transforms how we relate to ourselves & to people, services, products, policies in our environment
• More people are >65 today than ever in the history of our species
• Yet, aging remains a subject neglected in mainstream dialogue … which inhibits our ability to consciously design for the future of it.]

So, that's kind of the context of why we wrote the book. As Neil said, we are aging while I'm talking. Some of you might feel like you're aging even more listening to me. But anywho, it really is this kind of so universal experience. As you can think, it transforms how we relate to everything, policies, products, services, each other, ourselves. And then, given kind of the prominence of the older population, as Neil alluded to, it's largely remained a subject that's been neglected in really deep, good conversation about who we are and what we want to be. And therefore, you can't consciously design for an aging society if there's not a substrate to have a conversation. So, that's kind of why we wrote the book, and also to guide our own work when I was at Saint Eliz.

[00:10:23 A slide is shown with The Future of Aging book cover and the link https://futureofaging.sehc.com/ and the text:

• Introduction
• Chapter One – Aging and Community
• Chapter Two – Health Interventions
• Chapter Three – The Promise of Gerontechnology
• Chapter Four – Economic Contexts
• Chapter Five – Identity
• Conclusion.]

Methodology-wise, we partnered with a research firm and design firm, and together we collected over 350 signals. So, us in futurism, we just look at signals, not trends. Trends are signals that have manifested. They're already here. Signals is like, there's something in the drinking water, I'm just not sure. So, we let 350 data points tell us the story and we kind of saw them coalesce into five themes. So, we didn't come out and say, we're going to look at these topics. We let the data tell us, and that was around aging and communities, so kind of built environment, where people live, how they live, health Care, chapter two, chapter three, technology, chapter four, kind of the economy of aging, labour force participation, and then chapter five was kind of what we called the identity of aging. And of course, if any of you have ever done a book, this is my first one, in hindsight, it should have been chapter one because it underpins what's going on in all the other themes.

[00:11:32 A slide is shown with the text Identity & Aging – Chapter 5 next to an image of a traffic sign warning of elderly people on the left side and an image of elderly woman lighting a cigarette using the candle of a 100th birthday cake on the right side.]

So, I'm going to kind of go through a little bit of a helicopter ride through some key highlights of each chapter, starting with chapter five because if I would have written the book again… maybe in the next production, we'll switch it. So, I think this picture says it all, that the imagery on the left is kind of a relic of the past, right? That there's just very different constructs of aging. If you think about… at a high level, racism has gone through a thing and it continues to evolve. Sexism has gone through a thing kind of post-World War II and continues to evolve, and in some places in the world is going backwards. Ageism is going to go through that next reckoning, like in a very big way, and that's a lot of what this chapter is about.

[00:12:12 An aging cream advertisement poster is shown with the text:
Introducing the world's first aging cream
Restore up to 5x the confidence on the job
Minimize concerns over your reliability & skillset
Increase respect – practically overnight
Aging cream doesn't exist but the value of older employees does
Unmask the full story at TorontoForAll.ca/Ageism.]

Just to kind of get our brains a little shifty on it, this was a video that the City of Toronto kind of used to start to reframe the identity of aging. Can we play that?

[00:12:24 A video begins playing, showing the text Imagés – The world's first aging cream.]

[00:12:27 A vendor is shown selling aging cream to different customers.]

Vendor: Hi, would you like to try the world's first aging cream?

Customer 1: I'm not interested in that.

Vendor: It will actually make you look older.

Customer 2: Why would I want to look older?

Vendor: Don't you want to look older?

Customer 3: No.

Customer 4: No.

Customer 5: No.

Vendor: It will help you in the workplace to feel more confident, be more reliable.

Customer 5: Don't worry about confidence. I am confident.

Vendor: It'll help you with pre-presentation panic.

Customer 6: Okay.

Customer 1: Then starting towards maybe a little bit more interested.

Vendor: Do you want to try it?

Customer 7: Maybe I'll try it.

[00:12:56 Customers are shown moisturizing their skin with the aging cream.]

Vendor: What do you think?

Customer 8: I don't feel any different.

Vendor: Can I let you in on a little bit of a secret?

[00:13:05 The letters in the company name Imagés re-arrange to show the word Ageism.]

Customer 9: What?

Vendor: Imagés, our aging cream, doesn't actually exist but ageism towards older workers does. Did you know that 41% of older adult Canadians report feeling ignored? That's ageism.

[00:13:20 Text appears onscreen that reads Learn more at TorontoForAll.ca/Ageism.]

Unmask the whole story at torontoforall.ca/ageism.

[00:13:22 The City of Toronto logo and the National Initiative for the Care of the Elderly logo appear onscreen above the text Special thanks to Family Service Toronto.]

[00:13:25 The screen fades to Dr. Zayna Khayat.]

[00:13:26 A slide is shown with the text:
Future Identity of Aging: 4 Shifts:

• From… Reflecting; late life crisis To… Reinventing & recreating ourselves
• From… Accumulating knowledge To… Becoming a wise leader
• From… Conforming (sexuality) To… Authentically enacting gender & sexuality
• From… Avoiding mortality To… Agency over end-of-life experiences
  Old age is made up – Joseph Coughlin.]

Dr. Zayna Khayat: Okay, so in the book, when we looked at the data, we kind of summarized what we saw on this kind of identity of aging around four shifts. One is… this is a French version but I'll do my English. Oh yeah, we're mixing. This is right. The old construct of the older age being when you reflect on late life and often catapulted by some kind of a crisis of events, this completely different reframe of re-invention of oneself in multiple re-inventions and recreations from the role of aging to be accumulating all this knowledge, and that's kind of the goal in and of itself, to the wisdom that comes with that actually starting to create massive value, and a lot of this we drew from Indigenous populations all over the world of the wise elder as such a massive asset of society. So, that's finally catching up with, let's call it, the West, a lot on sexuality. If you think of the multiple generations of trauma around not enacting one's own sexual identity, that's kind of emancipating and we looked at that around the world. And then, this kind of construct of my goal is to avoid death and avoid mortality, to having power and agency over what end of life looks like, end to end, and I'm going to share some fun stuff about that.

[00:14:54 An article from 3 December 2018 is shown with the headline Emile Ratelband, 69, told he cannot legally change his age next to a quote that reads We live in a time when you can change you name and change your gender. Why can't I decide my own age?. Text reads Mr. Ratelband maintained he has the body of a 40-something and a young age is part of his identity. A Dutchman who wanted to change his date of birth to boost dating prospects has lost his legal battle to do so.]

So, just some kind of signals, when I was living in the Netherlands in 2017, this guy Emile Ratelband, he's like the Anthony Robbins of the Netherlands, maybe 20 years older, super fit, very tanned, and he was literally asking government to change policy to allow people to change their age, and I think this went up to the equivalent of like the Supreme Court, because he's like, you can change your gender, you can change your name, I don't feel like a 69-year-old, biologically, I am not a 69-year-old. And so, it kind of created a bit of a conversation. So, that was kind of one of the signals.

[00:15:30 An image of an elderly woman wearing sunglasses and jewellery is shown alongside an image of an elderly woman with a cigar in her mouth.]

Imagery like this, we collected files and files that look very different from one of those opening images.

[00:15:38 A poster of an elderly woman is shown with the text: Frumpy. I'm a lot of things, and frumpy isn't one of them. I #AgeStrong. How do you? – Judy, 70. Learn more at boston.gov/age-strong. A poster of an elderly man is also shown with the text: Childish. I'm a lot of things, and childish isn't one of them. I #AgeStrong. How do you? – Leo, 84. Learn more at boston.gov/age-strong. The posters are shown next to the terms AgeStrong, Aging Powerfully, Strategic Aging, Disrupting Aging, Nextraordinary, Wellderly, Perennials, Saging, Zoomer, Oldfluencers, and Grandfluencers The term Seniors? appears in the lower right corner of the screen in red, with a line strike through the text.]

I was in the Boston Logan Airport when we were writing the book. You know when you're going down and there's all the advertising down the tunnels. This is their campaign. It's called Age Strong. So, the City of Boston has said, we want to be a city that has a very different identity for aging and what it means, so imagery, language, playfulness around what it means to be an age strong city. And then, I started collecting just a very different language, right? And you guys know, language is mindset. The words you use is how you think. And so, there's also a pattern, including my own organization which we were a 118-year-old non-profit in elderly care, banning the word "seniors" because it carries a mindset of a way we did things that that's not going to help us to create the future of aging, so interesting kind of phenomena there.

[00:16:37 A series of elderly-themed traffic signs from the Centre for Ageing Better are shown, which offer more positive and active images of the elderly.]

Iconography, so the Centre for Ageing Better in the U.K. created… these are free for anyone to use. Stop using the bent over, frail person with a cane to represent when you want to talk about anything with an older adult population, with many other alternative options that just seem to resonate more for today.

