Proceedings of the Special Senate Committee on Aging
Issue 6 - Evidence, April 28, 2008
OTTAWA, Monday, April 28, 2008
The Special Senate Committee on Aging met this day at 12:34 p.m. to examine and report upon the implications of an aging society in Canada.
Senator Sharon Carstairs (Chair) in the chair.
[English]
The Chair: Good afternoon. Welcome to this meeting of the Special Senate Committee on Aging. This committee is examining the implications of an aging society in Canada. Today's meeting will focus on options we raised in Chapter 2 of our second interim report entitled Issues and Options for an Aging Population, which was tabled in the Senate on March 11. This chapter deals with issues surrounding active aging and ageism.
To help us understand the issues surrounding these topics, we have Donald Paterson from the University of Western Ontario; Elaine Gallagher from the Centre on Aging at the University of Victoria; Chad Witcher from the Alberta Centre for Active Living; Glenn Miller from the Canadian Urban Institute; Ian Scott from the Seniors College of Prince Edward Island; and Ruth MacKenzie from Volunteer Canada.
We will begin with opening remarks and then move on to questions.
Donald Paterson, Professor, School of Kinesiology, Faculty of Health Sciences, University of Western Ontario, as an individual: Thank you for the opportunity to meet with the committee. It appears from the list of witnesses to date that none were speaking to the importance of physical activity for older adults. As Research Director of the Canadian Centre for Activity and Aging, this has been my area of investigation over the past 20 years.
Physical inactivity is a proven major risk factor for all-cause mortality and for various chronic diseases including heart disease, diabetes, osteoporosis, colon cancer and breast cancer. In physically active and moderately fit individuals, these risks are decreased by 30 per cent to 60 per cent. Perhaps even more important in older age, the losses of fitness and strength become limiting to performance of daily activities and become predictors of functional limitations.
My own longitudinal study of community-dwelling older adults demonstrated that a lower cardiorespiratory fitness was significantly associated with an increased odds ratio of becoming dependent in an eight-year follow-up. In those of above average fitness, the risk of becoming dependent was 50 per cent lower. Thus fitness is critical in preventing or delaying the onset of chronic diseases of aging, postponing and compressing the period of disability and dependent living. In an aging society, the health benefits of greater population fitness would have an immense economic and societal impact.
I have recently published a review regarding exercise recommendations for older adults. It was commissioned by the Public Health Agency of Canada. This was a critical analysis regarding the dose or the types and amounts of physical activity needed to prevent disease or promote health and remain independent. The recommendations are for physical activities that result in an improved cardiorespiratory fitness. They require an intensity described as moderate to moderately vigorous, 30 minutes per day, four to five times a week, thus expending 1,000 kilocalories a week. In the older adult of average fitness, this translates to three hours of brisk walking to meet the recommendation.
A review from the American College of Sports Medicine and the American Heart Association concurs with these recommendations encouraging moderate- and vigorous-intensity activity. Note that these are in addition to the light activities frequently performed during daily life: household work, casual walking or activities of very short duration.
I have been asked to comment on Chapter 2, "Active Aging." However, I would first like to make a note about Chapter 4, "Healthy Aging." The term "physical activity" was mentioned only once in a chapter discussing the determinants of health and chronic disease. About 40 years ago, the Lalonde report on the health of Canadians emphasized lifestyle factors and prevention and particularly physical activity. I cannot emphasize enough the potential impact of physical activity and prevention of chronic disease in preventing the loss of independence.
With regard to Chapter 2, from my comments regarding the newest evidence-based guidelines for the dose of physical activity needed, I must say that the "active living" approach is not a promising policy. The "active living," "small changes in everyday lifestyle" and "active lifestyle" terminology suggest a misconception of what dose of activity actually imparts health outcomes. This sends the wrong message for those who would like to take the medicine required to improve their health. Moderately vigorous exercise in greater than 10-minute segments is required — not more activities of daily living and not the accumulation of more light activities throughout the day. General leisure activities including gardening, normal walking and household work have been found not to protect against functional decline nor be predictive of reducing chronic disease. Public health initiatives should emphasize purposeful exercise such as brisk or vigorous walking.
Chapter 2 recommends promotion and mass education. This may be of some value in educating older adults about the proven benefits and recommended types of activities. However, given the need for specific activities that improve fitness, I would suggest it is important to find ways to support the delivery of exercise programs to community seniors. There is also the need to train leaders, instructors and educators. Model exercise programs and leader training programs have been developed at the Canadian Centre for Activity and Aging.
Training professionals to organize exercise for seniors is viable in the university. However, the problem with that strategy is that it is a limited career path. Perhaps the development of seniors' exercise programs by the private sector needs support.
Chapter 2 also indicates eliminating barriers to getting older adults more active and suggests targeting the least active groups: low income, low education, ethnic groups and rural areas. Since the health and independence benefits of fitness show a linear dose-response, the benefit to health and society applies even to moving those of average fitness to a higher fitness level. It may be more effective to encourage exercise habits by starting with the groups most likely to comply and have these groups set a societal norm or standard that the more resistant types may follow.
Chapter 2 also indicates a desire to impact on nursing, home care and long-term care. There are benefits of strength and balance exercises that support functional abilities in these groups. Again, programs for these groups have been developed at the centre. These are important but do not have the population impact that can be realized from prevention programs in community-dwelling older adults of all ages. I would propose targeting community-dwelling seniors. Even if a small portion of the population takes the medicine of purposeful physical activity, there will be a significant impact on health. We need to create a societal norm of older adults exercising for fitness and health benefits.
I look forward to your comments and questions.
Elaine Gallagher, Director, Centre on Aging, University of Victoria, as an individual: Thank you for the opportunity to address this special committee. I was told I had five minutes and I will speak to Chapter 2 of your report.
In preparing these comments, I consulted with some of my colleagues at the Centre on Aging, one of whom does research on driving and seniors. I also consulted some of the seniors groups I am affiliated with and spoke to some senior officials in the B.C. Ministry of Health. These are not just my comments but rather a summary of several sources of input.
In section 2.1 on page 9 of your report, you speak as though slowing down in later life is necessarily a negative pattern, and the report equates slowing down with total inactivity. In our research on falls, it has been well documented that slowing down and exercising caution is in fact very protective for frail older people. In fact, slowing down a bit in their activities and being more mindful may be the most preventative things that a frail older person can do.
Some careful editing of that section would clarify the intent of this paragraph so as to differentiate between appropriate slowing down, which can be preventative, and premature or unhealthy declines in activity levels. The paragraph does not capture that differentiation but rather equates those two.
The attention to active living and our work on age-friendly cities and towns is excellent. I was the principal investigator for B.C.'s contribution to the World Health Organization project and lead researcher on the federal- provincial-territorial remote and rural Canadian study involving healthy, age-friendly, small, rural and remote communities.
In British Columbia, we are attempting to roll this initiative out across the province in time for the 2010 Olympics. We want to be able to say that this is the first jurisdiction in the world to host a senior-friendly Olympic Games, and we are looking for creative ways to involve seniors as volunteers and paid workers in the games.
I want to commend you for acknowledging this work. We recommend that it be adopted across Canada. I am meeting with the federal-provincial-territorial ministers tomorrow and the day following with the representatives of those ministers to discuss how this age-friendly communities movement can be rolled out across Canada. We think it has tremendous potential for changing the way that communities think about preparing for an aging population.
I found an excellent review of the literature on volunteerism. The authors found that seniors volunteer for a variety of reasons, including social benefits to society and opportunities to make a contribution; but they also volunteer in order to use their skills and knowledge, to learn new things, to develop new skills, to be intellectually stimulated and to feel good or needed. Potential older volunteers are hindered most often by health problems, other commitments or full schedules and lack of time. They want the flexibility to go south for a few months or on a cruise if an affordable opportunity arises.
People who recruit and retain volunteers need to know this information. They need to know what motivates people to get involved and to continue and what barriers they face in doing so. To promote lifelong volunteering, schools could offer course credit for volunteering. Some schools already do this to get children thinking about volunteering from an early age. Employers could offer flextime to allow for volunteering activities. More agencies could offer volunteer recognition awards. While most seniors do not want payment for their service, their costs should be covered. Such rewards as Tim Hortons or Starbucks coffee cards are often appreciated. A paid coordinator is absolutely essential.
In terms of lifelong learning, you had some very good suggestions in your report. In my view, tuition should be free for seniors, not just a tax right-off. You could combine the awareness campaign for lifelong learning with the ParticipACTION movement. We tend to segment people in terms of their bodies, minds and spirits. I am a holistic thinker; I think of a person as a whole. ParticipACTION could be a movement that promotes physical, social and mental well-being, not just physical well-being. These things all go together. In having the physical participation, you get your social and even mental stimulation. Keeping mind, body and spirit alive ought to be the motto — not just the body or the mind or the spirit.
