Proceedings of the Special Senate Committee on Aging
Issue 12 - Evidence, June 4, 2008 - Morning meeting
VANCOUVER, British Columbia, Wednesday, June 4, 2008
The Special Senate Committee on Aging met this day at 9 a.m. to examine and report upon the implications of an aging society in Canada.
Senator Sharon Carstairs (Chair) in the chair.
[English]
The Chair: Honourable senators, members of the public, welcome to this meeting of the Special Senate Committee on Aging. The committee is examining the implications of an aging society in Canada. The range of complex issues relating to aging have preoccupied governments for many years. They have become more prominent, however, as the number of seniors grows as a result of both a longer life expectancy and the aging of the baby boom generation. The public programs and services offered to seniors are essential to their well-being, and it is our duty as governments that we ensure there are no gaps in meeting their needs.
We are here in Vancouver today to hear from interested parties on the impacts of an aging society, and more specifically to hear their views on our second interim report, which was tabled in the Senate on March 11. The interim report focuses on active aging; older workers, retirement and income security; healthy aging; supports to aging in place of choice; and the regional distribution of health costs associated with aging.
This is the sixth stop of our cross-country Canada travels, and we look forward to today's testimony to help us to develop a comprehensive set of recommendations for our final report, which we hope we can table on September 30.
Beginning with our first panel this morning, we have the pleasure to have before us, on behalf of the 411 Seniors Centre Society, Ms. Margaret Coates, and we thank you for hosting us here today; from Providence Health Care's Centre for Healthy Aging is Dr. Sharon Koehn; and from Simon Fraser University's Gerontology Research Centre is Ms. Eunju Hwang.
Thank you all for taking the time to meet with us today. Let us begin with remarks from panelists, and then I know that my colleagues will have some questions.
Margaret Coates, Executive Director, 411 Seniors Centre Society: Welcome to the 411 Seniors Centre. We are pleased to be able to host everybody here, despite the fact that we are in the midst of a renovation; I kept assuring your staff people that we would be able to host you nevertheless.
I have been the executive director of the centre for the last 14 years or so. The 411 Seniors Centre has been around since 1972, housed in this building from that time. The building itself is nearly 100 years old and will reach its centennial year in 2010, the same time as the Olympics — two reasons to celebrate if you support the Olympics. We were given the building with all its potential and challenges, and one way we have been trying to deal with the challenge of the old building is to do some renovations which you probably noticed as you came in. I apologize for any noise or disruption.
Over the years, as executive director I have mostly been caught up in the day-to-day management of running a seniors centre, but I have also tried to look outward to seniors in my community. According to 411, I am actually a senior, since I am 61 and over the age of 55, which is our starting age for seniors. I have seen many changes in the demographic of seniors, and I have also seen, I am glad to say, a concomitant change in attitude towards seniors and their issues and concerns.
I read your report with interest and enthusiasm. I was asked to look at gaps in the issues that you raise, and I was really pleased to see that every time I said in my mind, "What about,'' there it was. I think that you listened to folks very hard. I noticed in the appendix that the people who presented were from a wide range of groups, including grassroots folks like people from the 411, and I was very pleased to see that.
We were happy to see a concentration on issues of income, because 411 itself supports seniors who are generally low income or on a fixed income; some may be land rich, but cash poor. Issues around that are important to us, especially changes around Canada Pension Plan, CPP.
In the past, you heard a presentation from a group that we have been supporting here at 411 funded through the Status of Women Canada, WE*ACT, Women Elders in Action. They did a lot of work around women and pensions, especially low-income women, and now they are focusing on middle-income women and the issues they will face as they age. I do not need to say more about that, because it is already in your report, and I am pleased to see that. However, when I asked the staff coordinator of the project to come up with other issues, she certainly had a long list of them, but I will not share those today.
I was happy to see the aging in place issues. We were glad to see that home support and home care are quite important pieces on your agenda.
I thought the section on options for the future was fairly comprehensive.
There were some gaps. For example, a small gap is the dentistry piece. There was a section on dentistry, but it talked about dentistry for two groups and did not look at dentistry as an option for low-income seniors and even middle- income seniors, who again may be land rich but cash poor. A lot of data supports the notion that good dental hygiene is important as a preventative measure for heart attacks and heart conditions, and I am taking it seriously, flossing three times a day, which I never used to do. I would like to see that topic opened up a bit.
I did not see advocacy in the report, and when I say "advocacy'' I am talking about seniors helping seniors, seniors looking after the needs of seniors through a variety of ways. Over the years, we have developed information and referral programs that help seniors at the grassroots achieve their entitlements, like helping to fill in forms and a number of things, even finding housing. We found that seniors need help, and we need to go beyond that by providing seniors as peer advocacy counsellors, to actually get seniors in touch with their entitlements and also to go beyond simply giving them information. They might, for instance, help a senior in a long-term care situation who has no family supports or friends to deal with long-term care issues.
As you mentioned in your report, there are a number of issues around regulation, and for a senior to be in long-term care and also deal with changing regulations or confusing regulations is difficult. We think that supporting seniors' advocates is a cost-effective and beneficial way to help seniors themselves. At 411 we have always believed in seniors helping seniors, and I believe many of my colleagues in the field support that notion.
I was happy to see that there was some discussion about home care. At a recent think tank on home care put on by the Ministry of Community Services here in Vancouver, B.C., we looked at some data that offered compelling evidence that home care is the cost-beneficial alternative to long-term care. I did not read all of the pieces that went with that, but I found the one from Denmark remarkable: in one small region they did away with all of the long-term care and put in home support, and the savings to government were quite astounding.
I would like to plug support to seniors organizations themselves. It is my contention and I think my colleagues' who work in seniors centres that this is a natural place for us to provide public education programs, which you talk about in your report fairly often; these could be the public education support programs on nutrition options, supportive housing information, use of prescription drugs. We have been hearing in the news lately about how we could cut the cost of emergency visits by having proper prescription drug information and that kind of thing. Seniors' places are also a place to support lifelong learning and volunteer programs. I was pleased to note in your report that you support volunteer programs. I think all seniors would support all of the ways that you could support volunteer programs through tax incentives and other measures. We are a natural place also for volunteerism. Our centre has 250 volunteers; we could not run 411 without that kind of support.
Over the years, core funding for seniors' programs has not been that available. We are just starting to notice a little bit of a shift, and I think that it would be very helpful to the government to support seniors' centres with more core funding in order to provide those kinds of options. I think the benefits in the end would be great for everybody, including less impact on government, less impact on beleaguered families and less impact on caregivers.
Finally, I think that in the report you should enlarge the concept of diversity to include supports to the lesbian, gay, transsexual community. I did not notice anything specific to that group, nor did I notice much emphasis on seniors aging with a disability, and a lot of work needs to be done, particularly with the latter. The former, the LGTB community, are starting to develop their own policies and best practices, and I think it is time that we tried to support them. I believe they have unique needs for housing, home support, long-term care and so on, so I would like to see you enlarge that. The 411 Seniors Centre has tried to expand its own long-term vision around expanding our base for diversity, so I would like to give a pump to that again as well.
The Chair: Thank you, and thank you for having us here.
Dr. Sharon Koehn, Research Associate, Centre for Healthy Aging, Providence Health Care: Good morning, and thank you for having me as well.
Forgive me, I do not usually read from a script, but I am very conscious of your time, and I am interested in engaging in questions with you. Congratulations to the committee for drafting a comprehensive interim report.
I have submitted a written brief to the committee in which I have included information on several topics concerning ethnocultural results relevant to your conclusions and recommendations. Given the time limitations, however, I would like to restrict my comments today to one of those topics, the special case of seniors who arrive in Canada as family class immigrants, and I suspect you will be hearing perhaps more on this topic from Charan Gill this afternoon.
My comments are based primarily on my 18 years of research experience with Punjabi immigrant seniors in B.C. as well as on literature on the topic, and much of what I will say today is extracted from a chapter that I co-authored with Charmaine Spencer, who is also coming this afternoon, and Dr. Hwang.
Reuniting immigrant families has been considered an important goal in Canadian policy. Between 2002 and 2006, 88 per cent of senior immigrants to B.C. arrived under the family class. Nationally, seniors comprised almost half of all family class immigrants to Canada in 2006. When an elderly relative is sponsored under the family class immigration category, the sponsor makes an unconditional undertaking of support for a period of 10 years to the Department of Citizenship and Immigration. This is a longer period than for any other family class group. During the initial dependency period, seniors may not be eligible for public pension such as the allowance, Old Age Security, or the Guaranteed Income Supplement, nor for social services, subsidized housing or housing subsidies, or other local benefits such as reduced fare bus passes.
In addition, many older immigrants remain economically disadvantaged even after sponsorship ends. This is because of the way the residency criterion for Old Age Security is calculated, although as Penny Priddy, the member of Parliament for Surrey North, pointed out, immigrants from South Asia, for example, are actually at a greater disadvantage in this regard than immigrants from countries such as Australia, New Zealand and the United Kingdom, with whom Canada has reciprocal agreements on social security. This can have a beneficial effect on residency credits, which determine the eventual amount of Old Age Security the person will receive. Ms. Priddy has put forward the argument that that is discriminatory against immigrants from other countries such as South Asia.
Sponsored parents are valuable additions to Canadian society. As a representative of MOSAIC, a large settlement agency in Vancouver, has pointed out in the testimony in another of these hearings:
In every society, the family forms the nucleus for social, physical, psychological and spiritual well-being. A healthy family is both a barometer of and a mechanism to promote the well-being of society.
In practical terms, sponsored parents often provide valuable child care services for young grandchildren. Many also contribute to the family's income through their work on farms and elsewhere. Finally, it is important to recognize the parents' valuable investment in raising productive sons and daughters who work here and thus benefit Canadian society.
Family-power imbalances are affected by sponsorship policies and practices. There are two components of the legal obligation to provide for all of the sponsored seniors' needs that significantly increases their susceptibility to abuse or neglect. The first is the length of time of the sponsorship obligation during which the financial status of the sponsor may decline through no fault of his or her own, and the health status of either the sponsor or the person who is sponsored may also decline. The result may be extreme financial hardship and sometimes emotional or physical abuse or passive or active neglect, and it is often the failure of the senior's health or the sponsor's health that results in sponsorship breakdown.
The second component of the sponsorship-related policies that may increase the potential of abuse is through the intensification of the dependency and resultant power imbalance between family members that the policy has invoked. Dependent on their sponsor in every respect, and now I am referring specifically to my own research, South Asian sponsored seniors seldom have accurate information about their rights. They are often fearful that the sponsorship can be withdrawn, and they do not know where to turn for help if problems do occur. Any public mention of abuse or neglect occurring in the family brings shame on all of the family members, which is something that the elders will prefer to avoid at any cost.
Access to health care is also affected by the seniors' extreme dependency on their sponsors for translation of written information and for rides and interpreting at medical appointments. The policy also renders sponsored seniors ineligible for many services, such as rehabilitation and long-term care, during their 10-year dependency period.
Declaration of sponsorship breakdown is considered an infraction of the sponsor's legal undertaking. Unless sponsored seniors have income or other relatives willing to support them, they must apply for social assistance, but we have found that this process varies considerably across Canada, and success is by no means guaranteed. The social assistance paid to a sponsored immigrant is classified as an overpayment, which empowers government to place a lien on the debtor's, meaning the sponsor's, house and endows it with special priority rights of debt repayment, including garnishment. Charan Gill has reported that this is breaking down sponsors' families.
In light of these arguments, and there are others, I would like to recommend that the period of time that elderly parents are dependent on their sponsors should be reduced to five years or less, as is the case already for spousal sponsors.
The Chair: Thank you very much.