[00:17:02 An article by Elizabeth O'Brien from October 20, 2018, is shown with the headline These 100-Year-Old Retirees Are Running, Teaching Yoga, and Living Their Best Lives. Here Are Their Secrets to Happiness. The image is accompanied by the pictures of an elderly man and woman.]

Very different kind of life re-invention, career re-invention well into centenarian.

[00:17:07 An of image of tens of thousands of people perform tai chi to mark the one-year anniversary of the opening of the Beijing Olympics in front of the Bird's Nest, in Beijing, China is shown accompanied by the text Image source: Quartz]

This was taken at that… remember that Bird's Nest in China during the Olympics. So, this is thousands of older adults in a tai chi class once a week.

[00:17:18 An article by Minali Nigam, CNN, from June 29, 2019 is shown with the headline The spirit is undaunted: Portraits showcase strength of senior athletes with pictures of elderly athletes.]

So, on the sports theme, rockstar athletes getting photoshoots in major magazines because of their athletic prowess.

[00:17:29 An image of an elderly man at the gym is shown next to the logo for Healthways Silver Sneakers Fitness.]

Entire communities for fitness that don't feel like some of the options we have on order today for older adults who want to… who have a major obsession with fitness.

[00:17:41 A photo of the Toronto Raptors' Northern Classics dance troupe and the Washington Wizards' Wizdom dance troupe are shown.
Photo credit: Globe & Mail
Photo credit: Olivia Sun/NPR]

And then, I'm a bit obsessed with the Raptors. I was mentioning to somebody I have a Raptors tattoo on my body. So, I had collected, for the longest time, the first older adult half-time dance troupe, which you're used to normally very young people jumping around with hardly any clothes on and a lot of sparkles and glitz. So, the Washington Wizards were the first to have the Wizdom dance troupe and then all the other NBA teams have started to follow, including our own beloved Raptors. Those are the Northern Classics and they're so badass, like they are so… they own it and everybody is kind of excited to watch these folks dance and they really kind of push some envelopes.

[00:18:20 An article with a picture of the Fuwaku Rugby Club is shown with the text:
The Fuwaku Rugby Club, which stages full-contact rugby matches for players over 40 years old, was the first club of its kind in Japan. Players as old as 90 still play competitively for the Tokyo side.
Since I joined Fuwaku Club, I have broken ribs many times and broke my collarbone too. 86-year-old Ryuichi Nagayama told Reuters, adding: I Don't mind dying playing rugby.
Players at Fuwaku Rugby Club in Tokyo are known to keep playing into their 90's.
Photo by Reuters/Kim Kyung Hoon]

This is a rugby league, very, very competitive in Japan, where the minimum age is 40. They've got 90-year-old players on this team and they don't mess around.

[00:18:33 An image of an elderly group in matching jackets is shown with the text Grandma Gamers.
Image: Lenovo]

Video gaming, so you guys probably know this but video gaming as a form of entertainment dwarfs all music entertainment, film, and TV combined, okay? It's a massive industry on a global scale. Well, who were the first video gamers? This generation. So, there are these major video game competitions. So, this group is from Germany. They're called the Silver Snipers. They show up all decked out. They have a lot of time on their hands. They train really hard, and those young 15-year-olds can't train like this and they don't have the discipline, and they're very, very skilled at their craft and they just slay and spank everyone and win all the awards. So, it could be financially lucrative.

[00:19:24 An image of a centenarian pop band is shown.
Photo credit: CNN]

In music, this is a pop band that are all centenarians.

[00:19:29 An article by Colin Drury from April 30, 2018 with the headline This Nightclub for the Elderly Is Fighting Loneliness with Tea Party Raves and an article by BBC News from August 6, 2018, with the headline Wacken festival: Ageing metalheads escape care home for moshing are shown.]

Older adults are busting out of their nursing homes to go to the Kiss concert because that's what they grew up on (laughs), raves, I mean, just all these things that just don't feel like the things we kind of see in society.

[00:19:45 A slide is shown with the text:
In sum: Reframing Aging
Overcome troubling & persistent cultural norms, stereotypes that underpin ageism in how people understand & engage with aging adults
Shift: how people think about things becomes fluid

• Bodies, Minds
• Relationship, Sexuality
• Mortality, Legacy
  Opportunities abound:
• Facilitate new forms of workplaces, rec spaces, schools, private & public institutions
• Media & other cultural institutions showcase a realistically diverse range of older adults.
  A drawing of an elderly woman accompanies the text.]

So, that kind of sets the stage of reframing aging, these kinds of cultural norms that are both troubling and persistent and just not consistent with how things are emerging. Those need to be undercome… overcome, and this shift is happening. Again, everything people relate to becomes very fluid now. It's not binary. It's not, you're young then you're old. This kind of fluidness of their own biology, their relationships, their sexuality, their mortality, their legacy, and the fluidness could change week to week, right? Because it just kind of depends on the circumstances. So, the ability of all the product services policies that are around us to adjust for that fluidity, that's kind of the job to be done in this context, so lots and lots of opportunities which we'll get to. I'll do one more chapter and then we'll check in and see if you guys have a burning comment or question or an example you've seen, and also those of you online.

[00:20:49 A slide is shown with the text Community – Chapter 1.]

Okay, let's get into kind of how and where people live.

[00:20:51 A slide is shown with the text:
Future of Aging in One's Community: 4 Shifts:

• From… Predefined community models To… Creating your own living community
• From… Informal systems of community support To… The formal caregiving economy
• From… Offline local relationships To… Making meaningful connections virtually
• From… Isolated & alone To… Intergenerational living arrangements.]

So, four big shifts that we kind of summarized as themes when we looked at this. One is… definitely the big one is this shift from predefined models of senior living, let's say, to you being able to kind of create your own living community and whatever definition. We used to say, it used to be you went to… at the time, they were called alms homes. So, when you aged out of society, they put you in these alms homes that came out of the U.K. Then, it's nursing homes. Then, it's funeral homes. No, this is not going to be tolerated. There'll be kind of a plurality of living models. Another emergence, and this kind of… COVID really accelerated the second shift from, you kind of stitched together informal support, like maybe you had a teenager who shoveled your snow or you had sons or daughters who could take care of you, but you kind of figured it out and it was very informal and there was no economy around that. There's a whole formal what we call caregiving economy emerging. Kind of like in Canada, we just had a new economy when we legalized cannabis, there is a whole other market emerging around the family caregiver or care partners, and not just for health care. The shift from most of your local relationships, well, most of your relationships were local and offline, to this kind of ability to make very, very meaningful connection virtually as we kind of emerge in this digital world. And then, this mindset around the older ages as the time to be isolated and alone, especially because the chances, if you're in a partnership, you're both going to die at the same time, are very slim, there tends to be about a five-year difference, to this emergence of these what we call intergenerational constructs of living and many other aspects.

[00:22:48 A slide is shown with the title Where would you like to live? and pictures of a traditional senior home next to pictures of Latitude by Margaritaville 50 and Better Living. Text reads Source: Brockdale House Website, Lattitude Margaritaville Website, Desert Entertainer March, 2023.]

So, just in terms of fixed models of living, this is a typical advertisement. I forget… I won't shame them, some Canadian senior living community, lots of beige. They have a section of their website called Fun Stuff, shuffleboard. That looks really fun. And then, we look around the world and there are these kind of niche kind of markets that appeal to a lifestyle of aging that people want. So, these are Margaritavilles, same set of services, same population living there, some quite frail, right? And needing a lot of help, but that's kind of what aspires.

[00:23:35 An advertisement for Priya Living is shown with pictures of elderly people listening to, dancing to, and playing music. Text reads Priya Living. Life is better, living together. Priya Living offers an new way of senior living, with a vibrant community and well being at its core. Priya is more than chic & stylish apartments. We promote bringing people together with unique shared spaces and innovative.]

The cover of my talk is probably my favourite one of these that we looked at called Priya. So, this community, seniors community, emerged in the U.S. because the diaspora of Eastern Indian was a very big diaspora in a lot of States, and they were going to settle for the not spicy version that I showed you earlier. And so, the whole aspect of this experience, the food that's served, the activities, the colour, the aesthetic… and this is not only attracting East Indians, right? There are a lot of other people who want to be part of this aging experience, and again, undistinguishable in terms of the end of the day, what's offered, the services, the price point, etc., but a very different offering.

[00:24:21 Bill 69 of the Legislative Assembly of Ontario is shown with the text:
All levels of government should recognize that Ontario has an aging population and should encourage innovative and affordable housing solutions for seniors. Local municipalities should not deter seniors from choosing affordable housing options and should recognize that unrelated seniors living together can reap significant health, economic, and social benefits. It is desirable to provide clarity to municipalities that the Planning Act should be interpreted in a way that encourages and permits home sharing by unrelated seniors as a housing solution. Therefore, Her Majesty, by and with the advice and consent of the Legislative Assembly of the Province of Ontario, enacts as follows:
1 (1) Subsection 35 (2) of the Planning Act is amended by adding including, for greater certainty, unrelated seniors after persons who are unrelated
-(2) Section 35 of the Act is amended by adding the following subsection: Definition
-(4) In this section, senior means an individual who is 55 years or older.
Commencement
-2 This Act comes into force on the day it receives Royal Assent.
Short title
-3 The short title of this Act is the Golden Girls Act, 2019.]