Regarding recommendation 10, we do need to promote the age-friendly communities initiative, but the recommendation says to promote it among relevant professional groups. However, while those groups do need to be involved, we have found that the work is best supported by a steering committee made up of a variety of people or stakeholders: city officials, key senior leaders and others who represent the makeup of the community. People with disabilities, wealthier and poorer seniors and people of different ethnic and cultural backgrounds need to be consulted. This movement is targeted in a holistic way, not just at the professional groups as your recommendation currently reads.
Page 15 talks about barriers to active living. One not mentioned, which I thought you could add to the list, is self- adopted ageism, the idea that "I cannot do that at my age." For many seniors, the personal definition of "what I am capable of" may be one of the biggest barriers to overcome. The work Mr. Paterson and others are doing is showing that people are capable of much more than what they had expected.
Under recommendation 13, I would not limit tax deductions to gym memberships as it reads now. Any fitness program should be eligible, whether dancing, swimming, curling or something that gets people out and beyond their daily activities, as Mr. Paterson mentioned. I would not limit tax deductions to gym memberships, because many older people do not feel comfortable walking into gyms full of 21-year-old hard bodies.
Regarding recommendation 14, we need to start dealing with ageism early in life, even among kids in school. Make this a mandatory part of the curriculum. Teach kids to start thinking of seniors as contributing members of society. We have introduced a program at the University of Victoria called the Masterminds program. It is an example of one way to address ageism. I started this month of lectures by retired professors to showcase the work they have done since retirement. We have had writers, artists, theologians, scientists and others. They talk about books they have written, plays they wrote or acted in and research projects they have spearheaded. I think the Masterminds concept could be adopted across the country to demonstrate the vast post-work contributions that people are making.
Commission a paper on ageism and, in particular, on what has been found to be effective in addressing ageism around the world. We do not have all the answers of how to deal with ageism — it is pervasive and subtle — but we could begin to address this systematically.
Regarding recommendations 15 and 16, we need to address the idea of competency in lieu of age-based criteria for many things, including driving and retirement. However, you need to have a clear definition of competence. It involves adaptation to change in a number of physical and mental subsystems of the body. For example, we have offered our chronic disease self-management program to more than 10,000 participants since 2000. It teaches people how to manage their health and improve their exercise and their nutrition overall. With adequate support, this program could be offered more widely across the country. Dr. Patrick McGowan is the leader of that initiative.
There is a need for more research on how to evaluate competency. The Canadian Institutes of Health Research could be asked to fund a special competition to address this issue. They could work with policy-makers to test out new guidelines based on research evidence. For example, I found one study that showed that not all persons diagnosed with Alzheimer's disease perform incompetently on driving performance measures. Yet, we would assume that a person suffering from Alzheimer's disease would not be a competent driver.
Older people do not cause a disproportionate number of driving accidents. Per capita, their crashes are fewer than those for the age group 16 to 64 and almost half of those for the age group 21 to 24. Older drivers tend to self-regulate: they drive more slowly, avoid night driving and stay out of high traffic areas and off unfamiliar roads. Future seniors may be more reluctant to do this, so we will need to have ways of assessing competence for those unwilling to self- regulate. However, I think self-regulation should be the social marketing message. It is up to you to self-regulate your driving as you get older; that is what the message should be because that is what most people are doing.
To combat the notion of ageism, we need to promote the concept of aging well. Australia considers this to be a model based on encouraging the maintenance of personal independence and self-responsibility as far as possible and consistent with each individual's capacities and choice. However, at the same time we must avoid putting all the responsibility on people for health and for their own well-being — that is, blaming the victim. Sometimes these models tend to do that, to say it is all up to you. It is not all up to individuals; it is up to us, as a society together, to work on promoting active and healthy living and aging well.
Chad Witcher, Representative, Alberta Centre for Active Living: I am a doctoral student in the Faculty of Physical Education and Recreation at the University of Alberta in Edmonton. I am here on behalf of my former master's supervisor, Dr. Sandra O'Brien Cousins, professor emeritus in exercise gerontology, who was asked to appear today on behalf of the Alberta Centre for Active Living. I would like to extend our sincere thanks for the opportunity to take part in this important forum, as we wholeheartedly endorse health promotion through active living at all ages.
Canada is a world leader in examining active living and ageism, in part because our workers have traditionally been encouraged to retire and rest at age 65. Changes in mandatory retirement will likely open doors and broaden thinking among today's older adults about how to live later life to its fullest. However, for today's age 65 and older population, research on exercise motivation suggests that keeping current seniors fit will offer huge challenges. Informing this topic is the 2005 report Overcoming Ageism in Active Living, written by Dr. O'Brien Cousins for Canada's Active Living Coalition for Older Adults.
My own research on physical activity promotion among older adults is also relevant to understanding the challenges of mobilizing older adults who live in rural communities. This research has demonstrated the importance of developing a broader understanding of how past and present-day contexts can influence participation in leisure-time physical activity.
We note the wisdom in the three approaches outlined in Chapter 2. We support eliminating barriers to active aging. We support the sharing of knowledge and best practices and heartily endorse the launch of a national strategy to combat ageism. Indeed, we are all seeking solutions at the individual level, at the community level and at the national level.
In terms of barriers, what do we know and what should we do? We know that sedentary living is a big problem among older adult Canadians. Only a minority are adequately physically active. Ironically, although profound improvements are seen in sedentary older adults who participate in frequent stretching, walking and strength activity, healthy sedentary older adults say that they obviously do not need fitness to be healthy, while unhealthy seniors say that it is too late for them, that they are too old or not well enough to participate. Many feel frail because they are frail. They have become too weak, too stiff and too unsteady to live without fear of falling. Yet research shows that frail elderly are most in line to benefit from daily physical activity.
Will public education help increase physical activity participation? Maybe not. Sedentary seniors say they already know exercise is good for you, but they do not feel it is good for them. The underlying issue may be self-imposed ageism.
We should work to eliminate individual and ecological barriers to physical activity participation by providing the inspiration and support necessary. At the individual level, specially trained educators, nurses, home support workers and other health care professionals can assist older adults to incorporate physical activity into their lives in structured or unstructured ways. Less mobile and frailer older adults can be introduced to beneficial physical activities in their own residences.
From an ecological perspective, we need to focus on aspects of the environment that can prevent or encourage physical activity. It is important that older adults feel their neighbourhoods are safe. It is also important that communities are walkable. Sidewalks need to be free of snow and ice. Streets, trails and walking paths need to be well lit. Assisting communities in building or enhancing infrastructure that encourages physical activity at all ages would be a wise investment.
As I have mentioned, we like the idea of a national launch strategy to combat ageism, as a launch of Canada's Physical Activity Guide to Healthy Active Living for Older Adults was almost a decade ago during the International Year of Older Persons. As Ory et al. wrote in 2003 at page 167, the challenge is to "move beyond conveying basic health benefits to focus on encouraging and inspiring audience members to get moving, all the while being careful not to alienate or turn them off."
Such inspiration could be found in a national launch, and seniors across Canada could be involved. For example, we could double the number of active seniors rapidly with an active buddy system, whereby an active senior helps an inactive senior get started. Buddies who make a successful commitment could both be nationally recognized with a coveted Active Senior pin.
In conclusion, we endorse the significant investment in older adult wellness. The three-pronged approach of overcoming individual barriers and environmental barriers and confronting ageism on a nation-wide basis is timely and commendable. I would be happy to answer questions.
Glenn Miller, Director, Education and Research, Canadian Urban Institute: We appreciate the opportunity to appear before you. The committee correctly notes that people who have been actively physically throughout their lives are more likely to continue this pattern after retirement. We believe the physical design and layout of our communities plays a key role in facilitating active living. Thanks to good work done by the World Health Organization in developing the concept of age-friendly cities, there is growing awareness among Canadian policy-makers that we need to prepare for and adapt to the demands of an aging society; but acknowledging the opportunity is not enough. There are important reasons why the federal government should take concrete steps to address these matters.
Most people agree that aging in place is a desirable goal. However, our research suggests that unless action is taken to address a variety of issues, ranging from urban design to the way we provide government services, the quality of life enjoyed by older Canadians will take a turn for the worse.
The reality of urban living in this country is that most Canadians depend on the private car to get to work, carry out errands and accomplish the things that provide us with one of the most attractive qualities of life in the world. If a majority of senior citizens live in communities where one needs a car to be able to function, what happens when we get too old to drive?
A majority of older Canadians live in single family houses that are located in urban areas. Most residential suburbs, built since the Second World War, have developed as car-dependent communities where essential services and amenities — such as shops, health care, libraries and community centres — are not available within walking distance. Even when the services are present in shopping malls, the lack of sidewalks and the width of suburban arterial roads is a daunting prospect for those whose agility and strength have started to decline.
