Proceedings of the Special Senate Committee on Aging
Issue 7 - Evidence, May 7, 2007
OTTAWA, Monday, May 7, 2007
The Special Senate Committee on Aging met this day at 12:33 p.m. to examine and report upon the implications of an aging society in Canada.
Senator Wilbert J. Keon (Deputy Chairman) in the chair.
[English]
The Deputy Chairman: Welcome to this meeting of the Special Senate Committee on Aging. Today's meeting will focus on healthy aging and active living. We have with us a variety of organizations, which should make for an extremely interesting meeting.
Our first panel includes the return of Dr. Barratt, who has been with us before and who is Secretary General of the International Federation on Ageing. By videoconference from the OECD in Paris, we have Monika Queisser, an expert in demographic aging. Also with us by videoconference, we have Barbro Westerholm and Karin Berensson, from the Healthy Ageing Project in Stockholm.
Thank you all very much for taking time from your busy agendas to join us today.
Karin Berensson, Project Manager, Healthy Ageing Project: It is a great honour for us to participate. I will tell you rapidly about the project and then Professor Westerholm will make comments on my rapid introduction.
The Healthy Ageing project is a three-year project funded by the European Commission, and one of the background parameters is, of course, the demographic changes with the growing older population. The aim of the project is to promote healthy aging in later life stages, and by that we mean people aged 50 and over. The main aims are to review and analyze existing data on aging and health, make recommendations, disseminate the findings and facilitate implementation.
The project is coordinated by the Swedish National Institute of Public Health and involves the World Health Organization, WHO; the European Older People's Platform, AGE, with our representative, Professor Westerholm; EuroHealthNet; and ten countries with their ministries, universities, NGOs, et cetera.
We have reviewed and analyzed the statistics, literature, best practices, and policies and strategies and have focused on ten major topics. Among those are social capital, mental health, injury prevention, substance use and abuse, use of medication, and retirement. We have also had four cross-cutting themes: socioeconomic health determinants, gender, minorities and inequality in health.
I would underline that we are not a research project, but we have tried to work in a systematic way. The results of this project are based a great deal on reviews and meta-analysis.
We worked in different ways to compile policies throughout Europe. We used questionnaires in European countries to collect facts on policy and best practice. We have also focused on cost effectiveness of health promotion for people.
We have suggested recommendations to decision makers, NGOs and practitioners on how to get action. They are based on five core principles, including equity in health, heterogeneity, it is never too late for health promotion, et cetera. We have also suggested what we call priority topics for action with more specific recommendations for the major topics of the project.
Now we are in the implementation stage. Our results are in this report called "Healthy Ageing — A Challenge for Europe." Short versions of this main report will be available in 18 languages.
Right now, people on the project are working on national implementation in different countries in Europe.
Barbro Westerholm, MP (Sweden) and participant of the Healthy Ageing Project: Now it is my turn.
I represent AGE, the European Older People's Platform. I am also a member of the Swedish Parliament. AGE is an umbrella organization for organizations of older people within the European Union. It has some 140 members representing a bit more than 20 million older people within Europe.
The 20th century gave us a success story in that we increased our lives by some 20 to 25 years. Now it is very important that these 25 years have a good quality.
Unfortunately, now we see in Sweden, Belgium and Japan — three of the OECD countries — that we have an increasing rate of severe disability. To avoid some of these severe disability problems, this means that health promotion is a top priority for us. It is important for the individuals, but also for society because now we face the baby boomers coming into old age. It will be a very tough burden on society if this change in severe disability that we now encounter in Sweden progresses. We have to stop it so that we have resources also for those who suffer from diseases that cannot be avoided.
How do we disseminate the information that we have? All of this knowledge is in the healthy aging booklet that Ms. Berensson showed just now. Here we make use of the associations of older people in Europe because they meet so many of their members. If we can meet only 10 per cent of the members — maybe 2 million people — they, in turn, will spread the message further.
It is fairly easy to catch their interest when it comes to injury prevention. It is much more difficult when it comes to substance abuse or misuse. I am thinking of medicines. Also alcohol is coming up as a problem among older people. We are especially worried in my part of Europe about older women who have increased their consumption so that we now see cirrhosis of the liver coming up again in the health statistics.
We are developing a plan on how to disseminate this information, which is evidence-based. It is not only beliefs; the recommendations in this booklet are evidence-based.
I think my two minutes are up, so I am willing to answer questions later on.
The Deputy Chairman: Thank you very much. Ms. Westerholm, our normal way of proceeding is to hear from all of the witnesses and then ask the questions, but I understand your time is limited. How much more time have you got with us?
Ms. Westerholm: I have 55 minutes more. It gives ample time for the others to give their presentations, I think.
The Deputy Chairman: Then we will go to the OECD and Monika Queisser.
Monika Queisser, Expert on Demographic Ageing, Employment, Labour and Social Affairs Directorate, Organisation for Economic Co-operation and Development: Thank you for giving me the opportunity to testify. I will give you some overview about the work we are doing at the OECD related to the wide topic of aging, particularly active aging, and give you some main elements of ongoing and recent projects.
Related to the question that you have been dealing with regarding the definition of seniors, let me first say that there is no unique definition of what constitutes a senior. Many countries tend to define seniors as those age 55 and older. At the OECD, we have decided to treat seniors starting at age 50, because that is the time when many people leave the labour market in OECD countries.
Although we see 65 years as the normal retirement age — the age at which, in most countries, pensioners can access a full retirement benefit — the effective retirement age is much lower in the majority of OECD countries. In 2005, we found that only about 60 per cent of the population aged 50 to 64 had a job, compared to more than 75 per cent of the people aged 24 to 49. That shows us that starting at 50, people start leaving the labour market — in some countries actually in droves.
Is this a problem? Yes, it is a problem for the financing of retirement systems. In Canada, admittedly, it is less of a problem than in many other countries, but it is a problem because we want to keep people healthy and active until old age.
The lifespan in retirement has been increasing incredibly. On average, in OECD countries in 1970, people would spend 11 years in retirement. Now men spend just under 18 years in retirement; for women, this time span has increased from less than 14 years to just under 23 years.
The health conditions and difficult working conditions can also be very important for older workers. We are seeing that some countries still have a long way to go to change working conditions. In many cases, older workers have to leave because they cannot keep up with schedules that involve working 50 hours or more per week. Many countries have to become more active in making working conditions more amenable to people staying in the workforce longer.
What are other ways to make working longer more attractive? Many countries have increased penalties in their pension systems. They make it harder to get a full benefit if you retire earlier, but it is not only related to pension systems. It is important that reforms are undertaken at the same time in unemployment and disability systems, so that people will not choose other routes out of the labour market.
Many countries have also introduced strategies to increase the employability of seniors. One of the most well-known programs in this area is the Finnish national program on aging workers, which ran from 1998 to 2002. It seems to be successful; indeed, employment rates increased quite substantially among older workers in Finland. However, at the same time, the economy recovered quite spectacularly also. It is still too early to see whether this was mostly the impact of the program or whether the general economic recovery played a larger role.
We see initiatives like this also in Germany, for example, and also recently in France and Belgium. The conviction that people have to stay in the labour market longer is starting to gain ground in many European countries, which, until recently, thought that you could replace work for younger people with work for older people. That meant that if you retire people early, you would create jobs for young people. I think by now everybody has understood that that is not the case.
Like Canada, many OECD countries have also started to incorporate the employability strategy into larger national aging strategies. These strategies can serve to raise awareness. Information campaigns can tell people that older workers are valuable for society and the economy, but such a broad strategy is not a panacea. This will work only if all stakeholders are committed to the strategy; if there are good evaluation mechanisms, which many countries still lack; and if there are appropriate targets against which progress can be measured.
We have also at the OECD increasingly been calling for a life course approach to aging, rather than focusing only on aging workers. Some countries have embarked on this area, but the first results, in some cases, are disappointing. Let me give you an example from the Netherlands.
Recently a new program was introduced called the life course savings scheme. Workers can save tax-free money in accounts that can be used for education or for time out of work. More than half of all workers are already saying they would like to use this money for early retirement. You can see that the early retirement culture is still very strong in people's minds; we have to change a culture here in order to get people to stay in the labour force longer.
Concerning aging and health, we just heard from Sweden that in several countries, severe disability — which we thought was decreasing in older populations — is on the rise again. It is very important not to become complacent and just say we are all increasing our healthy lifespan. We do have to prepare for possibly increasing rates of severe disability among older ages, and we have to devise preventive strategies for diseases such as obesity, for example, which are likely to increase the need for a long-term care services among older populations as well.
I would like to stop here, and I am looking forward to questions.
Jane Barratt, Secretary General, International Federation on Ageing: The International Federation on Ageing, hereafter referred to as the IFA, is honoured to present its views to the Special Senate Committee on Aging this afternoon. Our objective is to work with the public and private sectors, civil society and individuals to improve the quality of life of older people in all parts of the world and help to create environments that enable and empower them to participate in their communities.
With a continuously growing demographic of older people, new angles for responsible aging policy and practice must be considered. Canada must be ready to pioneer ways to meet the changing demands of society to ensure that older people have every opportunity for the quality of life they deserve. I am here today to offer some input, to highlight a few key examples of good policy both here in Canada and abroad, and to recommend a few key areas to be considered for Canadian policy.