Eunju Hwang, B.C. Real Estate Foundation Fellow, Simon Fraser University's Gerontology Research Centre, as an individual: Thank you for holding this hearing on this very important aging issue. The Gerontology Research Centre is in Harbour Centre in downtown Vancouver. I have held the position of B.C. Real Estate Foundation Post-doctoral Fellow in Environmental Gerontology for a year and a half. Previous to this, I was a supervisor of a congregate housing services program at St. Paul Public Housing Agency in Minnesota in the United States. I have worked with ethnic minorities over seven years, and I speak both as a housing researcher and as a service and affordable housing provider who has worked directly with and for the older residents of especially government-subsidized housing, here in B.C. as well as in the U.S.
In the interim report, I am pleased to see your consideration of diversity and discussion on different housing issues, at the household level as well as at the neighbourhood level. It is important to create age-friendly communities that are inclusive of all ages and different ethnic groups.
I would like to mention the importance of public education. You emphasize this over and over in your interim report, and I totally agree with that. The reality is that for many ethnic groups, the notion of seniors' housing probably does not exist in the countries they came from. This is especially the case for recent immigrants, like the Korean and Vietnamese, or the immigrants who came from the Middle Eastern and Asian countries. For these special populations, educating elders about seniors' housing and different programs is very important.
I would like to emphasize the importance of training staff who work with ethnic minority groups. I have worked with several neighbourhood organizations here, and in many cases the staff do not know what different kinds of seniors' housing exist. For the staff and for many ethnic groups, there are just two types of housing: affordable housing, like government-subsidized housing, or something expensive. That is what they know regarding seniors' housing. That is the reality. It was very clear in the interim report why we need to work with diverse ethnic groups, but probably it is time to move on to how we will work with different ethnic groups.
Briefly, that is my perspective on your interim report.
The Chair: Thank you. I know that we will have a very engaged discussion.
Ms. Coates, I would like to begin with the problem you identified of land rich but cash poor. Clearly that is a huge problem here in Vancouver, and it is increasingly becoming a bigger problem in other cities across the country. This is certainly the situation in Toronto and in Vancouver, and Calgary is quickly finding itself in the same boat.
How do we address this? We want to encourage seniors to age in place, yet so much of their wealth is in the family home, and from the literature I have read, reverse mortgages are not quite what they appear to be. Do you have any ideas on how to deal with this?
Ms. Coates: I was interested to see that you did touch on reverse mortgages. We have had people saying the same thing, that reverse mortgages were not going to work for them for a number of reasons. I think the major reason they put forward is that people still believe in an inheritance for their children. The seniors I work with are concerned about that, especially because to buy a house in Vancouver even for a middle-income person is extremely expensive now, so inheritances are one way to do that.
I know a number of seniors here who are actually what I guess you would call land rich. I do not think my president would think I am talking out of turn, but she has been talking to me about the difficulties for her future, and downsizing is one of the major ways she has been coping. She downsizes and downsizes and downsizes in order to be able to continue to age in place without being a burden on her family, because she is an incredibly fiercely independent person and because she does not want to be dependent. Downsizing is one way to do it, although in Vancouver it is extremely difficult even to do that now.
I think it is worth researching this topic. There is a lot of anecdotal information out there, but I do not think there has been much research, and I think that would be useful.
Ms. Hwang: My background is more on the planning side, so from my perspective, probably a flexible joining, a mixed land-use policy would be helpful. Of course, it helps if there are any direct income subsidies. I like the notion of a new urbanism village type of development, with planning regulations, non-profit organizations, commercial shops all together, that kind of thing. Then if there are residential units all together, probably in one building or in a very close area, that helps. That is one thing on my mind.
Dr. Koehn: This is interesting from the point of view of, for example, Punjabi immigrant seniors, especially people who come sponsored. The literature and the statistics say that sponsored seniors are least likely to be in below-level housing and are most likely to own their own home, of all types of immigrant seniors. This is an interesting phenomenon, because it does not mean that those seniors have any power whatsoever. They often come from countries where they are not allowed to take money out of the country, like India. That has loosened up a little in recent years, but still they come with very little. Of course, they are not eligible for any kind of income or any kind of assistance unless they work, and they work on farms and so on out of desperation.
They do live with their families, that is true, and their families do own their own homes. However those sponsored seniors do not have any power within their families; they do not have any income to do what they want, and they certainly do not want to ask for anything because they already feel terribly indebted because they have been sponsored. That is just a word of caution about statistics that make things look better than they are.
That said, I was at the Canadian Sociological Association yesterday, and Professor Monica Boyd and her student presented findings that for many immigrant communities, co-residence with the family does in fact protect seniors from being as poor as they would be if they were not residing with their families, and this is especially true of Filipino and South Asian seniors. There is a protective element to that.
To come back to the issue of sponsorship, which people have been talking to me about for years and years and which on account of that has become very central to me, if senior immigrants had even a small amount of income so that they did not have to destroy their health by working on farms, it would make a huge difference to the dependency that they face and to their ability to participate more fully in society.
The Chair: Dr. Koehn, while you are on that topic, I have read a certain amount, and I am sure my colleagues have as well, but can you just tell us what it is like for some of these seniors who were working on farms in the Lower Mainland?
Dr. Koehn: I think the best person to speak to that is Charan Gill, who has worked with farm workers for many years. I have heard from many people about the conditions. First of all, when they arrive, the seniors have not done that kind of work where they come from. We assume that because they are from rural areas they have worked on farms, but you can immigrate to Canada only if you have a fairly high position in your own country to have the resources to be able to emigrate. The seniors who come here were supervisors on their own farms, not workers. This is a huge status demotion for them.
Nevertheless, they put their shoulder to the wheel because they do not want to ask, and they go to the farms. There is some sense of community there, and they emphasize that for their own mental health. However, it is extremely gruelling work. The hours are long. They work in the rain, in muddy fields, under very poor conditions. They are shoved into the back of trucks and trucked out there in the cold. Usually they come out of it with greatly exacerbated arthritis and joint problems and all kinds of problems.
Last year I found out about an interesting phenomenon: seniors in Prince George do not have employment opportunities available to them there, so they come down to the Lower Mainland for the strawberry picking season and the blueberry picking season and so on, and they stay in huts provided by the farmers. Somebody at a symposium I put on last year had toured those huts, and she said the conditions were absolutely atrocious. All the people had to sit on were upturned buckets, and there were many seniors in these huts. The rain was dripping inside, and the huts were completely unsanitary.
Charan Gill fought for inspection teams that now go around to try to ensure that health standards and safety standards are upheld, but it is very hard to get them onto the farms. We would like to do research in that area. My hope is that we could get in with those teams, but it is very hard work to do in light of the protectionist attitude around the conditions.
The Chair: You said that we should take the dependency period for sponsored immigrants from 10 years to 5 years. Can sponsored immigrants not apply for Canadian citizenship after 5 years?
Dr. Koehn: Regardless of that, it is still a 10-year dependency period. There is no getting around the dependency, as I understand.
The Chair: That is very interesting. In other words, they are Canadian citizens or are potentially Canadian citizens because they have fulfilled the residency requirement, but they are dependent Canadians.
Dr. Koehn: Yes, the dependency period is 10 years.
The Chair: I did not realize that.
Dr. Koehn: That is a long time, especially for a senior. They can arrive in their sixties or late sixties and be just fine, but by their late seventies, as we know, health can go downhill, especially if they have been working on farms.
Senator Cordy: If they do become Canadian citizens and are still dependent, they are not entitled to that?
Dr. Koehn: I have not heard of anybody getting around it that way; let me put it that way. You could ask Charmaine Spencer this afternoon as well. We wrote the paper together. I provided the ethnographic date, as did Dr. Hwang. Ms. Spencer is our legal expert.
Senator Mercer: How many people are we talking about? Do you have an estimate?
Dr. Koehn: In terms of sponsored seniors, last night I took out my numbers. I can tell you where exactly to find that number. That is the best I can do, because I do not have a head for retaining numbers. In the Multiculturalism and Immigration Branch report and in the Department of Citizenship and Immigration report that I reference, citations 2 and 3 are where the information about the numbers exists.
Senator Mercer: Thank you. I will go over it.
Dr. Koehn: In British Columbia, which is what I know best, for the last 30 years, the Indo-Canadian population or seniors from India had the highest proportion of sponsored seniors, which is why I focus on that population. However, we are seeing now that seniors from China are also becoming very significant as sponsored immigrants, and that is quite a different group than the seniors we have previously seen coming from Hong Kong and Taiwan; these are not Cantonese speakers but Mandarin speakers. I have only a glimpse into what the situation is like for them, but my understanding is that often the younger family members come over because they see possibilities here for employment, and they are fairly highly educated. They bring the seniors over to be with the family, and then they may have young children, but they find that they are underemployed here, that they cannot find work commensurate with their experience. They go back to China for work and they send money, leaving the young children in the care of the grandparents here. The grandparents speak Mandarin only and do not have ready access to resources. They are quite isolated.
This is a brand new phenomenon. It has not been researched. I have this information from people at S.U.C.C.E.S.S., who are starting to see this phenomenon more and more. I would really like to look into this.
Ms. Hwang: This afternoon, Alice Choi will probably talk more about that. I will make one quick comment about income subsidies and using the existing programs. Many immigrant seniors fall into a marginal income level where they could claim they need some subsidy, but many people who are in the marginal group do not claim that. Education is very important for that group especially.
Senator Mercer: Ms. Coates, you talked about the lesbian, gay, bisexual and transgendered population, of which Vancouver has a large population. We have heard before that some people are going back in the closet as they age and find themselves without a partner, because they are worried as they move into "normal seniors' situations'' about all of the prejudices they might face. Many years ago they fought for and achieved equality, and they are worried about all of those prejudices coming back. Have you observed that? That is the first part of my question.
The second part of my question is whether the British Columbia community, particularly Vancouver, has come up with any solutions. Are there any facilities specifically targeted at this group of seniors?
Ms. Coates: To answer your first question, yes, we have noticed that. We hear that because 411 has consciously tried to provide a place for seniors from the LGTB community to come, be welcome and voice their issues and concerns. We have a fair number of venues for them to do that. Recently QuIRK-E, the Queer Imaging & Riting Kollective for Elders, came and talked about the issues, particularly this time about transgendered issues.
We did not really do research and analysis. Most of what we do here is listen to seniors tell us their stories, and in their stories we hear quite a bit that whereas laws are starting to change and seniors are starting to be able to marry and so on, they are still finding that at their end of life they are being subjected to the same prejudices, biases and discrimination they had to combat all their lives.
Even getting seniors to come to 411, which is considered to be a mainstream organization, is difficult. We built carefully the programs and services for that group so that they can feel comfortable here, but it has been very hard work and an uphill climb, and we have actually lost part of our own membership base because of the prejudices and biases. However, this is part of our community here.
A real estate guy in Vancouver is trying to put together a long-term care facility for seniors in the community at The Centre, which is not the centre of the universe but the LGTB centre. They have been looking at providing long-term care facilities, assisted housing and those kinds of things, particularly for that group of people, while at the same time noting that, again, we could be ghettoizing, and that is a real issue I have heard come up. At the same time we are trying to bring seniors into a mainstream organization to deal with that, they are trying to build their own centres.
Senator Mercer: You also mentioned that in the past you have worked with Status of Women of Canada, and we have complained about the cuts to Status of Women. Have the cuts to Status of Women Canada affected your work in the centre?
Ms. Coates: I think so. The Status of Women project that we had for the last four years, which supported WE*ACT, Women Elders in Action, was more about working in the community to eliminate discrimination. Now Status of Women is asking us, in order to be funded again, to have a very time-limited and focused project, which eliminates to some extent the possibilities for doing the more grassroots elimination of discrimination. Fortunately, the United Way of the Lower Mainland took up the challenge and they are now supporting that piece, so we have complimentary pieces. However, in my mind, combatting the discrimination is probably the biggest issue, although the piece we are doing right now is quite valuable, which is looking at women elders' voices and what they can offer from their own experience.
Senator Mercer: Dr. Koehn, I am interested in the discussion of abuse among sponsored seniors. I know that it varies from community to community, but to identify abuse must be extremely difficult because it is not abuse that you see, being mainly in the home; it could be financial abuse or it could be physical abuse. In your research, how are you identifying abuse? How are you digging that information out?