We were doing a lot of work with my team on addressing very little stock of available housing models that could support people across their age fluidity. Believe it or not, in 2019, when we published this book, it was still a law in Ontario that to own a house, you needed to be married or related. So, remember the TV show, I'm going to age myself, called The Golden Girls? That was actually legally not allowed in Ontario, for friends to own a house. And so, this private member's bill was enacted called The Golden Girls Act, just to do a little tweak to the language that you could say who could access house ownership, for greater certainty, unrelated seniors after persons who are unrelated. So, just to show, a lot of our policies were designed for housing, particularly around heterogeneous, married kind of homeownership. It doesn't reflect where the world is going.

[00:25:25 A slide is shown with the title Flexible zoning, liquidity options above a picture of James Street Housing in Hamilton and a picture of Lanescape Laneway Housing in Toronto.]

Other policy innovation to create the conditions for a stock of housing that meets people where they are is around laneway housing. Calgary was probably the most advanced in Canada on this, so just different ways to zone land, not just for nanny suites but for families, for all sorts of living arrangements, and very flexible and modular designs for evolving the housing construct as needs change and the number of people in the home change, etc.

[00:25:55 A slide is shown with the text New business model: House-as-a-Service, Rental + health & social care bundles next to an article from March 15, 2021 with the headline These apartments offer you health care with your lease. Text reads Source Images: Michael Burrell/iStock, Mike_Kiev/iStock]

My holy grail, what I was trying to work on, was to actually create a very new disruptive business model to have an alternative to, let's call them, nursing homes, which would be particularly given most older adults in Canada, the median, are on a fixed income, usually one of the pensions, which is below the poverty line. They cannot afford private pay, retirement, or senior living or a nursing home. Could you have rental apartments that are purpose-built where any health care services are built into the rental price as part of the bundle? So, a very different business model because this is emerging around the world. This is yet to be… to happen in Canada.

[00:26:37 A slide is shown with the title Intergenerational amenities, programs, policies above an article by Erin Anderssen, from July 19, 2018 with the headline Seniors have too much house. Millennials have none. A business model is born and another article with the headline It's like family: the Swedish housing experiment designed to cure loneliness and another article with the headline Grandkids On-Demand.]

I talked about intergenerational kind of models. Those have been already the norm and standard from a policy and practice in Europe, particularly Sweden, Denmark, Netherlands, a lot of the Nordics, starting to emerge in North America, whether that's a new bartering and currency where a student might do activities to help an older adult. In exchange, they get free housing or something like that, so lots of models but there's a policy regime under that that has to enable these to scale. Papa is one of my favourites. So, as Uber took off as a business model, this kind of on-demand of different services, Papa is grandkids on-demand. So, it's a two-market economy where young people can offer up time, services, expertise, older adults say what they need, and then there's an exchange at scale. This is a venture-backed company which means they're kind of on a path to scale.

[00:27:35 A graph is shown with the text:
Seismic Housing Demand Shift
47% of young adults (20-34) live in with their parents
207,000 millennials (35-44) will upsize into family-friendly housing in the next decade
484,000 seniors that may look to downsize over the next decade
30, average age of first-time mothers
36, age of average first-time buyer.]

So, just on housing, federally, we've had major programs on all sorts of housing, but for older adults, this is a very big problem. We called it the missing middle, right? That this… if you're low income and need housing that you can't afford, we've got social services for that. If you're high income, you can go buy what you want. 70% of Canadians, there is no option that works economically or for what they want to be. And so, this, I think we had quantified it like 500,000 older adults in Canada that there is not a stock for them, and that's a lot of what we are working on.

[00:28:17 A paper titled Four Scenarios for the Future of Housing, Health & Aging in Canada is shown along with the National Housing Strategy logo, the Building With Mission logo, and the URL https://www.buildingwithmission.ca/foresight-overview.]

And so, when the National Housing Strategy set up their solutions lab, some of you might remember that, which was, can we create little mini labs to try new policies, new practices, new forms of housing, that every jurisdiction in Canada doesn't have to reinvent the wheel? That's kind of the role of a federal government. So, we were kind of brought on to that to do a solution lab around, how do you forecast what the future might look like for housing for older adults? And then, how do you make your plans now? Because this is really long-range planning. So, some of that work got published, which is really taking a foresight practice to housing but we did that to inform our work, and the context here, we called it Building with Mission. So, my organization was one of the Catholic health charities. Well, a lot of religious-based health organizations, whether they're hospitals or, in our case, home care, they sit on a lot of land. And so, as they evolve their mission, because they don't have to really keep doing health care anymore because there's a lot of other people who can, they're looking to use their land as the next mission which is to support older adults to age in a place of their choice. So, that was what the driver of that was.

Okay, I'm going to stop. I've just dumped a lot on you guys. Checking in, what's coming up?

Neil Bouwer: Well, I got a question, first of all, but maybe others will too. So, I really like how you started off, Zayna, by showing some weak signals but also some trends. And then, some of the examples you give us are really provocative.

[00:29:45 Dr. Zayna Khayat walks over and grabs a glass of water to drink.]

So, they seem like strong signals to me. In other words, it seems like there's a lot here that's not just about the distant future or even the near future but the here and now. So, I'm just interested to know, when you're sharing these kinds of scenarios and doing this kind of futures planning, and on the specific topic of aging, how much do you think that the Canadian policy ecosystem gets it, or are they falling off their chairs when they see the seniors gamers and so on?

Dr. Zayna Khayat: So, look, I find, in general, with everything and certainly this topic, I don't… I've never met anyone who as a policy lever, whether it's federally, provincially, municipally, who doesn't get it, who crosses their arms and says, no, we will not change, but what I do find is this kind of crippling of to do something about it, right? So, yeah, all these examples exist and are the standard in other jurisdictions. There's no reason, in theory, why it can't be here but that's where I think we fall short, and whether that's mindset, belief, courage, boldness, that's where I find I'm not really seeing it other than in little pockets.

Neil Bouwer: Well, I mean, my two cents is I think we're pretty progressive as policymakers but I was blown away by some of the stuff that I saw, you know what I mean? So, even as enlightened as we like to think that we are, the stuff you're showing to me is very provocative nonetheless. Speaking of provocations then, let me just cast my eyes across the room and see if there's anyone here that wants to ask a question or take a point up.

Dr. Zayna Khayat: Or share an example?

Neil Bouwer: Or share an example.

Dr. Zayna Khayat: Anything going on online? We're good?

Neil Bouwer: Okay, no problem. Let's keep it going.

Dr. Zayna Khayat: Either you're like blown away or you're like, oh my, who is this? Okay, we're going to move in.

[00:31:31 An audience member in a red shirt raises their hand.]

Let's go.

Question: So, around the war…

[00:31:38 The audience member walks up to a microphone.]

Dr. Zayna Khayat: I like your red. I love how everyone brought their red. I'm just so plain today.

Question: I totally forgot it was Valentine's Day.

Dr. Zayna Khayat: What?

Question: So, around the war, when women were entering the workforce, there were a lot of tenement housing, those co-living things where there would be a lot of rooms and a lot of women, single women. Men weren't allowed in. There was a landlady, she would cook. There was a meal. That model was active for about 20, 30 years, right? And then, as the big push to get everybody into the suburbs and married women and all that, right? That model disappeared, and I can see that as a really good avenue for an aging population and I certainly have had those discussions with my friends of, we should open one of those.

Dr. Zayna Khayat: Communal, yeah, communal living, very popular.

Question: Absolutely, but the investment has to be there, right? There has to be an interest from the investment community to fund that type of change where the structures of our residential lives will change to accommodate these kinds of models.

Dr. Zayna Khayat: Yeah, and again, there's a massive market demand for that, all right? All of our work on housing models. So, I don't know that the incumbents are going to be the investors. Are you going to convince Chartwell and Amica? It's going to be new agents and that's exactly what we're seeing but it's a huge trend, absolutely. So, again, there could be policy barriers why communal living won't scale, which is where you guys all come in, yeah.

Neil Bouwer: Can I follow on that too?

Dr. Zayna Khayat: Yeah.

Neil Bouwer: Just to ask about the gender lens, just your question made me think of that. Does the picture look different for women versus men in terms of life expectancy and culture and identity and so on? Is there kind of a gender take on the issue?

Dr. Zayna Khayat: So, I think a lot of the work in the book on sexual identity was pretty eye-opening and I don't think it had been studied in the scale we had. So, that one, I don't think has a… it's gender fluid. For sure, women have a longer life expectancy generally in every population, and if they're in a heterosexual marriage model, which was the dominant norm because religion dominated a lot of our constructs, they'll die four to five years after their male counterpart. So, that creates a market for things a little bit more than for the male population.