Aging policy in Canada and in many developed countries still focuses on care provision and care facilities. We have a job to support quality of life, which involves two things of equal importance: first, to be as free from the effect of disease as possible and second, to retain enough function for active engagement in the world. I believe that increased emphasis should be placed on facilitating independent living and active lifestyles and on creating an enabling environment. It is a fact that in many developed countries, only one in seven persons aged 75 years and over will require high level clinical services in a residential care setting. Older people who are enabled and valued participants in society are far more likely to live healthy and active lives.
To date, Canada has shown great leadership in advancing the interests of older people through active aging domestically and abroad. Very recently, the new government established the National Seniors Council to advise the government on seniors' issues and to ensure that government programs meet the evolving needs of older people. In addition to this council, the government has taken several very important positive initiatives. Tax relief and pension splitting allow greater fiscal options for seniors and should help them remain financially independent for longer. The government has also begun to recognize the contributions of older people in the workforce by launching the Expert Panel to Study Labour Market Conditions that Affect Older Workers and the Targeted Initiative for Older Workers.
Recently, Canada has targeted very specific healthy aging issues, including fall prevention and emergency preparedness. These measures increase the safety of older citizens and will help them live independently for a longer period of time in our community.
Canada has been a leader in active aging at an international level. A recent example from the Public Health Agency of Canada has provided tremendous momentum to the World Health Organization's Global Age-Friendly Cities Project, to assist cities to adopt inclusive policies that benefit seniors.
Of course, Canada is a signatory to the 2002 Madrid International Plan of Action on Ageing. This plan outlines three key priority areas: older persons and development, advancing health and well-being, and ensuring an enabling environment. These priorities are a reminder of the importance of active aging.
While Canada is among the leaders in promoting healthy and active aging, there are no real international standards for healthy and active aging policy, and therefore there is always room for improvement. This country will stand to benefit from understanding efforts on healthy and active aging in other parts of the world.
Australia is one such country where Canada should be looking for inspiration regarding active aging policy. The Australian government has begun to understand the link between demographic aging and other sectors. The Prime Minister's Science, Engineering and Innovation Council was charged to release a detailed report, "Promoting Healthy Ageing in Australia." This report took into account the importance of linking the health and well-being of older people with the physical and social environment that they are in. The federal government's "National Strategy for an Ageing Australia" is a broad document with sections of great interest, including the acknowledgement of socio-economic factors and preventable disease as major factors in the poor health of older people.
Another example is from the province of South Australia, which has the highest population of people over age 65 years in Australia and which is particularly active in the concept and the implementation of policy and good practice in healthy aging. The Office for the Ageing in South Australia released a plan of action in 2006 entitled "Improving with Age: Our Ageing Plan for South Australia."
The plan acknowledges that aging is an integral part of society and outlines five priorities: one, enabling choice and independence in where we live, how we are involved in our community and staying healthy; two, valuing and recognizing contributions of all the roles that older people play in our society — including the roles of grandparent, mentor and informal worker — and recognizing diversity among older citizens, considering the impact of culture, gender and social strata; three, providing safety, security and protection to homes, communities and the marketplace; four, delivering the right services and the right information in a timely fashion that is responsible and tailored to their diverse needs; five, staying in front through research and collaboration, and recognizing that it is never too late to make a difference.
This list of priorities is simply one good example of many international policies that outline clearly the direction that Canada should embrace in developing and defining healthy and active aging policy. It is in Canada's own best interests to continue working with its partners in the private and public sectors and also with civil society.
Certainly Australia is not alone in developing good practice, and we heard from Ms. Westerholm and her colleague today about the efforts of the EU models. I would like to take a moment to highlight good examples from the Healthy Ageing Project. Finland has taken initiatives to alleviate loneliness among older persons through intervention groups resulting in not only solving the loneliness but also increasing the activities and improvements in health.
When I think about loneliness, about non-compliance of medication and about the increase in elderly suicide, I think that perhaps we need to be thinking about the social environment rather than the non-compliance. We need to understand what is at the bottom of some of these trends that we are seeing today, for example an increased prevalence of elder abuse.
The Dutch program, Groningen Active Living Model, was successful in increasing the physical activity of sedentary seniors aged 55 to 65, and in doing so improved balance, endurance, body mass index and fitness. That responds very clearly to the comment of my fellow speaker on obesity.
The Czech Republic introduced the program Healthy Region of North Bohemia — Add Years to Life and Life to Years as an effort to change the lives of older citizens from passive survival to active control through education and, again, enabling greater participation. Even simple measures like the Hambleton Strollers Walking for Health Program in England recorded a high rate of improved health and social interaction.
Canada is well positioned to continue to be a leader on healthy aging initiatives so long as there is a political will to do so, and it clearly seems that there is such a will. The future of older persons in Canada is our collective responsibility, and I believe proactive initiatives focused on promoting healthy lifestyles, community involvement and responsible design of our environments are the best methods to ensure this.
I believe strongly that healthy aging must be achieved through the development and design of environments that support people to live the choice of life that they want to live in a healthy and strong way. For that reason, the IFA has made the initiative to host its ninth global conference in Montreal, where the focus will be on how to design and create enabling environments to impact on health, participation and security.
The process of aging is gradual and unrelenting. Generally, it is not an appealing subject, and we naturally prefer to avoid the subject of decrepitude. However, there are costs to averting our eyes from the realities. We put off changes that we need to make as a society and we deprive ourselves of opportunities to change the individual experience of aging for the better. Aging and growing older as a nation is a subject that we must embrace as our responsibility for ourselves and for the future of older people.
There are four key recommendations that I would ask the Senate committee to consider in its deliberations. First, identify the healthy, active and active aging policies, practices and initiatives that are currently occurring in our country at a provincial level. There are some outstanding examples in British Columbia and Manitoba, where public-private sector partnerships are truly making a difference to the people in communities.
Second, ensure and encourage a direct contribution from the federal-provincial-territorial committees on healthy aging and active aging toward a national strategy, while acknowledging the unique differences of each province.
Third, with the participation of our seniors, develop action plans and disease prevention programs at all levels, in particular at the community level, because life happens at a community level and in boroughs and in neighbourhoods.
Fourth, encourage public-private sector partnerships so that healthy and active aging strategies are sustainable. That challenge can be achieved through the work of this Senate committee and its deliberations in the future.
The Deputy Chairman: Thank you, Ms. Barratt. A number of senators would like to ask questions of all witnesses, but first I want to come back to the question of when all these measures for an enabling environment should kick in. In Canada, we have had the phenomenon of "freedom 55" through encouragement from retirement investors for people to retire at age 55. Pilots for Air Canada, for example, have mandatory retirement at age 60, making it relatively simple to know when to activate pensions and make retirement plans. Until the past year or so, most universities in Canada and most public employers had mandatory retirement at 65 years of age. That seems to have been eliminated, certainly in Ontario. Therefore, the phenomenon of when to move the agenda and kick in with all of the programs for such an enabling environment can be quite nebulous.
There is another dimension to all of this that will require some serious thought. When we had mandatory retirement at age 65 throughout large segments of society, it meant that these people left the workforce and were no longer required to perform exacting tasks. In a way, society was insulated from them and their loss of expertise and so forth. Now, we do not have that either. We do not seem to have much in place to compensate for that.
Ms. Westerholm, because you will have to leave soon and because we always look to Sweden for the ultimate wisdom, especially from a member of Parliament, would you care to comment on how you see this phenomenon evolving? How can we plan for this enabling environment for seniors?
Ms. Westerholm: Well, Sweden changed its pension system a few years ago. However, the actual parliamentary decision was taken in 1994. We now have the right to retire at age 61 and the right to stay on and work until age 67. We have thus increased the retirement age from 65 to 67. Currently, there is a move in Parliament to lift the upper age even further. For physicians, it was raised to 70 years and for some physicians in private practice, we eliminated the upper age limit.
In the organization of seniors with which I have been president, we found that one third of our members who retired at 65 would have liked to continue their work on a part-time basis. They missed not being at work. This information has spread. There is a change in Swedish society such that people feel that an older person should have the right to choose whether to retire or to stay on and work as long as they are able to work. Sweden's retirement age a few years ago was between 58 and 59 years. Today, it is almost 64, so something has happened in society, not only because it has been recognized that some people want to stay on at work but also because we need this workforce due to the lack of professionals in certain occupations. Several things are happening, including improved physical working conditions, although perhaps not mentally, so to speak. In some areas, the stress level is extremely high and people have to take sick leave because they have been too pressed, and now we have to improve that. I see this happening in neighbouring countries.
That response was with regard to the workforce pension question. Would you like to add other questions?
The Deputy Chairman: I would like all the panellists to address that issue and then other senators will have questions.
Ms. Berensson: From the Healthy Ageing Project, I can add that we had quite a bit of difficulty finding articles on retirement and pre-retirement phases. We based our report on knowledge provided by a professor in Finland. This issue needs much more research and knowledge.