Dr. Koehn: You are right, it is extremely hard to identify. The work I do is qualitative and based on relationships with people over many years; I speak primarily about the work I have done with the Punjabi community because I have the longest relationship with that community. I have been going back to some of the same people for 18 years, and while they are quite reserved in different contexts, in a room with me they will just let rip at this point, which is great. It is a matter of building trust over a long period of time.
We talked about this in the conference yesterday. A limitation of using telephone interviewing or any kind of quantitative tool is that often people report positively. They will tell you what you want to hear, particularly in this community. However, over time we have heard stories from families and stories from seniors, always about people they know, never about them.
Senator Mercer: Of course; a friend of mine.
Dr. Koehn: Yes, but I see this as valid information. We see a lot of neglect; people are left really without any kind of support or income. It is a tricky situation there though, because some family members have said that they have tried to leave money around the house for the seniors to spend, but they are too proud and will not take it. There is a fine line there.
Relationships play a big role, particularly but not only with South Asians. For example, in India, you have a daughter-in-law coming to the household at a fairly young age, and the mother-in-law is fairly dominant. It is in her best interests to be dominant because she knows that as that daughter-in-law gets older and more confident in the household and has children, especially sons, the mother-in-law will lose her power in the family, and more and more the daughter-in-law will have the ability to go out of the house and do many of the things that the mother-in-law does. This is especially true now, because in India young women are also working more.
When an elderly woman comes here, often her son will have preceded her here to marry a young woman who was born and raised here, or at least raised here. That woman wants to go to university and to have a career like the rest of us. There is nothing terrible about her, but she is acculturated differently and will not accept that subordinate position, and so the potential for conflict is enormous. Sometimes you see an accommodation of that, but it is very difficult.
Conflict arises. For instance, the younger woman does not want to abide by dietary restrictions and will cook meat in pans that the elder then does not want to eat from, and the elder will starve herself and end up in emergency or dizzy because she is not eating because she cannot eat from any of these pans. It can be worse than that, too. Elders can be left in a basement with a bowl of rice; people can be told, and I have heard this many times, "Do not go in the fridge; do not cook your food here, because it is stinky. We do not want that kind of food.'' There is a lot of emotional abuse.
In terms of financial abuse, I have heard an elderly couple will work for a family firm. Their work and income is not reported, so when they are finally past their 10-year sponsorship period, they have not accumulated any CPP. It has been written off in a different way in the company, so it may not necessarily be direct. Or the family firm may take the pension too when the elders get it, because the elders are still indebted to the family.
However, a lot of abuse is more subtle than that, and it results from dependency on the sponsor and the fact that everybody is working really long hours. The elderly lack freedom, probably because they just want a little bit of income. They do not need a lot, just need a little to give them that freedom.
Senator Mercer: Your comments about senior immigrants working on the farms are convincing, because we do talk about the need for people to remain active as well, and how important this is for seniors. We come into a bit of a conflict where we are not talking about people who are working, but we are talking about people who are working too hard.
Dr. Koehn: Well, it is the conditions and the regulations, I think.
Senator Mercer: Are we talking about issues around standards?
Dr. Koehn: Yes, and I think also alternatives, because these people do want to work. They want to work very much. It makes them feel good about themselves, definitely.
When I was naive and doing my master's degree a long time ago, I had what I thought then was a great idea for these immigrant women. Many people said they had a problem with home care because home care providers did not speak the language and were not doing the sort of work they needed, like helping around the house and providing medical care; you have heard all of that. I thought, would it not be great if some of the more able-bodied seniors could be home support providers for other seniors with whom they have something in common; they could chat, and you would solve two problems at once. I went back to these women and suggested that. They responded, "I had servants in India; I will not be somebody else's servant.'' It is a tricky situation. It is a very sensitive issue, so it needs culturally sensitive solutions.
Senator Mercer: I think all of our programs need to be culturally sensitive, particularly when we are talking about immigrants, because it varies from community to community.
Dr. Hwang, you talked about people from the Korean and Vietnamese communities having no history of seniors' housing, and that is true of many other South Asian communities as well, I think. There are some examples of immigrant communities providing seniors' housing on their own; there are a couple of Chinese seniors' residences in Toronto that are specifically designed and built around the community. When they first started it was difficult because, again, there was no culture of this happening. Is that happening in British Columbia, particularly with the dominant immigrant communities?
Ms. Hwang: There is a mainly Chinese service group, S.U.C.C.E.S.S., that developed at least two assisted-living homes for the Chinese community. They have to be very creative to come up with their ideas. BC Housing and the local health authority partner with this non-profit organization, and I believe there is a big donor putting in a few million dollars to start with. It was quite challenging for them to start.
Mr. Gill will talk about this probably in the afternoon, but the Southeast Asian community developed seniors' housing, too. Although they encourage their seniors in their own communities to apply for this seniors' housing, there is none there. This so-called ethnic seniors' housing is not for their own ethnic group but is open to any seniors to apply for. The main ideas behind developing this ethnic seniors' housing are having their own ethnic food provided at the housing and also having services provided by bilingual staff. Those are the two key things they provide.
I do not have much experience in Canada, but in the U.S. I worked with several neighbourhood organizations to develop seniors' housing. Just to talk to these community leaders or non-profit organizations took about two years, saying we can do it. We developed several programs successfully in stages and then kept going to develop seniors' housing for them.
I also sit as the advisory board member for the Korean seniors. They want to build something, but the thing is that first they have to be registered as a non-profit organization, but they have no idea what that means.
Senator Mercer: That process itself is cumbersome and takes a lot longer than people think.
Ms. Hwang: Yes, it is quite challenging.
Senator Mercer: I have been there, done that.
Ms. Hwang: You are very brave, sir.
Dr. Koehn: In Surrey, there is a wonderful facility that Charan Gill did fundraising for and organized in collaboration with the health authority, but the fundraising that he had to do, honestly, I am surprised it did not finish him off; and it took a long time. He is very ambitious. He is also looking at the feasibility of constructing some long- term care facilities for Indo-Canadians out in Abbotsford, because there is a very large population there. They have independent living and assisted living. They spent a lot of time going out to the community and trying to make people understand why it is beneficial for them to be there. However, I have spoken to the medical director there, and his feeling about the residents in assisted living, which is still not full, is that many of them may in fact belong more in complex care, that their needs are actually higher. They have come to them in crisis. They do not have complex care yet, so they would like to turn part of the facility over to a higher level of care, because there are stringent rules around assisted living and the degree of disability that you can have.
I should say, to their credit, the diversity apparent within the PICS facility, the Progressive Intercultural Community Services Society, is unbelievable. They speak many different languages, not just a couple, and they have preserved and satisfied many different diets, both in terms of religious preferences but also around diabetes and dialysis and so on.
Ms. Hwang: I have two quick comments related to that issue. A number of organizations are interested in developing ethnic seniors' housing. They have to get government subsidies one way or the other, probably a little or a whole lot, but they have to develop seniors' housing, and also they have to talk to communities. When they talk to communities about these recent immigrant groups or any immigrant groups, they are so afraid of the word "government.'' For example, the Vietnamese community's experience with government is not so positive. Whoever develops ethnic seniors' housing has to educate the whole community that they will be fine; that is the kind of thing they have to work with.
The other thing I would like to mention is that for the existing seniors' housing development here, they are also experiencing aging in place with an increasing number of older residents who come from different countries. They are having more residents staying longer in their existing housing, so they are trying to develop more programs for them, but with all these residents staying there for long time, it is changing for them. We need to educate the current residents who have been there for a long time. There are often conflicts between different groups.
Senator Mercer: We have talked about providing services and have travelled across the country, and we have talked about the difficulty of providing services in minority languages, whether English or French, in certain parts of the country. We have talked also about the availability of doctors and nurses who speak French or English, depending on the community. Is there a shortage of professionals, doctors and nurses, who speak the languages of the people we are talking about in immigrant communities in British Columbia?
Dr. Koehn: I did a barriers to access for a minority seniors' project a couple of years ago, and we interviewed Punjabi, Vietnamese and Hispanic seniors. This did not come up as much for Punjabi seniors, because there are now a number of Punjabi-speaking physicians available. For the Vietnamese, yes, it was a big problem, and the same for the Hispanic seniors. The group of Vietnamese I spoke to were fairly highly educated, and many of them had worked in health professions. Even though their English is very limited, they sort of made do with English-speaking physicians, but they found it very difficult, particularly when they went to specialists, and they often had to rely on sign language. As I mentioned, often they have to take family members with them, or friends who speak more English. However, that is very tricky, because there is a lot of stigma around certain kinds of conditions and they would not want family members or even a friend knowing about it. There is a paucity of interpreting services.
We have also found that many professionals, even when they have access to interpreting services, do not order them. They can order an interpreter through provincial language services, but they do not, because of the time that it takes. They would rather make do and get an unsatisfactory or incomplete response from the patient than take the time, because they are not paid for that time. That is how the fee for services is structured much of time.
Repeatedly in interviews, service providers for seniors said there are five Spanish-speaking physicians in the Greater Vancouver Area, which is a very large area, and these seniors travel from Vancouver way out to Richmond and places like that to go to a Spanish-speaking physician because they do not have enough English to go to an English-speaking doctor. The seniors do not necessarily like that doctor, and it was a long way to go, but at least they could speak their own language. When seniors have to travel long distances to go to the doctor, they are less likely to make going a priority.
Senator Mercer: Ms. Coates, do you get people coming to the centre looking for help finding a doctor who speaks their language or for someone help them convey their problems to medical people?
Ms. Coates: Yes, we do. That was why I was pumping for the seniors' advocate programs. Seniors will often not ask a family member, nor will they ask an official translator, but they will work with other seniors, not only for doctors' appointments but for all kinds of areas. We do that, but we are still working with a limited number.
Senator Cordy: This is a fascinating discussion. I would like to go back to the issue of seniors' housing. Ms. Hwang, you mentioned that many immigrants come from countries where there is no such thing as seniors' housing. What challenges does that present if you are looking at a family where perhaps a senior has need of seniors' housing in addition to some of the challenges that Senator Mercer asked you about? I am wondering about that particular aspect. The two of you talked about going into the community and educating seniors. That is a major obstacle for people who are 75 or 80 years old and that is not part of their culture. How do you work around that?
Ms. Hwang: There are two ways we can work. The first is to offer comfort, and then let them know about their options and where they can apply for them. Offering comfort means reminding them that government will not do them any harm and at the same time informing them continuously about next steps and reminding them about what will happen next and what will happen in a year. Since there are a lot of steps working with ethnic senior citizens who are not familiar with these different procedures or options of seniors' housing, there is someone who can reach out at the organization level first.
A big challenge for the staff working with the ethnic seniors' groups is that the policy changes all the time. There was a continuum of care, and there is a complex of care, and there is assisted living. Very often when we work with ethnic minority groups, the focus of services is on the settlement issues or on language and not too much on housing. There is probably a need to educate staff about the application procedures for government-subsidized housing or nursing homes. That is basically what they know about.
Senator Cordy: Canada has French and English as the official languages, so our documentation comes out in French and English. Are these documents translated into appropriate languages for the Asian people?
Ms. Hwang: Thank you for bringing that up. The answer is no, for the most part. S.U.C.C.E.S.S. does have their programs translated into Chinese, but other than that, they are trying to put multiple languages out there, which is lacking, especially for the housing options.
Senator Cordy: It is my understanding that in the Vancouver area English is the first language, and then Mandarin is the next language. Is that correct?
Ms. Hwang: Yes.
Senator Cordy: A lot of people then would need access to materials in other languages.
