THE STANDING SENATE COMMITTEE ON OFFICIAL LANGUAGES
EVIDENCE
OTTAWA, Monday, November 27, 2023
The Standing Senate Committee on Official Languages met with videoconference this day at 5:01 p.m. [ET] to study matters relating to minority-language health services.
[Translation]
Karine Déquier, Clerk of the Committee: As clerk of the committee, I have a duty to inform you of the unavoidable absences of the chair and deputy chair. Therefore, I shall preside over the election of an acting chair. I am ready to receive a motion to this effect.
Senator Dagenais: I’d like to nominate Senator Moncion.
Senator Mégie: [Technical difficulties]
Senator Dagenais: I don’t think she has a choice.
[English]
Ms. Déquier: It is moved by the Honourable Senator Dagenais that the Honourable Senator Moncion do take the chair of this committee.
Is it your pleasure, honourable senators, to adopt the motion?
Hon. Senators: Agreed.
Ms. Déquier: I declare the motion carried. I invite the Honourable Senator Moncion to take the chair.
Senator Lucie Moncion (Acting Chair) in the chair.
[Translation]
The Acting Chair: Good evening. My name is Lucie Moncion, and I’m a senator from Ontario. I have the privilege of chairing this evening’s meeting. Before I begin, I would like to invite the members of the committee here today to introduce themselves, starting on my left.
Senator Dagenais: Jean-Guy Dagenais from Quebec.
Senator Mockler: Percy Mockler from New Brunswick.
Senator Clement: Bernadette Clement from Ontario.
Senator Mégie: Marie-Françoise Mégie from Quebec.
The Acting Chair: I welcome you, colleagues, and the viewers across the country who are watching. I’d like to point out that the lands I’m speaking from are part of the unceded traditional territory of the Algonquin Anishinabe people.
Senator Mégie, I believe that you had a proposal to make if there was no quorum at today’s meeting.
Senator Mégie: I move that, notwithstanding usual practice, pursuant to rule 12-17, the committee be authorized to hold this afternoon’s meeting without a quorum if necessary for the purpose of receiving evidence, provided that two committee members are present.
The Acting Chair: Thank you, Senator Mégie. Are there any questions or comments on the motion? Would it please you, honourable senators, to adopt the motion?
Hon. Senators: Yes.
The Acting Chair: This evening, we are continuing our study on minority-language health services.
[English]
For our first panel, we are pleased to welcome Frantz Siméon, Professor, School of Social Work, Faculty of Education and Health, Laurentian University. He is accompanied by Sylvie Larocque, Professor, School of Nursing, Faculty of Education and Health at Laurentian University and Bernouse Davilus, Student, School of Social Work. They are joining us by video conference.
[Translation]
Good evening and welcome. Mr. Siméon, we’re ready to hear your opening statement. A question and answer period will follow.
Frantz Siméon, Professor, School of Social Work, Faculty of Education and Health, Laurentian University, as an individual: Good evening. I would like to thank the Standing Senate Committee on Official Languages for this opportunity to speak to the situation of aging in French in northern Ontario. I’m a professor at Laurentian University and UQAC.
I want to begin by emphasizing that I have the collaboration of an entire team, two members of which are here today.
Our comments stem from research funded by the Canadian Institutes of Health Research. They focus on preliminary results relating to the project’s first objective, to describe and understand the experience of family caregivers in minority and northern linguistic contexts.
So far, our sample consists of 19 people living in the Sudbury, North Bay, Timmins, New Liskeard, Ottawa and Toronto areas. They range in age from 46 to 85, with an average age of about 71. This piece of data is important, as the scientific literature tends to suggest that the risk of loss of autonomy increases from the age of 70.
Of this number, seven people are caregivers who support or have supported loved ones with Alzheimer’s-type neurocognitive disorders.
Analysis of the data collected from these people reveals a number of phenomena that require urgent attention; we will highlight three for the purposes of this presentation.
The first phenomenon is that of the heavy subjective burden, which we define as follows: The feeling of an inordinate weight that makes a person feel powerless, overwhelmed and ill‑equipped. A number of people have told us that they were part of the research process in their quest for tools, saying that they came to acquire tools. The first characteristic of this burden is the fact that the person feels saddled with a heavy, unplanned and, therefore, often imposed responsibility. It’s a responsibility for which they had not prepared mentally and psychologically, and for which don’t have adequate and appropriate support. They say things like:
We had lots of plans for the future, for retirement, and then oops, just like that, everything fell through. And then I feel a kind of anger inside me. I’m not angry at him, but I am angry at the situation. And it’s stressing me out.