The current generation of baby boomers who, over the coming decades, will become senior citizens, has higher expectations in terms of mobility than any generation before it. This creates the prospect that reduced mobility, which will occur if and when seniors are forced to give up driving, will have a negative impact on quality of life if steps are not taken to address the issue.
Within a period of 25 years or so, by which time seniors will comprise one in four Canadians, the makeup of Canada's communities will look and feel very different from today's cities. The resulting impact on government finances, the delivery of public services and priorities for how the private sector responds to these changes will likely see profound changes throughout society.
Our search for best practices has focused on two countries that are ahead of Canada in terms of the aging of the population: Japan and the United Kingdom. Building on insights from these places, we urge this committee to expand its comments in its interim report to consider recommending that the government adopt the principles of universal or inclusive design to guide the actions of all government departments and its relationships with provincial and territorial governments.
Japan did this nearly a decade ago, and the positive impact of inclusive design is now being felt throughout Japanese society. Even though Japan has the most elderly population in the developed world, everything from the design of transportation systems to the delivery of government services is now viewed through the lens of equal access for everyone. This proactive approach is also helping Japan mitigate the impact of ageism.
A second recommendation, which builds on the first, is to borrow an idea from the United Kingdom. The government there is implementing a cross-departmental policy called Lifetime Homes, Lifetime Neighbourhoods. Nested within broader initiatives to promote sustainability, this program has set aggressive targets for introducing inclusive design into the private housing market, planning and municipal service delivery. A key attribute of this program is that its principles are to be embedded across government departments. Health is a key player, but unlike the situation in Canada, the roles of departments affecting the built environment, such as planning, housing and transportation as well as the delivery of government services for matters such as income support and communications, enjoy equal consideration.
The report, less than a month old, states:
Good design works well for people of all ages, but for those with mobility problems or with sensory or cognitive impairments it can make the difference between independent living and social exclusion.
It is not just lifetime homes that are needed, but lifetime neighbourhoods, where older people are not left out or forgotten because they cannot access buildings or public spaces. . . . They are neighbourhoods where transport, good shops, green spaces, decent toilets, and benches, are consciously planned for people of all ages and conditions in mind.
Canada's future prosperity depends to a great extent on how well our cities and towns are able to adapt to what the CUI calls "the demographic tsunami." As with demographics, there are powerful forces at play that drive the tsunami forward. The impact will vary across the country, reacting to differences in climate, immigration levels and regional economic drivers. How well we learn to retrofit existing communities and change our approach to the design of new ones in the coming decades to accommodate an environment where a quarter of the population is eligible for retirement will decide our future.
I would like to leave the committee with two thoughts. First, the federal government will need to broaden its understanding of the impacts of an aging society beyond health care and fiscal issues to fund research and work collaboratively with its many agencies, departments and commissions as well as other levels of government. Design will go a long way toward advancing this goal. Second, urban planners, led by organizations like the Canadian Urban Institute and the Canadian Institute of Planners and its provincial affiliates are well placed to foster collaborative partnerships with all levels of government, other design professionals, developers and other investors to creatively approach the design of new communities and the retrofitting of existing ones.
Ian Scott, President, Seniors College of Prince Edward Island: I would like to commend the Senate for undertaking this task. It is a masterful examination of many topics. I will focus on the area of active aging through a couple of examples.
I would like to speak about the Seniors College of Prince Edward Island. We are affiliated with the University of Prince Edward Island, but we have our own board. We have grown in 10 years from a membership of 45 to 527 members this year. It is a membership-based organization. Members pay $120 for the year and are able to take as many courses as they want throughout the year. It is unlimited. We serve four communities across P.E.I. It is a concept of peer learning that has grown around the world to provide opportunities for those who are 50 plus. The difficulty is that there are few connections between the various organizations. Examples of courses offered are family history, astronomy, Math Magic, life writing and singing. We have more than 100 courses. The best description of our operation can be seen on our website video. The first domain ever registered in Canada, upei.ca/seniorscollege, will get you to that video about empowering people to be more fulfilled. The belief that seniors have much to give and that seniors make a difference in their world is a powerful force.
We use both university and community facilities that we taxpayers have built. Often, most of us think of our university libraries, which are the finest in the country, as having a unique status. We give them that elite status and forget that they our libraries — the best in our community. When we get people on campus and using the facilities, they begin to realize that they are part of the campus community. It is an empowering process. We were lucky to be invited onto campus, and we are keen to make use of any campus facilities available. A challenge is that we have quickly outgrown the facilities on campus and have to look further afield for space. However, the campus is a key part of our operation.
It is important that in any kind of planning, multi-use rooms are integrated into facilities' planning so that community rooms are bookable spaces. We face a challenge every day in finding enough bookable spaces. A number of our members do not have transportation and will walk several miles to get to a class. It is a real commendation of their dedication that they will struggle, gaining exercise along the way, to attend classes.
I would like to touch on another example. One of our board members is a great living example of an active senior. She embarked upon a PhD in her 60s, completed her PhD and is currently an adviser to doctoral students. She wrote a paper recently on an area that is near and dear to my heart: literacy. I commend the Senate for its leadership role in literacy across this country, which has influenced government greatly. She entitled her study, which she presented a couple of weeks ago in New York, It Takes a Village to Raise a Reader: Building Literacy Across Generations. She looked at a very active intergenerational program in Prince Edward Island called Project L.O.V.E. (Let Older Volunteers Educate). It matches senior volunteers with elementary school students who need extra attention. It does not replace teacher assistants, but it provides a buddy system and an important linkage. It is all about giving back and contributing to our communities, which we built.
This project is part of an intergenerational movement that is helping to reduce and replace the loss of extended family structures. In particular in Eastern Canada, we have seen the reality of our young people leaving. Every family I know in Prince Edward Island has family members who live off-island. This was not as common 50 years ago as it is today. Many young people living in urban centres do not have grandparents within walking distance of where they live. Children growing up do not have that kind of close contact. This program helps to bridge that gap and to provide an opportunity for a kind of volunteer grandparent to become a part of the life of a young person.
As well, it helps seniors feel valued and in touch with the younger generation while helping young people feel connected to the values of caring through the reading experience. Reading together is not so much about decoding and eye-tracking across the page. Rather, it is about the caring process that printed materials matter, that reading matters and that it is a key to our culture and to the conveyance of knowledge.
On page 12 of your report, the third paragraph indicates that a number of the innovative programs across the country promote learning among seniors. The committee heard that the development of new programs could be accelerated if providers had an opportunity to meet and share ideas and best practices. I would like to underline or highlight that, but I do not find it reflected in the recommendations. Recommendation 13 could be strengthened a bit through some minor wording to acknowledge the fact that those of us across the country who provide low-cost programs are doing it as volunteers. We are dedicating our time to this effort. As a retiree, I do not have the option of being able to travel widely, whereas professionals in the field do so. My experience in literacy and government for many years with colleagues across the country that I could visit was of great benefit to advancing programs in Prince Edward Island. In particular, having colleagues across the country has been helpful when working in smaller communities and in isolation in a small province. If we can do anything to encourage communication in this area among those who are organizing programs for retirees, that would greatly enhance efforts and help to spread the word.
We held a regional conference last summer and attracted people from seven provinces. We have seen from that the growth of new seniors' colleges, one launched in Halifax in January, one that will launch in Sackville, New Brunswick, through Mount Allison University this September, and one in Cape Breton as well.
We encourage you to include some wording in recommendation 13 that recognizes that those who work at the community level do need help in spreading the word and working together.
Ruth MacKenzie, President, Volunteer Canada: I am pleased be invited today. You are undertaking important work. It is notable that you have recognized the importance of volunteering to the well-being of senior Canadians. Today, on the first day of National Volunteer Week, I thank you for that.
Values related to volunteer involvement are strong in this country. Forty-five per cent — 12 million Canadians — contribute almost 2 billion hours of time as volunteers each year. Deeply concerning is that much comes from the few: 11 per cent of Canadians contribute 77 per cent of the volunteer hours. More troubling still is that a significant proportion of that 11 per cent is older adults. If we do not find ways to engage generations as they move into their senior years to ensure their contributions are maximized, volunteer involvement and in fact our communities are at risk.
The recommendations contained in your report related to facilitating volunteerism are strong and undoubtedly would have a positive impact on volunteer engagement among our seniors' communities. Your recommendation to ensure multi-year funding is significant. Much of what volunteer involvement is all about is the relationship between the volunteers and where they choose to volunteer or direct their time. Relationships are about faith, reliance, continuity and momentum, concepts impossible to maintain without knowledge and trust that relationships that are there on March 31 will also be there on April 1, that the beginning of a new year will not mean that programs and people who are relied on might or might not be there.