We also made recommendations for retirement. First, we should increase the participation of older workers and the quality of their working lives using new management concepts. Second, we should keep a balance between personal resources and work demands and not tolerate age discrimination. Third, to prevent illness in the workplace, we need to promote healthy lifestyles and a supportive and stress-free transition from work to retirement. This is what we found was most important.
Ms. Queisser: Several points are important to address when thinking about how to manage the transition. One component is mental. We must get the idea through to people that life is not divided into periods of education, work, and then doing nothing. People tend to have lots of ideas before they retire of what they will do in retirement, such as charity and association work. Yet, when you look at actual time use — and we have commissioned some work on this — you see that after people retire there is an incredible increase in passive time use, meaning that people sleep more and watch more television. They do not do all the things that they said they would do. Maybe they go on trips and cruises until they have spent their budget. Particularly men sleep more and watch more TV. Women also have slightly more passive time use, but they have an increase in housework, which apparently the men are not helping them with.
We believe the best way to remain active is to keep some attachment to work. It does not necessarily have to be full-time work, but there must be new solutions in offering full-time work and having better working conditions.
Let me provide an example from Germany. They introduced a part-time work/part-time retirement scheme to help people move into a more gradual transition of retirement. Unfortunately, there was a clause that allowed people to work 50 per cent of the time, with 50 per cent pension, or use the five years as a block, which effectively means that you can work for two and half years and then retire two and half years early. What do you think everyone did? Of course they chose the early retirement option.
There seems to be, both on the side of employees and employers, the desire to push people out completely. Another lesson we learned from our review is that you have to engage employers in this. We still too often hear employers say that, yes, it is all very important and older workers have great experience and we value their contribution, but when the next economic problems arrive and people have to be laid off, the older workers are the first to go. That is not a rational way to manage one's workforce, particularly when you look at the huge challenge of aging that we are approaching.
Ms. Barratt: On one side of the coin, we are talking about retirement, but on the other side we are bordering on a discussion of age discrimination. We need to be clear that that is what we are talking about here.
There are political and economic imperatives when we talk about retirement and creating an environment that supports someone to choose what they want to do, whether it is to continue working or not. We need to have incentives in place to enable someone to make that choice, whether flexible working conditions or a part-time paid or unpaid position.
The other economic imperative is that we need to stop talking about this and put some action in place, because there are labour shortages now — not tomorrow but now. Many countries have started a pilot process of flexible working conditions.
We are bordering on age discrimination legislation and policies when we talk about any kind of mandatory retirement, and that then looks at what choices we are offering people in their future lives. For many people who are coming up to the retirement age, whether that is age 50, 65 or 67, work has been their role. They are defined by work that they have done for the last 30 or 40 years.
Then we move into the social issues around retirement and transitioning. It is a complex issue. It is not about age in terms of the mandatory retirement; it is about offering and creating flexible working conditions and choices. Some companies in Canada are working hard to create incentives, and they should be seen as the champions that guide our thinking about what works economically and socially.
Senator Cordy: Some companies are providing incentives, but many other companies are saying, "Sorry, you are age 55 or 59 and we want you gone."
I would like to hear from the OECD. Ms. Queisser, you mentioned strategies for keeping people in the workforce longer. You said that Finland has a program and that there are also initiatives in Germany, France and Belgium. Could you give us a sense of the initiatives?
In Canada there are many pension plans that are based on one's best three or five years of employment in terms of salary earned. If you were to work 50 per cent for your last three to five years, you would in fact be decreasing your pension substantially.
We mentioned earlier the labour shortage we have in Canada at the present time, and yet we still have the mindset of early retirement. It is sort of a hodgepodge. We are talking about flexibility and age discrimination. On the other hand, should someone in an extremely stressful or labour-intensive job be penalized if they want to retire at the age of 60 or 65?
I want to continue along the same line of questioning regarding how we deal with all those types of issues to come up with a policy in Canada that would promote healthy aging and the idea of people having flexibility and being able to make decisions and not just being told that they have to retire at a specific date.
Ms. Queisser: The problem of pension plans that you encounter in Canada is a specific problem shared by countries that have a relatively modest public pension system and a high importance of private pension plans. In countries like Belgium, Germany and France, private pension plans are not very important. The bulk of retirement income comes from public plans that are based on average lifetime earnings. What you earn in the last couple of years in your career will not determine the benefit you will receive from your pension plan.
You will find the same situation in the U.S. and the U.K, for example, but not in Australia. In Australia, there are mandatory private pension plans, which are more regulated. We believe at the OECD that there is a need to look closely at the effect on retirement that the private pension plans have because they do not provide the right incentives and do not enable flexibility. Indeed, we have sometimes found that the private pension plans serve as bridge financing until the public pension plan kicks in. With public policy, you are trying to increase the retirement age to make people stay longer, but in fact the private sector can do a lot to undo the initiatives that the public sector is taking to increase the effective retirement age.
In many OECD countries, there is actually a wish to go beyond age 65 as the normal retirement age. When we say "normal retirement age," in few countries does it mean that people actually work until age 65. It means that you get the full benefit only when you turn 65. Several countries, including Germany, which used to be a champion of early retirement, are discussing extending the retirement age. The U.K. is contemplating 68 as a retirement age. I think it is becoming clear to those countries that people with an early start into work life with heavy, physically demanding or monotonous or routine jobs will not be able to follow this.
There is an important policy question to ask here. What will happen? Either, as in Sweden, people will get increasingly sick and then move onto disability benefits or we will create a situation where people can leave because they have had hard jobs or they started to work very early. France, for example, has chosen to give the possibility to people who started working at age 15 to retire before age 60. Once they have 40 years, even if they are only 55 years old, they can leave. We think that 55 is, perhaps, a bit early and the decision even for someone who has been working hard should not be everything or nothing, but perhaps a transition into lighter work or a reduced work schedule.
The situation of people with hard work is a bit of a headache for policy-makers at the moment. They are grappling with how to deal with this. We do not want to come back to the situation that we experienced previously in many countries where different sectors would get early retirement. That means everyone in mining would get early retirement even if it was the secretary working in the mines, for example. That is vulnerable to political processes. Everyone who exerts a certain amount of pressure will be able to obtain a benefit in the form of early retirement. This is something we have seen in many countries and to undo the situation later is hard to do. We need flexibility and we need to address the problem, but have we found the solution of how to deal with it? I do not think so.
The Deputy Chairman: I tend to think so myself. I wonder how the actuaries will plot the curves to have enough money in the pension funds when there will be no rules for people to take their pensions.
Ms. Barratt: I do not have the answers but my colleague has given us a clear dialogue around some of the complexities that are dealt with in the OECD and we are dealing with in Canada. I am sorry, but I would lean to staying with the advice from my colleagues.
Senator Cordy: A couple of you have spoken about the social issues surrounding retirement, and someone mentioned loneliness in seniors. How do we address that? I think this is of utmost importance, because people who have been saying their whole working lives, "I am retiring at age 65," finally get there, have a retirement party and suddenly wake up the next morning wondering what to do. A couple of years ago, Health Canada did a study on depression in seniors. It is a major issue. We are all aging. What must we do to make aging a positive thing for people so that you are not just suddenly there and do not know what to and so that you do not run into problems like isolation and loneliness. Someone mentioned the television or sleeping longer, those kinds of things. What policies do we put in place to make aging not just a destination but a continuum?
Ms. Westerholm: Of course we age differently, so what is a good thing for one person may not be the best solution for someone else. In my country, about half of those aged 65-plus belong to one of the five organizations for senior people. You also have quite a number who join the Red Cross or join various NGOs. I think that during their younger senior years they fill quite a lot of their day with work for these NGOs. The loneliness that we see in older people comes when they can no longer go to meetings, help their friends or leave their flat or house because they have disabilities. We must solve the problem not only with housing but also with people being able to provide social life. When you get many disabilities in my country, you get help. Someone comes and brings food but they are in such a hurry that they cannot sit down and join you when you have your meal, for instance. We must do a lot there. For the younger seniors, there are possibilities but we must make them known. Some are a bit shy to join NGOs, so you must tell them about the possibilities before they retire or also talk to those who are already members and tell them to bring a friend so that they can form a network.
If you look into the Swedish statistics of what older people do, the ones who are between ages 65 and 75 are occupied with many things. I would like to put a price on that so that in the national accounts you could see what kind of resource this generation is. When you are 85-plus, however, life changes. We are worried about the suicide rate. A quarter of the suicides committed in Sweden are committed by people aged 65 years or older. Those are the drastic suicides. The ones who just give up eating and drinking water do not show up in the statistics. We have to find out by research why they do this and how can it be prevented. That is stressed very much recently. but people do not talk about this very much.
Senator Cordy: I was surprised to hear that in Sweden severe disabilities are increasing in older people. What is the reason for that? Is it because people are living longer?
Ms. Westerholm: It surprised us also. It arose in a very recent OECD report. We do not yet know what is behind it. We have to find out. Is it like loneliness, for instance? Is it lack of help, housing, and so on, or is it some other kind of preventable disease that is coming up on the scene? I mentioned alcohol and liver cirrhosis showing up among older women. Drinking habits have changed in older women. I do not know. That is the short answer to your very important question.