Neil Bouwer: Okay, so at least four to five years with no dad jokes.

Dr. Zayna Khayat: Yeah (laughs).

Neil Bouwer: Okay.

Dr. Zayna Khayat: You just did a dad joke, there's the irony. Okay, let's get into health care because we can all relate.

[00:34:28 A slide is shown with the text Health(care) – Chapter 2.]

[00:34:30 A slide is shown with the text:
Future of Health(care) Interventions:

• From… Anti-aging interventions To… Affirmative aging on your own terms
• From… Curing disease To… Adapting lifestyles to match healthspan to lifespan
• From… Physical determinants of health To… Emotional determinants of health & healing
• From… Treating cognitive decline To… Neuroplasticity & brain re-training.]

But I won't go too deep because this is what I do for a living, so just some constructs to think about. So, this kind of shift from the goal of health care services is to fight aging, and there's this language of aging as a disease, it's not a disease, it's a thing just like birth, it's not a disease, to a very different kind of agency of much more affirmative aging but I call the shots of how I want that to play out, and if I want that to play out, that I'm going to go to a nursing home and somebody is going to do everything for me, great, and then everything in between, right? Versus kind of a one-size-fits-all. This shift from the goal of health care is kind of the absence of illness to cure disease, to the ability to kind of adapt and self-manage as our bodies stop working, right? It's a very different construct and I'll share a little bit on that more. A shift from a very medical model which is obsessed about the physical determinants of health, blood pressure, heart rate, weight, whatever, whatever, and physicals to much more of a blend of kind of the socio-emotional kind of drivers of health, equal leg of a stool as to the physical. And then, of course, as our noggins start to decline, because again, our species never was alive this long, our brain works really, really hard for us, it consumes a lot of our energy, so kind of trying to treat cognitive decline and forms of dementia to the ability to say, how do we re-wire the brain? That's this whole emergence of neuroplasticity and brain re-training. So, lots of science there, amazing stuff.

[00:36:20 A graph is shown with the text New goal: Match Healthspan to Lifespan Th graph compares the LIFE in YEARS against YEARS in LIFE.
Text reads >99% of our time on this earth. With an arc from 0 to approximately 25 YEARS in LIFE, with the peak of LIFE in YEARS being reached around 20 YEARS in LIFE, followed by a sharp decline to 0.
Text reads Past ~120 years. With an arc from 0 to approximately 70 YEARS in LIFE, with the peak of LIFE in YEARS being reached around 25 YEARS I LIFE followed by a gradual decline to 0.]

So, again, I told you, 99% of our time in this earth, if horizontal is years of life and then vertical is how healthy you are in those years, as a species, we were very, very healthy. We had great sunshine on our circadian rhythm. We exercised all day looking for food or running away from predator. We slept. And then, we ran into a sabre-toothed tiger and we died (laughs), okay? So, the area under the curve was very high. Now we sit, we smoke, we don't eat well, we have very poor exposure to light, and so… but science is extending us, and like I said, that could go to 150. We will not accept this decline over that. So, that's a very different goal of health care. Before, it was to keep you alive at all costs, to maximizing health span to life span or what I call morbidity compression before death. What? That's a fancy word.

[00:37:23 A slide is shown with the text:
Life Course View of Aging + Healthcare
Healthy & Active, Healthy At Risk, Illness Onset, Multi Morbidity, Life Limiting
Context: Social-historical determinants of health, Community inclusion, Accumulation of experience, knowledge & relationships, Preferences, Demographics, Physical determinants of health [Exposure to & accumulation of disease risk]
Approach: Preferences-based, Strengths-based, Needs-based
Health.]

Okay, so just to kind of go a little bit deeper, this was a bit of a framework. So, at SE Health, we have a research institute and they kind of created a different frame of what's the role of a health care system or health care, which is taking a life course view when you look at your role in health care across aging. So, if you think about it, on average, when you're quite healthy and active and then all the way through to kind of life limiting illness, for most of the time, at the left side, you're calling the shots. So, it's a preference-based approach because you don't really need to outsource your agency or power to anybody else because you can take care of yourself. As you more move towards life limiting, it's more of a needs-based approach. Others do things you can't do yourself or your community. And then, maybe in the middle, it's kind of a blend where you're weak, you get help, where you can handle it, you do it yourself, but the reality is we're all different on that spectrum. I might be at my life limiting stage and I still want to call all the shots. I want to die on my terms and don't want to involve anybody, and others might be very, very healthy but they want to outsource all their agency and power to a third-party provider like a health care, and being able to adjust for that. And then, to do that then, the inputs into deciding what's the role of a formal health care system. Again, when you use health care, it's when you're outsourcing your agency over your health to someone else, goes well beyond our current blunt inputs of basically age, demographics, maybe gender, and physical inputs, your chart, your history taking, etc., etc., to being able to incorporate all these other kind of socio-ecological contexts, and that together decides what you do do, don't do, how it's approached, etc., etc.

[00:39:17 A slide is shown with crossed out text that reads EMR, EHR, Electronic along with the text Life Record [ELR]. An image from Lifesprk is also shown of an elderly woman pointing to a graphic with the text:
Wellbeing Index – 85
Social Connections – +5.8%
Fatigue – -4.4%
Mental Health – +5.8%
Blood Pressure – 115/84
Body Mass Index – 27.5
Average Heart Rate – 62
ER Visits – -62% YTD
Health Costs Saved - $90,000 YTD.]

Now, that gets us into the era of data. We use blunt instruments to decide health care and wow, we do not touch the possibility of understanding what is the status of health of our population based on much broader inputs than our medical chart. So, we're predicting the word electronic will drop from "electronic medical record" and "health record", and it won't be your medical record or your health record, it'll be your life record because that's how we'll know kind of the status of health and well-being. And so, this is an example of kind of like a check engine dashboard of the health of an entire older adult community in the United States, it's run by Lifesprk, where they can literally push a button and they can crawl data from multiple inputs, not just the medical records. And sure, some of that data is blood pressure, body mass, heart rate, but they can quantify social connections, fatigue. How do people feel today? How did they sleep last night? Are they moving? Are they not moving today versus yesterday? And then, you get kind of this composite index of well-being. This should be the goal of health care systems when one in five Canadians are going to be over 65, versus what we do today, some pretty blunt metrics.

[00:40:29 A graphic from Dispatch Health is shown with the title ER @ home and the text: Normal journey – Patient has to drive to the ER, average wait times ~4 hours Patient request urgent care via phone or app. Help arrives within 1 hr. A paper titled Bringing Long-Term Care Home is shown beneath the text Nursing home @ home. Text reads Source: Dispatch Health website]

Some big areas that are kind of finally coming to the mainstream is around allowing people agency to age, heal, and die in the place of their choice. When Canadians were surveyed, 70% of Canadians desire, maybe now it's more, to die at home when it's the end of life, 70% of Canadians die in a hospital. That's a market right there. And then, if you go to all the other steps, in the U.S., the model for how emergency room care is done is exploding to do all that at home, not just talk to a doctor from home. The ER comes to your home with a business model that works at scale versus you going to the place, waiting in line for hours and hours and hours. One of the best policy shops on aging in Canada and probably one of the best in the world is out at Toronto Metropolitan University, the National Institute on Aging. They've really helped frame some policy papers around, what would it take to bring nursing homes to the home? Because that's what's already happening around the world. New Brunswick is kind of leading the way in Canada for nursing home at home but it is not yet a mainstream model.

[00:41:49 A slide is shown with an old-fashioned black car and a headline that reads Memory Town is Coming to Your Strip Mall next to the text:
Town Square

• Day program for Alzheimer's
• Recreate 1950's-60s city
• $95/day; franchising now.]

And then, kind of the last one on health care is thinking about dementia. So, right now, I don't know if you have family that you've seen, managing through somebody with dementia, very, very hard for the family at home. And so, the option is basically to go to a nursing home or a memory care centre. So, it could be a floor of a nursing home that's only for dementia patients or an entire building. But again, we will never have the real estate to institutionalize people that way, nor does anybody want it, and families will express, I can't do seven days a week of taking care of my partner with dementia or whatever but I can do evenings and weekends or we can help it out. So, in the U.S., that's a massive market. There's another business model that's dying called malls, especially strip malls in the era of on-demand purchasing and what have you, so lots of available real estate. And so, this non-profit foundation created Town Square which is taking this big real estate, creating daycares for people with Alzheimer's and other forms of dementia, keeping the price very low, $95 a day. I don't know about you but when my children were in daycare, we paid about that if not more, but really a franchise model that can scale. But most importantly, they incorporated science, so reminiscence therapy as a science, the idea that, in this case, these were a lot of boomers, if the years when formative memories were formed, so this kind of looks like a Happy Days lot, if you put people in that environment, actually their behavior is very, very different, and that's the same with music from their era, other visuals. So, the outcomes for this population are very, very different from a typical, what I call the three B's, big, beige, boring type of memory care centre, so lots of new business models around, new ways to manage and actually have better outcomes with dementia.