Infrastructure is critically important, but often a layer that is less attractive to funders — public and private sector alike. This recommendation recognizes that volunteering, while organic in its ethos, is also not free, or free from the need for support and nurturing. National leadership is important here to identify and answer the research questions that tell us what is around the corner for volunteering and the voluntary sector, so that we can be prepared to shape volunteer involvement to fit with emerging issues, trends, shifts and interests.
Your recommendation to recognize and promote volunteering throughout the life cycle is strategic, but the life of every single Canadian is unique and ever-changing. We must recognize that individuals come to volunteering for different reasons. We need to recognize and respect that people move into and out of volunteering at different stages of their lives, understanding youth, the sandwich generation, the socio-economic stages of life, the role of employers, family or intergenerational volunteering, the new Canadian experience, and of course the focus of this committee, seniors.
I have purposely left tax credits for volunteerism, your first recommendation, to the end of my comments. In considering how to foster volunteerism, it is important to consider the barriers to volunteering. Volunteers tend to be fairly middle-class. The statistics tells us that they are educated and that they come from incomes on the higher end of the spectrum. One could draw the conclusion, then, that there is an economic barrier to volunteering and, as such, that providing an economic incentive to volunteering makes sense.
I approach the issue of tax credits with some trepidation. If we need to engage those from lower incomes in volunteering, those households are unlikely to benefit substantially from a tax credit. Alternatively, finding a mechanism whereby it is possible to reimburse for out-of-pocket expenses would be of tremendous advantage. Many non-profit organizations are stretched for dollars and cannot reimburse volunteers for direct expenses, and at times the cost of a bus ticket is in fact a barrier for many people.
The issue of attaching an economic value to volunteering and providing tax incentives is significant and timely in the sector. The reality, though, is that there are a number of unanswered questions regarding the real benefit or associated incentive to such an approach. Does measuring volunteerism in economic terms detract from its inherent value and thereby diminish the importance of the underlying passion or qualitative components to volunteer involvement? Do we know that providing an economic incentive such as tax credits will result in increased engagement? Will individuals volunteer to the associated maximum number of hours and then drop off? Will providing tax incentives for seniors who volunteer have a detrimental affect on the engagement rates of other demographic cohorts who are not provided such a benefit? While it is certainly an interesting and perhaps even attractive proposition, more research is necessary to truly understand the possibility for positive impact and associated risks to volunteer involvement and the culture or philosophy of volunteerism.
Perhaps the most dramatic component to this recommendation is the potential for administrative burden on already resource-stretched managers of volunteers in voluntary organizations. I would urge you to consider the significant organizational resources that would be necessary to manage the associated record-keeping and reporting. We must be acutely aware of the ultimate impact of having perhaps increased volunteer involvement while decreasing our ability to manage those volunteers well.
In closing, I would urge the committee to implement the recommendations that we know would result in a significant increase in the capacity of organizations to involve volunteers before considering the recommendation for tax credits. If undertaken in a well-thought-out manner where the concept of tax credits is fully researched and understood, there may be potential for this to work. I would also urge the committee to share its insights with other such initiatives occurring within the framework of our government or perhaps to add a final recommendation, that a special Senate subcommittee on the state and future of volunteering in Canada be appointed.
The Chair: Thank you very much. We heard some interesting debate and discussion. I would like some interaction between Mr. Witcher and Mr. Paterson. I was interested that Mr. Paterson is encouraging much more physical activity. Mr. Witcher, you seem to be doing the same, but you seem to be saying that sometimes seniors are their own worst enemy. How do we get them from what you have identified as perhaps having a sense of unease with being physically active to where they should be, from your comments, Mr. Paterson, which you think is absolutely essential? I must say that you are saying it in front of someone who has diagnosed herself as being allergic to exercise.
Mr. Witcher: Maybe a good place to start is with your allergy. On the surface, it would seem as though we have a conflict here. Mr. Paterson and I would bash heads a little. Fundamentally, I agree with him that a lot of research shows that in order to really move people into the realm of benefiting physically from physical activity and exercise, there needs to be a shift into the 60 minutes, and maybe more, per day.
Given that the majority of older adults currently are not physically active at all, from a promotion standpoint it is meaningful to move people from inactivity to some activity. It would be very difficult to move people who are currently inactive to relatively high rates of physical activity.
Mr. Paterson: This issue goes back a fair time. It was the behaviourist approach that invented active living with the idea that if you do just a little bit more, that will get you into an active lifestyle. The activity guides were an example of that. They have not worked. Population activity has not increased. The need for certain activities is clear from the research evidence now, that active living, even if we got everyone involved, would not do a damn for the health of the nation.
It is not too scary even if you have an allergy, because once we get older we lose enough functional capacity that brisk walking becomes exercise. That is where I sit.
One of my slogans is "get fit for active living." If we can get seniors into an eight-week course called "Get Fit for Active Living," educate them about the benefits of exercise and, in particular, teach them how to do these things, because there is nervousness about getting involved initially, they would then take up other activities in daily life. There are many examples from the centre where this has happened. A woman who quit golf was back golfing two years later because if she could survive the 7:30 a.m. exercise class, she could golf eighteen holes, so now she does both. It is not too intimidating to get people exercising.
The other small issue is that we do not have to get the whole population doing it. For the economic and societal benefits, getting just 10 per cent of the population to avoid chronic diseases and going to dependent living would be a huge cost savings.
Mr. Miller: Some middle ground, perhaps, is found in the concept of natural exercise, which is an idea from the planning world. It looks at the kind of natural exercise that you get from having a community that you can literally walk about in, and the suburban areas that we have done a rather poor job of building as car-dependent make it difficult to do that.
When we look at the senior population, with the three cohorts that you identified in your report, it is useful to look also at what we call "seniors in training," the cohort before age 65, and to pay attention to informing this cohort, because if they have not been active in the past, it is probably a good time to get to them, so that when they reach the later years, they are able to change their behaviours.
Ms. Gallagher: In our work with remote and rural communities, we found that some of the challenges in those communities are different than those in urban areas. One size does not fit all when thinking about encouraging people to become more active or fit. Many of the people in those areas talked about the harsh winter conditions and the difficulties of getting out of their homes in winter. There is an absolute lack of public transportation of any kind to go anywhere, and unless you have a family member or a friend to drive you, you are homebound for a great deal of time during the harsh winter months.
All those things are interlinked. It is not just about getting people to go out and get exercise. It might be that other barriers and other factors local to that community need to be addressed.
Senator Mercer: Mr. Paterson, as you were talking and responding to the prod of the chair to get discussion going, I could not help but think about my 88-year-old mother who always concerns me and who does not exercise very well. I have tried to encourage her not to go to the corner store for a quart of milk but to go the supermarket, put the quart of milk in her cart and walk around the supermarket in every aisle just for the exercise. My mother is a fairly gregarious person who would probably meet half the people in the store, and it would take her an hour and a half to do that walking and it would be good exercise for her. Some exercise is pretty easy to do.
Many years ago, when I used to travel to see my sister-in-law in North Carolina, in the summertime the temperature would be as stifling as it could be in the southern United States. I noticed a walking program at the local shopping centre that started early in the morning, from eight o'clock to ten o'clock, and they had paths built right into the floor of the shopping centre for seniors to walk in the mornings in the air-conditioned environment so that they could exercise and not have to suffer the above 90-degree heat.
We have the opposite problem here with the cold. Do we have good examples from across the country of people doing that? It is good for the retailer, too, because if the seniors are in the shopping centre, they will stop at the Tim Hortons after the exercise and have a cup of coffee or buy that quart of milk at the grocery store in the shopping centre and so on.
Mr. Paterson: There is a mall walking program at three malls in London. To beef it up a little, we put an exercise leader in each of the malls for the morning time and the late afternoon time when most seniors decided to do their walking program. It is marked off so they know how far they have gone, they can time themselves, if they like, and the leader is there to give them advice on walking briskly and to keep them motivated.
Another resource that we do not use, which could answer some of the urban questions — although I appreciate that if we ploughed the sidewalks, it would be easier to walk on them — is the schools. It has been a heck of a job to get into schools. I do not know what their worry is.
Senator Mercer: No vandals with seniors.
Mr. Paterson: There are mall walking programs, and there are other places that we could arrange to do it, if we could get permission. It is a good idea.
Senator Mercer: Ms. Gallagher, I want to make a recommendation. I share your concern about rural and remote communities. I also sit on the Standing Senate Committee on Agriculture and Forestry, and we have just finished a major study on rural poverty. It has not been published yet but will be soon. You will note in that study that we covered some of those concerns, so you might want to follow up with that.
Mr. Scott, I am interested in the Seniors College of Prince Edward Island. Who are the faculty and who pays them?