I would like to go back to the issue Dr. Koehn raised of the intensification of dependency and the challenges that can create. Seniors who are a little bit dependent on their families, but not a whole lot dependent, still feel a sense of age limitations. They feel more dependent than they did certainly when they were 30 or 35 years old. That dependency brings with it certain challenges. For instance, if you are suffering from abuse, be it financial or neglect or any number of areas, you are not as inclined to tell somebody about it because you are dependent. You wonder what will happen: will you be sent back to your country of origin or put out of the home?
How do you deal with that intensification of dependency? I think it would be a real challenge to get people to seek help when they needed it.
Dr. Koehn: Referring back as well to the question that you asked Dr. Hwang, about getting people into assisted living or any kind of supportive housing, a big issue for many communities is shame. It is extremely shaming for the family, for everybody, if it looks like the family cannot take care of their own elder. Therefore, as well as translating material, you have to help communities get over that notion. Charan Gill has had to overcome that, and he is in a good position to do it because he is a respected community member, and you need the right kind of person to do it. It has to come from many directions, including from the media. The community as a whole has get over the notion that to have somebody provide care for seniors is a shameful thing.
The family needs to feel involved as well. They need to be able to demonstrate to the community that even though the senior is perhaps in a different kind of living facility and not residing with the family, the family is still very much involved in the senior's care. That is definitely what PICS is like. It is very welcoming of family members, and there are no limitations about who can be there. It is very children-friendly too.
This goes back to the issue of whether or not you can get past that shame piece when it comes to detecting abuse and relying on broader community resources. It is a really hard thing to do, and that is why people do not reveal abuse. However, if there is that overall education piece about connecting and about localizing and using different resources, I think the shift will eventually happen, albeit slowly. It is just that different pieces of the community have accelerated, but not in sync with others.
On the other hand, I think it is important not to essentialize these communities and say they are not accessing home care, for example, because they are worried that this will shame the family. I have heard that from service providers. On the other hand, I have heard from people in need of those services that they perceive that because they are doing that good work for their family looking after family members they are discriminated against by the system, which will not provide them with the home care they need because the system sees the family as being in place. That is their perception, whether or not it is true, and a lot does go into a home care assessment. So, there are those two sides to the story.
Coming back to the second question that you just asked about intensification, I think that we also play a role. We may unwittingly play a role in intensifying that dependency if, as is often the case, as health authorities and health service providers we assume that the family takes care of their own. Certainly the community will tell you that, because it is a source of pride, but it is not always possible.
Another factor, like the housing services, is that many services are available here. We are greatly specialized here. We have many services such as nurses who specialize in incontinence support. When a senior is being discharged from the hospital, the case manager will tell the family, "Let us know if you need any help.'' The family will go back home and take over the care of the senior. The case manager assumes that the family will talk to him or her, but then the senior turns up in hospital, and the family members are in a terrible state because they have been completely run down by the intensity of the senior's physical dependency on them — the frailty, the dementia combined with incontinence. The case manager says to them, "But I said, please, come to me if you need any help.'' The family respond, "Well, what could you possibly do? Only we could do that sort of work for our father.''
There are two things going on there at once. It is that the family is supposed to take care, so there is tremendous guilt if they do not; also, they are not fully aware of the types of services that are available to them, and that needs to be clearly spelled out. Instead of saying, "Let me know if you have any trouble,'' the case manager needs to say, "Here are some of the things you may run into. Here are some of the ways we can address those issues. I will phone you every week to start, and then maybe every other week, and we will talk about these issues.'' It needs to be very clear.
Senator Cordy: You spoke about language, training staff to work, the need for bilingual or trilingual staff members, but it is more than just language. I think, and you touched on it a number of times, it is the cultural aspect of it; just the idea of "call me if you need me'' would be an example.
Dr. Koehn: Yes.
Senator Cordy: Are medical schools and nursing schools looking at cultural training in addition to language training?
Dr. Koehn: Yes. There is a move towards cultural competence; it is a slow thing. I had a symposium last year on cultural seniors' issues, particularly around access to care. Naina Patel, who has done some amazing work in England for seniors in advocacy and research, said that seniors were saying that in order to feel comfortable they needed quality care, and there was not enough emphasis on quality.
I do not want to underemphasize the language piece; the language piece has to be there. However, some service providers are not able to speak the client's language but have a capacity to respond in a very sensitive way, and there are others who do speak the same language as the client who nonetheless respond in a very insensitive way. A big thing in the Punjabi community, for instance, is that many service providers are from urban environments whereas many service recipients are from rural environments. There is discrimination and a difference in perspective between them, and that often comes across as insensitivity.
There have to be both pieces of it. I doubt that students get enough training in medical schools. There is a lot of literature about this, and one of the most significant pieces in that literature is the importance of sensitizing people to the fact that we all have cultural biases, and the things that we accept as the norm are not necessarily any sort of norm other than in our own cultural biases. That is a big piece that has to be built into our thinking.
Senator Cordy: I would have thought your idea of seniors helping seniors was a good idea.
Ms. Coates, how is your seniors' centre funded?
Ms. Coates: We are funded in a number of ways. We have project funding from the Status of Women and the United Way. We also have some core funding through the municipal government and the United Way, and gaming, good old gaming. We have funding through our own resources, fundraising, and some internal fundraising. It has always been a struggle.
Senator Cordy: How much of your staff time is spent fundraising?
Ms. Coates: Probably about a half of my time, and at least a quarter of another staff person's time, which is too bad, because I would rather be more caught up in these interesting discussions.
Senator Cordy: That is a shame. I was on a board for homeless youth in Halifax, and once I got on the board I discovered that most of the time was spent fundraising, which is very frustrating. You are right that one likes to get into other areas.
Ms. Coates: I have noticed over the years, since I first started fundraising for seniors, that the mythology around what seniors are has changed. There was not a lot of knowledge about seniors. Most people seemed to think that seniors were people out on golf courses who did not need any supports. Now again, they are not a hard sell anymore. I came from an organization for which the client group was children, and that was so much easier. I have noticed a change, and I am very happy to see that we have got an interest in seniors, particularly as I am going there myself.
Senator Cordy: If we are lucky, we become seniors.
I would like to get back to the issue of support for the lesbian, gay, transgendered community. You talked about currently looking at separate housing, which does not sit well with me, because I think of that as ghettoizing. Is that what the community wants at this point in time, and will that change? I can understand that those who are seniors now may not be accepting, but with the changes made in Canadian legislation, will that attitude change?
Ms. Coates: I think ghettoization is a danger, but the LGTB community is looking hard at that, and while they may feel they need to create specific centres, they are also looking at training long-term care folks and people who work in those kinds of centres about the issues. I think they are approaching it from a broad perspective.
Senator Cordy: You have 250 volunteers at the centre. Are many of them seniors?
Ms. Coates: We try to have at least 75 per cent seniors.
Senator Cordy: Are there financial challenges for seniors becoming volunteers? We have heard of challenges in some areas, like the price of gas for example.
Ms. Coates: Fortunately for us at 411, we are on a good bus route, and if seniors have the free bus pass, then it works well for them. We also provide lunch every day for anybody who volunteers here, which is very helpful.
Senator Cordy: That would be very helpful. You mentioned a free bus pass. Is that municipal?
Ms. Coates: It is government.
Senator Cordy: Provincial government?
Ms. Coates: Provincial government, yes.
Senator Cordy: Is that working well? We have heard that free buses could be a possible federal initiative.
Ms. Coates: I think the provincial government would like that. When the current government got in two terms ago, they did talk about cancelling the bus pass, and I think there were a lot of interesting comments at that time.
Senator Mercer: They stopped that right away.
Senator Cordy: Does is make a difference?
Ms. Coates: It makes a difference, yes. When we had a bus strike in Vancouver it was quite hard on many seniors. It was also hard for people to get to our centre.
Senator Cordy: We have heard that the current legislation where people get a tax rebate if they buy a bus pass only works if they are making enough income to pay taxes. A free bus pass would be good for everybody, whether or not they are making enough income to pay tax.
Ms. Coates: Right. Do not forget, lots of seniors pay taxes.
Senator Cordy: We know that, but we are trying to cover everybody.
The Chair: I want to concentrate a little bit on immigration policy generally. I was quite shocked that somebody could become a Canadian citizen and still be a dependent, so I will want to know more about that.
In terms of language training, I remember a number of years ago when the federal government was very active in English as a second language, ESL, and I also remember when the government got out of it all together as a program initiative. Something Dr. Koehn said struck me personally because I had a daughter teaching in Brampton, Ontario. Eighty-five per cent of her children were Punjabi, and the language at home was Punjabi; the language going to school, at recess, at lunchtime and after school was Punjabi. Her difficulty was ensuring that those children learned to speak English, but that opened a much broader issue: are the parents learning to speak English? Are their grandparents, who are now their caregivers — that is what struck me — given the opportunity to speak English? Are we doing enough or are we woefully inadequate in terms of allowing new Canadians to learn either of our official languages?
Dr. Koehn: Some settlement agencies offer ESL classes to seniors, but they are very few. They need to offer babysitting services at the same time, because typically those seniors are grandparents and have nowhere else to take the children. However, as you are aware, the majority of ESL classes are targeted at getting people into the workforce. Often, in the families I know and have worked with, some of the parents will speak English at least enough to participate in the workforce, but at home the language of choice is always the first language, Punjabi, Hindi, whatever is spoken inside the home. The grandparents operate in that sphere. The grandparents are the primary caregivers.
There is an interesting initiative now in Surrey by a group called DIVERSEcity, funded by the United Way of the Lower Mainland. Their focus is young children. They are noticing, as you mentioned, that the children are coming to school not only without English language skills but also without the sorts of skills that we anticipate children will have by the time they come to school. These are not things that the Punjabi grandparents grew up with. For example, they do not encourage children to use crayons to express themselves, and that is an important pre-literacy skill. Because these children are in many respects quite alien to their grandparents because of the cultural differences, often the children will be put in front of the TV, so they might have TV English. Keeping up with children is also exhausting for grandparents who do not have that energy, so the TV is a good alternative.
This group has put out calendars in Punjabi that have a child development tip for each month to encourage these skills. They have gone beyond that, too. They have appeared on radio shows to talk about these issues. Now with new funding from the United Way, they are taking advantage of spaces that are not used much, and they are making joint drop-in learning centres for the children and for the grandparents. There may eventually be some effort to build into that English language training for the grandparents as well.
We used to have a home-school liaison. I knew several people who worked in that capacity who were bilingual and who interfaced with people at home and people at the school. I know that different languages are a challenge for many of our schools, and sometimes the school has no way to communicate with the parents or grandparents. I think those positions have been cut.
The Chair: I think it is important that they speak both languages. It is important that they speak the language of their culture and the environment from which they came, but as a teacher, and two of us are here, I am also very concerned with their success in school. I know that as they move further along in the school system, if they do not learn English, or French if they happen to be in a French environment, then they will probably be diverted not to academic programs but to vocational programs, which may not be in the best interest of a particular child. Frankly, I am concerned that we are failing these children, but we are also failing the parents and the grandparents.
I spent some time looking at the Swedish system. When the immigrant family arrives in Sweden they all study Swedish together, mom and dad and all the kids, so that when they find a job, go to school and interact in the community, they already have at least a small understanding of the new language. I would like your reaction to that. Are we doing enough?
Dr. Koehn: There is a wonderful argument for making English as a second language available to grandparents. We have a huge child care crisis in the province; there are not enough child care spaces. You have to have your children on a wait list many years before they are born. What grandparents do to relieve that crisis is tremendous, and language classes for those grandparents is a small price to pay to invest in that and then invest in the future of their children. I do not think we are doing enough now, not yet.
The Chair: Dr. Hwang, you do not speak English as a first language, although you speak it very well.
Ms. Hwang: Thank you.
The Chair: What would your reaction be to having a more welcoming attitude in language training?
Ms. Hwang: First, creating a more welcoming environment for the immigrants would help them go to ESL classes. Once they are in their class they are probably fine, but to actually get there and be there in that class is a real challenge for many immigrants. It takes courage. However, once they are there and they do something together with other people who do not speak English as native speakers, then they realize that this is not too bad, and they encourage themselves. Taking the first step is very challenging.