[00:43:46 A slide is shown with the text Gerontechnology – Chapter 3.]

Okay, we'll do one more and then we'll kind of pause and have a conversation. So, now, we'll get into… sorry, one more, we'll check in, and then there's one more chapter.

[00:44:01 The 2024 AgeTech Market Map and Canada's AgeTech Startup Map are shown.]

Technology. So, you know that a technology segment has arrived when very robust, what we call, market maps are published. So, the left is the global market map by this incredible woman. I forget her name now. She's Israeli. She's called The Geron Technologist. So, all these clusters are kind of these categories of new products and services in the tech economy to support an aging population. Some countries have taken it on to say, we are going to be the new economy of AgeTech. It's going to come from our country because the whole world is aging. Canada is getting there. So, thank you to our national centres of excellence that had the foresight, I'm going to say, back to 2012, to form AGE-WELL, one of our NCEs, to kind of create this ecosystem to emerge and our participation in the AgeTech economy. So, this is kind of our Canadian market map and I think it's doing really well.

[00:44:59 A slide is shown with the text:
The Promise of Gerontechnologies:

• From… Biologically determined life stages To… Tech-enabled age fluidity
• From… Replacing human labour To… Modifying the laboring body
• From… Limitless life spans To… Increased healthspans
• From… Institutional aging To… Aging in place, thriving in motion.]

So, on gerontechnology, some of the themes is around the old model of these kind of biologically defined life stages to much more fluidity of those stages because technology can really extend the boundaries of what used to be very discrete stages on multiple dimensions, this idea that when you can't do stuff for yourself, you now need other labour to kind of service you, to the ability to modify the labouring body in ways we couldn't before, and that's where technology comes in. I kind of talked a little bit about lifespans that go forever to much more ability of technology to maximize healthspan and then the shift to aging in place which technology helps a lot.

[00:45:46 A slide is shown with the text don't use social media [55% do!], don't have access to internet, can't use a tablet [1/3 own one!] next to a Wall Street Journal article titled Tech Savvy or Tech Addicted? Older Adults Are Stuck on Screens Too. Text reads Pew Research Center, May 2017, Tech Adoption Climbs Among older Adults]

So, I think, right away, you think about, and I hear this a lot, especially in health care, older adults can't use technology. The data doesn't match that statement, right? So, PEW, P-E-W, does a lot of the best research in the world on facility with technology and older adults. The curves just are growing and growing of adoption, utilization, etc., etc., on every dimension of technology and some where the older adult population is actually superior in embracing certain technologies than everybody else, tablets for example. So, if you give a kid a tablet and an older adult a tablet, the kid might not know what to do with it because they're so used to texting and Snapchat and whatever, so lots of great data on that. During COVID, this one study kind of quantified that older adults were spending sometimes up to ten hours a day on one or more screens, and that's a bit different, especially how I saw how my father age and when I've seen grandparents in nursing homes where the TV is on all the time. That's kind of the companion. That's the screen. They are ditching that a lot more and hanging out in these other kind of modalities.

[00:47:03 A slide is shown with the title Recreate inaccessible real world experiences above an image of a Nintendo Wii, Wii Balance Board and an image of a Kinect for XBOX 360.]

So, the key thing about technology, the take-home is what it does in the older adult kind of context is it recreates world experiences that without it are inaccessible, right? That's this idea of extending the boundaries of ability, of biology, etc., and the other big thing is there are no longer these other accessories that are created just for this population. You remember that thing people used to wear around their neck? Life... what was it called?

Neil Bouwer: Life Alert.

Dr. Zayna Khayat: Life Alert by Philips, or the clapper, I've fallen and I can't get up, all those things. They're kind of like medical devices. That's not the case. These are everyday technologies that are used anyway being just blended and part of their life.

[00:47:53 A slide is shown with images of an elderly man holding a trophy and playing a racing simulation game along with the Pedal On – Road World For Seniors and Motiview logos, and the quote The Road World for the elderly will be the biggest sports event in the world – Motiview CEO.]

There's a company out of Norway called Motiview that developed kind of a model of… they would record areas of the village wherever older adults grew up because in a lot of nursing homes and retirement communities, it's very local. People stay where they grew up. And then, if they play those videos at a slower pace and give any kind of a bicycle, their own or your own, the results of people's engagement and exercise, every physiological measurement, cognitive measurement are through the roof. And so, this got taken up very quickly, including across Canada. I think Ottawa was one of the first to really bring these into things, and they now have the biggest road race in the world of people in their own wherever they are, racing. I think they've quantified they can do like seven laps around the earth of territory covered. That just would not have happened if you, I don't know, put an exercise bike in the fitness room of the retirement centre, so just technology we use all the time.

[00:48:55 A slide is shown with an image of an elderly woman playing a bowling video game along with the National Senior League logo and the text:
2019 NSL Senior Wii Bowling Championships – Registration Now Open
www.nslgames.com
The NSL Does All The Work – Senior Wii Bowlers Have All The Fun
Join The Internet Based League Today
No Travel Necessary
Bowl Against Teams All Over The United States
Awards For Championships and Runner-Ups
Certificates For All Bowlers
11 Years Of Crowning National Champions in 7 Divisions.]

This is the biggest bowling league in the world with the Wii controller.

[00:49:01 A slide is shown with an image of an elderly man in a wheelchair next to an image of a virtual forest.]

Again, making world experiences that were inaccessible, you can recreate them. So, this is a wheelchair bound gentleman with the Wii board, and then a little bit of gamification is literally walking through a forest, catching the rabbits, hitting the butterflies, whatever, whatever, so lots of great tools.

[00:49:20 A slide is shown with the title Mobility innovation above a series of articles with the text:
The Elderly May Toss Their Walkers for this Robotic Suit – An early prototype of a soft exoskeleton that helps you walk could prove useful for the military and the aging population
Lyft, UnitedHealthcare See Transportation as a Game Changer for Seniors' Health
Ford launches GoRide service to get patients to their medical appointments
Senior citizens will lead the self-driving revolution – The Verge.]

Probably the biggest explosion of technology, and again, I haven't seen a lot in Canada, some European clusters, they're really doubling down on this, is mobility. Some people think mobility, so your ability to move, should be the most important vital sign, not your heart rate, not your blood pressure, your ability to move. It correlates to so many things. So, a lot of the science and technology that's coming into the older adult segment, so garments that can boost up your legs or give you this extra exoskeleton. I think our kids are going to look at wheelchairs and be like, really? That's what you did to move around. Companies like Ford Motor Company, which has been in the car manufacturing industry for hundreds of years and doesn't make a lot of money off that industry anymore, getting into businesses around transportation. Lyft is doing the same, Uber and others, and this company Voyage is kind of all ex-Uber and Tesla Silicon Valley folks creating kind of a driverless car ecosystem for older adults with Chrysler Pacifica. So, a lot of this though came from the elite sports industry. So, if you design clothing and movement technology for older… for elite athletes, there's an application for the older adult population.

[00:50:44 A slide is shown with the title Digital assistants, robot companions. Images of seniors and robot devices along with the text:
Alexa, when do I take my medication?
4/5 aging adults to receive support at home from robot.]

So, that's nice that the R&D is being done elsewhere. And then, of course, the last technology that I think we can all relate to is, let's call them, robots, whether they're chat-based, avatar-based, voice-based like Alexa, or literally humanoid robots. This is Pepper. She's all over Japan. There are pockets of Pepper here in North America. Paro on the bottom left is like a stuffy, a seal, but it has a lot of robot features and that's manufactured in Canada, selling all over the world. Japan made a policy innovation, I'm going to say three years ago, that the state would fund four out of every five older adults in Japan to have a home robot for what we call activities of daily living, helping you wash, helping you do the laundry, helping you get dressed, and instrumental activities of daily living around toileting and things like that. So, does that sound dystopian to you? Can you imagine if our feds were like, four out of five Canadians that over 65, we will pay for you to have a robot. We'd be like, we don't want this world. So, I think this is again where we have to (inaudible) assumptions because Japan's been at this for 20 years. They've had to play around and experiment and figure stuff out.

[00:52:06 A slide is shown with the title Necro-tech… and the text:
Plan end of life
Remains
New biz models: dying, obit, funeral, will
New norms & biz models to memorialize.
Death Doulas
Text reads Source: subtitle adapted from Frog Design; Images: NY Times]

Okay, the last tech area is a new fancy word too for you guys. So, you've got longevity, escape velocity, this is for your dinner conversation tonight, and now necro-tech. What is this? So, think of the whole institution of dying, how it's done. Do you have a say in how you die, where you die, when you die? What happens with the remains? How you eulogize, how you memorialize, that whole value chain is up for grabs and there's an entire ecosystem of new products, new services, and it's rarely the incumbents, like the funeral homes or the cemeteries or the old school will companies, that are going to come up with those new solutions. COVID accelerated this as well. I've yet to see any country take on this as a new economy.