The second characteristic is a feeling of exhaustion. Some participant exclaim that they find it heavy, nearly sobbing. It’s almost like a pressing cry for help, they’re saying they can’t take it anymore, or just about. Despite the magnitude of the load, the person assumes that the responsibility belongs to them.
This goes back to our second phenomenon, which is that of the moral obligation to care for the person, a kind of sense of loyalty to the other. People say:
The importance of taking care of my mother is paramount, because first of all, she’s always . . . taken good care of us, so it comes back to me. Well, now I’m her spokesperson.
Others tell us that it is quite natural for them, culturally speaking.
So loved ones feel like they’ve been given a mandate from which they cannot deviate, hence this pressing cry for help in handling a responsibility they are given for which they must perform, considering the weight of societal perception that expects these people to be up to the task.
When this directive is incorporated, they become fearful, afraid of failing and appearing incompetent, afraid of being unable to care for their loved one. That’s why they seek help.
The third phenomenon we’ve identified is this role in tension exacerbated by a quadruple disadvantage. The first disadvantage stems from being a woman because of society’s normative expectation of women to care for others, even if this premise is challenged by feminists.
The second disadvantage comes from being a francophone and having to play the role of navigator of the health care system in a language other than their own, which means that they also become a translator. When someone comes from an immigrant background, they have to navigate an unfamiliar system.
The third disadvantage comes from living in a remote region and having to deal with service deserts — you can imagine the difficulties in winter, for example.
The fourth disadvantage is due to being virtually alone in bearing the burden of caregiving amid almost complete indifference: It’s up to the caregiver to find help.
In relation to these phenomena, we recommend setting up psychosocial support services within local organizations. I’m thinking in particular of the Club amical du nouveau Sudbury, with which we’re running the SSHRC-funded project, which has set up a system navigation service upstream of the person being cared for. In our opinion, this kind of initiative should be supported.
We also recommend: supporting community organizations in their role to increase the supply of French-language and culturally safe services and care; increasing the number of care providers; funding research into this particular phenomenon; and encouraging research partnerships throughout francophone minority communities.
In conclusion, we know that, in a difficult situation, everything takes on gigantic proportions. Feeling alone in a caregiving context, where the burden of navigating an already complex system is increased tenfold, adds to the difficulties faced by caregivers. For people with immigrant backgrounds, having to learn both how an unfamiliar system works and how to navigate it means that we maintain that taking care of our caregivers of French-speaking seniors is an urgent necessity. Thank you for your attention.
The Acting Chair: Thank you very much. Colleagues, we now open the floor to questions.
Senator Mégie: I’m going to ask a question that may be upsetting, but I’m going to ask it anyway. I’m vice-chair of the Special Joint Committee on Medical Assistance in Dying, and I was wondering if francophones in your province have equal access to end-of-life medical care in their mother tongue, compared to regular care.
Mr. Siméon: That’s a very interesting question, but unfortunately it doesn’t fall within the scope of what we’re studying in our research on aging. Obviously, it’s an area that deserves to be studied in depth. I don’t know if Ms. Larocque has a comment to add on this subject.
In the research I’m doing, this isn’t really an issue I’m looking into. So it would be difficult for me to answer your question.
Sylvie Larocque, Professor, School of Nursing, Faculty of Education and Health, Laurentian University, as an individual: When it comes to care, whether it’s end-of-life care or hospital care in our regions — and Ms. Davilus can attest to this because of her research — it’s often the case that family caregivers of people who end up in long-term care facilities perceive this as a respite. Often, these caregivers are called upon to translate because hospital staff don’t understand French. There’s a kind of remoteness that can sometimes be perceived as a respite, but that’s not the case for francophones, as they’re often called upon to stay by the person’s side to make sure that the person has fully understood the questions that have been asked and the care that has been administered.
Ms. Davilus, I don’t know if you had a comment to add.