The Chair: Do you also think that they could perhaps learn more about the cultural reality in these ESL groups? I can understand the fear of someone who comes from a culture that does not have assisted living or seniors' housing and who also does not speak the language. If we envisaged a plan in which not only was English as a second language a more welcoming environment, would it also become a more culturally sensitive environment?
Ms. Hwang: That is a very good point. Actually, my sister teaches English as a second language, and she said exactly that, that learning about the culture and putting that into the language program is successful. Thank you for bringing that up.
The Chair: I would like to thank all of you. This has been an extremely useful panel, and I know that you will see many of your ideas reflected in our final report.
Senators, we will now proceed to our second panel. Appearing before us on behalf of MOSAIC is Eyob Naizghi; from Progressive Intercultural Community Services is Charan Gill; representing the Collingwood Neighbourhood House is Jo-Anne Stephens; and from S.U.C.C.E.S.S., we have Alice Choi. Our previous panellist was not sure what S.U.C.C.E.S.S. stands for, so you can begin your presentation by telling us that, Ms. Choi. However, let us begin with Mr. Naizghi.
Eyob G. Naizghi, Executive Director, MOSAIC: Thank you very much, Madam Chair. As you can see, I am aging.
The Chair: As are we all.
Mr. Naizghi: I am joining the club. I am an immigrant myself. MOSAIC is a multi-member orientation service association for immigrant communities. MOSAIC is our brand name.
Madam Chair, honourable members and guests, if you will allow me, I will read my notes so that it is much quicker and saves us time. My presentation is more or less set up to tell the story of MOSAIC. Then I will get into how we interact with immigrant seniors around aging and will speak a bit about what we know anecdotally. Finally, I will make my observations about the report. I read it in more detail, and I am very happy about what I see there, now that I know a little more than you do.
On behalf of the board, staff and volunteers of MOSAIC, I thank you for inviting me to appear before the Special Senate Committee on Aging. I would also like to take this opportunity to congratulate the committee for their hard work, as demonstrated by the very impressive report, which will serve as a living document as well as a road map for our future direction on the issue of aging.
MOSAIC is a non-profit organization that is governed by a diverse volunteer board. The organization is located in Vancouver, but we serve the immigrant refugee population from the Lower Mainland. We are a multicultural and a multilingual organization.
MOSAIC has also, in the past, been a member of a number of provincial initiatives on aging. We are a member of the Age-friendly Leadership Network, which we just started this past year. It is a leadership network aimed at fostering the health and well-being of older citizens; it does not define age, and it may include all of us here. This network is based on guidelines and tools developed by the World Health Organization. We also participate on the Premier's Council on Aging and Seniors' Issues, an initiative of the premier to guide the province's policies and practices on seniors. We have not seen much yet, but we hope to see more.
Our mandate is to support immigrants and refugees, to bridge economic, cultural and language hurdles to fully transition them into their new communities. Our mission is to listen and to respond to their needs. We do this through engagement, such as this, and through culturally and linguistically accessible and practical diverse services that allow them to meet their personal goals while building bridges to their larger community. MOSAIC's guiding principle is framed within the context of Canadian social inclusion, fairness and social justice and is grounded on accountability, responsibility and partnership.
I would like to go through the existing programs and services in our organization. We have five areas of services or departments. Settlement services offer information, referral and advocacy to newcomers in the first language of the immigrants and refugees in the community. Within our organization we have about 12 staff who speak collectively about 20 languages or more.
Our family programs focus on families with children and provide diverse programs that range from parenting and early childhood development to addressing domestic violence issues. This is a summary highlight of the department. Again, most of our family-oriented services are provided in the first language of the communities we work with.
Employment programs are primarily geared to enhancing the participation of immigrants and refugees in the labour market. Most of the programs in this department are offered in English, although there might be some limited level of support in the first language.
We have what we call ELSA, which is English language training for adults with child-minding support. The majority of the participants in our program tend to be women.
Language services provides interpretation and translation services in close to 75 languages on a fee-for-service basis. This is a social enterprise that has become a valuable asset to the citizens and the public as well as to the private sector in the province of British Columbia, in Canada and in the United States; we do good business in that area.
I would like to talk briefly about our organizational capacity. We have over 150 employees, 300 volunteers and about 150 freelance interpreters and translators, with an approximate budget of $50 million for 2008-09. Close to 80 per cent of our funding is based on government funding, federal, provincial and municipal, although the municipal is a miniscule 1 per cent; nevertheless, it adds a part of the funding. About 15 per cent of our revenue is generated through fee for service, primarily interpretation and translation, and then 5 per cent comes from foundations, including the United Way, and donations. We are heavily dependent on government funding.
At this point in time our fundraising capacity is very limited — hence, our ability to be very creative in terms of meeting the needs of the client. By and large, based on mandates and priorities, funders tend to determine what programs they like to fund and whom they would like to serve. For example, the Employment Insurance fund is very prescriptive by policy and legislation as to what programs it funds and for whom.
Based on existing funding modules, the immigrant and refugee aging population is not targeted as a special population for service, so they are the ones who fall through the cracks. As part of the newcomers population, with language and systemic barriers, they are serviced through our settlement services, where they receive information and referral on available services. Our family programs see grandmothers attending family support groups with grandchildren. We do see a limited number of older immigrants and refugees attending our English language classes, notwithstanding that they have different learning needs and processes.
In the early 1990s, MOSAIC accessed federal funding, New Horizons for Seniors, on behalf of the South Asian seniors, who quickly became independently organized. Although New Horizons assisted in building the capacity for these specific seniors, from our experience, we did not use it to build capacity for our organization; hence, our organization is weak on supporting seniors. That I should admit.
The Settlement and Multiculturalism Branch of the Ministry of Attorney General, the provincial ministry that manages the settlement funds, is beginning to show a keen interest in services to the aging immigrant and refugee population. They have conducted some consultation with stakeholders, both government ministries and the volunteer sector. From our perspective, this is a very promising opportunity, as research may be allocated to support the immigrant and refugee aging senior population.
What do we know about diversity and aging? From census data, we understand the immigrant and refugee population is aging in a similar way as the population at large. However, there is limited language on how this segment of the population is aging. It is only very recently that we are beginning to see some research interest or themes appearing from the universities, such as the one that dealt with gerontology from Simon Fraser University; as well, the University of Victoria is doing some research, but it is still in an infantile stage.
We equally know very little about the challenges of the organizations or industry that is in the business of supporting the seniors, nor do we have clear knowledge of how the immigrant and refugee seniors are managing as they enter the different levels of support, be it language, food, culture, or other systemic areas. There have always been specific old-age homes supported by the communities and the public, and we are beginning to see some of the larger non-European cultural communities establishing similar institutions to take care of their aging population. Charan Gill will be speaking to that, so I need not elaborate.
Anecdotally, we understand the aging immigrant and refugee population forms part of the extended family; this is with the cultural communities that exist. We also understand that they form part of the nuclear family's economic base, be it looking after the grandchildren while both parents are working, or working in the agricultural sector, particularly on a farm as seasonal workers, or working in the family businesses. Although this has its own challenges within the Canadian system, there is abuse. There are a lot of unknown factors. As somebody mentioned earlier, seniors may get tired and cannot manage looking after young, growing, energetic children. On the other hand, from my perspective, at least this group of people has some level of support and network within which seniors exist.
There are also those who are aging alone. They are found across the board, but they tend to show significantly within the smaller ethnocultural communities, such as mine. I appear there; I do have family, but the African community is very segmented. We come from 50 or more countries; every day there is a country being developed or growing in Africa. There are also more from the Latin-American community and the Vietnamese community. Those are the groups that I tend to call the smaller communities.
As has been well documented, for the immigrant and refugee labour force, earnings are much lower than for the average Canadian-born population. Within the aging population, this phenomenon affects the access to and the adequacy of any form of what I call, for lack of a better word, pensionable or pensioned income or support. Hence, we tend to see a compounded level of poverty among the aging immigrants and refugees. Poverty is the bottom line. Then it translates into homelessness or substandard housing and other health issues. As it is to be expected, language and cultural hurdles are more pronounced among this population group. This complicates their ability to interact with the available resources and leads to loneliness and isolation, translating into health issues.
I have read this committee's report, and I will highlight some of the themes that jumped out at me as they relate to immigrant and refugee seniors. You have to understand, most of the report is very clinical and health-oriented, areas in which we have little knowledge, so I want to comment only on some of the soft services, which are crucial for the aging population.
The report acknowledges diversity of the seniors, and the disparity that exists between immigrant seniors compared to non-immigrant seniors; that is very well documented, and I really appreciate it, as it speaks to the poverty issue. It acknowledges the changing demographics among the aging population, and the report recommends the need for change in service delivery to include the needs of the immigrant and refugee population. We are very pleased with that aspect of the report. The need for making information and resources available is clearly stated, but we would like to stress the need to make this information and resources available in our languages.
The report recognizes the informal family support in the community. This is very apparent within the immigrant and refugee population, and it needs to be recognized and supported. It also fits nicely with what is referred to in the interim report as "Aging in Place of Choice.''
The report recognizes the risk factor and prevalence of social exclusion of immigrants and refugees, and it questions whether their needs are being met within the existing social service structure. Within the inclusion-exclusion paradigm discourse, we would like to add the effect of racism and discrimination. Hopefully Charan Gill will speak to that. The report emphasizes the need for education and information on healthy and active living and promotes anti- discriminatory practices. I would like to emphasize that these needs are felt more among the immigrant and refugee population.
In terms of program development for immigrant and refugee seniors, our 10 years of experience with the Community Action Program for Children, from ages zero to five, which is funded by Health Canada, informs us that promotion and prevention, which are the soft services I related to earlier, are a good approach to early intervention. From MOSAIC's more than 30 years of work experience with immigrants and refugees, we know that any form of program development has to use the linguistic and cultural competency lens from its inception.
Last but not least, the interim report acknowledges that this is a shared responsibility among the different policy bodies, both federal and provincial, and recognizes the active role of the volunteer sector. By the same token, the report's recommendation as it relates to adequately resourcing the volunteer sector is very much welcomed and supported.
Madam Chair and honourable Senate committee members, on behalf of the communities we work with, I would like to once again thank you for giving me the opportunity to appear before this committee.
The Chair: Thank you very much.
Charan Gill, Chief Executive Officer, Progressive Intercultural Community Services Society: Good morning, Madam Chair and honourable senators. I will just speak from my heart. I do not have a written report. I have been involved in many, many reports. This bag is full of reports from the last five to ten years, but as you have said, you did not see much action really. The government machinery is pretty slow; it is a slow-moving process that takes a long time, and when it happens, then the problems multiply.
I am the founder of the Progressive Intercultural Community Services Society, PICS. I am by profession a social worker, and I felt the need in the community. Also I felt there is a big service gap. We have to meet those gaps. We have to meet the needs that are emerging in new communities, but we have issues in the new communities. The reason for that is that we do not have expertise to write proposals; we do not have knowhow. Although I myself, as a social worker, have some knowledge, the whole community does not have that accessibility because they lack the expertise to know what is needed.
When I used to go to seniors' homes to visit, South Asian seniors were put in a corner. In every community resource there were one or two people who were very unhappy. There were no culturally appropriate services and none of the food they used to eat for 60 or 70 years. The food was totally different; it was European food, not the food they were used to. There were very few bilingual workers, and they could not even communicate.
Recognizing all those needs, about 20 years ago I started this organization with eight friends putting in $10 each, $80, and I was the only worker. Now, 20 years later, we have over a hundred people working and we have many resources and diverse organizations like MOSAIC and S.U.C.C.E.S.S. We provide the same kind of immigrant services.