[00:53:01 An image of an elderly man holding a bright yellow handle is shown.]

I'm not going to do the next video but we'll make sure we share it with you because it's very fascinating, just what… this video is a concept video, and I'm so guilty of this. So, most of us whose parents, if they're still alive, we're usually not in the same city, this is their whole urbanization for labour force participation. So, mostly to assuage our guilt, we buy them all these technologies. I bought my mom the doorbell with the camera and this and that and Amazon, and we do it actually for ourself, not really for them, and then we wonder why these things don't get used. So, there's just a bit of a social commentary on that.

[00:53:38 A slide is shown with the text Economy + Aging – Chapter 4.]

Let me just check in before we do the last chapter and then we'll wrap up.

Neil Bouwer: Fantastic. So, I'll be soliciting your questions and those of you online, but let me first ask, so the people that are viewing this here and online will have come from many different disciplines, many different parts of government, service delivery, government programs, administration, policy, and so forth. And so, I'm curious, to what extent do you think that the initiatives that you're talking about and the directions that you're sort of provoking us with, are they for particular programs? Is it an agenda of initiatives or is it something that's ubiquitous that we all need to… is it a lens that we must all use in all of our domains?

Dr. Zayna Khayat: Yeah.

Neil Bouwer: Just your thoughts on to what extent should everybody have literacy in these issues?

Dr. Zayna Khayat: Everybody has to because this is really a social revolution. It will impact everything in society, and the underpinning institutions that are everything in society is where policy has to unlock those, right? So, the big areas though, you could imagine, and it kind of matches the book, for sure all aspects of housing but kind of re-structuring our financial systems for this very different mix of a population, kind of social constructs. There's so many. So, it is everybody.

Neil Bouwer: Absolutely, I'm also thinking about law enforcement and the judiciary and everything else.

Dr. Zayna Khayat: How streets are done, the urban landscape. I mean, it goes on and on. So, I've got a great takeaway because there's a hot-off-the-press policy paper that just got published like three weeks ago that answers your question, which I'm glad because we didn't go that deep.

Neil Bouwer: Amazing. Well, why don't we take a question online and see how we do?

Question: Okay, you mentioned ageism but not ableism. Are the trends of showing aging adults as youthful, colourful, active, and strong not in part a symptom of ableism in our culture and our discomfort with disease, aging, and death?

Dr. Zayna Khayat: Yeah. So, absolutely. I forget the language we use. In health care, we say we have this deficit model for aging, like it's this big bad thing and there's all these things you can't do and now we have to do it for you. I think maybe ableism we didn't use because it's kind of commonly used as, okay, so what? So, it's more of like, what does it actually look like? I did have a point on that that I did want to make. Where was it? Yeah, so, kind of if once you have it, if you have an ageist attitude or a construct, that kind of embeds in everything you do, whether you're in policy, practice, etc. which is why, again, identity, to me, should have been the first chapter because once you shift your mindset, then everything else can fall into place.

Neil Bouwer: It also seems like the accessibility agenda and inclusion agenda helps us with dealing with aging as well.

Dr. Zayna Khayat: Yeah, we're not starting from scratch compared to other areas like around housing, around retirement, labour force were kind of starting from scratch. I would agree.

Neil Bouwer: Yeah.

Dr. Zayna Khayat: Yeah, urban environment will be accessible by default.

Neil Bouwer: Amazing. Let me just… with my eyes, I'm going to scan the room to make sure nobody's got a burning question or comment. Nothing burning.

Dr. Zayna Khayat: Okay, let's talk about money.

[00:56:48 An audience member raises their hand.]

Neil Bouwer: Back here.

Dr. Zayna Khayat: Yes, come on over here.

[00:56:54 The audience member walks up to a microphone.]

Question: Very interesting. I had a question. You sort of touched on it briefly when you were talking about cognitive decline, and I was just wondering, in your book, do you talk about, how do we maintain… a lot of times they say, learn a language or read a lot. I'm just thinking, if we're going to live to 150, we really have to incorporate some things in our lives so that we don't do that.

Dr. Zayna Khayat: Yeah. So, I'm going to cut to the chase and it may be a question you were going to ask me later. To me, if I had to pick from a role of you all on a federal, like for the country, it's exactly what you said. If we don't find completely new policy constructs and therefore practices to prevent the devastating consequences of cognitive decline and physical decline, we won't make it. There's just no way. So, I think that that is getting a lot of attention, a lot more science, a lot more research, in parallel, incredible development on treating the disease when it happens. There are some scientists who are in the Alzheimer's and dementia space who think… right now, when you hear dementia, it's a death sentence, right? On average, within five to seven years, you pass, no matter what age you are. That's how HIV we used to think about and most cancers. Now, they're chronic diseases. So, I think science is going to help a lot but absolutely the kind of preventative strategies.

Question: Yes, that's what I'm thinking.

Dr. Zayna Khayat: Got to be the next thing. Some think dementia will be the economic sinkhole of our country before some of the shenanigans from down south (laughs), yeah.

Question: Thank you.

[00:58:47 A slide is shown with the text:
Future Economic Contexts of Aging:
-From… Retiring To… Working longer to retain purpose in life
-From… Purchasing power through saving & proportions To… Economic uncertainty
-From… Intergenerational divisions To… Cross-generational class consciousness
-From… Investing in the future: financial legacies To… Investing in social legacies.]

Dr. Zayna Khayat: Okay, let's get into money. So, this is kind of the economic context of aging. So, again, no surprise, retiring will kind of go away as a language and a construct. It doesn't exist, and it's not that you're working longer because you have to pay the bills, although that is some of it which we'll get into. But really, it's about this kind of eternal purpose in life, and it doesn't stop or change when you were 64 years old in 364 days and then all of a sudden, you're retired. A lot we looked on purchasing power, the kind of longevity economy through both accumulated savings but also very creative use of pensions and savings and retirement vehicles to this kind of emergence also of, I'll have massive uncertainty. I'm one of those, like I'm a gig economy. Deloitte's model, about 40% of all jobs will be fractional kind of gig economy jobs, that's massive economic uncertainty from the old model of stay at the same job and get the pension. So, how do you have a market environment for that kind of growing cohort? The shift from intergenerational divisions, you're young, I'm old, and never shall the two meet, to this consciousness of class across generations. And then, finally, this kind of shift of the goal of aging from an economic… is wealth accumulation a pass on a financial legacy, right? For your kids or your grandkids, to a social legacy too. It's a very different role. Social legacy isn't getting your name on the wall of some community building, a real impact on society as your kind of… your footprint.

[01:00:34 A slide is shown with a series of terms that have been edited, Retirement is changed to Rewirement, Future of Work is changed to Future of Worth TM, Youthfulness is changed to Usefulness. The words Repriorment, Renaissance, Elderpreneur, Seniorpreneur along with a CBC article from June 15, 2018, with the headline Teaching is a calling: Meet the 101-year-old teaching computers to seniors.]

So, just some language I love to play with, it's not retirement, it's rewirement, repriorment, renaissance. There is an incredible group, actually started out here in Canada, called the Future of Worth, not the future of work, the Future of Worth. You might want to take a look. Usefulness in the startup economy, elderpreneurs, seniorpreneurs, this kind of encore career of entrepreneurship, the cohort of founders that's kind of over 60 is growing. I think Calgary was the first to be like, no, it's not about top 40 under 40, it's top 70 over 70, then it'll be top 80 over 80 (laughs), top 90 over 90. And then, just we need a lot of talent to teach and to do other things and it's sitting there. And so, how do we tap it?

[01:01:23 A slide is shown with an image of the flag of Japan and the text:

1. To secure employment opportunities until age 70
2. To extend healthy life expectancy by more than 3 years to 75 years or over
3. To improve the productivity of health care and welfare services by >5%.]

Again, from policy innovation, Japan, we should just follow some of their experiments and take them. So, their current priority are these three what I call BHAGs, big hairy audacious goals. At scale across the country, employment opportunities up to the age of 70, think of what it takes to do that. The second one is to add healthspan, so healthy life expectancy, by three more years after 75. Again, all indicators are healthspan declining, right? So, you're going double against what the curve is. And then, to do that, they've got to take 5% of productivity gains out of their health care system, and we've been growing our health care spending 5, 10, 15% a year, right? Kind of with no end in sight.

[01:02:10 A slide is shown with the title The Business of Granfluencing along with a New York Times article titled The Glamorous Grandmas of Instagram and a Forbes article titled The Future Is Female & Instagram Grandma Has Her Game On. The three top earning granfluencers are also shown: Helen Ruth Elam, Lili Hayes, and Linda Rodin.]