Mr. Scott: We pay our own way. The college is founded on a fair bit of volunteerism, and the board are all volunteers. We cannot even get a travel claim. We try to keep our costs as low as possible. We do have a coordinator whom we pay approximately $10 an hour assuming he will work maybe 10 hours a week. He works pretty much full time. He is very dedicated but would get about $5,000 a year in recognition of that. He is retired.
We pay our facilitators $300 for a course. A course runs for eight weeks; because of the short duration, it is not a lengthy commitment. We get three semesters between September and June, and we have slight breaks between them at Christmas.
With respect to the cost, $120 covers the costs for the year, and it is self-supporting. We do pay a small amount, approximately $10 per person, for the courses that are on campus, and then we access church facilities. Churches have been wonderful hosts to us. In some cases, they put on the coffee and provide everything, and there might be a cup out for coins and any money goes towards church causes. Churches have been great hosts to us, but it is done inexpensively.
Senator Mercer: I come from the volunteer sector and spent my entire career working with volunteers across the country. I spent a good deal of time working for the YMCA where no one was turned away due to inability to pay.
What happens if someone comes to the college program who does not have the ability to pay?
Mr. Scott: We deal with them on an individual basis. Some of them are unique cases, for example individuals facing a cancer diagnosis who have no idea whether they will be able to continue for more than one or two classes. We give them an honorary or free membership for the year and recognize their circumstances. We have offered free memberships to people who have indicated that they are in a situation of poverty. We do not have a special program set up, but we deal with each case as it comes along.
Senator Mercer: If you need help I am sure the local Y could help you. They have a standard they use.
Ms. MacKenzie, I want to make sure that your last recommendation, that perhaps there should be a subcommittee studying the state and future of volunteerism in Canada, does not get lost in the process.
I hate to do this to my staff, who are listening, but I would love to volunteer to be on that committee. You are absolutely right with your numbers at the beginning of your report about the decline in the number of volunteers and more volunteer hours being done by fewer people. We are reaching a critical point here. Some of our most important community organizations will grind to a halt. If we factor out religious groups, it becomes even more critical. Religious and faith-based groups are different, but if you look at community-based groups, the numbers are critical.
Do we have examples across the country of organizations that have had to stop because they did not have enough volunteers?
Ms. MacKenzie: Almost any organization you asked would say that it is facing volunteer-recruitment challenges. Off the top of my head I cannot think of any organization that does not exist anymore solely because of volunteer shortages.
I certainly know that organizations face challenges around planning for the future and being able to position themselves strategically within the community. They experience severe shortages in individuals wanting to join boards of directors. It is often boards that provide the strategic planning for an organization. Organizations are very much at risk, in terms of being able to position themselves for the future, because of volunteer shortages.
Managers of volunteers are critical positions in organizations, yet frequently they are not recognized for their importance in being able to look at the volunteer program, at the shifts, changes and trends in volunteerism and say what they need to do. Perhaps they can no longer support an initiative or program in their organization that has an expectation that someone will serve tea at an oncology clinic every Wednesday afternoon for the next 35 years.
Programs that are more attached to the historical or traditional forms of volunteering are very much at risk over the next 10 to 15 years. That cohort — we call them the über-volunteers — is currently donating a significant number of volunteer hours, more than double what the next highest cohort is contributing. When they move out of their volunteering careers and become more substantial consumers of volunteer services that will be dramatic. While I cannot think of any off the top of my head right now, those examples will be plentiful within the next 10 years if we do not significantly change volunteerism.
Senator Mercer: I believe Ms. Gallagher said something about having volunteerism on the curriculum in high school or elementary school. I think this is excellent. There was a test program here in the national capital region a number of years ago. I know it met with a great deal of success, and the young people were very excited because volunteering is a rewarding experience. Those who volunteer know that. It seems to me there is an opportunity for all of us to attack the problem of not having enough volunteers to help aging people. We were talking a bit about fitness. There is an opportunity to utilize young people and to expose them to older Canadians and vice versa.
Ms. MacKenzie: That is critical. We need to be thinking about volunteerism with young age groups and ensuring that their first experience as volunteers is good. Then volunteering becomes part of their DNA and they will be contributors to volunteering, or at least attached to volunteering, throughout their whole lives. I think mechanisms to encourage volunteering within school programs are critical. It is important that those programs be considered well and managed well.
Ontario is an example of how it has not been managed very well. A program to say that every single high school student needs 40 hours to graduate is not volunteering: that is coercive in nature. Many young people would look at that as being potentially punitive in nature. That is not to say there is no potential there. I think if you attach civic participation and citizen engagement to the curriculum in schools there is an opportunity to have young people view their volunteer work, the community service they are required to do, as volunteer work and something that is of benefit to them and to their communities and that attaches them to something bigger than themselves.
Often, volunteering is the first time young people really view the world outside of their own microcosm. It is the shift from being all about me to being about something bigger than me, about our communities and an opportunity to see that we as individuals can have a role in shaping and making a difference in our communities. If that is messaged in the right way and those opportunities are managed in the right way, that can have a profound impact on young people.
The Chair: To build on what you have said, Ms. Gallagher, it is wonderful to have young people volunteer, but they will have a good experience only if they volunteer in something that interests them.
One problem I have identified quickly, as a former teacher, is that there is usually not someone on staff seeking out volunteer opportunities to match with particular children. For example, if you match boy who is a strong athlete with a young children's soccer team, that will probably be a wonderful activity for him. However, if you ask someone like me who is an unmitigated klutz to work with a soccer team, I do not know how to do it.
Ms. MacKenzie: Again, the allergy.
The Chair: Yes. I would be useless.
I wanted to build on that with respect to a comment you made about flexibility. It seems to me that you will be able to engage seniors in volunteer work only if you build in that flexibility. If seniors have to make a year-long commitment to a volunteer position but they still want to have the flexibility of going to the cottage in the summer or down south for a couple of weeks in the winter, they do not want the guilt trip associated with not being able to show up in the summer of for those two weeks in January.
Ms. MacKenzie: You are absolutely correct. Again, that speaks to the need for a solid understanding about volunteerism. Managers of volunteers need to be resourced and brought into organizations with the skill sets necessary to manage volunteers. It is important that recognition also happen at the senior leadership level in an organization — at the level of the board, the executive director or the president. The importance of thinking strategically about volunteerism and volunteers beyond those who sit around your board or those raising funds for your organization needs to be considered. That is about strengthening recognition and understanding of volunteers as not being free but requiring support, nurturing and leadership. That is about investing in infrastructure.
Volunteer Canada is an example, of course, as are volunteer centres at the community level. Those who think about volunteering on a day-in-day-out basis will have an opportunity to address those research questions, take that learning and establish programs to support thinking around volunteerism that is responsive to the changing needs and desires of volunteers.
Senator Keon: I would like to ask a question following on something Mr. Miller mentioned, but I would like the entire panel to respond even though the question might be slightly peripheral to your own presentations.
You mentioned inclusive design. There was something in today's paper about a phenomenon in Ottawa of people with empty nests moving from the suburbs into downtown condos. Apparently, the condos cannot be built fast enough, regardless of price. These people are a bit ahead of the aging curve, but it seems this is a tremendous opportunity to accommodate the thinking that virtually all of you mentioned in your presentations, something to improve the environment for these people when they do become seniors.
We have a great country, but it is not simple as far as relationships go among federal, provincial and territorial governments and the large municipalities. I think Mr. Scott mentioned that it takes a village to raise a literate person. It is repeatedly stated that it takes a village to raise a child, and we have lost all our villages. There is no reason we cannot have villages within the large cities; we can have communities, but no one quite knows how to accomplish that.
It does not matter who responds first, but I would appreciate it if you would all pitch in. How can we influence the very top, the federal government? There is the cabinet, but every minister is preoccupied with what he or she must accomplish. Ministers have busy lives. There are cabinet committees in various countries of the world that dedicate themselves to integration of one sector or another. To provide the kind of communities that our seniors need is way beyond the mandate of any individual minister or individual government, not to mention the NGOs.
How do you think our report could be useful in assisting these well-intentioned people to fundamentally get their act together, integrate things and provide an ideal milieu for seniors?
Mr. Miller: Those are interesting comments. As you said, we live in a complex environment. One sliver is to deal with the issue of standards. The federal government, for example through the Department of Public Works and Government Services, Canada Mortgage and Housing Corporation or many of its other departments, could adopt the principles of inclusive design or universal design, which first began in trying to overcome issues related to disabled people. That thinking then imbues the rest of the thinking about the design of programs.