In addition, I ventured into organic farming. We got 20 acres of land from the Greater Vancouver Regional District, but there were other implications. Most of the seniors were working on the farms; there are 20,000 or 22,000 South Asian people working in the agricultural sector. About 10,000 are in the greenhouses or hothouses, and another 10,000 work outside in the fields. They are mostly seniors. Those seniors are dependents of their sons and daughters. They came under the Family Relations Act. They are not eligible for any other services for 10 years, so they are forced to work even at age 65 or 70, and for many years those people have been exploited because they do not know the language, they do not know their rights, they do not know their responsibilities.
We have a specialized program for agricultural workers. We provide rights and responsibilities workshops. We train people in other things, like through ELSA and programs we have, a similar kind of program to S.U.C.C.E.S.S. and MOSAIC.
PICS is a new organization. It may not have that many programs, but it is a similar kind of outfit, trying to serve the needs of immigrants in the multicultural community. Our focus is on the seniors now. We have lots of programs, including agricultural workers programs, and also for seniors; most of them are for seniors.
Knowing this need, we started about eight years ago. The most difficult part was to buy land. I had to raise $1 million to buy land, and it was hard to establish credibility, respectability and trust that I would not run with the money. It was not easy to convince the community members, who always feel that most people here are for money and do not agree with the collective benefit of the community. I was one of those people with feet in each community. I pressured them, I tried to work with them, and I told them I mean business; we want to do that.
In 1998 we bought a piece of land, but it was very tough. We had very sleepless nights when we could not meet the mortgage payments. Finally, after putting 10 per cent down, we bought two and a half acres.
We also have a future plan to have seniors' housing and assisted living. We had the plan from day one when we bought this land. There were many seniors within the 10-year period who may be working. Some people had heart attacks, and some had disabilities, and then they are really stuck. They have a tough time.
The values are not the same as they used to be in the old country, where the children will look after their parents. Some children have gone to New York, Toronto, somewhere else — wherever the jobs are. The seniors are left over here. Those seniors are in dire need. They cannot claim any social services. If they do claim social services, what will happen? Now the governments, federal and provincial, will go after their sponsors, who are not rich people, who are working at $10 to $12 jobs. Some people have got money, $30,000 or $40,000; then the bill goes back to their sponsors, and it is very tough on their family, causing lots of stress and strain and actually pressuring some family members. Families get separated because of this pain and all the payments they could not make. The Government of British Columbia put a lien on their homes. The government claims they want $40 million, which they paid, and they recovered about $5 million. They still claim that they will take all the money or put a lien on the homes. That is what is happening.
We have two homes. One is for living, which we started first. There was so much need by people who are in farm work, people who are paying. All the immigrants have very low wages. Only people who worked in the sawmill industry at a time were making $18 to $20 an hour. Now that industry is going downhill. The majority of seniors were janitors or farm workers or doing entry jobs, security guards and the like. It is extremely difficult for those people, when there is a small pension, to live anywhere. They were living in basements or in cars, or going to Sikh temples to eat the food over there and then go home.
Their children cannot look after them because they are no longer here. The values are in transition. It is not the same as in the old country. There is change, and the parents tell me the kids are not the same. They think, like in the old country, that the children will work outside and bring the head of the family money; but they might take the money from the head of the family now.
Another abuse occurring in the community is financial abuse. They take the pension cheques away. They make them work as a babysitter, and they do not have the fundamentals of babysitting. Sometimes they do not even know how to dial 911 in case of emergency. At one time we put together a course for one year. We got a little money to train seniors how to look after grandchildren. That program ended because, as I said, the government did not think it is was worthwhile to put money into the seniors. That was a valuable program, because many of the seniors' children can go to work and leave the kids at home with trained parents, so we did that.
Out of the first supported-living situation, we now have 450 people on the waiting list, and there is no hope in the next 10 years, before they go out of this world, that they will have a chance to have a place there. Unfortunately, the government is not planning any more money to give to supported living. They are putting more money into assisted living or long-term care.
Long-term care is a fiasco. I have done some surveying, and I know that many people are stuck in hospitals and in long-term care facilities. If they are given proper care, some people we have taken back in the assisted living, and they became so happy and so good that they started working. They did not work before. I think they will live a couple of years more than they anticipated when they came to us. It makes a hell of a difference when people talk to them in their own language, listen to them, listen to their poetry or listen to any songs or whatever and also celebrate some of the festivals with them.
We see the difference; we see so much difference in the people who were in isolation, living in seniors' homes, in the Caucasian homes, as we call them, or any other home, because they were the only few people. Now they try to meet each other, and they talk to each other.
We also put together assisted living. This year it started, and it is about 60 per cent full with more people coming gradually. We see huge differences, even in the long-term care people coming here. We took three people from long- term care into assisted living, and now they are very different. They did not need long-term care, actually; they needed assisted living. Those are the practical experiences I have with other people.
Many people go out to the parks, as they have nowhere to go; recreation places are minimal. The government does not plan any recreational activities or places for seniors. They sit in parks, 10 or 12 people, and play cards there. Sometimes, in isolation, they go to washrooms; in Bear Creek Park, two seniors were murdered by young people. I do not know, I do not want to say it is racist. They robbed them; they did not have to kill them, but they did. Two seniors were killed two years ago. So many seniors are insulted and abused on the roads because they have no place. Sometimes they sit in shopping malls, sometimes in public parks. Those are the situations we see every day.
Because of the family reunification program, I believe there are over 8,000 seniors in the Lower Mainland, but there is no place to go. The one place we have is behind the Sikh centre; they play cards and stuff and congregate in the Sikh temple and talk and eat there. That is the main social place for them to go and talk to each other.
Sometimes I ask people why, when they make $4 or $5 an hour, they work on the farms. They say that because they came from a tropical country they have never stayed in the home. They say glass is jail at home. They want to socialize outside more than what they have learned. They will talk about the villages and their life back there. Also, even making $4 or $5, they do not want to put a burden on their children. In the meantime, they go out and socialize. They do not want to sit at home.
The major issue is for more resources for seniors around language, so that they can go on buses and the SkyTrain and say something, or know how to call 911 in case of emergency. We see those needs are not met, so that is where we are at.
We are just starting. We would like to do some more for people in Abbotsford. There are lots of seniors in Richmond and they want more recreational resources where they can get together and talk about things.
Absolutely, health education is very important for seniors, because sometimes they go to the doctor because there are people they can talk to there. They do not need to go to doctors or emergency hospitals if we give them basic exercises and some basic education on what to do, but those programs are not there. I hope the government will look into those programs where seniors can be activate. There are very small programs coming in, but that is not good enough. As I said, the machinery is so slow, they will probably triple up, you know, before they come to their attention. In the meantime, they are always behind.
Those are the issues for the South Asian community, where I work mostly. In the multicultural community, I see that the smaller communities, like the Filipinos, have no resources, so we are opened up to everybody. We have Filipino people living there, we have people from Sri Lanka, all kinds of other people living there, because of a lack of the social part of the community opening up those resources to them. They do not have any agencies, because it is not easy to start an agency.
I know, I started one. It is very difficult, and you need to work 10 or 12 hours a day. You need to get respectability in the community, as a leader of the community, as a spokesperson for the community on those issues, and it took me 20 years. Now I think I have got it after 20 years; they are helping me and supporting me.
Thank you for listening to us and our issues. I really appreciate your coming here. I hope there will not be another report; there are very good reports — I have four or five of them. I think there will be some action.
The Chair: Well, you have three senators at the table who will insist on some action.
Alice Choi, Administrator, S.U.C.C.E.S.S.: Thank you very much for giving me the opportunity to appear before the committee. I will try to be brief with my presentation. I will be repeating some of the issues, and the theme will be more or less the same as the previous speakers.
To answer Madam Chair's question, S.U.C.C.E.S.S. represents United Chinese Community Enhancement Services Society. I joined S.U.C.C.E.S.S. in 2001. It took me three years to memorize that, but I still have that in front of me in case I get stuck.
S.U.C.C.E.S.S. was incorporated in 1973, so our thirty-fifth anniversary is coming up. It started as a social service, providing settlement services for immigrants, including women's and health issues, employment counselling and group and community development. Back in 1989 there was a group of enthusiastic board members who saw a need to create or to build a culturally appropriate care home for Chinese seniors, so they started lobbying, trying to talk with different levels of government. Eventually, in 2001, the first Chinese seniors' home was established in Chinatown. That was the point at which I joined the society.
I will not talk too much about the evolution of seniors' health and housing services in British Columbia, because I have got that in my submission, but I think the campus of care is really the thing in British Columbia now. We are looking at forming communities in order to follow the concept of aging in place. We have different levels of services within the campus, so that people can move from one program to the other when they need changes without leaving the community.
Since 2001, the S.U.C.C.E.S.S. multi-level care society has established a care home right in Chinatown, serving the Chinese seniors. We have 103 beds; of those, 21 beds are for dementia care. Attached to the care home, we established an adult-based centre in 2003, again to serve the Chinese seniors. We take in referrals from all over Vancouver; the centre is not restricted to Chinatown but serves people from West Vancouver, the University of British Columbia, East Vancouver and so on. Again, it is the only centre we have established that speaks the language, so that when we carry out programs, it is easier. In 2006, we established 33 beds of assisted living in one of the high-rise buildings right next to the care home.
With the three programs we have in place, in 2006 Vancouver Coastal Health declared us a campus of care, which means that any of our seniors who have changing care needs will be able to move from one program to the other. As I speak today, we already have a number of assisted living clients who are deteriorating, but they have the first priority to move into the care home so that they will still be within the same community. That will reduce relocation stress, and it is good for the family and also for the residents who are able to stay in the same community.
We also have many community programs. We go to radio shows, to different organizations, to seniors' groups in the community to talk about health and so on, and we also work with the other societies to provide the Chinese Meals on Wheels programs for seniors in Vancouver, Richmond and Burnaby. The mandate of our society is really to provide a continuum of health services. Our mandate is not limited to complex care or long-term care, but we want to look at the whole continuum of serving seniors until the day they leave this world, which includes hospice care, too.
At this point I want to talk about what we mean by "cultural appropriateness.'' For us, for our society, for our staff, it does not mean that we only have the staff to speak the language and we provide a traditional meal. I suspect a lot of people think that way, but we want to cultivate an organizational culture that respects the uniqueness of the seniors we serve. We tell the seniors who come to the care home that the care home is not the place for you to come and die; the care home is the place for you to come and live, and live with purpose and meaning. We try to create that kind of a culture with all our staff, our volunteers, our board, our community partners, so that the residents who come into our care home in any of our programs have a purpose for coming in there. We have tried to cultivate that kind of culture ever since we started the multi-level care society, when we opened the home in 2001. We carried that philosophy in all our programs, and we see tremendous progress, and not only because we have people who speak the language or we provide them with a Chinese meal. It is the climate of love and respect that we have in our programs that makes residents want to live and be more independent, and to live longer. That is the point of trying to create hope in their life.
Also, I think respecting the traditional values of the group that we serve is very important. When we say "cultural appropriateness,'' people think we only do that for the Chinese, but that is not so. In our programming in Richmond we have a 50-bed assisted living, and we serve two populations, a Chinese population and a non-Chinese population. We have a Western menu and a Chinese menu, and we respect the traditional values of both groups we serve. We celebrate not only the traditional festivities of the Chinese but also the Irish St. Patrick's Day and St. Valentine's Day and Chinese New Year. Even in our care home, which serves only the Chinese seniors, we do make sure that they are still connected with the main community by celebrating not only Chinese New Year but also Christmas. We double everything when we do our activity programming.
Respecting the culture and traditional values of the seniors we serve is what I mean by cultural appropriateness; and we do that not only for the Chinese but for the Filipinos, the Irish, whoever. We always have to have that component of the person in place. We look at the person as the culture, because every individual has their own journey, their own life history, and you have to put all of that together in order to give culturally appropriate care. By doing that we develop trust, and it is important for the seniors to feel safe, not just physically but psychologically. Having a culturally appropriate environment creates a sense of security and affects the physical and mental state of the person in a lot of ways.