Bernouse Davilus, Student, School of Social Work, Laurentian University, as an individual: To support Ms. Larocque’s comments, of course, as Mr. Siméon mentioned, our research doesn’t necessarily focus on medical assistance in dying, but we do know that francophones who obtain services, whether at home or in long-term care settings, are faced with the problem of service provision in French. As Ms. Larocque said, it’s often because the caregiver has to be available throughout the day to answer questions or give additional explanations to the loved ones being cared for, as most of the time, medical staff are anglophones.
Senator Mégie: In this context, if there is a need to have an interpreter and caregiver accompany the patient, could a request be made that language be one of the determinants of health care?
Mr. Siméon: Absolutely. There are two reasons for this. There’s the issue of service quality. We know that a person suffering from Alzheimer’s disease will revert to his or her first language, and comprehension will pose a major challenge if there is no interpreter or person playing this role. It’s for this reason that we insist that this role is really exacerbated by the fact that the person has to play the role of support person, caregiver and provider, but also has to translate and interface constantly between the health care system and their loved one, which becomes very burdensome. This can indeed be seen as a stress and anxiety factor that can affect the person’s health.
Senator Mégie: Could I have another point of view? Do you all agree with what has been said? Then I’ll ask another question.
The Acting Chair: You can ask another question in the second round.
Senator Mégie: Very well.
Senator Clement: Good evening, and thank you for your testimony and also for your work in general.
I’d like you to talk a little more about the navigation service project. I can’t remember who funded this project. Could you give us more details about it?
In terms of cultural competency and intersectionality, is this an additional burden or challenge? If so, are there things that have been done that you would recommend to specifically address this issue?
Mr. Siméon: Thank you for both questions.
With regard to the first question, this is a project that has just started. We’re in the recruitment phase. I’ve just recruited a student to take charge of the project. The project is funded by the Social Sciences and Humanities Research Council, or SSHRC, and carried out in collaboration with the Club amical du nouveau Sudbury, as I mentioned in my introductory remarks. This is a Sudbury-based active living centre that accompanies, supports and helps people; it organizes both social and cultural activities, as well as networking activities between its members.
Unfortunately, at this stage, we’re really at the very beginning. So it’s a bit difficult for me to tell you about it. Perhaps on another occasion, if you invite me back, I’ll be able to tell you what we’ve achieved through this project. However, I can tell you that it’s already a huge relief for the people who can already turn to the Club amical. I think it reduces their stress level. They know that someone is listening to them and can accompany and support them in their various dealings with the health care system.
With regard to the second question, I lost the thread, and I apologize. You mentioned cultural competency, I believe.
Senator Clement: Yes, and I also talked about intersectionality.
Mr. Siméon: I wouldn’t want to comment on intersectionality, as I’m not well versed in feminist theories. However, I can tell you, as we said earlier, that in the role of caregiver, it’s quite a heavy additional weight, in my opinion, on the shoulders of the caregiver, especially the one who comes from immigration, who doesn’t know the system, who may speak French, but not English very well. Often, the caregiver is also a little elderly. I mentioned earlier that many of these people are in their 60s and 70s. These people also have their health concerns. This certainly adds to the caregiver’s burden, the subjective burden of the role.
On the other hand, it can also have positive effects, like this lady who tells us that she takes care of her mother as she took care of her. We’re happy to give back to the next person. Nevertheless, the burden is quite heavy for the people who have to play this role, but also that of translator, navigator, companion, service seeker, without necessarily knowing where to turn. In this sense, I think the Club amical is breaking new ground by setting up this system navigation service.
Senator Clement: My question has more to do with the intersectionality of racialized people. I don’t know who was included in the cohort you studied, but the question was more along the lines of: Do aging people who are also members of minority communities need something else in the way of a navigation service, something to help lessen the burden they have to carry as they try to find their way through the health care system?
Ms. Larocque: I’m going to invite Ms. Davilus to tell us about her results. These recommendations are preliminary and come precisely from the participants; perhaps Ms. Davilus could tell us about a few recommendations.
Ms. Davilus: Of course. Thank you for the question.