Ms. Queisser: I will tell you a little more about the OECD study that my colleagues have conducted. They looked at 12 OECD countries around the world. They found that in five of the 12 countries — Denmark, Finland, Italy, Netherlands and the U.S. — the severe disability among elderly people declined. However, in three countries — Belgium, Japan and Sweden — it increased. In two countries it stayed the same; those were Canada and Australia. In some cases there are measurement issues. To measure severe disability is more difficult than one would immediately think. For example, in France and the United Kingdom, it is difficult for us to distinguish the trends from changes in the measurement, but one of the reasons, of course, is that in general the health status of people has become better and many other diseases that would show up earlier, perhaps, are treated better. People stay healthier longer, but when they finally get sick, their disabilities may be more severe.
As our Swedish colleagues pointed out, we do not fully understand the trends yet. We want to do more research to better understand what is happening. The answer is unlikely to be the same for all of the countries, but there will perhaps be very specific answers in specific cases. As we mentioned, suicide is perhaps more of an issue in Sweden than in other countries.
Unfortunately, I am not the person who conducted this research, but we would be happy to provide you with more information and with the background study on this, if you would like. My colleagues from the health division might have more specific information for you on this particular issue.
Ms. Berensson: I will comment on loneliness, and then I would like to emphasize that we found that voluntary work for and by older people was important. Voluntary work is not so usual, at least for Sweden. We have found in our study that as well as the older people who get the help, those who give the volunteer work gain health from it. It is good for both groups. This is one way you can work for better social capital.
Ms. Barratt: I would like to respond to the question in a number of ways. I would like us to think about function rather than disability because it is people's ability to function that helps them to stay in the environment in which they are living, for example in their home. If they can function at a certain level — wash themselves, do their shopping, be part of the community — then they will stay in their home. Even though they may have a disability, it is the level of function that tells us whether they will be able to live independently.
The other aspect is that we need to step back and think about where they are living. Where are older people living? How are the communities being planned? What is the urban planning that gives rise to certain increasing trends?
I have mentioned the increased prevalence of elder abuse before. Does that have something to do with our social environment? We need to step back and think about why there is an increased prevalence rather than try to fix what is happening.
The other aspect is housing. What kind of housing would be suitable for a person living by themselves? Her husband has died; her children are living in another country. There is a different social network now than there was 20 or 30 years ago. The family caregivers are not there to support mom and dad as they grow older. Therefore, there is a good reason for them to be lonely. When they are lonely and depressed, there is a good reason not to eat, so their nutrition deteriorates. If they are not eating properly, why should they be taking their medication? There is then non-compliance. If we step even further back, we see that they are not able actually to unscrew the top of the medication bottle because they have arthritis. Arthritis is a disease condition; the product should enable them to open and pour the medication.
I like to look at disability in relation to the function. Then we need to look at the urban planning that is going on. The neighbourhood structure that I grew up with is not apparent now. There were many support structures that helped people grow old gracefully in their community and as an important member of that community.
Their role has been taken away from them by the changes in social structure and in the community. Transport is a major issue in some areas in our country and in other countries. Once again, they are not able to go outside. Their neighbours have either died or gone to different places. There are many social issues that we need to look at when we are talking about the loneliness, the depression, the suicide — and there certainly is an increase in suicide in many developed countries. This is where I feel that we need to go to, looking at our social environment and seeing what is happening there that gives rise to some of these important trends.
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Senator Chaput: Thank you, Mr. Chairman. I would like to focus on the question of healthy aging and active aging. For me, this is one of the key elements of everything that this committee has been discussing since it started, and that you are discussing among yourselves.
Since this special committee began and we started hearing from witnesses, one theme keeps recurring: an aging person must have the choice, either to be able to continue work, or to be able to modify it, or to be able to stop work. This theme constantly returns: having a choice is good for a person's mental health, it gives the person a degree of control over what he or she does, the person can make decisions, and remain engaged. It all helps the person to stay healthy.
I also think that, as long as this committee has been sitting and hearing from witnesses, we have been talking about baby boomers who are getting to a certain age, and who, according to what we have heard, are also going to want to choose.
We are all also aware that the workplace is experiencing a labour shortage, and that employers, if they really wanted to, could change their ways of doing business in order to keep older workers involved.
This meets so many societal needs that I am wondering why decision-makers could not immediately work on a solution as a matter of priority. If policies have to be rewritten or reworked, or if new policies have to be developed, on an international, national, or any other level, why not immediately look into what form a new policy would take, or what policy changes would be needed, so that people have the choice, and by that I mean both those who are getting older and the labour market?
I think it was Ms. Barratt who said earlier that "something has to be done." Would it not be possible to set as a priority the choice that an older person would have to work either less or not at all, and then see what that would mean in terms of policies and programs?
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Ms. Queisser: The question of choice is also one of information. People need to have much better information and at much earlier ages of what awaits them in retirement. They need information on what they can expect in terms of benefits if they stop working. They need to understand what is required in terms of their personal savings effort if they want to retire early. They need to know what they will have to do in terms of improving their skills if their choice would be to work longer.
There is an enormous amount of public policy challenge related to giving people this information or to enable them to make choices.
Retirement planning, for a lot of people, as we heard before, is extremely unpleasant. We heard from a survey in Australia, I believe, that people preferred going to the dentist to thinking about retirement planning. If one thinks about how much people usually like going to the dentist, it means that retirement planning must be pretty bad for most people.
They are quite simply overwhelmed. They have been told that they can do this or that. They think sometimes they have choices in terms of retiring early, until somebody calculates their pension for them, and then they realize they cannot retire or they badly need another job or need to leave their apartment because they cannot afford it anymore.
The preparation for retirement has to start early in order to give people the choices. Then there needs to be flexibility, but countries must decide at what age they want to start giving people the choice. As I have said before with many examples, when you give people the choice to leave, many people want to leave.
Giving them a choice might also mean that only the richer people can afford to leave and stop working and the poorer people cannot because they must work until the last minute; otherwise, their benefit will be too low. Therefore there is an equity issue also surrounding this flexibility. Some countries have chosen quite simply not to allow anybody to leave with a public benefit before age 65 because they think that it would not be fair to do this. You can see quite spectacular increases also in people working until later ages when there is simply no retirement benefit available before a certain age. That, in a certain way, contradicts the flexibility we are looking for, so it is a very difficult choice for policy-makers to determine. To a certain degree, you will never be able to avoid the situation of some people who more money and are better off and in better health likely — because those who are better off usually also have better health — also having more choices in life, including the decision of how to manage their retirement, than poorer people.
Unfortunately, I do not have a satisfactory answer. Reforming pensions towards more flexibility is one way to address this, as we have heard from Sweden. At the same time, one must think about the equity consequences and, of course, the government must think about the financial consequences.
Ms. Berensson: I would like to underline what you said about the information. In Sweden, it is difficult to know what the pension will be. Most people, very educated people, find it difficult. Information is important as it is an incentive to stay in the workforce. Some organizations will probably defend their rights to go early with a high pay, but it might be difficult for the national finances. However, if they put in incentives for working longer, that might be successful. In our system, there are some incentives, and therefore people are working longer today than some years ago.
Ms. Barratt: I have just a quick comment along the lines of information. Information is only as good as the timing that it is available. Some of us live in this fog that everything will be all right and there will be enough money when we retire or when we get older. Some of that is because we do not want to know whether there is not enough money; there is a fear for many older people in the community that they will not have enough money. If there were some kind of policy or program that offered free information and education at a community level in different languages, to all people aged 55 and over about what it meant to them to retire and what their pension entitlements would be, that would give them the opportunity to then decide what they needed to do. At the moment, they are not able to have choice because they do not know what the next ten or twenty years will look like.
Senator Chaput: I have heard baby boomers say that they will not be able to retire because they are earning quite a bit of money, but it is going out as fast as it comes in, and they will have to work longer. If that is a tendency, and we hear more about this, could we not take that into consideration also?
Ms. Barratt: Absolutely. That is a fine comment, and you are correct.
We do not know the extent of the baby boomer trend at the moment. We are just beginning to see baby boomers retiring or not retiring. We do not know the full extent of what they are thinking and how they will respond. Yes, we could certainly act now on the basis of what we know.
The Deputy Chairman: I would like to follow up a bit with Ms. Queisser and Dr. Barratt about how we can try to put some plans in place in Canada, because we are suddenly dealing with a very different situation than we were just a couple of years ago. This has not been an evolution over ten years. It has been full stop. How can we plan for people continuing in the work force whom we did not expect to continue, and for people who will not be accessing their pensions whom we expected to access them at age 65? In some areas, such as Senator Cordy's profession, teaching, how can we maintain the standard of excellence if we have many older teachers who may not have the energy they once had? What can we put in place to plan for this?
Ms. Queisser: There is a range of measures that you have to address step by step in this process. One important area to address is, of course, the retirement systems. An important comment was made at the beginning regarding the function of private pension plans in Canada. It is very important that more attention be paid to how these plans are managed, what type of retirement age policy the plans adopt, and to what extent these plans are used to push older workers out of the labour force. Public pension policy has to take a broader view and look at all resources that people tend to have in retirement.