I will not burden you a lot with statistics Toronto has the biggest population of Chinese immigrants, and next is Vancouver. We are most concerned with the areas around Vancouver and Richmond, where we have a very large population of Chinese immigrants and the seniors are aging fast.
In 2007, the City of Vancouver did a study on the needs of Chinese seniors who were living in buildings around the Chinatown area. They interviewed about 1,700 seniors and found that only 0.3 per cent of them could speak a little English. The language barrier is the major thing. Because of the language barrier, they were not able to access services or did not have any knowledge of the services available to them.
Most of the seniors are in subsidized housing with no support at all, and this group of seniors in Vancouver are aging fast. They are the first generation of immigrants, and they are approaching their eighties and nineties. The Vancouver area has the older population; in Richmond, the seniors are a bit younger so the problem there is not as imminent as in Vancouver.
The people living in this subsidized housing now have no support in place and have a language barrier, and I am afraid that if we do not do anything now, in 10 years' time this group of people will collapse the health care system, because they will age and be frail so fast that they will be accessing the system at a very fast pace. The study was done, but, again, there are many reports, but I do not see any action.
Funding is a big issue because in order to have support in these places, you need the collaboration of many agencies and different levels of government in order to put these programs in place.
Around the Chinatown area there are about 11 subsidized apartment buildings and 714 units. Most of them are occupied by Chinese seniors. There is an urgent need in that area for health education and to have people there to help the seniors navigate the health care system. When there is any health need, the seniors do not know how to access or navigate the system, and they have no way of getting there.
Although the problem is not as imminent in Richmond now, when we looked at the housing and the assisted living and complex care bed situation in Richmond, we found none that are really culturally appropriate. We have enough long-term care beds for the Chinese seniors; if the need is there, they will be able to access the beds. However, the component of cultural appropriateness is important for their well-being. When you get to be 80 years old, you cannot learn to speak another language. People ask me how the seniors are integrating in our assisted living in Richmond, but I tell them, "They do not integrate; it is co-habitation. You try to learn.'' I think there is an advantage to that, because they learn to respect each other's culture. Living together, they start to learn about each other, and I am happy to report that they are living together very peacefully. It is interesting for them to learn about each other's culture and customs. We cannot ask them to learn to integrate and learn another language and be part of the melting pot system. We need to have more education about how to respect each other's culture and try to live together.
Going back to the campus of care, I think it is very important to have culturally appropriate care for the seniors who are here today. Maybe when I am older, I will be able to integrate quite well. I have been in Canada for 35 years. However, for the seniors who are aging now, in their seventies and eighties, there is an urgent need for us to give them an environment with culturally appropriate services so that they will be able to age well.
This is from my heart. I have been here for 35 or 40 years, but when I get to this stage — I am getting to the retirement age too — it does not matter how much I have integrated into the other culture, I still want to go back to my own culture. Maybe when I get to be 80 years old I will be happy to live in a mainstream care home. I will still survive, but if you want to improve my quality of life, I think I want to be in a culturally appropriate environment.
The Chair: Thank you. This is interesting. Earlier this week we were in a francophone community in Manitoba, and we heard exactly the same message, that the Francophones in southern Manitoba are extremely well integrated, but as they age, and as they enter their senior years, they want to live in their culturally appropriate language, and for them, that is French. It is not one group over another; it is pervasive.
Jo-Anne Stephens, Seniors Program Coordinator, Collingwood Neighbourhood House: Thank you, Senator Carstairs and honourable senators. Collingwood Neighbourhood House is in the east side of Vancouver. We are a multicultural organization, known internationally for our multicultural integration of different groups. At this time in our history we are focused on integrating other people who you might think would already have been there, and that has to do with supporting people who are living with homelessness and very few resources. My work there involves programming for seniors, supporting seniors. It involves working with the homeless, interfaith and ecumenical response to homelessness in the neighbourhood, and also working with intergenerational projects with seniors and children. It is that area, intergenerational work, that I decided to zero in on as regards your report.
It is a privilege to be a part of your work on the aging population, and I am celebrating the fine work you and your contributors are doing to make a difference to people in Canada. My offering in response this morning is related to the ideas of empathy, compassion and contribution as they relate to social inclusion and individual well-being. If I could accomplish it, I would make this document, even as it is now, available to every adult in the country, so that people, if they do not yet realize, might know that integrity, dignity, compassionate action and care are what is most needed in their lives, and perhaps the most hoped for by people as they grow older.
It is enormously challenging in a market-driven nation to propose and try to function successfully also as a needs- based society, to create systems and programs that support people to become as fully human as they can be. Sometimes we imagine strategies as the need, rather than the tool to meet them; and your work, it seems to me, certainly knows the difference. From my experience with people of all ages in the community, many isolated and disengaged, meaningful, lifelong learning and activity could be a major contributor to contentment in one's life and is perhaps more difficult to perpetuate as one ages, as your work illustrates.
Another important contributor to successful aging is the need for friendship in its many forms, and it is something that also in many ways is very difficult to perpetuate as one ages, and especially as health, income and visibility are greatly diminished. I would like to see this idea of friendship in its broadest sense, as well as in a typical sense, addressed in more depth in the work of the committee. It falls within the rubric of social engagement and capacity.
You have addressed and continue to pose the important questions of income and health sustainability. I would like to see addressed a deeper understanding about the importance of lifelong learning as it relates to keeping one socially engaged as well as employed. It is in this idea, perhaps, that deeper attention could also be given to intergenerational connection. Can we integrate the education of older people together with the younger ones, foster learning and relationship-building together?
I might pause here for a moment to talk about the Neighbours for Peace program that we have at Collingwood Neighbourhood House, funded by New Horizons For Seniors. This program was initiated out of the desperate pleadings of a teacher who was going a little bit mad with a classroom of Grade 2 and Grade 3 students who were having a lot of difficulty socially in their classroom, and her hermeneutical suspicion was that perhaps some of the behaviours and habits of some of the children were coming as a result of being nurtured and taken care of at home by grandparents. The grandparents were not connected socially in the neighbourhood as well. The classroom was multicultural, and the children were often, as she could discern, left alone. She wanted to figure out how we could help these children to be more socially connected, to speak in a language that was inviting rather than disconnecting.
So we created the Neighbours for Peace project, which brings the grade 2 and 3 class together with a group of seniors who are multi-abled and at different ages in their mature lives. We work with a program called Compassionate Communications, working together to try to be the peace we want, to create the world that we would like to have, and to bring together a way of speaking and "languaging'' ourselves that we both, in the different age groups, can understand and can support. It has been a wonderful learning tool for both the seniors and the students; the seniors provide their wisdom, and the children's energy has been just completely engaging to the seniors. We have seniors there who have never been to school, who have a hard time hearing, cannot see, and who are being loved by the children.
I personally and professionally feel despair when I encounter, time and again, people who are older and who have lost their voice because they have not been able, for many reasons, to transition with the ideas of contemporary society, how it thinks, organizes, and behaves itself. I see and listen to the despair expressed by aging adults because they cannot enter the conversations of society, community and family, since the world they learned and understood is now radically different and more complex, more multicultural, more multi-religious, and so forth. This seems to result in diminished confidence and enjoyment, especially for those who have little education to begin with or who have interactions that are not understanding or compassionate towards them because of it. Speech and actions, for instance, may reveal ignorance of how to now think of what it is to generate mutuality and inclusion for themselves and others.
I think it is important for those people who are aging to be able to contribute their wisdom, recalibrate their understanding of the world, and be engaged with those most able to participate with them: the young, young adults, adults, the very old, everybody. We do not have to discriminate between age as much we do, perhaps. In a society given to specialization, it may be difficult, but it is vitally important for any aged person to be able to engage in the dialogue of their society.
Therefore, I would urge greater attention in your work for intergenerational opportunity, intergenerational dialogue and education, and development of friendships amongst these folks. We have roots of empathy for children directed at babies; let us create it in the other direction as well. This can also contribute to a more healthy, confident aging society, and can provide some crucial strengths for people to face the challenges of maturing, and to face them with welcome, wonder and hopefulness.
I want to share one anecdote with you. When I first came to Collingwood Neighbourhood House and I was working with the seniors, there was a great resistance to anything I wanted to offer. They seemed to be shoved up to tables, and they sat there, and everybody did things at them, and that was extremely difficult. There was so much resistance, I was in fear of losing my job for the complaints that came. However, I began to realize that there just was not any confidence. They did not feel competent to speak, to have an opinion; they did not think that they could be heard. They had not heard their own voice, many of them, in a very long time.
I embarked on educating and having speakers come in. The first many speakers must have been appalled, because nobody questioned them, nobody responded to them. Now it is impossible to get the seniors to be quiet. It is really wonderful.
Two key things occurred to have this happen, and one was that I brought in a speaker who talked to them about human rights in Canada today. They had been grounded in equality — that is the period they grew up in, dropping the paternalistic language and so on — and had not shifted into the ideas of the importance of particularity. Just giving them that background generated a lot more confidence and a lot more conversation in their families. That was a very important step.
The Chair: Senators, you may have realized that I did not ask any of the witnesses today to limit themselves to short presentations because I felt that what they had to say was perhaps even more important than our questions to them this morning.
I want to thank each and every one of you, because you gave us an important perspective on life as a senior in the communities in which you are working and contributing, and it is a perspective, I have to say, that we have not heard expressed in the same way. That is exactly why we came to Vancouver and specifically asked to speak to groups like you. We have heard from many resident experts, but it was time to go across the country and talk to people who were actually experiencing the work. I thank you very much for what you have enriched us with this morning.
Senator Mercer: I want to thank you, as the chair has, for being here. Several of you were referenced in our first panel.
Mr. Gill, you came highly recommended by the previous speakers here this morning, so we were anticipating some of the good things you have said. I am interested in your project. You bought the land, two and a half acres, and raised $1 million. My professional career has been raising money for charities, so I understand the difficulty of raising money, particularly when you do not have an established track record in the community, and also working in communities that are not necessarily used to giving in that way. What have you built there? Is it a seniors' residence with assisted care? I would like to hear more about that.
Mr. Gill: One building is supported living. It is a rental place with low rents subsidized by the government. The second building is 72 beds of assisted living. When we started this project, the first part was very difficult. When the first building went up, the visibility was great. It is a very nice six-storey building, and lots of people wanted to live there. The visibility created an impact on the community. People started to trust me, trust that I will not run away but stay here in the community, and they started building confidence. The second part of the project, the 72-bed assisted living facility, was much easier to build than the first part.
Senator Mercer: How many units are in the first building?
Mr. Gill: There are 54 units.
Senator Mercer: That is a big project.
Mr. Gill: There was a big struggle. I feel good about it, that we finally accomplished something. When we started, though, after I bought the land, as an executive director of the society I had sleepless nights worrying about how to meet the mortgage, deal with the many delays in planning, and get through the process with city hall. Luckily, city hall was quite cooperative. Many values came through the process, and I have learned everything, but it was new to me in the first place. I feel very good that we accomplished something, and we can do a little more if avenues are opened up.
Senator Mercer: That is great. Congratulations.
Ms. Stephens, you talked about your Neighbours for Peace project. I really like the idea because of the interaction, and you are addressing a couple of issues at the same time. Do you think this program is portable? Could it be duplicated in other communities?
Ms. Stephens: Yes, definitely. As happens in programs, which I am sure you have experienced, as we have gone along we have noticed the missed opportunities in a new initiative, so we are planning to prepare a small curriculum that could be portable. The problem is just having enough money to make the curriculum as full as it can be, to help people to understand what compassionate communications means, what it is to be at peace in the world, and all the different aspects of what you can do to accomplish that. I come from an arts and entertainment background, so puppetry and music and dance and all of those things are very easy for me to do; it is not so easy for everyone else, but it is adaptable, I think.