In collecting data from caregivers from immigrant backgrounds, what we hear from them is that being an immigrant and a newcomer adds to the burden of being a caregiver. Why is this? Because some people are new to the system in Canada, and they don’t know how to navigate it. They don’t know where to go for help. There are others who are looking for services that are culturally appropriate for them, and the services don’t always take the cultural component into account. Others talk about referrals; they would like to have a community centre that would offer referrals. For example, if someone comes from Haiti, it would be interesting if we could help them find the appropriate service. If someone comes from another culture, we could do the same thing. The fact of being an immigrant and a francophone, that’s where the intersectionality you’re talking about comes from, senator; it’s the fact of being a new francophone immigrant to the country, of being new to the system. All this plays a role that adds considerably to the burden and responsibility of a caregiver, as compared to a caregiver of Canadian origin.
Senator Clement: Have any solutions been proposed?
Ms. Davilus: Yes. They’ve proposed putting services in place at reception, reception centres for immigrants. From there, we can welcome them and tell them about the services available to immigrants, because according to them, they’re lost in the system and don’t know where to go for help. For the majority of immigrants who come here, their first contact is an immigrant reception centre. If we can make this connection between an immigrant reception centre and health care services, it could lighten their load. For example, the person could call a centre they already know; they could mention that they are taking care of their mother and ask for help. From there, someone at the centre makes the referral to the appropriate health services.
Senator Clement: Very well. Thank you very much.
The Acting Chair: I’m going to ask a question. You’re at Laurentian University, in northern Ontario, and you work in a huge territory; there are about 250,000 francophones in an area of about 800,000 square kilometres. You also know that in the North, not all towns are organized in the same way. Sudbury, for example, is probably better organized than other northern cities. The city of North Bay, for example, is much more English-speaking — that’s where I’m from — and services are perhaps a little less adapted or accessible to francophones. The more you go into smaller communities, the more you find that there are more and more precarious services, depending on the community and depending on the percentage of francophones who are in those different areas.
Let me come back to what you were saying when you were talking about the burden on caregivers. There’s an urgency in this area precisely because the services aren’t always organized. What kind of concrete proposal could you make when we think of northern Ontario and access, especially when we know that the majority of funding comes from the provincial government?
Big question and big territory; what are the solutions?
Mr. Siméon: I’ll jump in and ask others to complete my answer.
You were right to mention that coverage of the territory is unevenly distributed. This was one of the first observations we made when I began my young career as an independent researcher at Laurentian University, when I realized, with CNFS funding to map aging in Sudbury, that the majority of services were concentrated in the downtown core. Outside the downtown core, there were gaping holes — what people who work in health services generally call service deserts. There are indeed quite worrying service deserts all over the area, which raises the whole question of how difficult it is to access service. As I said earlier, it’s easy to imagine the difficulties of getting around in winter, for example, given the conditions you know about when you live in the North.
One of the mechanisms we’re suggesting is support for local organizations; it’s about making sure we have wider coverage of local organizations that work upstream of problems. I’m thinking in particular of what the Club amical du nouveau Sudbury does, which has a bit of funding and makes sure it meets the specific needs of its members, which reduces both the emotional and subjective burden, knowing that there’s someone there to listen. That alone — having someone who can listen, make referrals and let you know about a service — can make a big difference to a person’s life.
I would suggest a network of community organizations and support for these organizations, so that they can have the resources they need to offer culturally safe services and care in French, and so that they can also increase the number of care providers throughout the territory. Obviously, we haven’t yet been able to determine how much this would cost. It seems to me that working upstream, by supporting the organizations that already exist in the territory, would require lower costs than if we had to build a hospital centre, for example.
It’s really important to be able to support and accompany local organizations and work to increase the number of these organizations, which are closer to aging people who don’t want to move or leave their territory. When we ask people where they want to grow old, their first choice is always their own home. It’s also good practice for people to be able to stay in their own community, surrounded by family, friends, networks and so on. If we could strengthen these networks by supporting local organizations, in my opinion, it would make a very big difference to the aging population.
The Acting Chair: Thank you very much. I don’t know if Ms. Larocque wants to add anything.
Ms. Larocque: Yes. I’d just like to add to what my colleague mentioned about health care providers. We need to continue to recruit and retain French-speaking health care providers in northern Ontario regions and support them on their journey.
I’m also doing research in telemedicine; we need to use these means. As my colleague mentioned, winter isn’t always easy in northern Ontario, so we need to find ways of not making people wait to get the care they need.