The next point concerns skills development. That is a difficult issue, and not only for older people. It is difficult in general to determine what skills people are going to need. Why do so many countries grapple with youth unemployment? If we all knew what skills were needed, we could shape people's experience much more to what is needed in the labour market. Unfortunately, we often do not know this. Continuing education, time out of work for updating skills and a redirection of skills throughout careers are very important.
What a policy-maker can do to get this done is much trickier, because these are things that take place at the company level. Employers need to see where someone is at risk of having obsolete skills. What actions can employers promote in order to make such people take further education? After age 45, in many countries, workers no longer receive offers even to visit training courses. People consider them already too old; they think they cannot learn new computer programs or new management techniques. That has to change.
I personally, and some of my colleagues at the OECD, are optimistic that this will change, because we will have so many older people. So many more people than today will be in that situation that the behaviour of employers and employees will adapt, to a certain extent, to this situation.
There are a number of other measures that Canada could take. In 2004, the OECD conducted a review of the situation of older workers in Canada, and we would be delighted to share that if you have not yet seen the study. We would also be pleased to share the synthesis report, which goes into much more detail about the issues Canada should be addressing in order to improve the situation.
Canada is not in such a bad situation. You are actually doing quite well in terms of employment of older workers compared to many other OECD countries. Still, there are things that could be improved. This report will be made available to any of you who wish to learn more about the study.
The Deputy Chairman: Thank you very much. Please forward that report to the committee. I have not seen it and would love to.
Ms. Barratt: Senator Keon, my colleague has rounded out the entire response. I would just remind you that older people bring experience, wisdom and a history to the table. There could be a commitment made to older workers to engage them in retraining not only from a business and corporate perspective, but also from a government perspective.
If the private and public sectors sign off on a commitment, that would surely trigger some change in the way older workers are viewed generally.
The Deputy Chairman: I want to thank all of you very much.
We will now go to phase two of our meeting. We have representatives from three very interesting groups: the Active Living Coalition for Older Adults, Creative Retirement Manitoba, and the International Council on Active Aging.
Dianne Austin, National Executive Director, Active Living Coalition for Older Adults: Honourable senators, on behalf of the Active Living Coalition for Older Adults, I wish to express our appreciation for being given this opportunity to present to you today on the very important subject of promoting active living for older adults. One of the Active Living Coalition's prime goals is to convince today's older adult population that they must resist the notion that once they reach retirement age they are expected to slow down. Some believe that slowing down will protect their health and allow them to live longer, healthier lives. This false sense of caution is exactly the opposite of how they should be living. Research has proven that accelerated aging is the direct result of inactivity. The challenge for us is to spread the word that a healthy, active lifestyle is the best means towards ensuring a longer, healthier, happier life as we age.
In 2001, 3.92 million Canadians were 65 years of age or older. By 2041, that number is expected to climb to over 6.7 million Canadians, or 25 per cent of the total Canadian population, with 1.6 million being over the age of 85 years.
Why promote active living for older adults? Because the benefits of active living for individuals and to society have been well-documented. Currently, over 66 per cent of older adults are not active enough, and that physical inactivity is costing our health care system $2.1 billion annually and is contributing to 21,000 premature deaths each year. Diabetes is projected to increase by 44 per cent over the next 20 years. More than 4 million Canadians have arthritis, and that number is expected to increase to over 6 million Canadians by 2026, with the largest increases among adults aged 55 and older. Cardiovascular disease accounted for almost 75,000 Canadian deaths in 2002 and was cited as the cause of death in 32 per cent of all male deaths and 34 per cent of all female deaths. Coronary heart disease is now the number one cause of death among older women.
Improving one's physical activity levels will help to alleviate or diminish many of the above-mentioned health risks. Regular aerobic and strengthening activities have been proven to reverse disability, improve walking speed, increase strength and improve capacity, even in frail, older adults. Mobility plays an important role in the quality of life for older adults, and with proper training it does improve significantly. Exercise also decreases the level of risk factors related to falls and has proven to lower blood pressure.
A 2001 study of women aged 50 to 65 years who walked for 60 minutes five days a week showed that after only 12 weeks on this new physical activity program they experienced improvements in blood sugar levels, increased fitness levels and decreased body fat. A 2004 regional heart study showed that cardiovascular mortality was reduced by 34 per cent in men who took up even light activity in later life, compared to those who remained inactive. Research has shown that the more an individual exercises, the less likely they are to experience anxiety, depression and stress. They will benefit from improved sleep, work performance, sexual function, self-esteem and overall physical fitness.
What then needs to be done to encourage older adults to become active? Why do we choose not to exercise more even in the face of all these research studies and statistics? In February 2006, in an attempt to address these very questions, the Active Living Coalition for Older Adults conducted a health policy project entitled The Healthy Living Strategy and Promoting the Health of Older Adults through Active Living. With input from groups and agencies across our nation who represent the needs of 700,000 older adults, 28 recommendations were developed to advance active living in older Canadians. The recommendations were divided into four key areas: leadership and policy development; knowledge development and transfer; community development and infrastructure; and public information. I have attached the report and its 28 recommendations to my presentation but will focus my remaining comments on the five recommendations that were determined to be of the highest priority.
Recommendation one: There is a need to ensure that the active living for older adults sector is recognized as an important area of health policy implementation and that organizations and projects in this area are consistently and increasingly supported by funding. The reasoning behind this recommendation is that, in order to provide the required leadership and research to promote active living in older adults, the sector must receive sustainable funding. Much progress has been made; however, there is significant risk that improvements in research will not continue. For example, our agency, after working in the field of active living for over 10 years, was planning to close its doors this coming June due to insufficient funding. However, we won a reprieve when we recently received funding to conduct a research project on type 2 diabetes in older adults and a second grant to conduct a cross-Canada consultation regarding physical activity in older adults. However, that only guarantees existence until March 2008. It is very difficult for agencies to continue to maintain their good work when the question of continued funding is always at issue.
Recommendation two: There is a need to use the mass media to reach a national audience with the benefits of physical activity for older adults. The 1973 ParticipACTION advertisement comparing the health of a 60-year old Swede with a 30-year old Canadian is an example of how powerful a good social marketing message can be, especially considering that more than 30 years later people still speak of the impact of that ad. To achieve effective outreach, there is a need for a national social marketing campaign that uses mass media channels to reach a large segment of the population.
Recommendation three: There is a need to work with health care professionals and their associations to jointly develop initiatives that will promote the health of older adults through physical activity. The physician and other health care providers are accorded much respect by older adults and their advice is given a lot of importance. Therefore, medical practitioners are an important agent for behavioural change when we are looking at promoting active living for older adults.
Recommendation four: There is a strong case for designing programs that are inter-generational and look at addressing certain health risk factors that cut across the generations.
Recommendation five: There is a need to look at the enablers and triggers or the motivators of regular physical activity among older adults and, once this information is available, there is a need to share it widely. There has been a lot of research and data collection regarding the barriers to physical activity, but not much has been researched on the motivators and the psycho-social aspects of motivation in older adults.
With the support of all three levels of government working in conjunction with groups such as the Active Living Coalition for Older Adults, together we can achieve the vision for healthy living from the Living Strategy Framework of "a healthy nation in which all Canadians (including older adults) experience the conditions that support the attainment of good health."
Marjorie Wood, Executive Manager, Creative Retirement Manitoba: Last month, Jean Johnson celebrated her eighty-seventh birthday. She spent the afternoon of her birthday teaching a computer class at Creative Retirement with Isabella Dryden, also in her eighties. Jean and Isabella have been volunteering for Creative Retirement for 20 years. Last year they decided to slow down a bit and they cut back to teaching three classes a week. The slower pace did not last long. This year they took on a new challenge — teaching seniors enrolled in English as another language courses how to use a computer.
Jean and Isabella are exceptional but not unique at Creative Retirement Manitoba, CRM. Many of our instructors are older seniors and our students range in age from 50 to 90 plus.
CRM's programs are based on a philosophy that embodies and supports active living within the overarching framework of lifelong learning. We believe that retirement presents a creative opportunity for individuals and communities; that all people have the right of access to education; that lifelong learning promotes mental, physical, emotional, social and spiritual well-being; and that the well-being of individuals and the health of communities are interdependent.
While CRM is the only senior's education centre in Manitoba, we are part of a vast lifelong learning network. Institutes for learning and retirement in the U.S. number more than 300. Universities of the third age in the European Union and Australia are in equal or greater number. CATALIST, the Canadian Network for Third Age Learning, includes organizations from Vancouver Island to Newfoundland. A recent poll of its members indicated that more than 60,000 older adults are actively involved in lifelong learning programs.
What motivates these older learners? What can we learn from this phenomenon? How can we creatively apply this information to the question at hand, which is the challenge of aging?
Research shows that lifelong learning is linked to both longevity and quality of life. It helps seniors develop new interests and stay actively involved in the community. They feel happier, healthier, more respected and more independent when they are actively involved in learning. Active learning also helps maintain brain health by preventing loss of brain function and cognitive skills such as memory, reasoning and judgment. This discovery has important implications for the prevention and treatment of dementia.
A recent Manitoba study found that seniors participate in continuing education activities to learn for learning's sake, to socialize and to achieve a goal. It is interesting to note that the goals mentioned were to learn about specific issues such as health or world issues and not to receive a credential.
