Proceedings of the Special Senate Committee on Aging
Issue 14 - Evidence, June 9, 2008
OTTAWA, Monday, June 9, 2008
The Special Senate Committee on Aging met this day at 11:35 a.m. to examine and report upon the implications of an aging society in Canada.
Senator Sharon Carstairs (Chair) in the chair.
[English]
The Chair: Good morning and welcome to the meeting of the Special Senate Committee on Aging. This committee is examining the implications of an aging society in Canada. Today will be the final meeting on our second interim report, Issues and Options for an Aging Population, which was tabled in the Senate on March 11.
This will be our final group of witnesses before we issue our final report in September, hopefully. Appearing before us once again, on behalf of the National Seniors Council, NSC, is Jean-Guy Soulière, Chair; Jane Barratt, Secretary General, International Federation on Ageing; and Joyce Mitchell, Treasurer, National Pensioners and Senior Citizens Federation.
You are here today because we have now heard from all the witnesses we wanted to hear from, and because we have now travelled across the country. Given your various positions, we wanted you to give us a final "kick at the cat" in case there are any issues you think we may have missed. In that way, we can ensure it is part of our final report. Let us begin with Ms. Barratt.
Jane Barratt, Secretary General, International Federation on Ageing: The International Federation on Ageing, IFA, is honoured to be invited to this Special Senate Committee on Aging to respond to the second interim report. The IFA is one of only four international non-governmental organizations in this field. It uniquely works as an information exchange and point of connection with public and private sectors, civil society, academia and individuals to improve the quality of life of older people.
Enabling and supporting physical, social and cultural environments are key elements to engaging and empowering older people. First, the IFA wishes to congratulate the Special Senate Committee on Aging in not only listening but hearing the views of witnesses and other experts over many months. The report, with some 84 proposed options, is evidence of a comprehensive process of consultation. The committee now has some serious decisions to make in understanding the way forward. It must prioritize many demanding calls for improvements and change — not all is achievable.
In broad terms, this report spans four main areas — engaging seniors, financial protection, care and support, and age discrimination. These areas are interdependent and have an effect on one another. For example, discriminatory employment practices have a relationship to mental health, to marginalization and, in its extreme form, may in part result in suicide. The following comments highlight some of what could collectively be known as the "tipping point." "Positive," "healthy," "active" and "successful" aging are terms used to generally describe the kind of processes and outcome we all want — that is, to have the cognitive and physical capabilities to choose what and who we want to be and where we want to live as we reach our later years.
The IFA uses the term "engaging seniors" as a catch-all for policies and programs that denote participation, involvement and involution. Together, these naturally give rise to being "in action."
"Engaging seniors" embraces many of the proposed options in the report related to lifelong learning, volunteers, social inclusion, and health promotion and prevention. It also recognizes that the mental health of seniors is often related to their involvement in family, community and society as a productive and worthy member.
There are, however, underlying factors not noted in the interim report that may prevent success. For example, there is no question that volunteer programs can be created. However, the "value" of "unpaid work" is not yet recognized as a critical part of community; volunteerism is often still considered "something" you do after "real work" is completed. We may want to think about the economic value of volunteers and include this in all annual reports in both the public and private sectors.
Lifelong learning programs are a further example where we may not be fully realizing the potential. Can programs of lifelong learning be established in the context of mentorship programs across generations and value-added propositions for mature workers?
There is an opportunity for tremendous leadership across sectors for knowledge creation and translation to be more than a textbook exercise. Healthy aging, social inclusion and good mental health are characteristics that we would all want for seniors in this country — they are interwoven and embedded in a supportive and enabling physical and social environment.
Perhaps the Senate committee may consider the importance of design disciplines, including landscape, industrial design and product development. This resonates with a more inclusive approach of what it is to grow older in a community that enables us to grow old actively and thereby benefits from the economic opportunities of this nation's demographic change.
The internationally recognized leadership of the Public Health Agency of Canada cannot be underestimated in the development of various models of age-friendly communities in many provinces since the conclusion of the World Health Organization's global age-friendly cities project. There is a true sense of ownership by and for several communities in Canada that reaches out to solve many financial and social issues experienced by seniors. In addition, the endorsement by the federal, provincial and territorial ministers responsible for seniors of the age-friendly rural and remote communities initiative continues to gain momentum around the world.
The IFA notes the weight that the Senate committee places on abuse and neglect of seniors which is unacceptable. Awareness campaigns and sharing best practices do not necessarily address the "pointing end" of this growing trend or the causative factors. Abuse of seniors is a public health issue and a community responsibility — and a multisectoral approach is crucial to build solutions.
The increased prevalence of abuse and neglect of seniors in our nation cannot be viewed as separate to the social and physical environment. Not enough attention is being paid to the potential underlying causes such as inadequate training of care workers, insufficient appropriate home care services, a lack of long-term care facilities for older people with advanced dementia, and the non-uniform approach to a national understanding of the need for community and residential services.
I wish to make some brief comments in relation to the broad area of care and support for seniors.
There are many options for the committee to consider. There are also some fundamental issues in the decision- making process. These include: inequities in care services and the access and uptake of medication across provinces; inadequate training of health care professionals; socio-economic status as a factor in accessing care services; the capacity and capability of visible minority groups to age in a foreign land; and a lack of national standards and accreditation of home care providers and staff that may result in risk to staff, clients and families.
All seniors must have the same options, regardless of where they live in Canada, to access good quality care and support provided by trained care workers and professionals, regardless of their race, religion, education, gender and geographical location.
Caregiving is a growing business across the world and, while it is imperative to develop necessary programs to support family caregivers, the landscape is also changing. Demographics, urban migration and the role of women in the workforce gives rise to concerns about the role of family. Therefore, we need to look beyond the current generation of solutions.