One anecdote that may resonate here is that when Mike Harcourt was mayor of Vancouver, he was challenged by someone in a wheelchair to leave City Hall and meet this gentleman at a White Spot café not far from City Hall. Mr. Harcourt tried to meet this man but he could not because the café was inaccessible. Therefore, he did something that started the ball rolling. He required his public works department to change the standards so that there would be curb cuts. The engineering community then picked it up, and the next thing you knew, it was happening throughout North America. Today, a sidewalk is not built without curb cuts.
Those little standards started dominos falling in order to overcome barriers. You can apply that in non-physical ways as well. For example, when the government designs a program and is considering reliance on websites, that gets into the area of literacy and people's ability to have access. The government must broaden its thinking and realize that it cannot put all of its resources into web-based information; it has to think about people who do not have access.
There is a gerontologist in Birmingham, England, who says that if you design for the young, you exclude the old; if you design for the old, you include everyone. It is a general thinking of inclusiveness. We cannot afford to deal with just a senior population. We have to think of everyone.
With respect to the issue of housing, the British government is setting off on an ambitious target to require the private sector housing providers to start building in things that are now extras found only in seniors' projects. Therefore, they are not building for only one stage in the life cycle. When they start to scale it up to the community level you will see dramatic results, which could be very positive.
Ms. Gallagher: I have done some work with Dr. Nancy Edwards at the University of Ottawa, and we have looked at a variety of factors that influence falls and injuries among the elderly. It is one window into the world of design. It is unique, but it can highlight many of the issues.
One issue we uncovered was the current design of stairs: the standards do not require that there is a minimum rise of seven inches and a maximum depth of 11 inches. That 7/11 concept has been shown to be highly effective in providing a much safer stair for older people that many fewer people will fall on.
However, when we tried to introduce this concept as a standard in Ontario when the building code was open for review, which is only once every five years, there was huge opposition from the building industry. In fact, they defeated it, because they said that in order to meet that standard they would have to increase the incline of the stairs and cut off three or four feet of floor space on the next floor up, because the stairs would go up at a different angle. They argued that it would cost too much if in every building they built they had to lop off three to four feet of space for every single floor. They said that they could not possibly do that and remain profitable.
Therefore, it was squelched, which goes to show there are competing interests here. It is not just politicians. Where there is good evidence and good initiatives taking place, there are other issues and other people's interests that have to be taken into account. It is a values thing and an economic issue. We have to find a way of making these things work so that these kinds of barriers do not cut us off at the pass in terms of having good design.
A group of 41 communities in Northern British Columbia have come together and decided to adopt the concept of visitability, which is an interesting concept. It dictates that you must be able to have anyone with any disability visit your home for a period of three to four hours with no problem. That means there should be a washroom on the ground level, the front entranceway cannot have stairs and the doors should be wide enough to accommodate a wheelchair. That is it — three concepts. Therefore, all new housing in those 41 communities will be required to have visitability standards right at the beginning of construction in order that anyone with any disability could comfortable go to any home for a visit.
That is a simple notion, but it could be powerful in beginning at least to address the idea that your home should be a home that someone else could visit or live in. It is a good concept — one that is viable and will not break the bank — as a starting point for thinking about these things.
I, too, like the idea of universal design. If we could convince the country to go that route, like Japan has, it would be phenomenal, but it might be a big step to start. Maybe we need to start with something manageable and doable from day one and move to a more comprehensive model as we show the success of something like that.
Mr. Scott: We are at an opportune time when green living and green housing is all of a sudden on the radar screen. We cannot afford to keep burning furnace oil and natural gas as though it will last forever. We have to find ways to make housing much more economical and efficient. At a time when we have economic factors and energy factors driving us to look at green housing, it is time to look at a whole lot of other factors.
I would like to mention two examples I have come across over the years that I think are worth examining. Whether we look at best practices on a national level, we need to be doing something in this area.
The first example was a British design competition about 15 years ago that came up with a novel idea when mortgage rates were climbing. Affordability for young people is still a major issue in the U.K. and really everywhere. The concept was modelled around essentially a duplex structure; one part of the unit was larger and one was smaller. The financing was done on a variable system, which would help the young couple — I know it is a stereotypical model — in their early years, maybe having some earning capacity. They start off contributing more towards the mortgage. They live in the small unit and rent the big unit out. They then want to start family and do not want to be required to have two incomes for a period. It allows their mortgage rate to drop for a period of time as their family grows. Then they move into the larger unit and rent out the smaller unit. Finally, they move back into the smaller unit, which again is all accessible, and they stay in the same neighbourhood. They have the equity growth of owning property, and they have the income from the larger unit for retirement. They have already paid off their mortgage by that point and so have an income for retirement.
The mortgage that they pay through the entire period varies with their needs, and through the entire period it is structured so that it will be paid off on time, but it is totally variable. The two units are adapted so that they can work at various stages. It was a very innovative idea that came out of a design competition for designers and architects.
The other model I think highly of is in Wolfville, Nova Scotia. It is a development called Tideways. It grew out of a group of seniors. Wolfville is an interesting community that has brought some innovations to the country. Smoking with children in the car was not on the national radar before a little town in Nova Scotia passed a bylaw that says you cannot smoke in a car if there is a child in the car. Every province then lined up and said that makes sense; we should recognize that children should not be exposed to second-hand smoke.
In Wolfville, a group got together in the 1970s and realized that they needed to do something about housing for themselves. It was driven from the standpoint of not wanting a model like condos in which people paid a lot of money and had a lot of equity tied up. It was based on a model of co-operative and non-profit housing. It has worked well. They bought a piece of land and hired an architect, and they have built three buildings on that piece of land. It is a beautiful setting with grounds. If you want to have a vegetable garden, you can. If you want to enjoy the grounds kept by others, you can. They are connected to the transit system. In most small communities, it is challenging to live without a vehicle, but this particular arrangement allows people to live without a vehicle and still access all the other services in their community.
The project was funded with CMHC funding, and that was the key that unlocked the door for them, that allowed them to build a building without any capital. They paid off one building and then started another, and now, 30 years later, they have three buildings. They are an example of what we can do.
The high end of the market, the condos, will always look after the high end. It is the rest of Canadians we have to be concerned about, those who for whatever reason are not in a position to be able to afford a condo. We need a variety of options. Mr. Miller mentioned Lifetime Homes, Lifetime Neighbourhoods. If we can have green planning around lifetime options, we can build communities that work.
Mr. Paterson: I have one comment about facilities. When Wintario dollars flowed — I know this because I am an old-time hockey player — out in Woodstock and in Lambeth the community facility that is an ice rink also got a swimming pool, a seniors' centre and a library. Those are fabulous facilities, and the seniors are using them, using the exercise classes and equipment in the seniors' centre while the grandchildren are playing Timbits ice hockey.
My second comment is in response to Senator Keon's question about what he could say to cabinet members to influence them. We will have a lot of old people. Already we have had a crisis in the last month of older adults with chronic diseases taking up hospital beds. Other patients were out in the hall because there were no places in long-term care. The research shows a 50 per cent reduction in the risk of going into long-term care in those who are fit, just moderately fit. Average fitness gives a 50 per cent reduction in going into long-term care. That is because many people go into long-term care not because of cognitive dysfunction but rather because they cannot walk anymore.
We have three lady senators here. At age 74, you will live for another 15 years. Men are smart: they die. Of those 15 years, you can expect six in long-term care on average. When an older woman reaches age 85 she cannot get out of a chair without pushing up on the arm rests. She cannot stand up; the legs are not strong enough. If you see the birthday parties of people over 100 on TV, very seldom are they standing up or blowing out the candles. We lose function and end up in long-term care. We can avoid that with greater physical activity. That is what I would tell cabinet.
Mr. Witcher: I have a quick comment or perhaps a practical solution. The essence of the question is what can the federal government do. I was thinking about that and wondering about federal grants that could be made available to municipalities that would be interested in making their communities more age-friendly. With the right approach, that might catch on.
Ms. Gallagher: I might respond to that. The Union of British Columbia Municipalities, through a grant from the provincial government, has made a grant of $5,000 available to any community that wants to assess itself as age- friendly to hold an initial meeting, a consultation. I and two colleagues have been funded by the government for three years as an implementation team for age-friendly communities. We will work with the community to assess their needs. An additional $35,000 grant is available to any community that identifies a project, such as putting in more public seating, making more public washrooms available for older people or other small projects that they can undertake to begin the process of making their communities more age-friendly.
However, that is not enough. People in the government with whom I spoke said that it would be successful if the federal government could support this initiative and make it visible across the country. It probably would be done through transfer funds rather than a direct program. However, the money would have to be earmarked for that purpose to recognize its valuable contribution.
A great deal can be done at the municipal level. That is where local involvement is to be found on local issues. The issues are different across the country. One size does not fit all. It is impossible to establish standards that fit every single municipality in terms of what is needed to make it age-friendly. Solutions have to be locally designed.