Telemedicine is one example. In addition, what was mentioned in some of our research was that there are very few French-speaking specialists. So we need to increase the number of specialists who can offer health care in French.
The Acting Chair: Ms. Davilus, would you like to add anything?
Ms. Davilus: I’d just like to support the point my colleagues have made. We need to fortify and expand the offer of services in French.
Senator Mockler: First of all, I’d like to congratulate you on your interventions in the area of health care. I’d also like to hear from you on a few points, and I’ll end with the Nursing Home Without Walls for Aging in Place program.
I have several quick questions that I’ll read.
In your opinion, are the laws, regulations and policies sufficient to protect the rights of official language minority communities to access health services in their language? I also have a follow-up question. How would including health among the sectors essential to community vitality in the Official Languages Act advance rights?
I’d like to hear from our three witnesses, please.
The Acting Chair: Do any of you three want to answer the question first?
Mr. Siméon: I’ll jump right in, and thank you for the question. In my opinion, drafting a law is a step in the right direction. However, in the words of an author I like, Amartya Sen, a law is an enabling device, but without conversion factors, i.e., without means made available to professionals and communities, a law risks remaining a dead letter.
So yes, the law is important and indispensable, but in the absence of conversion factors, without financial, human, temporal means, et cetera, it’s not enough. In the words of the International Bill of Human Rights, the right to health is one of the fundamental rights to which we subscribe as a society. So, in my opinion, enshrining it in law should be automatic, insofar as it’s the Canada Health Act that ensures that every citizen has this fundamental right.
Already, not being served in French or waiting longer to be served in French in a minority context is a hitch in the law and, in my opinion, has no place in a society like ours. Including health in the law should be an automatic response to our obligations as a society that has opted for the Universal Declaration of Human Rights, since health is a fundamental right. That’s how I would answer the question.
I don’t know if my colleagues want to respond. Sylvie, I invite you to complete or qualify my answer.
Ms. Larocque: I’m just going to second what you just said. I think it’s essential to have laws, but we must have the means to enforce them so that people can say they have the right to obtain services within a reasonable time. In our research, we shouldn’t hear our participants say, “I’ll speak in English, because I’ll get services faster.” Yet this is something we often hear and don’t want to hear again. We may also hear, “My mother refused care because the attendant wasn’t French-speaking.” The perception is that she no longer needed the care.
It’s not that she no longer needs the care, it’s that she would like to receive it in French, which is a right, in my opinion.
Ms. Davilus: Thank you for the question. Indeed, I support what my colleagues have just said. I agree that laws must apply to protect the right of francophones and linguistic minorities to receive health services in the language of their choice.
I think having laws is one thing, but putting them into practice is another. As Sylvie mentioned, the laws may exist, but in reality, people tell us that they don’t always receive services in French. Yet the laws stipulate that they do indeed have the right to receive services in French.
In short, I think we need to make sure that these laws are enforced and respected at all levels of service.
The Acting Chair: Senator Mockler, you may ask your second question.
Senator Mockler: I want to talk about the responsibilities of different levels of government. In your experience, is there real cooperation among the federal, provincial and municipal governments, French-language health networks and francophone post-secondary institutions? What role should the federal government play in improving the delivery of minority-language health services?
Mr. Siméon: That’s a good question. Thank you for asking it. Obviously, I won’t wade too deeply into the relationship between the federal and provincial governments. That’s not my area of expertise and research.
However, I often hear that there aren’t enough tools and local resources available to help implement the Official Languages Act.
It isn’t right that a French-speaking person in Ontario must wait twice as long to receive services in their language and face the risk of their situation becoming worse, or that they fail to receive services because they don’t understand English well enough. In my opinion, there should be enough human and financial resources to apply this legislation, so that every Canadian citizen, whether they speak French or English, can have their health needs met across the country.
Why is a person who chooses to live in the North penalized because they can’t truly live in their mother tongue? It’s a fair question.
I think that the federal government plays a key role here. It must provide financial resources that meet the needs of people who, as stated earlier — Sylvie said it well — have a right to this service in French. Not only are they entitled to this service, but they are entitled to receive it in their mother tongue.
We know that both languages are equal in Canada. I’m calling for enough financial means, financial resources and factors to ensure that legislation makes a real difference in the lives of every Canadian.