For example, a government subsidy to every senior in need of a personal help/medical alert device may enable them to remain in their home safely and, in many instances, enable family caregivers to remain in their employment rather than take on the role of "sole caregiver." A small financial investment is a simple and effective way to support seniors to remain living in their home coupled with a case management approach.
As a side note, Australia is considering a safety plan to "tag" people with dementia. Under the plan, about 3,600 approved providers delivering services for residential aged care, respite services and transitional care will report cases to the Department of Health and Ageing when a resident is deemed to be missing. In the State of Victoria, over 6,500 older people with dementia will go wandering in one year. It causes great concern for families, but also enacts a multisystem community approach in locating these people.
To age in place is to have choice to live in an environment that is responsive to changes in one's functional ability. That is what it means to age in place, whether this is in a private residence or a residential care facility. Home modifications are only one element of a strategy that could be considered. The other elements may include mainstreaming transport services, community case management approaches, education of architects and those involved in the built environment, and postgraduate training in designing environments that give life to all age groups.
Aging in place is of such national and international interest that the IFA is convening a senior governmental officials meeting this year in Montreal on this subject. It has attracted over 50 governments. In 2009, we will convene an international forum in Japan to examine in greater depth the models of best practice and how they relate from an economic and social perspective.
There are many models in Canada of aging in place. A growing body of knowledge exists in Canada that requires nurturing and transference provincially. Integrated models of care have received attention globally for over two decades. The efficacy and transference of such models is not conclusive.
In a practical sense, people of all ages require and expect a health and care system that is continuous — providing a continuum of care that is responsive and cost effective. A national framework that goes beyond a set of guidelines but has a certain level of accountability is necessary.
International trends and the status of residential care require specific comments.
Standards and accreditation beyond building codes are essential. Facilities that encourage independence and active aging are the future of residential care. While residents may require high levels of clinical care in response to chronic or terminal conditions, this should not be a substitute for, but rather complement, promotion of health and wellness.
Finally, age discrimination is a characteristic of our time. "Casual ageism" is among the most common and glaring examples of age discrimination. This refers to the general negative perception of older people and their position in society. Age discrimination in the workforce is one of the most pressing legal issues that Canada and many countries in the developing world realize today. The changing population demographics and increased life expectancy rates are having an effect on the make-up of our workforce. This necessitates review and action on discrimination in this area.
Other forms of age discrimination, such as the provision of goods and services or access to health care and insurance, are often not addressed by legislation. Equality will not be achieved if only some forms of discrimination are illegal while others are allowed to continue.
Furthermore, some legislation only extends to discriminatory practices in the public sector. Equality cannot be achieved if only the public authorities are subject to the rules of non-discrimination. The state must ensure that non- discrimination is practised within both the public and private sectors.
The tremendous recent interest in Canada and abroad of "law as it relates to older people" calls for more than quiet reflection on this. It is a product of occurrences in our community. An increase in the prevalence of people with decision-making disabilities vis-à-vis dementia calls for review of guardianship and administrative policies and practices. One can expect an increase in the number of cases presented to the public advocate in the future.
Aging and growing older as a nation is a subject that is sometimes avoided and often is not a priority for governments. We cannot put off changes that we need to make as a society, and we cannot deprive ourselves of opportunities to change the individual experience of aging.
The IFA is committed to working with all parties to further improve the quality of life of older people in this great nation. As secretary general of the IFA, it has been my privilege to bring a critical mind and voice to this interim report and the options before the Senate committee. I acknowledge each member of the Senate committee as dedicated and committed individuals and I thank you for the opportunity to share this perspective.
The Chair: Let us turn to the National Pensioners and Senior Citizens Federation. Ms. Mitchell, please proceed.
Joyce Mitchell, Treasurer, National Pensioners and Senior Citizens Federation: If I appear nervous, I am. It reminds me of the first day of school.
I am Joyce Mitchell from Trenton, Ontario, representing the National Pensioners and Senior Citizens Federation of which I am the treasurer. I will give you a brief history of our organization. In 1939, at Saskatoon, Saskatchewan, there was a lady named Agnes Nurse who had the responsibility of caring for her aging father. After a bit of research, she learned that, at the Empire Hotel, a group of seniors met daily to socialize, play cards and for great fellowship. She made several inquiries and found that she was able to take her father there each day and pick him up each evening.
While doing this, she met a lady named Annie Douglas, later known as Tommy Douglas' mother. These two ladies often discussed the needs of the seniors and came to the conclusion that they should lobby other groups, in particular in their own province, to form senior clubs and groups. This is how the Saskatchewan Senior Association Incorporated was formed. As a matter of interest, the old age pension at that time was $19 a month. Their idea was to lobby the government for a pension increase and absolutely no means test required in order to qualify.
Before long, they had 32 clubs. These ladies saw a need to expand their interest to other provinces so they canvassed Alberta and British Columbia. From this, the National Pensioners and Senior Citizens Federation was formed in 1954, with Annie Douglas as the president for 20 years — what a dedicated individual and volunteer. Of course, we all know how Canada's excellent health care plan came into being. Do you not think that a mother's influence was partially responsible?
The point I am trying to make is that these ladies started out as volunteers. Our organization still operates strictly on a volunteer basis. The executive is based throughout Canada. For example, our president lives in Little Britain; our first vice-president in Surrey, British Columbia; our second vice-president in Prince Albert; our third vice-president in Brooklin, Ontario; our secretary in Saskatoon, Saskatchewan; and I am the treasurer. In previous years, we always had one or more representatives from the Maritime provinces. I am looking at a familiar face that came and spoke to us in Truro, Nova Scotia, and we thank you for that. Geographically, area is not a criterion for being on our executive. Each year we hold a convention. This year it will be in Surrey, British Columbia, where resolutions will be discussed and voted on. Those that meet the approval of our delegates are put into a brief which, in the early part of the new year, is presented to different members of Parliament with a copy forwarded to each senator for their perusal.