We also have to find a way to ensure that seniors' voices will be heard in the long run. These cannot be one-off, one- shot things. Having active local advisory councils comprised of seniors is important in the long run to make progress sustainable. It allows their voice to be heard over time regarding the design and in decision making about where municipal dollars are directed and what public works are needed to make the community friendlier for them.
We need more than a one-off public campaign that is popular this year because the World Health Organization introduced it. We need to think about structural changes in society that guarantee that local engineers and communities making decisions about walks, parkways, sidewalk design and so on consult with seniors and other users of those facilities to ensure that they address their long-term needs.
Senator Cools: I thank the witnesses for their very sensitive and humane presentations. This is such important subject matter and of such enormity that I should also thank Senator Carstairs and Senator Keon for taking us into this important debate on this vital aspect of human activity — growing old.
I want to put on record a request that I had made at the last meeting where we stumbled upon what you are calling inclusive universal design. At the last committee meeting, I raised the point that designers of homes and builders are responding to the needs unfolding before us, such as many couples wanting their master bedroom on the first floor. This seems to be a new trend I have been hearing. In addition, many families are now opting for the inclusion of a granny suite that can be used by their children in the interim.
I asked the witnesses whether they had any data or evidence that society was responding naturally to these pressing needs coming upon us. Essentially, they said they had no evidence, but they had no doubt it was happening. However, they could not measure it yet. I raised the possibility that we should bring witnesses before us who could help us with this subject matter. I would like to put that back on the table.
Planners, urban designers and developers may want to address this. It seems eminently sensible and natural. I frequently see houses for sale now advertising a granny suite. The house I live in has the master bedroom on the ground floor. It seems eminently sensible for people my age and older.
I wanted to piggyback on Senator Keon's questions. It would be insightful for us to look at planning and urban design. The witnesses have done us a great service today. If we were to bring forward recommendations around the concepts of home design, we might discover that a lot is already in motion and only needs some parliamentary support or political support.
Nowadays, many of these facilities are simply there. We do not even think about them. There are wheelchair access and ramps. I have not been to a house for years that does not have a washroom on the first floor. However, it was revolutionary some years ago.
The Chair: We had CMHC before us and they gave us some information. Much of the building in this country is done with CMHC mortgages. They establish certain design criteria that can make a significant difference.
Senator Cools: I was thinking of builders such as Tamarack Homes and some of these individuals. A characteristic of many developers is that they are often looking to the future. Their business is making money and they often can lead the market.
Mr. Paterson, you are in the world of movement. You say kinesiology.
Mr. Paterson: Yes.
Senator Cools: The other word is movement — movement of the body. Motion is a wonderful science. The opposite of motion, after all, is inertia — stillness or the lack of life. I want to thank you for putting that language on the record today.
You are all saying that as we go into the future, we must approach life with considerably more sensitivity to human needs and humans' lack of understanding of their own needs. It is difficult for a 20-year-old to envisage that he or she will be 60 years old or even 40 years old. You are raising a deep and profound question: How do we assist and support human beings to look into the future, to perceive, identify and discern their own interests in only a few years? It is a profound issue.
I believe people will age as they have lived. People like me who grow up with a lot of exercise and being an early riser will continue to get exercise and be early risers. The real question is how this committee can move forward the notion that we must move in a direction of human beings understanding their own nature and essence where aging is a natural part of life. If you were in the business of athletics, you would know that an athlete is old at age 25. From a public policy point of view, how can we introduce this concept into public policy-making, and how can we perhaps influence the relevant ministries and so on to take this approach?
A few days ago, a dear and great physician said to me, "The only way I can answer your question, senator, is to say that I was too soon old and too late smart." There is a philosophical, spiritual dynamic and dimension to this matter, which we have been called upon to challenge.
Mr. Paterson: It is never too late to start. Although I continue to play hockey because I did those things when I was young, at the centre we have been pretty effective in getting non-athletes into our programs.
The first program we ever ran 20 years ago was called Retirement Research. It was just for men and it was at the year of retirement. They were randomly put into a control group or an exercise group. From talking to those men, I know that many of them did not want to be in the exercise group. They envisaged army training. They said, "I hope I do not end up in that exercise group with the military counts." Once they got into the program, they loved it. After the program was done, the control group wanted to be in the exercise program. The research study was over, but 19 years later, the group is still going on. The university allows them to use the track and the hockey facility for their exercise. There were people who did not want to exercise. Now, 20 years later, the club is still going and has nothing to do with the researchers any more.
If our methods are strong, once older people realize that it is not too late to start and once they are in, they will love it. Part of it is the social experience, as other people have talked about. We cannot kick those people out of the centre. We wanted to bring people in, teach them how to become involved, to be exercise fanatics, and then send them off into the community somewhere. However, they will have none of that. They keep coming back to the centre because that is where their social group is. They go to Blue Jays baseball games and have wine-and-cheese gatherings. It is remarkable to see people who used to do only one thing a day now doing many things. If they had a wine and cheese at night, they would rest up all day. Now, they come to the exercise class in the morning, go to the afternoon Blue Jays game and return to London in time for the wine and cheese at night. It is invigorating.
Senator Cools: One the challenges before us is to endeavour to interest public policy in the direction of supporting active motion as a part of life.
For example, a member of Parliament was greatly devoted to the notion of amateur sports. According to him, supporting amateur sports would be the healthiest thing for the country. He said that amateur sports attract a lot of volunteers, and in addition to supporting the amateur athletes, the volunteers themselves will become physically active. According to him, the greatest investment that government could ever make in the health of the community would be to give more support to amateur sports.
Would something like that feature in your thinking?
Mr. Paterson: I had not thought of it. It sounds look a good idea. Another promotion I remember is Roland Michener. I am old enough to remember reading in the newspaper about his running. If we can get Senator Carstairs in the newspaper going for a run, we would pretty well have it beat.
Senator Cools: Perhaps a bike ride would be better.
Ms. Gallagher: Different target approaches for different audiences are called for. There will not be one size for all.
One example is a program we developed called SAIL, Seniors Active in Independent Living, for which I nominated my colleague, Dr. Vicky Scott, for a CIHR Knowledge Translation Award this year and she was the recipient. Through this program, we worked with home support workers, the people who go in and give bed baths to people receiving home care services. The home support workers would do an assessment of people's fall risk and, through that, introduce some interventions. One intervention is a simple in-home exercise program the home support worker would do for 10 minutes with the care recipient in the home.
These home support workers are an army of the most underutilized health care workers in our country. They are given little to no training for their jobs, they are paid at the very bottom of the pay scale, and they are given no respect for picking up early signs of dementia, frailty and other issues. With a little bit of extra training, they could do a great deal.
With this program, for example, they were able to identify fall risk to the points where, in our first study, we had a 44 per cent reduction of falls among people who had received the services of these trained workers of this program. The workers do 10 minutes of physical exercise on each visit. It took 10 minutes extra time. None of the home support agencies had any economic concerns about the extra time at all. They said it proved to be well worth it. It gave the workers the knowledge, training and information they needed to work with one the highest risk and most difficult populations that we have. People loved the program.
A number of the clients were able to move beyond that and then get involved in an exercise group in their building, for example, if such a thing existed in the building where they lived. Some decided that they wanted to go out to a neighbourhood recreation centre and take part in a fitness program. However, the start was getting the home support worker to spend 10 minutes each visit doing basic flexibility, strength training and mobility exercises. It proved to be very successful.
Every health authority in B.C. is now adopting this program and introducing it to their home support workers. However, it is also a great idea that nationally could make a difference for that population of people.
You need different approaches for different groups. A massive public education campaign that says "Go to the gym" will not work for frail, elderly people living at home getting home care service. Also, the approach I mentioned will not work for people who are very active and involved in the community. Therefore, the approaches need to be tailor-made to address the actual conditions of the people whom you are trying to target.
Senator Cools: It would be nice if we could assist to develop an attitude within the school system that mobility and movement are desirable and should be actively supported across the board.
Ms. Gallagher: I agree. There are two good times to starts exercising: one is when you are young and the other is today.
Senator Cools: That is very good. You remind me of the gentleman who once said, "What is the problem? Giving up smoking is easy. I do it every day."
Is there anything else on that concept of motion as becoming a part of daily living?
Mr. Scott: You really touched on some key concepts of how we think about motion and how we think about preparing so that we do not become frail elderly before our time. In chatting before, Mr. Witcher mentioned that the research population he was studying was a population with a very active rural lifestyle in which exercise was what you got from doing your day's work; by the time you sat down at the end of the day, you had achieved your activity from natural exercise.
We are becoming a more sedentary society. I think all of us spend more time in front of a computer than we need to. I know I do. It is part of our life and it allows us to communicate and do a number of things around information, but it is a sedentary lifestyle. We need to be more active.