Witnesses today have been asked to give some thought to the use of age-based measures to define seniors, to the question of diversity, to policy approaches and to the federal government's role in addressing the challenges and opportunities of an aging population. These questions are all extremely complex. Creative Retirement's consideration of them will be given in the context of our experience and expertise in lifelong learning.
CRM stopped using age as a criterion for membership in the mid-1990s. We did this in response to the forced retirement of a large number of city employees, many in their late 40s and early 50s. Whether forced or by choice, people began to retire much earlier than age 65 and the age-base that defined them changed.
Seniors' organizations were faced with a new challenge: How could we develop and deliver programs for such a diverse group? We had the young-old, the middle-old and the old-old. They were 50, they were 80; they were healthy, they were frail; they were rich, they were poor; they were educated, they were illiterate. Today all of these factors are still present, but the age spread has again increased.
What does this all mean in the context of lifelong learning and active living? The first interim report of this committee includes a brief section on lifelong learning. It notes that lifelong learning supports seniors' participation in society, but it appears to focus on learning in its relation to stimulating the economy. Creative Retirement believes that when lifelong learning is defined by and based on primarily economic realities, appreciation of peoples' roles can become very narrow. This stifles creativity and limits creation of social capital.
CRM also believes that lifelong learning means creating a culture that allows people to learn what they want, when and where they want and how they want; a culture where everyone knows the value of learning and expects to learn throughout life, from pre-school years to post-retirement.
CRM recognizes that the impending labour shortage is real, but we do not believe it should be addressed by a legislated age of retirement or by policies based on the myth that retired people do not share the burden and expense of society.
The noted MacArthur Foundation study by John W. Rowe and Robert L. Kahn reported that one third of the older population worked for pay, another third as volunteers, and another third provided informal aid to family members, friends and neighbours. Rowe and Kahn also noted that the most important idea to take from any discussion on aging is that lifestyle and attitude matter. Education can play an important role in these areas.
For seniors, understanding that no one is ever too old to learn is the basis for pursuing lifelong learning. How they perceive themselves, their abilities and their goals has a significant impact on their willingness to pursue lifelong learning. A broadened definition of education is essential to create a culture where this can happen. When asked what enabled her to make the significant contribution she had made to society, June Callwood replied: Energy, health and curiosity.
Learning throughout life can foster all of these attributes. It can enable and assist seniors to live rich and rewarding lives. It can open doors to find the creative solutions to the challenges of an aging population that this committee seeks. Thank you.
Colin Milner, Chief Executive Officer, International Council on Active Aging: Honourable senators, thank you for inviting me to speak to the committee today. It is an honour.
I would like to start with looking at the benefits of an active aging framework. I will touch briefly on two issues raised in the committee's first report, which I found very enlightening. First, it was gratifying to see that both you and the previous speakers recognize that level of function is far more important than chronological age when describing older adults. Our organization uses five different levels of function to describe older adults. By level of function, I mean how well the individual can function independently. Some more frail adults in their 60s need assistance with basic activities, such as dressing, while others run marathons in their 80s.
Second, the committee asked whether the framework to coordinate policies should be the life course perspective, healthy aging or active aging. My points of view are based on the active aging framework.
The term "active living" refers to giving people the opportunity to engage in physical activity. "Active aging" actually expands on that concept and means being engaged in life as fully as possible throughout the lifespan. Those areas of engagement can be categorized as physical activity, intellectual and social activity, vocational activity and emotional and spiritual health. These are called the dimensions of wellness and are increasingly used as a framework to structure programs for older adults.
People can stay engaged in life and contribute even if they have health conditions. That is why we prefer the active aging concept rather than defining people by their health issues or status.
We have heard in your reports today that physical activity is one component of a healthy and engaged lifestyle or life; however, it is a key component because being physically independent and able to function enables people to participate fully in life. An additional advantage to promoting physical activity is that it often encourages social and intellectual activity and improves emotional well-being. A group exercise class and a walking class are examples of social interaction. Memorizing an exercise sequence or using a hand-held compass or global positioning system to walk or run a trail is an example of the intellectual component.
You have already heard about the health care expenditures attributed to older adults. The data on economic burden is available, as is the role of physical activity in preventing or controlling chronic disease and disability. We recommend four broad areas to encourage physical activity. The question then becomes what will motivate aging adults to become more physically active.
The first area we wish to look at would be to increase the priority of physical activity as a component of health promotion. There is a need to increase the awareness of public officials about the current research, which demonstrates that increasing physical activity among older adults will ultimately save Canada money by helping to control health care costs.
Points to consider are to recommend legislation and policies that will allocate funds to support physical activity and recreational programs for older adults. These would be important in both public and private sectors. Another aspect is funding and publicizing demonstration projects and model projects that are successful in attracting older adults and improving their health and quality of life. This has been a comment among our membership.
There are already many initiatives to increase physical activity among older Canadians. What we do not have at a high level is communication to know about them. Many people are working in the dark. It would be helpful to have a central repository to collect and disseminate these resources so that there is awareness of available frameworks for all. The next point within that is to build physical activity programs into current funding streams for community and seniors centres and other organizations partially or fully funded by government to make physical activity programs part of their mission and program offering.
The second point that we would like to focus on is to present messages that are likely to be meaningful to older adults. You only have to turn on the TV to see messages that are not. Fear-based messages that a person may fall or be at risk for a medical condition are not generally successful for behavioural change. People usually think they are not at risk and that these messages do not apply to them.
Messages of the advantages of exercise in supporting the everyday lives of older adults are more effective. If you can increase physical activity, you can play ball with your grandchild. Along with the words of the messages are the images. Show real older adults who are independent, engaged and contributing. A less obvious but critical component to this effort is to make exercise fun. When the emphasis on science and evidence-based outcomes is too great, physical activity becomes intimidating and not enjoyable.
Our third point is to provide policy incentives to organizations and older adults themselves. For individuals, consider that the cost of planned exercise can be a barrier to participation. One option is tax relief. Recently Canada provided a tax credit of $500 for children who engage in physical activity. Why not offer the same benefit to older adults? Another option is to remove the GST from fee-based programs for older adults. Another is to offer tax incentives to companies that implement workforce wellness programs, with financial incentives increasing according to employee participation.
If half of the older adults in Canada decided today that they wanted to start a physical activity or exercise program, is there a place for them to go? Are the programs appealing to the diversity of functional levels, cultural diversity and interest?
We would recommend providing tax incentives to health clubs, manufacturers, wellness programs, personal training businesses and recreation programs that create products and programs specific to adults over 50 years old in community settings. Of course, walkable neighbourhoods with safe sidewalks and nearby services encourage physical activity, and urban and rural planning committees and policies are needed to encourage these.
Finally, encourage training for people who will work with older adults. You heard this in the first report as far as gerontologists and physicians go. It is no different with exercise trainers. Can community colleges and other educators be rewarded for launching programs to train physical activity instructors? Could we provide scholarships and tuition reimbursement for fitness and wellness instructors taking geriatric courses or certifications in exercise for older adults, which is grossly lacking? Could we develop programs that train primary and allied health care workers how to coach adherence to physical activity participation, and also offer them a support network to which they can refer people?
The conclusion is that we have heard, in the first report, that older adults today are different from in the past. Therefore, why would we continue to offer them the same programs and services they were offered in the past? I will leave you with one example of this.
Consider the importance of strength to someone as they age. Between the ages of 35 or 40 to the age of 90, we have the possibility of losing up to 50 per cent of our strength if we are inactive. That is the equivalent of me putting someone who weighs as much as I do on my shoulders and walking around all day long, picking up garbage, carrying my grandkids, et cetera. Then we wonder why some people have issues functioning at a high level. Simply reversing strength loss in many older people could have a significant impact on the health of the country.
The Deputy Chairman: I notice that you are all emphasizing the active living theme. Mr. Milner, you are suggesting that government has to come forth and subsidize some facilities to do this and so forth. Paradoxically, if the workforce is increased out another next 10 years, that increases the Canadian tax base. Would this have a neutralizing effect? Have you addressed that at all or are you just interested in the active living side of the equation?
Mr. Milner: I am certainly not a tax accountant. However, I can tell you that research out of the United States by HealthPartners, I believe, has shown that being physically active just 90 minutes a week — walking three times a week — can save up to $2,200 a year off the costs of health care. It is one of those things where you pay now or you pay later. We are investing in the future.
The Deputy Chairman: You did not address the other side of the question. Should we accept the fact that at some point in a person's life — and I will not say age because that is not the thing to do these days — they decide they are going to retire; or perhaps when they were 45 years old they decided when they were going to retire. They could be encouraged to push that date back and work longer; then they are contributing to the economy.
Mr. Milner: Absolutely; I would encourage that. The trump card is the person's health. If they are not healthy, the odds are they will not be able to work longer.
Ms. Austin: Many people do not realize that the benefits of participating in physical activity will often decrease the pain they are in from osteoporosis or arthritis. Quite often, people assume they should not be moving; in fact, the opposite is true. The more they participate in exercise — especially strengthening exercises — the better they can reverse the complications of osteoporosis. However, for the most part, people do not realize that. The research has been done but not communicated to the general public.