After reviewing the second interim report of the committee and noting all the witnesses that have presented to date, I feel honoured and humbled to be here today because I am just a senior giving the views of just a senior. You write early on about seniors having a healthy, active living lifestyle. On page 11, item 9, you have first-hand knowledge of the program. I have first-hand knowledge of this program because I and eight other volunteers from different seniors' organizations in Ontario make up a panel that evaluates the Ontario proposals submitted that have met the criteria as set out by the government. This program is important. Many agencies, for example the VON, submitted at the first funding an exercise program they called S.M.A.R.T. This was a series of exercises designed for all seniors regardless of their limitations. This was a superior-run program in my home area, and continued each year even though they were funded only for the start-up year.
This is possibly an area where financial assistance could be given to continue on with any of these programs that have proven to be so successful. On the negative side, there were many small seniors' groups who needed small amounts of funding simply to pay rent to a municipality or church for the use of a hall once a month for their meeting, but they were denied that funding. We found this discouraging, especially in rural areas, where they need these meetings for communication and for reaching out to others. I feel they should have been allowed this and where isolation should have been addressed. As we all know, this program has been expanded into capital funding. As today's teenagers would say, awesome.
On page 18 in chapter 3 of your report, you write about older workers, retirement and income security. As a panel member of the seniors advisory committee for old age security at Health Canada, I realize all the hard work that both committee members and staff do to make this more supportive, flexible and financially productive. They have come a long way, in particular since the advent of their call centre and the work of the outreach officers. I saw this in the Western provinces when they presented at each of our conventions. The outreach officers work so hard to try to get the information out. There were many TV advertisements but one that I really enjoyed, as I hope you did when you were watching the Brier, was the one about the curler. At times, we seniors just need a small little kick and not a two-page article.
On page 28, your report talks about fall prevention. It still amazes me that it took so long for the Ontario government to approve payment for the new drug Lucentis that was prescribed for some candidates with macular degeneration. It was not until March 25, 2008 that agreement was made to cover this drug. Prior to that date, it cost $1,800 per injection. As a senior affected with this disease, I know first-hand that this is true. After the news release, the doctors involved were given a list of criteria to be met by the patients. It is my understanding that, because of the outcry from seniors and the CNIB, these restrictions have been lifted. One restriction to qualifying was being diagnosed prior to January 1, 2008; another was having had laser treatment.
As you all are aware, failing eyesight would surely put a person at higher risk of falls and possibly hospitalization. It is important that we work towards health care in particular for eyesight.
It was with great joy that I heard that the National Seniors Council was crossing Canada to hold meetings with different seniors' groups to hear their views and ideas. It seems to be one of the positive steps that the government has taken to date — to hear from the average senior and the grassroots seniors' clubs, as well as professionals, institutions and researchers studying ageism. We have wonderful reports back from small clubs saying how much they appreciated being considered and listened to.
On page 32, section 4.5 talks about hospice, palliative and end-of-life care. I would like to take this one step further. Why does the government tax the death benefit given to the surviving spouse, if qualified? The television and news articles tell us that up to $2,500 may be received, but no one tells you that it is a taxable benefit. I feel strongly that we should not pay tax on this benefit and, if it is to be, then advertise it as such. Do not tell people that they may receive up to $2,500 without adding that it is a taxable benefit.
On page 39, section 5.2 is about home support and health care. I found this section interesting, but I did not read anywhere that there was a possibility of an adult daycare centre as in child care centres that are now funded. I think adult daycare centres should be considered for funding. There is a great need, even going back to 1939 when Agnes Nurse had to search for a safe place to leave her father during the day. Many working people today are searching for some place where they can leave their aging parents or the people they are responsible for, but there is nothing out there.
In summary, I give you my personal thanks and appreciation for your well-prepared report. It reflects a great deal of study and research and, most of all, that the average, everyday seniors' needs have been considered.
I thank you for your patience and time, and for your invitation to present on behalf of the National Pensioners and Senior Citizens Federation.
The Chair: Thank you. You need not to have been nervous.
From the National Seniors Council, the overarching body, if I may put it that way — Mr. Soulière.
[Translation]
Jean-Guy Soulière, Chair, National Seniors Council: Madam Chair, thank you for inviting me here today. I am glad to have an opportunity to talk with the committee before it wraps up its consultations and begins writing its final report. On June 4, 2007 — almost one year ago today — I appeared before you, and what a busy year it has been for the committee and for the National Seniors Council.
[English]
When I was preparing for this presentation, I had a chance to reflect on the National Seniors Council's first year. At our inaugural meeting in May 2007, the Secretary of State for Seniors, the Honourable Senator Marjory LeBreton, asked the NSC to examine two initial priorities — elder abuse and low income among seniors. The committee's options pertaining to elder abuse and retirement income security were of particular interest to me.
Let me start with what we discussed in terms of elder abuse.
[Translation]
In the fall of 2007, the NSC hosted five regional meetings on elder abuse across Canada. It submitted its report on elder abuse to the federal government in November 2007. Our report identified six key areas for action.
[English]
Allow me to summarize the six measures included in the report: As a first step in addressing elder abuse, increase awareness of elder abuse in all its forms among the general public, professionals, service providers and seniors themselves through a national awareness campaign; enable the transfer of knowledge and dissemination of information among those involved in the field of elder abuse in Canada; improve education and training and standards for professionals and personal support workers who provide care and services directly to seniors; enhance the research and knowledge based on elder abuse as part of a comprehensive plan to ensure that actions and responses to elder abuse are based on accurate and up-to-date information and data; support, through financial and human resources, the efforts taking place at the community level to combat elder abuse, including building capacity within voluntary sector organizations working in the area of elder abuse; and examine federal legislative and legal frameworks to better understand how they may be utilized and applied to cases of elder abuse.