Senator Mégie: I heard you speak earlier about newcomers. I also know that keeping seniors in their homes is still the focus. That option is their first choice in the various surveys conducted. However, when navigators want to direct people, do they point them to private or public services? Do they choose home care or private or public services? How much choice do they have, given the language?
Mr. Siméon: I think that this constitutes the crux of the issue. At this stage, social innovation is needed. When the person is already in the system, it’s somewhat easier. In some settings, translators may be found, even if it takes time. However, when the person is outside the system, the situation is extremely complicated. We don’t necessarily have navigators in the system. This may be a key need. It would prevent our emergency services from becoming clogged up. Responses would already have been given before health problems arise. This is a real issue.
I’m currently co-supervising a doctoral student whose thesis focuses on the need to develop a tool to help people navigate the system, before they even enter the health care system. I want to emphasize the need to give local organizations the tools and resources to find caregivers that fit in with this reality.
I don’t know whether this answers the question, Madam Chair. I think that there’s a real need for help with navigating the system.
Senator Mégie: How would you approach this? Have you thought about it? I’m sure you have. What could be done to meet this need?
Mr. Siméon: As I said, I’m currently working with the social club that launched this initiative. We’re not at this stage yet, but we’ll be documenting the experiment and determining whether the initiative benefits people and leads to better health conditions. I think that initiatives of this nature should be studied, nurtured, reviewed and supported. The goal is to find tools and resources from both the community and the people who receive these services. They can then tell us how the service has been useful, important and beneficial. These are truly grassroots initiatives.
Ms. Larocque: I agree with some of what the participants have said. However, private services always come at a cost. A number of people can’t afford to pay for private services to keep their loved ones at home. This becomes an even greater challenge for immigrants.
Bernouse, you may have something to add.
Ms. Davilus: On top of that, people tell us that they want to contact public services first, because public services most often receive funding from the provincial government. That said, the services provided aren’t always adequate and sufficient. When they ask for more services to properly meet the needs of their loved ones, they’re told to turn to the private sector. However, they don’t have the money to pay for private services. This is where the problem lies. The issue comes on top of the other challenges faced by caregivers, whether they come from an immigrant background or they come from here. It’s always the same thing. “We can’t give you any more services. You’ll have to turn to the private sector.” We often hear this when we compile our data.
The Acting Chair: I’ll ask two quick questions, because we’re running out of time. I know that Senator Mockler still has a question. I don’t know whether you have a question, Senator Clement.
Let’s take another look at northern Ontario. Ms. Davilus, I want to know whether your study explores the differences, for example, between a city such as Sudbury, which has a population of 170,000, and a town such as Hearst, which has a population of 6,500 and well-organized community services. In terms of support services for seniors and language in a town such as Hearst, language isn’t an issue, since 95% of the population is French-speaking. It may be more of an issue for anglophones who want to be served in English.
Did your study compare well-organized communities with large cities, where the demand for services is much higher; where the population is far more spread out; and where services may be limited given the number of people who need help?
Ms. Davilus: Good question. Thank you for asking it.
I’ll make a comparison with Ottawa. At one point, we received ethics approval to expand our area to Ottawa and Toronto. I was personally surprised to see that Sudbury and Ottawa aren’t much different when it comes to French-language services or the adequacy of services for caregivers. People in Ottawa say that it’s hard to find French-language services and that the services are insufficient. Sudbury participants say the same thing. It’s difficult. There are only two French-speaking doctors. You have to wait or speak in English to obtain faster service. In this case — and I don’t see any difference — the research data still doesn’t show any difference when it comes to a big city such as Ottawa or Toronto, even though we know that Toronto is practically an anglophone city.
Ottawa and Sudbury aren’t much different when it comes to French-language services. We’re still collecting data. We’ll see what the next data says. However, our current data doesn’t show much of a difference.
The Acting Chair: Your response is intriguing. I have a quick question, but I’m also interested in your answers. Could you share your perspective on a possible obligation to include language clauses in health transfers and the associated intergovernmental agreements? Mr. Siméon, what do you think about this obligation?
Mr. Siméon: I spoke earlier about the right of francophones to receive the same service as anglophones across the country. We’re talking about people across the country. Yes, I think that this should be an obligation, as it becomes a determinant of health. Moreover, as we’ve also seen, when we have to wait twice as long for service in our own language, we have time to see our situation decline. Quality of service is at stake here. I think that this should happen.