So, just one that I think is always fun, again for your cocktails tonight, is granfluencing. This is a real market, a real business. Forbes is writing about it, Wall Street Journal, and some of these granfluencers are making way more money than any of us in this room, so just again, a signal of what's to come.

[01:02:31 A slide is shown with two papers from the National Institute on Ageing. The first is titled Healthy Outcomes: Understanding the Impact of Adequate, Stable and Secure Retirement Income on the Ability of Canadians to Age Well and in the Right Place and the second is titled 7 Steps Toward Better CPP/QPP Claiming Decisions – Shifting the paradigm on how we help Canadians.]

Look, just on the retirement income, pensions, income security, so again, most Canadians, one, I think at most have about $6,000 of savings upon retirement and they're on fixed income. Usually, one of the pensions may be a little bit of a supplement. The NIA, the National Institute on Aging, has basically two policy thrusts that they focus on, retirement and income security and everything about age, health care, and living arrangements for the older population. Some of their work is incredible and has actually already led to, I think, two pieces of policy reform from the federal government because of their work directly. To me, that should be the gold standard of any policy shop. So, they're, really, in my view, a do tank, not a think tank. So, I would have a look at some of their work, really incredible, I think a gem for Canada on the world stage.

[01:03:25 Four images are shown: A Sears department store, a suburban neighbourhood, fries and a burger, and a child with a pediatrician.]

Okay, so just last part of spending, does anyone recognize what's common about these four things, malls, suburbs, fast food, and pediatricians? Any guesses? What's the thread? And maybe, I'd add to that, refrigerators. What else did I have? Baby food, telephones, and the franchise called Toys 'R' Us.

Question: Going extinct?

Dr. Zayna Khayat: Yes, kind of. So, every one of these was created, did not exist until the boomer generation preceded it, because there was a demand now for houses that could have multiple kids. I think there were something like 4,000 pediatricians in North America before the boomers, then it became 400,000, but we don't have 400,000 geriatricians, right? Ray Kroc, teenagers wanted their out and they wanted food, so he created McDonald's (laughs). Fridges, mall, all of that, so you can see these patterns that everywhere, the boom precedes something. There's a major market shift, and that includes schools, colleges, universities, marriage, child rearing, employment. So, boomers will change every institution, and they're kind of turning about 78 to 80 right now, right? The markets, the products, the services, the policy, have yet… we don't even know what they're going to be that they're going to create. So, just kind of keep that in mind because a boomer was born every 10 seconds, okay?

[01:05:18 A slide is shown with the title Big brands & the longevity economy along with the cover of the book The Longevity Economy by Joseph F. Coughlin and the logos for AARP, Walmart, P&G, Google, Amazon, Apple, Best Buy, Assured Living, and Uber Health.]

So, that's kind of the context here. Well, that's all summarized in probably the most seminal book I've seen on this by Joseph Coughlin. Joe Coughlin is at the MIT Age Lab and he wrote The Longevity Economy where he kind of looks at this phenomenon, and one of the signals is when these massive brands here… so, I used to do a lot of consulting. So, for Procter & Gamble that makes like Gillette razors and those things, for them to create a new category, like a feminine product, very rare, like it's a once in decades, so that they're all creating entire categories' divisions for the older adult. It's a pretty good sign that this market's here. Remember, I said it will be the third largest economy for people over 50.

[01:05:57 A slide is shown with the title Aspirational branding along with crossed out images of Ensure Plus and Boost drinks on the left and an advertisement for the Perennial drink on the right which shows seniors living active lifestyles.]

That includes kind of the aesthetic and the branding. So, the days of… as your diet needs to adjust, it looks like the thing on the left, this is Perennial, very different positioning. The inside of those bottles, identical, right?

[01:06:18 An image of an elderly person on a colourful accessibility vehicle is shown with the URL inspiringdesigns.net.]

We won't see beige, boring, and big products like scooters.

[01:06:24 A video still of an elderly man having his beard shaved is shown.]

I'm not going to play this video, although it's very good, just to say… and that includes a whole market of products and services for you and I as we take care of our older adult parents or what have you, so this caregiving economy, and this video, which maybe at the end we'll play it, we'll see how our time is because I want to get into discussion, but Gillette… this is a Gillette video and this is a son shaving his father, and Gillette realized they've kind of innovated on razors, remember one blade, two blades, three blades, what are we at? 12 now, colours, whatever. They never thought of designing a razor for someone to shave someone else, because it's a very different design when you got to… and your loved one is afraid of getting cut or nicked, or for a lot of especially older gentlemen, having a good shave sets their whole day up very differently, right? And they can't do it themself and they don't want to get cut. So, just to think about that time, all those other things, so whatever was McDonald's and Toys 'R' Us. I don't know why we don't have Seniors 'R' Us yet, because Toys 'R' Us has gone bankrupt or going bankrupt (laughs).

[01:07:33 A slide is shown with a CSA Public Policy Centre paper titled Aging Canada 2040: Policy Implications of Demographic Change along with the URL https://www.csagroup.org/wp-content/uploads/CSA_Public-Policy_Aging-Canada-2040_12.04.24_Accessible.pdf and text that reads:
Key Trends and Issues

• Healthcare
• Mental Health and Dementia
• Long-term Care
• Housing and Independent Living
• Accessibility
• Labour Market
• Learning and Education
• Pensions and Benefits
• Business Continuity
• Consumer Spending
• Climate Change.]

Okay, so this was published in 2019. I'm no longer doing this work, but just if you want to go a little bit further and pick up on this for the work you do, the Canadian Standards Association took this on and this report just came out maybe a month ago, I think, where they did actually a futurism exercise, like gold standard, which one of my favourite future shops called Creative Futures, I was part of the work of it where they gathered the biggest kind of combination of signals around how aging is emerging in Canada, and this is them, and there's labour market, learning and education, pensions, etc., something for everybody, back to your question. And then, they started to play around and go, okay, well, if… and this is what we do in futurism, if the trends around, say, consumer spending go this way, combined to maybe the trends around housing and independent living, what's the scenario for the future? So, you can play and mix and match and you create all these possible scenarios for Canada, and then you step back and you go, what's the policy implications? Well, if you do that in enough combinations, you start to have a coalescing of the same kind of policy questions that emerge.

[01:08:48 A graphic is shown with the text:
Policy pathways

• Reimagine where we are
• Transform our understanding of health
• Leverage and safeguard technology
• Prioritize equity
• Embrace the silver opportunity
• Take a whole-of-society approach.]

And that's kind of what's now got published. So, their work kind of updated our work, and our work wasn't just for policy audience, it was for everybody. These were kind of the six policy vectors that they thought if we double down and start to experiment in these areas, we might be ready for these possible futures that it might emerge. So, I think it's a great pick-up point in addition to the now policies that the NIA has. So, that's what I wanted to talk about. Let's get into a conversation.

[01:09:18 Dr. Zayna Khayat walks over and sits back down next to Neil Bouwer.]

Neil Bouwer: Amazing. Okay, the first thing I want to do, I just can't resist asking you, if you could wave the magic wand of a policy change and you could change… take three policies, maybe it's a health care policy, maybe it's the Canada Health Act, maybe it's a workplace policy, maybe it's an economic policy. If you could, right here and now, say there's three things that need to change, what would be some of the things that come to your mind that you would like to go and see Canada come out quick out of the gate?

Dr. Zayna Khayat: So, I would say one is definitely entire set of reforms around pension and around cash flows, income security. There's a whole bunch of them out there other countries have experimented with.

Neil Bouwer: Not public servant pensions though, mind you.

Dr. Zayna Khayat: Well, you guys are probably fine, but you're… again, in the missing middle, you're probably okay but 70% of Canadians are not.

Neil Bouwer: Right.

Dr. Zayna Khayat: And it's only going to… their are out-of-pocket costs as they age, because our health care system is designed for hospital care, are only going to grow, right? So, there's just ways. Could you play with physical assets to have new forms of cash flow that's not just to reverse equity. So, there's tons of innovation, I think, on income security, if you will, and kind of re-structuring our financing systems for that. That's one. I think two would be creating conditions for a very different labour structure in this rewirement, whether that's learning and education. What was the word I was going to use? Timebanks. So, how do you have this new pool of capacity, whether that's to teach coding or to teach music or to volunteer at a thing, but this whole pool is out there and there's no economy for that. There's no way to liberate that pool and kind of distribute it in different ways. So, that would be two, labour force, and the last has got to be health care. And so, I'd have maybe two ideas. One could be what we talked about earlier, like I would love to see the feds use their platform to have a new way to really prevent illness, because it's not really the jurisdiction of the provinces. Those are sick care systems, and I'll just give you an example. In the Netherlands, we created a completely new national health insurance scheme. So, we have government-funded health care, sick care over there, €95 billion a year for 14 million people. We created a publicly-funded health insurance scheme for wellness, right? That can be done. That's the first country. So, I mean, my more practical health care example, which was the intention with the federal transfers, I think you guys know about 35% of all health care in this country is federally financed, okay? Through the transfer of money. Give them money with some contingencies. Set the conditions under which we will pay the provinces (laughs).