I am certain all committee members have read our report. I will not give you a test afterwards. It coincides with much of what you heard across the country on this subject.
[Translation]
Elder abuse is a national problem that requires a national response. The NSC is of the view that the federal government is well positioned to work with partners, including provincial and territorial governments, to assess needs across key sectors, identify existing gaps and take proactive measures.
[English]
Further, the National Seniors Council is pleased that some of the advice in our report contributed to the $13 million commitment to help seniors and others recognize the signs and symptoms of elder abuse, as announced in the federal budget of 2008.
The National Seniors Council's advice aligns well with some of the views expressed by the committee, particularly as it relates to the sharing of best practices and training materials for front-line workers. The work of the committee is also helpful in raising awareness on this issue. Awareness is critical.
[Translation]
In regards to the NSC's low-income seniors priority, the NSC is getting ready to prepare and submit its report to the minister later this year.
Between February and May of 2008, the NSC traveled across the country holding Roundtables on Seniors' Well- Being. In fact, on May 25, 2008, the NSC completed its 11th roundtable, which brought the total number of participants to 100.
[English]
The NSC invited representatives from seniors' organizations and service providers to hear their views about the experiences and challenges facing low-income seniors; program and service delivery issues such as potential barriers to accessing information and benefits; and the important issues for seniors in their communities. The NSC has not yet had the opportunity to undertake a thorough review of the round table discussions or analyze them in relation to some of the specific options in your second interim report. However, I am pleased to share with you a general overview of what we heard at the round tables.
Overall, seniors in Canada are doing well. They are healthy, financially secure and enjoying active retirements. The low-income rate among seniors in Canada has declined significantly from 21.3 per cent in 1980 to 5.4 per cent in 2006. This is based on Statistics Canada's after-tax low-income cut-offs. However, pockets of vulnerability remain, particularly among senior women, persons over 85, those who have worked less than 10 years, recent immigrants, Aboriginal peoples and unattached seniors.
[Translation]
Although many of the issues linked with seniors' well-being are under provincial/territorial jurisdiction, participants emphasized that all levels of government must cooperate and coordinate efforts around issues of importance to seniors. Despite some regional differences, the discussions and issues raised were remarkably similar across the country.
Let me outline six specific issues that were repeatedly identified by roundtable participants.
[English]
Participants at the round tables voiced their opinions about the adequacy of income during retirement for seniors living on low and fixed incomes, especially in light of greater longevity and increases in living costs. Increases in housing costs, food and fuel were of particular concern.
Round table participants were not experts on Canada's retirement income system and did not discuss public and private pensions and savings vehicles in great detail. While they would like to see incomes of low-income seniors increased, few specific means to do so were identified or discussed at length during our round table discussions.
In terms of preventing low income during retirement and old age, participants talked about the importance of financial literacy and pre-retirement planning.
[Translation]
Health and access to health-related services and supplies is fundamental to the quality of life for seniors. Health- related issues came up at every roundtable, in particular the prohibitive cost and lack of formal care services and supplementary health benefits — particularly dental and eye care. During our roundtables, we repeatedly heard about the need for healthy and active aging options.
Specifically we heard about the need for removing barriers to accessing programs and services that will help seniors in this regard.
[English]
The issue of social isolation came up at every round table. Low income limits the ability of seniors to actively participate in leisure activities and engage in their communities.
Participants talked about the limited availability of public transportation options and associated costs, particularly in rural areas, and how a lack of transportation may place seniors at risk of social isolation.
Social isolation among seniors may contribute to myths and stereotypes about aging and old age, and intergenerational contact is important to help dispel them. The lack of social relationships is a risk factor for the development of health problems, whether mental or physical.
Round table participants told the National Seniors Council what the committee members already know — seniors prefer to, and should be able to, age in place either in their own homes or at least in their own communities. The council heard about housing-related challenges facing seniors in all of its round tables. The cost of housing — increasing rents and property taxes, utilities, and the cost of maintaining and adapting a home — are making it difficult to age in place and comfort.
The reality of families as caregivers will only increase in importance. This issue also came up repeatedly — specifically, the need for respite and some kind of support to enable family members to provide care to seniors while also maintaining their own health and well-being.
[Translation]
The NSC also heard how volunteers across Canada are helping seniors to live better lives. Canadians have a long tradition of helping individuals, communities and causes.
Yet this sense of responsibility for the well-being of fellow citizens and for the quality of life in our society needs to be continually nurtured. It is important to recognize the crucial role played by volunteers and the need to attract and retain baby boomers as volunteers, not only for their own benefit, but also to help seniors-serving organizations that operate with minimal staff and financial resources.
Promotion and public awareness are important to ensure the growth and to rekindle the spirit of volunteerism, particularly at the community level.
[English]
The sixth issue I would like to raise today that was discussed during the National Seniors Council's round tables was whether seniors are sufficiently aware of programs and services. Participants believe the federal government is working hard to ensure that seniors are aware of the information they need to know about programs and services. However, they believe that efforts to increase awareness and access information can be improved. There is also a need to communicate more effectively with seniors. Participants support having information available in multimedia formats but the message was loud and clear that seniors continue to prefer human contact, whether in person or on the telephone.
[Translation]
Again, thank you for the opportunity to appear today. These dialogues and deliberations are critically important to seniors' quality of life. I would like to reiterate that during the National Seniors Council's Roundtables on Seniors' Well-Being, we heard many of the same issues and concerns that the committee has.
[English]
Good luck as you write your final report. I look forward to reading it and making comments when you get it done.