We are fortunate because the Collingwood community school has access to our community centre by way of a door; we are completely connected and integrated that way. We have made presentations to other teachers in the school, and they all want to have the same thing happening in their classroom. Of course, there has not been the money to do it, and it requires training. I think that people can be trained to do this in their classroom. There are certainly seniors. You have to motivate seniors to participate, because many seniors think they have done that already — they brought their own children up — and they do not think in terms of the importance of this interaction to their own life and their energy and their contribution; they think they are done with that now. However, once they got going, the senior involved did not feel that way. Thomas, our person who never went to school and had to learn all different ways, has bequeathed his will to this program at the school — that is how important it became in his life.
This program is definitely portable if the funding is there, and I think it is worthy of the work.
Senator Cordy: It has been interesting sitting back and listening to your stories; they have been wonderful.
Mr. Naizghi, you talked about translation and the need for translation with seniors, and several others have also talked about seniors not knowing what programs are available to them, and because they do not know what is available, they are not able to access those programs. What can we recommend in terms of translation services that would make it easier for seniors to become aware of what is out there for them? It is challenging enough to find out what programs are out there when you speak English or French; if English or French is not your first language, then the problem is compounded.
Mr. Naizghi: I think translation and interpretation are valuable tools. As the demographics change, whether over the whole population, we comment that everybody should attempt to make their resources available in other languages. If you look at the resources, it is very challenging to have every language represented within our organization. That would be my wish, but I have to be realistic and pragmatic about it.
Translation is a very cost-efficient way of making the information available to immigrants and refugees in their language as a first step. However, it does not replace the fact that there are systemic periods, there are cultural periods, there are linguistic periods that require personal navigation; I heard Ms. Choi speak to that. Nothing can replace that personal touch, that personal relationship that our counsellors build with the communities. However, as I said, I think it is very unrealistic for me to expect that we should have a worker who speaks that many languages; there are not that many resources. However, it is a first step to have every health provider, every activity, every resource that works with seniors make sure that their resources, location and services are translated and available to the community. I think the distribution aspect could be done by the community organizations that work with those communities, and it is not that difficult when we look at it from the designation. My preference would be to make those resources available in other languages person to person, but if the funding does not allow it, make those materials available in other languages so that people know and can at least attempt to navigate themselves.
Senator Cordy: We have heard that type of thing before, that one needs a personal navigator just to work through the system. I think the other panel talked about how changes are coming so rapidly that it is very hard to stay on top of them.
Ms. Choi, I was interested in your comments about education to respect one another's culture. That cannot just start when people are seniors. That has to start within the school system. Do you have any programs that are really working?
Ms. Choi: I think you are right; it has to start at the very beginning, actually even from the immigrant services. I do not know whether that would have been your experience. I hear from some of my colleagues about expectations of immigrants who come from various parts of China, because there are two different cultures, and they have to start at the very beginning, for the young kids, to incorporate that in their school curriculum. When immigrants first land here, those things need to be included when we orient them to Canadian society.
Given the diversity of ethnicities of all the immigrants we have, I think we should have opportunities to interact and exchange ideas. However, there is only so much funding and only so much we can do. Therefore you take care of the immediate needs of the immigrant first, and somehow the importance of this other stuff is not being taken into consideration. I think it is increasing their awareness, and also the stewardship of the government is important for that to start at a very early stage, when people come to Canada and with the kids in the school system.
To add to what Ms. Stephens said about the intergenerational programs, even within our programs, we try to promote that, because I think young kids have a negative view of seniors, that they are horrible creatures, all wrinkled up, and they do not want to speak to them. We also have intergenerational programs where we try to teach young kids about the values of the seniors and what they have contributed to society, and we teach them how to interact with the seniors in simple ways, how to push the wheelchair, how to speak to them with respect.
We do not do a very big program and we do it on our own, again because of the level of funding. There are so many things we want to do, but because we do not have the funding, we can just try to do a little bit here and there to try to make a little difference. If we can recognize the importance of having this intergenerational kind of program, I think in the long run it will make this world a better place for everybody.
Senator Cordy: Yes.
Mr. Gill: I just want to add that we have the same program, connecting young people with seniors. Young people love it; seniors love it. It is free, and schools are willing to bring some kids in there. It is an extremely interesting program. I think it should be promoted much more.
Senator Cordy: I used to be an elementary school teacher, and I know those programs work for both the young people and the older people. I am very interested in this program, Ms. Stephens. Funding came from New Horizons for Seniors; is that correct?
Ms. Stephens: That is correct.
Senator Cordy: Does New Horizons for Seniors ever look for responses for programs that really work that could be transferred across the country?
Ms. Stephens: When I was researching the program and looking for components, New Horizons for Seniors told me they did have other groups that had done projects that seemed related or of good potential for the one we were creating, but that information is not easily accessible. It is not impossible, but there needs to be intentionality about it.
Senator Cordy: Ms. Choi, you have your seniors' homes. Are there waiting lists for these facilities?
Ms. Choi: Yes, there are very long waiting lists for all our programs, for assisted living, for Evergreen Centre, for the dementia clinic, for our complex care.
Senator Cordy: What are people doing while they are waiting, just managing on their own?
Ms. Choi: Yes.
The Chair: As we were talking about the importance of culture and language with all of you, it seemed to me that the federal government publishes many documents that it could easily publish in many languages. Several weeks ago we were in Sherbrooke, Quebec, and they were talking about Canada's Food Guide, saying that there are many aspects of it that are not appropriate for seniors; seniors' protein needs, for example, are higher. That led us into a whole discussion of Canada's Food Guide. To my knowledge, the guide is available only in French and English, and yet it could easily be made available in Chinese, Punjabi, Korean and all kinds of languages. Then, while I agree that nothing replaces the individual, if in your communities you are trying to teach nutrition, after some nutrition lessons, the individual can give out a copy of Canada's Food Guide in the senior's language. It seems to me that would facilitate the language on an ongoing basis, rather than just a single interaction. We should make note of that, regarding the need to promote the language in a much better way.
I have a bit of an idea of how it came about in Ms. Stephens' case, but I want to ask each of you what was it in your communities that led you to do what you ended up doing. Obviously, Mr. Gill, if it was not for you and your initiative, along with the seven other friends and their $10 each, the whole system that you put in place would not exist. Ms. Choi, although you may not have been there in 1973, when your organization began, somebody did it. Who were these somebodies, and how did you or they identify that there was such a desperate need to engage?
Mr. Gill: As a social worker, I used to go to seniors' homes. A friend, Mr. Lidhar, whom I respect quite a bit was president of Sunset Seniors for 20 years. I went to see him, and I sat with him; he knew that I am quite active in the community, and he held my hand. When I wanted to leave, he said, "Just stay more; I will talk to you more.'' Then he picked up a piece of bread, which was very stale. He said, "This is what we get for eating. I cannot eat it because I do not have any teeth. I do not have my food at all.'' Tears came into his eyes. I was quite moved. By that time I had started working a little bit. I said, "If you stay alive until Christmas, you will be the first person to go into this home,'' I promised him. He died before Christmas.
Those were very moving things. I was almost in tears myself when I saw this person, who contributed so much to the community for 20 years as the president of Sunset Seniors Club, and now he is nobody. His kind of image is no longer there, his kind of self-respect is no longer there, he does not have any dignity any more. I was just moved, and I started doing this. That is how I got into this.
Ms. Choi: I guess I can talk on two different levels. Our former CEO, Ms. Lilian To, who has passed away now, many years ago had insight into the needs of the Chinese seniors. That is why some 20 years ago they started lobbying the government to build a seniors' care home.
On a personal level, I had been a nurse for a long time. I have been in Canada for over 35 years. I had worked in mainstream long-term care facilities for a long time, where I witnessed many Chinese seniors or seniors of a different ethnic group coming into what I would call the mainstream environment and not coping well. The environment was different than the cultural environment they were used to, and because of the language barrier, the food and their inability to communicate, the seniors developed despair and hopelessness, and it broke my heart. There is only so much that I could do as the only person who could speak their language; I could not be there 24 hours a day. I could imagine the fear and insecurity they had when they could not make their needs known, especially the people with dementia. I always call it the double-edged sword, you know, when you cannot speak the language and have got dementia. Can you imagine the kind of fear that they have when they wander around and they do not know what is happening? The person with dementia cannot make their needs known, and that is why a lot of aggression happens.
When the opportunity came, when S.U.C.C.E.S.S. was building the care home, I do not know whether I was being noble or not, but I saw this was the time I could go back and serve my own community. That was one of my career goals, that from what I have learned, with my experience and education, that one day I would be able to use my expertise to serve my own community. When we first built a care home, suddenly it brought home to me that I can see the tremendous difference in these people after they have been in the home for a couple years. From then on, I eventually brought in the different programs at the adult centre and assisted living and so on, because I know that there is a big need in the community for such services.
It is not to say S.U.C.C.E.S.S. is trying to go multicultural and trying to serve the different ethnic groups, but as far as senior health is concerned, I think there is a big need in my community for things to be done to serve them better; not to say that I will negate other opportunities. I have the opportunity to serve other ethnic groups, but I think that is a big thing in the community, and more needs to be done in many, many ways.
Mr. Gill: As first generation immigrants, we are very much connected with the cultural community we belong to, whether we are French Canadian, South Asian or Chinese. We are from that community; our roots are there. We understand, we can communicate in both languages, so we are very much connected. It really is a satisfying experience and fulfilling to see something you are accomplishing. It is a fantastic feeling.
The Chair: Mr. Naizghi, you yourself were a refugee to this country?
Mr. Naizghi: Yes, very proudly; I do not know when it will wear out of me. I have been here for close to 17 years. I think if I go through the history, and I have gone through many of MOSAIC's archives, it was a group of immigrant women who started MOSAIC in 1972. They were Japanese, Korean and Chinese. They knew the challenges newcomers were having. Some of them were running English language classes, and other groups were visiting homes and prisons and what have you. Those were the visions that have driven this organization. I joined them recently, in 1993.
When I finished my studies at UBC, my passion was international development. I have done a number of works in Africa, programs funded by CIDA. I never worked for CIDA, but as a third party I did a lot of evaluation and designs. I was committed to solving Africa's problem, to be honest with you. I failed and came back and applied for this job, a management job. I had never heard of MOSAIC or S.U.C.C.E.S.S. in those days. I had never heard of an organization serving immigrants and refugees, or else I would have gone there. I did support international students when I was at UBC, giving them orientations, taking them around the city, or even finding them homes for a while as they established themselves. I did have that experience. I even did that at the University of Alberta, as my first job after graduation.
When I first got this opportunity to work for MOSAIC, I thought it is a transition job, two years. The more I got into it, the more I worked with people, the more I got hooked. I saw the challenges people were facing, but at the same time I saw what hopes and opportunities the staff and the volunteers and the board were giving to newcomers. I think what I find more attractive for me, and what I find is very passionate, I develop a passion for it; I can relate to all of the challenges people are having. I could speak to it, and I could have empathy with my work. Even as an executive director, to this day, many of the African people who know of me ask for me, and I would never say no; I will never say no to any person who would like to sit with me because that is what grounds me. That is what gives me the passion and the motivation.
The paper pushing, the standing before you is an honour, it is a privilege. Looking after the finance is a headache, and looking after human resources is even more headache. But what keeps us driven is that we touch people's lives. We make a difference in their life. More important, I think in this sector, at MOSAIC, I look at my work as if I am building a nation, because immigration is not only about labour force. Yes, we have money that way, fortunately. Yet immigration is about building initiative. It is about bringing citizens, and it is about all of us being treated equally and being responsible for our nation. That is what gives me the passion.
The Chair: I have to say on behalf of the whole committee that we are all very lucky that you are all Canadians and that you are making the kind of contributions you are making to the Canadian society.
Ms. Stephens, I suspect that you are not a new immigrant. I suspect that you have been here all your life, but we are very lucky that you are working in your areas as well, and I want to thank you.
Ms. Stephens: Thank you. I am very much Canadian-born, but there is a lot of Irish in me.
The Chair: With that, honourable senators, we will adjourn.
The committee adjourned.