Ms. Wood: I recently signed a little thing about having some tax benefits because I do participate in an exercise program. I have to rethink that even as I sit here listening to the process.
In response to these issues, I would say that whatever information we have and whatever messages we want people to embrace, people will not embrace them without a framework of lifelong learning and without a framework where they believe that they need to constantly receive and engage in information. We can disseminate information and put up all kinds of posters and programs, and in fact many organizations have, but we still need to change the culture; we need to get people believing all through their life that they can change and that learning enables them to make the changes, to take the information, to move to new levels, to take on new challenges, to become active livers. If we do not have that basis, the messages just keep circulating.
The Deputy Chairman: The difficulty we have, as a committee, in trying to frame some of this information is the question of when this type of educational program should kick in. I was trying to ferret that out from the previous panel. Does such an educational program begin in grade school? Does it kick in at the work place or is it a continuum? I am not sure that kids in primary school or Senator Cordy's students would be interested in hearing about aging well. Yet, your message is correct. It is just a question of how a program could be implemented.
Ms. Wood: We have asked for a broadened definition of education that goes beyond learning for work. The idea that learning is only about your work life, your career, prevents us from expanding our ideas about what we learn into other aspects of our life.
The Deputy Chairman: I certainly agree with that from the health point of view. I have worn out the word nebulous this afternoon but I will use it again. We just do not seem to have a concept of how and when we will introduce these measures. Life used to be a little simpler, but that time is not coming back. I do not think it will get simple again. When we had fixed retirement ages and so forth, it was a great time to implement programs of this kind associated with pensions. Now there is no timing along the road of life. We have to find another way of doing it.
Senator Cordy: That is an excellent point. How do we make it a continuum? How do we make it so that lifelong learning starts when you are young and continue, so that there is not lifelong learning while you are in school and then lifelong learning in middle age and then another brand new learning aspect taking place when you retire?
We have heard today and on other days about ensuring that seniors continue to be active. I do not think it starts when you are a senior. I do not have results of any studies, but perhaps you do. It seems to me that if you have been physically active your whole life and involved in your community, then those aspects are likely to carry on when you retire from your work. Those who have not been involved outside their home, who have not been involved in the community, or who have not been physically active would find it more challenging to begin when they retire. Is that assumption correct?
Ms. Austin: That is true in part. Also, as they go through life, especially in their middle years, many people define themselves with the work they do. When this work comes to an end, they are left at a loss. They do not know what they will do with their life. Often, they have lost their social network and families and children have moved away. Perhaps they have just lost their parents and now they see themselves growing old. Quite often depression sets in. They do not have social connections and may become isolated.
I find that is especially true with certain professions, such as executive directors or presidents of companies who do not have much of a social network because of their work position. They retire after making decisions all their lives and directing others and now they are left to their own devices. They just do not know how to reconnect.
Senator Cordy: Is there a difference between men and women? I am not sure whether it is true, but I have heard that women develop stronger social networks than men do. I am just about whether there is any information on that.
Ms. Austin: I do not have the research in front of me to prove it, but I would certainly say that that is true. I think women tend to be more social beings. Certainly you see a large number of men who do not see themselves as having any self-worth anymore. I think that is because they wrap themselves up more in their work while women tend to be both workers and the ones who brings up the family. That is still sexist, but it is unfortunately the reality, although it is changing. Hopefully it will change in the next generation.
Senator Cordy: Ms. Austin, you commented about your agency not receiving funding. Who funds your agency?
Ms. Austin: We are funded primarily through Health Canada on a project basis. We primarily do project-based research. We go from project to project, and once a project is done we do not know whether there will another project that will allow us to continue. To be honest, I am new to this field. I was at a recent seniors' conference where I heard that repeated over and over by many seniors' organizations. Seniors' organizations are mainly being run by volunteers and many of them have zero staff. It is very difficult for them to achieve what is expected of them, especially with some of the grants that are being awarded, without some staff support.
Senator Cordy: Ms. Wood and Mr. Milner, are you also funded by Health Canada?
Mr. Milner: No. Our organization is membership-based. We have 5,600 organizations that run retirement activities, active adult communities, senior centres and YMCAs.
Ms. Wood: Our members pay approximately 50 per cent of our operating costs through registrations, memberships and a high level of donations. We receive the rest of our money through project funding. It is very much the same thing. Of our $400,000 budget, $32,000 is core funding. Actually, it is tied to the delivery of our technology programs, so it is not, in essence, core funding.
Senator Cordy: Some people who have appeared before this committee or other committees that I sit on have said that when you have project-based funding, the paperwork can become so cumbersome that you question whether you should even bother applying for the grant. Do you find that that happens?
Ms. Austin: There is such a competition for dollars. There might be times when you write 20 proposals and only one or two will be successful. It did not used to be quite that extreme. There is a tremendous amount of work involved in writing a proposal. You are always looking for funding and you have to be honest as well as a little creative to fit it into your programming. Once the grant is received, there are many reporting requirements.
Senator Cordy: Ms. Wood, are there other agencies such as yours across the country? It seems like such an excellent program to have seniors involved in lifelong learning.
Ms. Wood: As I mentioned, there are many programs across Canada, through the U.S. and in other parts of the world. Creative Retirement is unique in that we are not affiliated with or supported by a university. Lifelong learning institutes and third age learning centres all over the world are supported by universities. While they are not receiving huge amounts of funding, in part because of a trend to cut back in continuing education for older adults, they do have that benefit.
I would like to comment on the granting aspect. I agree that it can be an onerous task to write grant proposals. However, as has always been the case, the lack of some part of a grant for operating expenses and for administrative support presents a challenge. The New Horizons for Seniors program, which we were all delighted to see come back, has a flaw in this regard in that only 25 per cent of a grant is allowed for administrative support.
If you have a grant for $10,000 or $15,000, that is a very small amount. While the idea that these projects would be senior-led and senior-driven is quite noble, the reality is that the seniors we deal with and work with do not want to get involved with a project that they will have to lead and manage for one to three years. Rather, they want flexibility in their lives and they want to be able to choose when and how much they will do, although they will assist you. In our experience, they do not want to be the driving force. There must always be a staff person at an organization who will be the driving force behind projects.
Senator Cordy: I can understand that because if you have been involved in things your whole life, you feel that you have earned the right to have some flexibility. If you commit to it, then you are limited for your travel and family commitments.
Mr. Milner, you talked about what will motivate older adults to become more active and whether there is a place for them to go. I have seen seniors' communities in places like Florida, for example. I love going to the pool when it is for seniors but I am not likely to go to a public pool in Halifax with my bathing suit on. As well, I have no desire to go to a gym full of bodybuilders, although we have gyms designed for women. That has come about. Is there a market for senior-specific activity centres?
Mr. Milner: There is a huge market for them. As a matter of fact, it is already happening. There are groups such as Fit After 50, Club 50, Age Well, et cetera. Many centres are opening for the 50-plus population.
We find that one of the challenges faced by seniors centres is the term itself, "seniors centres," because their clientele are aging and becoming frailer, and the new clientele coming in would be the baby boomers. The baby boomers do not see themselves as seniors. I do not think anyone sees themselves at any time as a senior. My 96-year-old grandmother always talks about "those old people." She is not old; the others are old. Research from AARP showed that the term "seniors" can be a deterrent, depending on whom you are addressing.
Some organizations like retirement communities and active adult communities are building beautiful fitness and wellness centres. There are some good examples of what is happening with seniors centres markets, for example, south of the border, such as Chicago, which has ten or twelve centres available for their residents, and Bothell, Washington. It is happening, but under the radar, because it is not considered sexy so it does not receive much press; but that is who our members are.
Senator Cordy: My last question has to do with messaging and communication to seniors. I recently read some research indicating that up to 320,000 Canadian seniors are eligible for the Guaranteed Income Supplement under Old Age Security but are not receiving it. That brings to mind government agencies unable to communicate to seniors. Obviously, government is not doing a great job of communicating programs available for seniors.
Mr. Milner, you made references to messaging that is meaningful to seniors. What works and how does it work?
Mr. Milner: I would turn on the TV and look at the Dove soap campaigns that are pro-age and promote real beauty. They increased their sales within the first four months by 700 per cent. They have been covered in over 800 different publications. They won the award for the most effective marketing campaign in the U.S.
Looking at what works, you have to ask why does it work. All of the other products are promoting themselves as anti-aging — products generally associated with young, smooth skin — and the ads feature people who are 18 or 19 year old saying, "I do not have a wrinkle." Well, of course they do not have wrinkles; they have not reached that age yet. Dove has done a great job with that campaign after a great deal of research to truly target the market. Bringing in such an organization certainly would be beneficial. It is a new day, a new era and a new approach.
Ms. Austin: It shows older adults delivering the message in a very positive way. It celebrates age as opposed to trying to cover it up.
Senator Cordy: Should we look at television to get the message out?
Ms. Austin: By far that is the best media because it reaches the greatest number of people. People learn visually more often than they learn from reading or hearing. Television is by far the strongest media. Unfortunately, it is also the most costly.
Senator Cordy: That is true.