I have one other comment — and I think you noted it on a number of occasions in your report — about the enormous commitment, knowledge and engagement that the volunteers and the people involved with seniors' organizations demonstrate across the country. It was an eye-opener for all of the council members and certainly something we all want to see continue and, hopefully, develop programs to make it happen.
I will be happy to take questions later.
The Chair: Thank you all for such a wonderful summary of what we have heard over the last couple of years of our engagement with experts, interested parties and citizens across the country.
Mr. Soulière, we ended on Thursday at a visit to Hospice Victoria. They mentioned that they had the equivalent of 70,000 hours of volunteer service. I think they had put a dollar value on it of some multimillions, which was more than they were able to raise in any given year for their programming. That clearly indicated that they could not do what they do for the citizens of Victoria in providing hospice palliative care at the end of their lives if it was not for this huge resource of volunteers. Your final comment struck an interesting note in that it was a repetition of what we heard on Thursday.
I will turn now to Senator Mercer, followed by Senator Cordy.
Senator Mercer: I will pick up where the chair left off, namely, talking about volunteers. Ms. Barratt, Mr. Soulière and Ms. Mitchell all mentioned volunteers. These last few years, everywhere we have gone, people have talked about volunteers. There have been several suggestions before this committee and others that we need a special committee or a subcommittee not only to examine volunteerism in Canada so that we can truly assess the value and encourage people to be involved in it but also, as several of you mentioned, how we can properly recognize volunteerism.
I have spent my entire adult life working for volunteer organizations. I have a great respect for the volunteer. Do you think there is a necessity for us, when we finish this report, to have someone sit down and do exactly that — namely, examine volunteerism in Canada to ensure that we are encouraging the next generation to be good volunteers; that we are recognizing the people who are volunteering now; and that we are identifying, if we need to recognize them in a greater way, what that way might be?
Mr. Soulière: This is more personal than as chair of the National Seniors Council. I, too, have volunteered in many organizations and continue to do so. For the first time a couple of years ago, we started to hear about the term "volunteer burnout" in the sense that too few were being asked too much. Something must be done. This is scaring people from becoming volunteers.
In your report, you mentioned that baby boomers are looking for something different when they volunteer. They want some specific things to do, they do not want to overcommit, and they want to deal with subjects of interest to them.
As to whether or not we need to have a study on volunteerism, the volunteer organizations will tell you that there has been enough study. What is required is action. I think the focus should be how we can assist volunteer organizations to do what they want to do. With regard to some of the round tables dealing with trying to reach seniors who are not accessing their benefits, the seniors' organizations know where those seniors are. Give us assistance so that we can do the job of reaching out to them. This is one of the areas we will be looking at in terms of potential recommendations.
Ms. Mitchell: At a recent seniors' meeting, a lady of 93 years asked me that question about volunteering. She said that most of us have to file an income tax return regardless of age, even 16- and 17-year-olds are filing. They are given volunteer time through the schools.
Could we not have one space on our income tax form that says, "How many volunteer hours have you given this year?" When you read reports of how many volunteer hours are given, where do you get that from? You get it from Statistics Canada, but where do they get it from? Our own church group was never asked for volunteer hours. Our own seniors' group of 800-some members was never asked to submit how many hours our volunteers give. This lady wanted to know if it was possible to have one area where she puts her name, address and how many volunteer hours she gives because she does a lot of hospice care. I know it does not sound like much, but at 93 years of age, it means a lot just to sit with people and hold their hands.
This was the suggestion of how to record volunteer hours. The other side of that is children in high school having to volunteer X number of hours a year. Rather than trying to run computer programs in school, when not all of us have transportation to get there, why could those children not be assigned to come into the senior's home and help them with a computer program a couple of hours a day, if only to learn how to go to a website to read something or how to use email so they can talk to their grandchildren. Going to the school has not really worked. It is confusing. There are a lot of people in the room, a lot of students, and some seniors feel challenged because they do not even know how to turn the computer on. They wanted to know if students could be sent into their homes.
Senator Mercer: We saw a similar program at the 411 Seniors Centre in Vancouver last week where they identified that big classes did not work in big centres. This was a small group where they had no more than six seniors at any one time, and it was easier for them.
Ms. Mitchell: Most teenagers have access to a vehicle, more so than seniors.
Ms. Barratt: I have a slightly different perspective. If a subcommittee, a ministerial-appointed committee, makes a difference to the formal recognition of volunteers in this country, then I would say yes. What we have here is a nation of volunteers — volunteers who could potentially be part of an intergenerational program, part of the promotion and awareness of abuse and neglect, and part of healthy aging.
There are many programs across the country where volunteers commit hours and time; however, the landscape of volunteers across Canada is not well recognized. The value of a volunteer, in terms of time and energy, is only one part but I see volunteers as part of the vehicle for change in some of the issues being addressed by this committee.
One other interesting point — you may have heard of the time bank. This is an important initiative about seniors being able to ask for assistance because they have banked volunteer hours. Many seniors will not ask for help in various areas of their lives because they do not feel worthy or they feel unhappy about taking something they do not deserve.
The answer is yes, if a subcommittee raises it to a different level.
Senator Mercer: Mr. Soulière, towards the end of your presentation you said that senior Canadians are doing well, are financially secure and are generally healthy. Then you went on to give the exceptions to that rule: unattached seniors, Aboriginal seniors, new immigrants, the 80-plus — the majority of these groups being women.
There are few people who then fit into the category that you described as doing well in terms of being financially secure and healthy. You are right about the groups you mentioned, but the evidence we have heard is that there are still large numbers of Canadians who are not doing well, who are not financially secure because financial assistance programs have not kept up with the need, and who are not healthy. They are healthier than they were in the past, but they are still not as healthy as they could be.