The Acting Chair: Thank you. Senator Mockler, you have the last question.
Senator Mockler: I think that I’ll change the subject rather than talk about the Nursing Home Without Walls program. I want to ask about funding.
In your view, how does the Canadian Institutes of Health Research, or CIHR, take into account the health needs of official language minority communities? In your experience, are francophone post-secondary institutions or francophone minority researchers at a disadvantage when they apply for funding from these granting agencies in Canada?
Mr. Siméon: I’ll let Sylvie weigh in, since she has much more research experience than I do. I started in 2018.
However, I do sense a willingness on the part of the CIHR to fund and support research on francophone minority communities. With this in mind, I received my current funding. I’m not familiar with past practices. However, in my meetings with CIHR representatives, I sense a willingness to support, nurture and fund research.
Initiatives in this area seem to be creating relatively good conditions for francophone minority researchers to carry out their work. Things seem to be moving in the right direction.
Ms. Larocque: I agree with my colleague. I’ve been a researcher for a number of years. We’re seeing improvements. I hope that, as a result of our final recommendations, we’ll really see some benefits.
The Acting Chair: Ms. Davilus, did you have anything to add? You’ll be our last speaker for this panel.
Ms. Davilus: I have nothing to add. I’m a student researcher, so I work with researchers who are there and who support me. I hope that, in the coming years, I’ll have much more to say about funding. I’ll be working with organizations that support health research involving minority-language ethnocultural minority communities across the country.
The Acting Chair: Good luck with your study and research, and all the best for the future.
Senator Mockler, do you have another question?
Senator Mockler: I think that the question has already been fully covered, thank you.
The Acting Chair: Thank you for participating in our meeting this evening. We greatly appreciated your responses and the information provided for the committee’s study. Thank you.
Colleagues, we’re continuing our work as part of our study on minority-language health services.
[English]
For our second panel this evening, we are pleased to welcome, in person, Dr. Suzanne Dupuis-Blanchard, Professor and Director of the Centre on Aging at the Université de Moncton; and Mario Paris, Associate Professor, School of Social Work at the Université de Moncton by video conference.
[Translation]
Good evening and welcome. We’ll now hear your opening remarks.
Ms. Dupuis-Blanchard, the floor is yours.
Suzanne Dupuis-Blanchard, Professor and Director of the Centre on Aging, Université de Moncton, as an individual: Thank you, Madam Chair, and honourable senators.
First, thank you for inviting me to speak about the important matter of minority-language health services. This topic is closely tied to the aging population. We know that, as people age, and especially in times of crisis or illness, such as dementia, they fall back on their first language learned. The subject studied by your committee must be addressed.
In 2023, seniors in official language minority communities are still facing challenges when it comes to accessing health care and services in their own language. There are many reasons for these challenges. Not everyone is comfortable asking for health care or services in French. According to an ongoing research project, people who are more daring or assertive will demand care in French, and will sometimes face negative consequences. Others are afraid of bothering the staff. Above all, they’re afraid of receiving lower quality care and having to wait longer.
However, the challenges involved in accessing French-language health care and services are often outside the control of seniors and their families. My research team’s 2022 report on home care in francophone minority communities confirms the challenges involved in accessing care in French. We observed a lack of consideration for the French language and francophone culture in home care, and a shortage of francophone human resources. Very few promising studies or practices were identified in the paper to paint a current picture of the situation in francophone minority communities. Often, reports from governments and stakeholders failed to include language barriers, or simply made no mention of them at all.
The impact of language on care reportedly affects the risk of hospital readmission, leads to poorer health assessments, prolongs the use of home care and increases the number of home visits as a result of communication challenges and lack of compliance with treatment. Language barriers reportedly also mean less planning for end-of-life care. In addition, language barriers often require the support of family members, putting caregivers at greater risk of fatigue, stress and burnout.
It’s also important to understand the reality of nursing home residents, one of the most vulnerable groups of French-speaking seniors. Nursing homes with French or even bilingual designations are unable to hire French-speaking caregivers.