Ms. Wood: I agree that television is an important medium; however, the number of people not applying for the GIS indicates a larger systemic problem. It is my view that those people have simply fallen between the cracks. They might think they do not have to file a tax return because they are not earning any money. They might be living at the poverty level or so far below it that they do not file a tax return and therefore do not receive the benefit. We will never know about them if we do not have some information about them.
How would you reach such people when they are at that level of existence? I do not think television would do it for those people, although it might have a huge capacity in terms of the active living messages and the framework.
We have to be careful that we do not develop new ageist stereotypes. What happens to the group of people who do not fit into the categories of successful aging, active aging and active living? How do they feel about themselves? What is the message that we give to them? Also, what is the message we give to government and communities in terms of our responsibility to the people who are not in these broad categories of the active, successful aging population?
Mr. Milner: Active aging takes into consideration all elements. I can be actively aging and be a frail or dependent individual. I am not able to do some of the things that a marathon runner can do, but I am still actively aging. How you define the term "active aging" matters. You are right; you do not want it to become an elitist term, the same way you do not want the term "senior" to become a deterrent to people.
There are examples in the marketplace. I was speaking with Dr. David Buchner from the U.S. Centers for Disease Control and Prevention. Typically, it takes about 30 years for change to happen. If that is the case, use examples that have made it happen quicker, such as Mothers Against Drunk Driving. It hit the hearts and change happened much quicker. They utilized TV, but they also utilized people in the community to get the word out.
Senator Murray: We have heard over the weeks, including today, what appear to me to be some very sensible approaches to public policy in this area. When it comes to preparing our final report, sooner or later we will have to address the perennial Canadian question of who does what, with respect not only to federal and provincial responsibilities, but also municipal, private sector and voluntary sector. If we do not do that, the ideas are just left floating out there. It is important for a committee like this to be as specific as we can about who should be responsible for the implementation of the policies that we recommend. I suppose we could just address ourselves to the federal government, but that, I think, is not the most desirable course for a committee that has operated on such a broad front as this one has. When she spoke about the insufficient funding in answer to questions from Senator Cordy, Ms. Austin said that with the support of all three levels of government, together we can achieve the vision for healthy living from the Living Strategy Framework.
Let me start with Ms. Wood, because you operate within the borders of the province of Manitoba. You spoke about the fact that a good deal of your money comes from membership and user fees, a lot from donations, and some from project funding, which I took to mean through Health Canada.
Ms. Wood: It can be provincial government, the city and the arts councils.
Senator Murray: Yes, of course. It is not just a health issue. Tell me about the participation of the Government of Manitoba in helping you.
Ms. Wood: We receive funding through the Advancing Age Strategy, which is a Manitoba initiative. It is a small amount of funding. It was at one point $20,000 and has been reduced to $10,000. We receive funding from the Winnipeg Regional Health Authority for technology programs, which comes through the government as well.
We assist other organizations, such as Partners Seeking Solutions with Seniors, which is about drug and medication use and misuse. We receive an administrative fee to manage the money and their projects with them. That, however, is federally funded.
Another large portion of our money comes from foundations in Winnipeg. The Winnipeg Foundation is a strong and good supporter of Creative Retirement. We certainly receive some funding from the Government of Manitoba, but it is not by any means the bulk of our funding.
Senator Murray: I am interested in that aspect of it, Ms. Wood. We are glad to see you here today and to hear about what you are doing. Have you appeared before a committee in the Manitoba legislature? Do you regularly make representations to the provincial government about what they should be doing for you?
Ms. Wood: Yes, we do.
Senator Murray: But with limited success?
Ms. Wood: Yes. We had core funding in the 1980s and we lost that funding in 1996. We have been making many appeals. We have appeared before the Manitoba Council on Aging. We have been before many different government entities. We met with the past premier. We are constantly trying to bring the issue forward.
In terms of my remarks today about needing this broadened definition of aging, we are simply not getting anywhere with just saying that we need some core funding and that this needs to be a priority for government.
Senator Murray: At several levels.
Ms. Wood: Right. We conducted a pilot project that was funded by New Horizons for Seniors. We were teaching computer classes to Afghan refugees. Now we have a program where we are teaching computer classes to people taking English as another language. It is absolutely amazing to watch the students in these classes. We are conducting this with the support of the Advancing Age Strategy. We would like to run these programs as a regular part of our technology programs, but we cannot access money for anything that does not produce a job at the end of the training.
For immigrants and refugees, coming to an organization like Creative Retirement — which teaches senior learners and has a different style of learning, with a slower pace and more repetition — is a required step before they advance into the next level of training to be able to go into the job market. It is another area of consideration for us.
Senator Murray: Overall, though, the project funding is now principally from user fees, we will call them; private donations, foundations and so forth; and, after that, federal and provincial government. Is that accurate?
Ms. Wood: Yes.
Senator Murray: Ms. Austin, I quoted you already as having said "with the support of all three levels of government." Can you tell us what you think are the respective roles of the three levels of government?
Ms. Austin: There is a role, certainly at the federal level, to support agencies like ours in some ways with health dollars. At the local, municipal level, they are the ones that can help provide the locations for seniors to be active. They can subsidize through local tax dollars some of the activities that seniors can be involved in. There is an opportunity for all levels of government.
Senator Murray: Where is the province?
Ms. Austin: The province has a seniors' secretariat. They need to step up to the plate and provide some funding as well.
Senator Murray: In the representations you make in terms of policy and the requests you make for funding, how much time and effort do you spend on the provincial as distinct from the federal level or the municipal level?
Ms. Austin: We are a national umbrella organization made up of about 21 organizations that are either provincially based or nationally based.
Senator Murray: Are all the provinces and territories represented?
Ms. Austin: Yes.
Senator Murray: Do they ever discuss the need for provincial strategy as well as a federal or national strategy?
Ms. Austin: I am actually the first national executive director they have ever had and I have been with them only six weeks. That is part of the problem. They have been getting project funding and they would hire someone to manage the project and once that is done, that person is gone.
Senator Murray: From whom have they been getting project funding?
Ms. Austin: The funding is usually from Health Canada. Most of the active living work is research geared toward older adults to help them either manage a particular illness that they may have or do the preventative work for it so that they do not get the illness in the first place or put in proper physical activity to help alleviate some of the symptoms of a disease.
Senator Murray: We do not have a good handle here on just what the various provinces are doing. We can probably do some research, but we are not in a position to convene provincial ministers to this table very often and ask them to give an account of themselves because they account to their provincial legislatures and to their electors. We all have our biases. I can tell you straight up that my bias in these matters is that the role of the federal government in regard to seniors is, first, good income support, second, good research, in which I would include things like the national advertising you mentioned, and, third, good example where our own employees are concerned. Institutionally, we are not on the ground. If we are on the ground, we are either duplicating what someone else is or should be doing or interfering with them. That is a bias to which I confess right off the bat.
Mr. Milner, I take it some of your members are for-profit organizations, are they?
Mr. Milner: About 90 per cent are non-profit.
Senator Murray: From where do you get your funding?
Mr. Milner: We get our funding through six publications. We get it through advertising revenue. We have four conferences, so we get it through conference revenue; and we get it through membership revenue as well as products and services.
Senator Murray: Do you know the organizations that these two witnesses represent?
Mr. Milner: I am aware of the Active Living Coalition for Older Adults.
Senator Murray: How about the International Federation on Ageing? Ms. Barratt was here earlier. She is the secretary general.
Mr. Milner: Yes; I am aware of them.
Senator Murray: Are you associated with them in any way?
Mr. Milner: No.
Senator Murray: Should you be?
Mr. Milner: Absolutely.
Senator Murray: Why are you not?
Senator Murray: That is a great question. We are tied in now with many different organizations south of the border, including the Administration on Aging, the National Institute on Aging or AARP. When we have extended the opportunity to tie in with different groups in Canada, we have not gotten very far. Presently, about 80 per cent of our membership is U.S. based.
Senator Murray: Where are you located?
Mr. Milner: In Vancouver.
Senator Murray: The relationship appears to be north-south. Is this because all the good ideas are there?
Mr. Milner: No, they look to us for the ideas. The good ideas come from here.
Senator Murray: Considering many of the recommendations, someone like me will say this one is primarily federal, that one primarily provincial, maybe joint, exclusively federal, exclusively provincial. Witnesses come and they leave these ideas with us and we have to give thought to who should be implementing them. It is not just a matter of cost to the federal treasury — we print money, as you know — but it is a matter of what is the most effective way to achieve the desired objective. Thank you all very much.
Ms. Wood: The executive directors of the provincial and territorial secretariats do meet annually. I do not know whether you have ever tried to access information from them as a group, but that is something they do.
Senator Murray: Do you mean the government people?
Ms. Wood: Yes. Not every province has a secretariat, though.
Senator Murray: I see; the federal-provincial-territorial ministers meetings and the whole works.
Ms. Wood: The executive directors meet on an annual basis and do share all their findings in terms of trying to come to something more comprehensive for the country.
I think that the federal government has the ability to develop that more universal approach and that is what we are looking for.
Senator Murray: That is a collaboration issue given the nature of this country, as you well know.
The Deputy Chairman: Are there any other questions, honourable senators? If not, I will thank our witnesses for testifying here today and helping to enrich our report.
The committee adjourned.