I would like to hear your comment on that. You said they are doing well. While we have heard about some instances where that is the case, generally speaking, we have heard about problems. The problems are within those groups that you mentioned but also within other groups. White men and native-born Canadians with their partners are in the group that seem to be doing well, but we have not found that to be the case across the board.
The Chair: If I could add to that, Senator Mercer. We heard from a couple of physicians in Sherbrooke, Quebec, who made the point that it is a myth that seniors will continue to live longer and longer and will be healthier and healthier. He pointed out, for example, the obesity and diabetes studies that say we might have peaked in terms of having seniors who are relatively healthy and well off, and we might start going the other way.
Mr. Soulière: I cannot comment on that. They might be right, and that is something we did not discuss. We certainly have a generation of young children who are too heavy, which is a problem, but that is not something the council looked at.
When you attend these round tables, you tend to focus on matters that are wrong, not matters that are right. Our mandate was to look at vulnerable seniors. Many of the people at the round tables ended the meeting by saying: Listen, we talked about what was wrong with seniors but I am a healthy senior. I personally am living well. I have sufficient income to have a balanced life and I am all right.
The point we were making is that, although we were focusing on vulnerable seniors, not all seniors are vulnerable. If you attend these round tables, you get the wrong impression that there is a major problem because you are asking questions that deal with vulnerable seniors. There is a problem but the majority of seniors — and the statistics will show this — are aging in security and with dignity. Still, as a Canadian society, we must deal with those people who are vulnerable. In the low-income situations, these people happen to be unattached women.
Senator Mercer: We have certainly seen the discrepancy in our travels. During our visit to Manitoba last week, we saw probably one of the starkest discrepancies. We went to a centre in Ste. Anne and saw some quality care. Then we went to a reserve north of Winnipeg where we saw quality care again, but there was no equity in the delivery of service. The people are doing a great job there; it was just the facilities that were not great.
The Chair: Ms. Barratt, did you want to add something to that?
Ms. Barratt: Just a general comment, senator. I do not get the same sense of well-being that my colleague does. I am concerned about the inequities that I observe across our nation. I have an understanding that there are inequities in access to, and uptake of, medications and access to health care services. I think that one of the roles of the Senate in finalizing this report is to ensure that we recognize that some proportion of seniors in this country are doing well financially and socially, but there are some silent voices in every round table and consultation process. There are silent voices because some us are too busy trying to survive to get to round tables and consultation processes.
There needs to be a balance in the message that the report makes.
Some are doing well, and let us address those inequities that we have observed and know from the literature and the evidence.
Senator Cordy: I cannot help talking about the inequities that I saw travelling across the country. When you do it in a one-week period, one day you see a facility for seniors that has state-of-the-art technology and excellent care by the caregivers, and the next day you go to an Aboriginal community where the caregivers are wonderful and making less money than those nurses who worked off-reserve a short distance away, which really struck me, but the physical building the seniors were in blew me away. I could not help thinking about the discrepancies that we have in our country of Canada. It saddened me a great deal.
That was not my question but I could not help commenting on it.
Ms. Mitchell, you talked about drugs and access to drugs that seniors have. We also heard that there are discrepancies from province to province as to what drugs are available for their populations, and I am wondering whether we should have a national drug formulary so that whatever is available in my province of Nova Scotia is also available in Ontario or Quebec or Saskatchewan or wherever you happen to be.
Ms. Mitchell: I certainly agree with you. I lived for 13 years in Inuvik in the Northwest Territories and retired from there. If you want to see a difference in health care alone, live there. I am not just talking about the native people.
I will give an example. To have our eyes examined, the University of Alberta had a contract and they came in, I believe, about every three months and examined our eyes. They brought an optometrist who brought his colleague in that had glasses, and you had to choose from those glasses, but you could not try them on afterwards because they mailed them back to you.
Once when they sent me back my glasses, I tried to walk down the hall in the hospital after picking them up and could not see. Four times they went back. Now, I know it does not sound like much, but every time you have to mail your glasses back, and they send you another pair, and you mail them back — you do not think about it until you come back and are living in Ontario, and have your choice of where to get glasses. The government eyeglasses for some people were free so there was limited choice as to what we could get. We could buy the frames he brought that were the cheapest kind, worth $9.50 I believe, and you know what you pay for a pair of glasses. The native people are so limited. It is not just through language or travel. They are just limited, and people are going out to care for them. To get their drugs, maybe they can go to the pharmacist at the hospital and get them for free, if the doctor diagnosed them and gave them a prescription, but they had to get to that town first and get to the doctor. Most of them just had nursing stations.
I will agree. Whatever we have in one province, we are all Canadians and we should be treated the same but we are not.
On another line, with respect to seniors and diabetes and obesity, I worry more about the generation coming behind me — namely, my children's generation that are being burned out in their jobs. They will have more mental anguish than we ever thought possible. You listen to them talking about how much time in the workplace is lost through counselling — through drug abuse, alcohol counselling and mental health counselling. Watch for those seniors coming behind us. They will have many more medical problems than we ever had.
Senator Cordy: You have raised another good point.
Mr. Soulière, you talked about those suffering from low incomes, women over 65 and immigrants. We heard a lot about that in British Columbia last week. One thing they raised was that, if you are bringing over parents, then for 10 years you are responsible for sponsoring your parents. It was felt that this created great hardships for the parents because, if you are 21, 10 years might not be a long time but if are you 65, 10 years is a long time.
The time period for spousal sponsorships has been reduced to three years. It was felt that family sponsorship of parents should be for two years because, while a person is being sponsored for the 10 years, they are not eligible for programs we have in our government, which leaves them open to poverty. We also heard about the fact that some of the seniors are working at hard manual labour on farms because they have no access to any money and are totally dependent on their children.
There are two problems here. Parents do not necessarily like to be dependent on their children and, second, the financial resources of the children may not be such that they can support their own family that is, perhaps, growing and their parents. Did you look at all at a reduction of the period of time from ten years to three years when you were looking at those most vulnerable financially?