What stood out in your report that we have not touched on much today was the benefit of mental health of exercise. We should not diminish that. The science is there. Many studies have shown that an hour of activity is as good as medication for some patients, particularly for depression. Definitely, there is a tie between active living and healthy living. The social component we have touched on. Again, we have seen the natural exercise thing, where you encounter people in the run of a day, particularly if you live in a household in which there are a number of generations and many people.
Social isolation is a reality of our environment. Active living and active learning do in fact promote more social contact and they do reduce isolation. Your report mentions that very well, and it is important.
How do we ensure that exercise does not become a detriment? We have all heard of people who have worn out joints by over-exercising and overtraining.
Senator Cools: That is me.
Mr. Scott: There is a whole field now of low impact activities, such as aquasize, exercising in a pool, that type of thing. Much has been done that shows that we can in fact prevent the frail elderly stage. We can enhance things that reduce isolation. Those do have beneficial effects, both physically and mentally.
Senator Cools: Madam Chair, perhaps we could strengthen the relevant areas.
The Chair: We will get into a discussion of that later.
Senator Chaput: My question is very brief and it relates to questions asked in regard to volunteers. Ms. MacKenzie, if I heard right, you said that a majority of seniors who volunteer are from the middle income, and that lower-income seniors do not seem to volunteer as much. Has this been studied?
Ms. MacKenzie: I did not say that with particular reference to the senior cohort, but generally speaking the makeup of volunteers is from higher incomes and they are university educated.
Senator Chaput: That is for volunteers but not necessarily seniors?
Ms. MacKenzie: Yes.
Senator Chaput: You would not say that that is the case among seniors?
Ms. MacKenzie: That is right.
Senator Chaput: When you talked about volunteers and their needs, you did mention the importance of having coordinators.
Ms. MacKenzie: Yes.
Senator Chaput: Could you speak more about that?
Ms. MacKenzie: A manager of volunteers is a particularly important member of a staff team in any organization or a responsibility in any organization that does not have staff. Volunteers need to be well managed. Volunteer positions need to be crafted in such a way that they make a meaningful contribution to the mission of an organization. Attachment to a particular cause was mentioned earlier, and that is particularly true for why people come to volunteering. It is important that volunteers have an opportunity to contribute their skills in a way that directly contributes to the cause. To design volunteer positions that are connected to the cause of an organization is important.
Increasingly, people are busy. They want to know that when they donate their time to an organization, their time will be well utilized. They need to be recognized. It is National Volunteer Week. It is a critical time to thank volunteers for their contribution. Someone within an organization who understands the psychosocial elements of why people volunteer and what they want to get out of volunteering is critically important, and it is often a skill set that is undervalued in an organization, in the same way as general infrastructure and support for volunteerism in organizations generally are. It is a critical component in any organization.
Senator Chaput: How do you see it being put into place, if it is a critical component? Do you have ideas about the best way do it?
Ms. MacKenzie: There is a recognized profession of volunteer management. Again, continuing to recognize the importance of that leadership with respect to volunteerism as a construct or component of an organization is critical. Understanding that while volunteering is intrinsic to who we are, in many cases it requires thinking and fostering. One main reason people do not contribute their time as volunteers is that no one has ever asked them. People need to have the awareness that volunteering is critically important and requires knowledge, analysis, research, understanding, tools and resources, to maximize volunteer recruitment but also maximize the contribution that volunteers are able to make.
Senator Chaput: That leads me to a program that was put in place a few years back. I do not remember the name of it, but it had to do with training volunteers. One of our Senate committees met with seniors in Prince Edward Island. It was not in regard to seniors' issues, but there were seniors present. They were talking about the component of training volunteers. Three senior ladies were saying, "We do not need to come to this session and be told what it is to be volunteering. We want to do something." We have heard that in other places also. They want to do something that means something to them, but then that has to be coordinated so that it answers their needs.
Ms. MacKenzie: That is true. Increasingly, though, volunteer jobs do require certain skills. Volunteer agencies are out looking for people with specific skill sets to complete specific tasks or they recruit young people who want to gain specific skills through volunteer contributions. In that case, training is critically important.
Senator Chaput: Are they doing that for seniors also?
Ms. MacKenzie: Absolutely. This baby boomer generation is behind some of the early changes in volunteer involvement. We are increasingly seeing that people of that age group are more stretched for time: they want flexibility in the time in which they contribute their volunteer hours; they want to know they are coming in for a defined period of time; they want to do something very task-specific; and they want maximum impact for the contribution they make.
Senator Mercer: I want to follow up on the discussion of volunteers and how we develop them. One way to do that is what we do at the end of the process, how we thank them, how we recognize them, how we make sure their skills are utilized. People bring different skill sets to volunteer jobs, and we need to learn how to maximize those. You are absolutely right, Ms. MacKenzie, that we need to recognize the people who manage those aspects as well, because the stewardship of volunteers is an important part of the process.
One of the underlying points, as you know, is that volunteering has to be fun. It has to be enjoyable. You probably do not measure the number of volunteers involved in the political process. Every political party will tell you, if they are being honest, that there is a decline in the number of people volunteering in political parties. There is a greater reliance on professional people to do the politics. There are fewer people knocking on your door and more telemarketers calling you on the phone.
This issue involves the recognition and measurement of the time and the value. Volunteer Canada can really help us with that. I know that in my years with the Y, we always very carefully measured our volunteers' time and tried to put a value to it. It demonstrated to the professionals running the organization what it would mean to us if we had to replace that volunteer time with paid staff.
If we had to replace the volunteers by paid staff in every province or every community in the country, we would not get anything done. We would not be able to afford it; volunteers make this place work.
Ms. MacKenzie: That is absolutely true. One statistic that is front and centre in my mind, because I have done about four interviews this morning, is that volunteers are involved in the hundreds of thousands in our health charities and health care system. That volunteer work is valued at over $20 billion, so you are absolutely correct: that cannot be replaced.
You speak of the democratic process. In any given federal election, there are approximately 40,000 individuals who are involved in supporting the candidates of their choice and in the democratic process in its broadest sense. That is critically important; and the need to have those kinds of measurements is critical. It speaks to funders, to government and to the value of our programs.
There is another layer too, though, that is critically important. I love to quote Albert Einstein when he said that not everything that counts can be counted and not everything that can be counted counts. I think if you are talking about the value of volunteers and ensuring a democratic process in this country, there is no dollar value attached to that. The difference between how an election plays out in Canada and how an election plays out in Zimbabwe, for instance, is about volunteers in many ways, and you cannot put a dollar value to that.
If you think about hospice work, what is the value in dollars and cents of holding the hand of a dying child? I think that is critically important; and I think Volunteer Canada is well positioned to play a leadership role in that. However, it is critically important, as well, to recognize that it is not just about the quantitative value — it is all about the qualitative value.
Those stories around what volunteerism means to our social fabric and to our quality and way of life should be valued to the same degree that the economic value of volunteering is. I would end with that.
Ms. Gallagher: We tend to think of either paid work or volunteer work as though they are two separate things entirely. Maybe there are some areas of blurring or overlap, and perhaps there would be some opportunities for attracting lower-income people or people who had economic hardships into the volunteer sector by offering them small stipends for some of the work they do. Maybe we could try some pilot projects and see. It is not either just paid work or volunteer work.
I know you have unions to deal with and the mentality of us thinking for years and years that volunteering is always free. However, maybe there is some room there. We do not have any problem using a sliding scale for assigning value to services that older people receive, so why could we not have some kind of a sliding scale for thinking about services that they offer to others?
I do not want to open a whole can of worms here, but maybe we need new thinking for the future if we want to engage people in this area of work that have not been engaged.
The Chair: I want to thank you all because you have all made a special contribution today. I will have to physically rethink my own allergy, given that I would like to be one of those who stay out of a long-term personal care home.
In the messaging of inclusiveness and in terms of volunteerism, the message we heard is that you can be more cautious and more careful while still being active. I do not think those are opposite ends of the scale. I remember, with my father-in-law, suggesting that we really did have to take the throw rugs off the floor because he was not lifting his feet high enough. However, that did not mean I did not want him lifting his feet at all. The whole concept of urban design and the inclusive universal design was extremely important.
Your comment, Mr. Witcher, with respect to self-imposed aging is a very important comment that we need to hear. Obviously, as an educator, promoting education is extremely important to me, and to keep people learning their whole life is very important.
I do not think there is a politician here at the table who does not understand the value of volunteerism. As my campaign chair said, what other job do you get by having 500 to 1,000 people out helping you get it? That is what politics is all about. Having been elected on a number of occasions, I do understand the value of volunteerism.
Thank you all very much. It has been an extremely enjoyable panel and I hope you will see many of your ideas in our final report.
The committee continued in camera.