Neil Bouwer: What would be a good example as a condition?

Dr. Zayna Khayat: Around… well, one will be for sure data, liquidity, and all that, which was supposed to be done but didn't happen, and then around paying for outcomes instead of inputs, right? Pay for outcomes instead of inputs. That's what Medicare did in the United States, because Medicare is a maybe $3 trillion publicly-funded health insurance scheme for over 65, and they're like, if you want to participate and get paid for by Medicare, these are the conditions under which, and they're outcomes-based, right?

Neil Bouwer: I love it, and those go hand-in-hand, having data and looking for outcomes.

Dr. Zayna Khayat: Of course, you can't do an outcomes-based model without the data.

Neil Bouwer: Right, fantastic.

Zayna Khaya: There, I just… I've never done that before.

Neil Bouwer: That's nice.

Dr. Zayna Khayat: I'm going to write a paper about that.

Neil Bouwer: That's a trifecta.

Dr. Zayna Khayat: Thank you.

Neil Bouwer: That's amazing. Okay, I'm going to scan and see if we've got a question right here.

[01:13:07 Neil Bouwer points to an audience member.]

Question: Should I use the mic?

Neil Bouwer: Please use the mic, yeah, if you don't mind.

[01:13:09 An audience member walks up to a microphone.]

Dr. Zayna Khayat: Can I just… how much time do we have? Because I can go on and on. Okay, let's go. I got to be crunchy (snaps fingers).

Question: Hello, I'll make it quick.

Dr. Zayna Khayat: Who are you?

Question: I'm Bradley Gaudet and I work for the CRTC which is Canada's regulator of telecom and broadcasting. I'm thinking of policy analysts within the government, specifically government departments, that administer certain industries within Canada, like for example, the banking sector. I don't know which department administers that but I know for sure, the CRTC, we oversee telecommunications companies. And so, of course, I'm aware of the growing demographic of seniors, but I'm also… through many months of research, I'm also increasingly aware of the fact that no two seniors are alike in terms of health, in terms of economic prosperity, in terms of technological abilities and the like. So, if the CRTC were to impose policies, regulatory policies, that benefit seniors or require the industry to deliver certain services or tailor their services, how do we?

Dr. Zayna Khayat: It's hard, yeah.

Question: Because there are so many intersections with younger Canadians. Some seniors might have visual impairments and likewise younger Canadians would as well. So, that's sort of an open-ended question. My follow-up question is, I know that for sure in the banking sector, the large banks have come together and created a voluntary code of conduct for the treatment of seniors. And so, I find that quite interesting.

Dr. Zayna Khayat: That's great. I'm going to add that to my examples, yeah.

Question: Sometimes we can offload that onto the industry and say, hey, get together and come up with… so, I guess, it's more of a comment rather than a question.

Dr. Zayna Khayat: Yeah, but just a couple ideas. So, there's a big movement. I think the guy who kind of was part of it in South America, ran for Mayor of Toronto in the last election, it's called 8-80. So, if a policy, a practice, a process, a product can work for an eight-year-old or an 80-year-old, it'll work for everybody. So, that's a big framework that's used around the world for everything. The iPad is that, right? A kid can, a baby can use an iPad, an 80-year-old can use an iPad. Accessible and inclusive by design is just everybody, as we have neurodivergence. So, it's not even for physical inability and all that. So, that's kind of a given, just like privacy by design.

So, the last thing on policy, which I'm sure you guys talk about at the School and I'm sure you teach about this, is the new governance model for everything is flex everything, right? So, it's not about policies, which I'm going tell you are going to be out of date the second you write the policy because of the world. It's principles, so exactly, like a code of conduct. So, if you do a principle-based set of regulatory regime, that's the only way because it's flex everything. There is no one segment for anything in anything. It's an end of one. So, end-of-one policymaking is the new practice and not just for, of course, the elderly, any public good.

Neil Bouwer: And I guess we would call it adaptive policymaking.

Dr. Zayna Khayat: Massively adaptive.

Neil Bouwer: In the language of the policy community.

[01:16:16 Neil Bouwer points to an audience member.]

Question: Hello, here is Sidy, Amadou Sidy Diallo from the Policy and Strategic Relationships team. So, my boss is Josianne. So, thank you, Dr.…

Dr. Zayna Khayat: Khayat.

Question: Khayat, thank you. So, my question is about the identity of aging and the quote Joseph Coughlin quotes, the fact that he said old age is made up.

Dr. Zayna Khayat: Yeah.

Question: And I think there is that nature of… the nature of aging is that immutability, the fact that you cannot change it, the case you mentioned, Emile in the Netherlands.

Dr. Zayna Khayat: Yeah, yeah.

Question: So, the right to… the highest court in the Netherlands denied Emile the right to challenge his age. As we know, today, you can… in many jurisdictions, you can change your gender, etc. So, there is that. Is that character, the fact that age is immutable, is that also part of the identity of aging?

Dr. Zayna Khayat: Yeah, absolutely. That's what I said, remember, that by about 2030, old age won't exist as a word, right? If you kind of play out the trends. So, again, it's hard for you to imagine it but it's happening (laughs), and then what happens, right? Absolutely. So, I'm glad that theme struck you.

Neil Bouwer: Fantastic. Well, that's a good bridge to my next question which is, to what extent do you think this is happening to us and we need to react to it smartly?

Dr. Zayna Khayat: Yeah.

Neil Bouwer: Versus to what extent… you opened by kind of talking about the preferred versus the possible and the plausible. So, to what extent are we the architects of where we're going and we need to be actually proactive in engineering this future?

Dr. Zayna Khayat: Yes. So, of course, the default is to react, especially it's so easy with demography in addition to other things as policymakers. Like everything, I wish we would pick something in Canada, grab the bull by the horns, and like you said, architect that future. Deloitte, maybe two years ago, put out a vision paper for, what would it look like for Canada to be the best aging society in the world? And then, you unpack. So, just having that aspiration and kind of going for it would be what I would call for, and maybe it's not for aging, maybe it's for something else. I don't know. There are countries that have done that and I think there's an economic gain. So, I think, just again, this reframe is if you kind of start from a policy perspective of, as this demographic bulge happens, how are we going to finance all this at a time when there's less participation in the labour pool? That's this deficit model, versus, wow, there's a whole longevity dividend that can accrue if we create these new markets, and not only create them for our own country but to service the world. That's that kind of opportunity that is sitting here in front of us and very few have gone after it because very few have gotten to the super-aged the way we have, right? I think Japan, we can do a lot of shamelessly stealing from what they've done in this realm.

Neil Bouwer: Amazing. Well, I mean, you've given us a lot to think about.

[01:19:56 Dr. Zayna Khayat points to an audience member.]

Dr. Zayna Khayat: We'll talk after.

Neil Bouwer: We can take one last quick question.

Dr. Zayna Khayat: And remind us who you are.

Neil Bouwer: And we'll wrap it up.

Question: (inaudible), I work for iWrap.

Dr. Zayna Khayat: Yeah.

Question: In terms of A.I., what do you see as the… what could we leverage A.I. for?

Dr. Zayna Khayat: Yeah.

Question: To help with this?

Dr. Zayna Khayat: So, Singapore just announced this week they're literally doubling down on… so, Japan's focused on robots, which has A.I. built in but it's much more because of the labour force. The caring labour is just not there and people don't have a lot of kids. Singapore's doubling down on A.I. to take care of their aging population. So, have a look at that. I think they're way ahead of the pack. And so, I don't think A.I. is as big a deal though as just technology in general. And nowadays, everything is A.I. in technology. So, it's just a given versus the standalone, the way Singapore has.

Neil Bouwer: Great question and great note to end on. So, Zayna Khayat, it's amazing to have you here again and to help us think through, kind of with a futurist lens, such an important topic is aging. I think you've shown us that it's affecting all parts of society. There's a breadth and a depth to it. That depth is the profoundness of the change in maybe the intensity of the change, which I don't know about you but I don't think I appreciated just how foundationally paradigmatically shifting aging really is. And also, thank you as well for the ideas about the sort of the policy, the program, the service implications of this, and if we want to be proactive and we want to change our mindsets, the mindsets are going to change first, the language will change with that and so too will the actions. And so, it really is a call to arms for public servants. So, I want to really give you a heartfelt thanks for that, and for those of you joining online, thank you for taking the time.

A big thank you to everyone for participating today.

So, we hope you have enjoyed the session. It's one of many great sessions put on by the Canada School of Public Service, and we hope to see you again soon. Take care.

(Applause)

Dr. Zayna Khayat: Great summary, excellent summary.

[01:22:04 The CSPS logo appears onscreen.]

[01:22:10 The Government of Canada logo appears onscreen.]