Mr. Soulière: We are at the stage of looking at areas of recommendation so we have not made any yet. We will be preparing recommendations and our report is expected sometime in the fall.
Let me comment on the fact that, when we were having the round tables on low income, we did not specifically talk about immigrants. It was raised on a couple of occasions but what you heard, we heard once or twice; however, it was not the main theme across the country. Of the participants that we had, nobody made specific recommendations along the lines you are recommending.
We do have on council a person from Vancouver who is an immigrant from Korea. He is sensitive to the issue, and when we talk about areas of recommendation, we will certainly have input as to the plight of immigrants. However, to say that we specifically dealt with it, that is not the case.
Senator Cordy: Will you be looking at immigrants? The number of immigrants coming into Canada is increasing so much that we cannot plan any national program without looking at the needs of those who are new to our country.
Mr. Soulière: I will take it under advisement. It was not our focus, and I cannot comment more than that on it. Certainly, since you heard that, I will take a note and see what we can do.
Senator Cordy: I would like to talk now about the issue of abuse and neglect because we heard over and again about physical and financial abuse. We also heard that sexual abuse is much more rampant than we would like to think. However, because it involves seniors, they are reluctant, just as women — I say "women," and I know men can also be sexually abused — who were sexually abused were often afraid to disclose because they feared that it was their fault. Now this generation of seniors is reluctant.
A few of you on the panel talked about more training, that it is a public health issue and that it is a growing trend.
One of the things we heard suggested was that there be whistle-blower legislation for seniors so that those who are in seniors' homes, particularly, can be a bit freer to disclose that they are being abused without any ramifications to them. Have any of you heard anything along that line?
Mr. Soulière: It certainly was raised when we did the round tables on elder abuse. The round table participants on elder abuse tended to be experts in the field of abuse.
You are right that people are not reporting it and we were given examples of why. Much of the abuse is perpetrated by a family member, and people are afraid to report them. In our round table discussions, we also heard about projects ongoing across the country to make people more aware of elder abuse, and our report focuses on some of those.
The government is spending $13 million to make people more aware, and awareness is a key element. People do not know that elder abuse exists, and do not know how to report it. The RCMP and certain municipal police that participated in our round table discussions highlighted examples of how society can be more aware of and report elder abuse.
Yes, we heard much the same things as you did.
Senator Cordy: Is the $13 million going to be used strictly for dealing with abuse of seniors?
Mr. Soulière: It will deal with elder abuse, yes.
Ms. Barratt: I will comment on your previous questions before responding to this.
With regard to the national drug formulary, it is absolutely essential that there is equity.
I resonate with your concerns about immigrants. There is a whole body of search and research going on about people growing older in a foreign land. In Toronto in 2017, there could be around 3 million people in visible minority groups. Much attention needs to be paid to our aging-in-a-foreign-land cohort because we live in such a multicultural society.
In response to your questions on abuse, legislation is only one part of the solution. In my response to the Senate committee, I talked about training of care workers and the lack of care workers in facilities. It is one of the symptoms of this issue. Lack of trained care workers, lack of health professionals, or lack of education of health professionals can give rise to abuse events.
In Australia in 2006, for example, there was identification of sexual abuse in nursing homes that received federal attention, and action was taken within three months. It may be useful for the Senate committee to look at those mechanisms. All staff now requires police clearance. There was a massive national education program of care providers. That comes back to a national framework of standards for home care providers. That is a worthy consideration because abuse in facilities is about health professionals and care workers as well.
A systematic policy program was put in place within three months of this occurring. I would be pleased to get the information on that for the Senate committee, if that would be of use.
Whistle-blower legislation is a possibility. For seniors to make it known is unlikely at best, and almost an impossibility. We have to tackle this problem in a different set of ways.
The Chair: Mr. Soulière, you might want to broaden your inquiry to couples who want to bring their parents over and make the 10-year commitment but then have health issues, marital breakdown or a couple more children, and their situation is greatly changed from when they made the commitment. You might want to consider that aspect.
Senator Stratton: Unfortunately, I did not have the good fortune of travelling with the committee due to the current state of the union here with regard to numbers.
You said that, in 1980, 21.3 per cent of seniors were in poverty and currently 5.4 per cent are. When I was a kid delivering groceries in the west end of Winnipeg, I occasionally delivered to an old World War I veteran who lived in a third-floor garret. I do not see evidence of situations like that any more. I believe there are seniors in poverty, particularly single women who were never married, and that area needs to be addressed.
However, from watching what is transpiring, I believe that seniors are a pretty vibrant lot today. As my son said to me, I am much younger at 70 than my parents were. Although my children have a much higher stress level than I had, I believe their lifestyles are much healthier than mine was. As I have said before, I am paying the price now but, fortunately, drugs keep that in check.
I want to focus on age discrimination. I do not see it, and perhaps it is because of the world I live in. What do you mean by age discrimination? I accept that it exists in travel insurance and licensing of automobiles. Are there other areas in which age discrimination comes into play? Is there excessive forced retirement?
Ms. Barratt: I will give you a couple of broad examples. If an 85-year-old was brought into a hospital emergency room at two o"clock in the morning and a surgeon was asked to operate, age would be considered in the triage process.
I give that example because a nine- or ten-country study on triage in emergency situations suggested that health professional decision-makers need to make judgments from time to time and that age figures in that decision-making.
In terms of accessing health care services — there being no right or wrong — the system may have to make some judgments about age. In that case, seniors may not get the prize. Discrimination occurs in the access in uptake in health care services as well as in employment.
We know there is legislation around employment practices, but we need to be careful about discriminating practices in terms of employment because we want and need people of a mature age to remain in our workforce, because it actually supports our labour market. There are two examples.
If we look in the newspaper for stories about seniors, we do not want to see good-news stories all the time, but we generally only hear about seniors when there is an issue, an unproductive, unworthy member of a community, just as youths of 15 or 20 years of age have that same sense of profile.
It is a process where we need to engage media, as well as decision-makers and the corporate sector. I do not believe that we engage the corporate sector in terms of being a vehicle of social change when it comes to age discrimination.
Senator Stratton: I believe you about the health care system. I know people in the health care system must make choices, some of which are particularly unpleasant.
With respect to universal access to drugs, in other words one drug program for the entire country, I have found it easy to say yes because it is easy to say that, but then you have to deal with each province and territory in negotiation. Of course, if it was possible to have one, we would have been on our way. I put that as a cautionary note as to problems in the future of achieving that end, although I think we should continue to push for it and hopefully gradually accomplish that.
It is like having free trade across the country. We have greater free trade with the United States than we have across our wonderful nation for the same reason.
With respect to volunteers, what I have observed, which is not empirical evidence, is there are fewer and fewer volunteers. That is my perception. Active volunteers suffer burnout simply because there are fewer volunteers pushed to do more and more. In the end, they say, "To heck with it," and take a hike.
What do you think is a possible solution to that? How do you encourage people to volunteer? They do it in the schools now. They never had that when I was a kid. I had never heard of the voluntary sector. Your scout master or cub master was a volunteer.
How do we overcome that problem of fewer and fewer volunteers and, as a result, more suffering from burnout? Is there a solution? I have a pessimistic view about this.
Mr. Soulière: From a personal point of view as opposed to chair of the National Seniors Council, my experience is there may not be fewer volunteers, but rather the volunteers are more selective in what they will do. How can you improve? I think Volunteer Canada has produced a number of reports that deal with possible solutions. You may wish to visit the reports they have done.
Before returning last year, I worked with an organization called the Federal Superannuates National Association, which represents retired public servants working with a volunteer base entirely except for 17 paid employees at the beginning. It is a highly successful, very influential organization. Why is it working and why do they not have any significant problems finding volunteers? Because the people there have a sense of mission and talk the same language.
All of the 85 presidents of branches across the country have committees, but they are focused on a mission. I feel that, when people are focused on a mission, they tend to be more committed to volunteering, so maybe we are asking too many volunteers to do too many things as opposed to focusing on some of the things they would like to do.
I personally volunteer only in things that I want to do when I want to do them. I am at that stage of life, too.
Senator Stratton: I think there are a few of us.
Ms. Barratt: I wonder whether we are asking volunteers to do jobs that should be paid. We seem to call on people to volunteer in so many capacities, and I could suggest that some of those capacities should be paid jobs, but we are asking people to step up and not be paid. We are also moving into a generation with an expectation of volunteers that is quite different from 10 years ago. I will not volunteer in the next 10 years because I may want to go and do something for myself. I think volunteers are becoming much more discerning in what they want to do and what hours they want to volunteer and why they want to do it.
As my colleague said a moment ago, the purpose of doing volunteer work must be clearly enunciated. Is it time limited or is it long-term and what will you get out of it? Volunteers want to know that what they do, whether it be involved in palliative care, they can see they are doing something worthwhile and are received graciously and with acknowledgement — recognition that they are important.
The world that we live in is so fast. Sometimes we do not take that time with our volunteers as well as we should.
The one thing I do not think we are experiencing in this country yet, but we will, is insurance around volunteers. Gone are the days when volunteers can transport Ms. Smith from A to B, and when that hits our country, and it will, that will put a whole different shape on the volunteer movement. That is why I think we need to seriously refer in this report to the role of volunteers and how we support them to remain as volunteers.
Ms. Mitchell: As a parent, when my children were growing up, it was a different age. We were at home to bake the cookies, to make the costumes. However, today I think the employer should be encouraged to allow employees time off to volunteer. I know some do. My granddaughter is fortunate. Her company encourages and expects their employees to volunteer at least for one thing, and the employees are given time off to do that.
The society seems to be today, if you want your children to play hockey or ball or whatever, you do not have to go and be the coach — you write a cheque. If you go and work a bingo or whatever, you get that money back, and if you do not work the bingo, your cheque gets cashed. My children are some of these people who say, "Fine, let them cash my cheque; I do not want to give up my entire afternoon or evening."
We need to give volunteers an income tax reduction to make it, but I feel there is no greater role in this world than to be a volunteer.
I can remember growing up in a French Canadian village in New Brunswick, our mother was gone and my father said to us, "Whenever you do a favour for someone, do not expect it to be returned, but it will be returned to you 10- fold." When you go through life and are at the latter part of life and things happen and you see what people do for you, it will amaze you.
I would like to find some way to take the 40-, 50-year-old, my kids included, and encourage them to volunteer, and not just on a golf course or to run a golf tournament, which is something they want to participate in. If they were allowed time off from work, I really think it would make a difference.
There was an article in The Toronto Star recently about a man changing his clothes because he was allowed time off to take his son to soccer. Do you remember he was carrying his three children out of the car? We have to encourage employers to allow that kind of thing. I know that could not happen in many retail businesses. Maybe it could be scheduled at different times and an allowance could be made for a couple of volunteer hours a week and be paid for it.
The Chair: Thank you, Senator Stratton and Ms. Mitchell. That is a good place to end. There are hundreds of thousands of Canadians volunteering every single day in this country, but we need more. Many of our organizations cannot exist without their contributions.
This has been excellent. We have previously heard, as you can imagine, many of the ideas that you have presented but you provided us with a very thorough summary, and we appreciate your attendance today.
Senators, we will suspend for half an hour and come back at 1:30 p.m. at which point we will be giving some instructions to our drafters.
The committee continued in camera.