Family members and loved ones have shared unimaginable situations. Their relatives use signs with one side in French and the other in English to communicate with unilingual anglophone health care staff when they’re thirsty, in pain or need help getting to the bathroom. Shocking. As a nurse, it’s hard to even hear these types of statements. The shortage of staff in our nursing homes is worrying. It’s becoming a quality-of-life and safety issue for French-speaking seniors in these communities.
In New Brunswick, I’m in charge of two projects to promote healthy aging in French.
The first project, called Pivot santé pour aînés, or health hub for seniors, provides health-promoting services to francophone seniors, while giving university students training and internships to teach them about healthy aging, all within a research environment.
The second project, Nursing Home Without Walls, helps people stay in their own homes by pointing them towards services and activities that combat isolation, while reducing the number of avoidable emergency room visits. After the success of the pilot project, the program is currently being rolled out across New Brunswick.
In terms of recommendations and findings, the federal government could help in the following ways: create an analytical tool similar to gender-based analysis plus, but to recognize the influence of official language minority communities in the development of federal initiatives; develop and implement a common policy for gathering information on francophone identity in a care context; develop research funding initiatives that focus on key issues for official language minority communities, or OLMCs; and fund training for future health care professionals to meet the needs of francophone minority communities, but also increase training on aging, since health education programs spend very little time on preparing future professional caregivers for the aging population.
Thank you for your listening. I look forward to answering your questions.
The Acting Chair: Thank you, Ms. Dupuis-Blanchard.
Mr. Paris now has the floor. You can give your opening remarks.
Mario Paris, Associate Professor, School of Social Work, Université de Moncton, as an individual: Good evening. Thank you for inviting me to speak today about the delivery of health and social services in the face of an aging francophone minority population, in particular in New Brunswick.
As an associate professor at the Université de Moncton’s School of Social Work, I’m happy to share my experience in participatory research with a number of the province’s francophone communities. Specifically, I’ll discuss the results of a recent study that I conducted with a colleague on the francophone minority community in Saint John.
For over 15 years, I’ve been studying and working with municipal, community and public officials to improve the quality of life of seniors, right in the heart of their communities. In particular, I’ve been studying the age-friendly city and community program in Quebec and New Brunswick, and at the national and international levels.
This World Health Organization program seeks to create communities where seniors can continue to live active and healthy lives and to fully participate in social life. Over the years, I’ve shown how the results of this program are measured not only by “outputs,” meaning quantifiable ways, but also in an approach based on a transparent decision-making process, open communication and consensus-building among stakeholders. I’ve also worked with different communities, sometimes at a local level, and sometimes at the level of a neighbourhood or even a seniors’ residence, to find solutions to their problems.
The project that I’m presenting today took place in 2022 with the Association régionale de la communauté francophone de Saint-Jean, or Saint John regional francophone community association. The association invited me and my colleague, Elda Savoie, a professor at the Université de Moncton’s School of Social Work, to conduct a qualitative survey of francophone seniors. The goal was to identify their needs and possible solutions for French-language health and social services in their community.
We conducted 32 individual interviews and set up three focus groups. In total, we met with 47 seniors living in different Saint John neighbourhoods. The data analysis helped identify a number of key issues. Two of these issues concerned health and social services.
In terms of health services, we found that all the people encountered wanted to grow old in Saint John in their own community, with their family and friends.
A handful of people were planning to move from Saint John to another part of the province. They wanted to move because of access to care and services in French.
Throughout their lives, and particularly in their later years, participants said that they had dealt with inconsistent health care services in their area, right across the continuum of services. A number of challenges were identified. These challenges include an inadequate service intake process in French; the poor French skills of bilingual professionals; the limited active offer in the Horizon Health Network; and the limited active offer in Saint John hospitals. Against a backdrop of widespread mistrust in the medical system, a couple in their seventies shared their concerns. They noted the importance of mutual understanding in medical communication. As one member of the couple pointed out, the language barrier can be a source of anxiety, which becomes apparent when they prefer to explain their condition in English to ensure that their medical needs are understood. This experience shows the challenges that seniors can face in health care in Saint John.
In terms of social services, for the participants, most of these services were provided in English in Saint John. Sometimes, social services were available in French, but it took a long time to receive them. In extreme cases, people had to pay for the services, when they could have been free in the public system. This is also the case for home support services, for both activities of daily living and domestic living.
The challenges identified by the participants include the limited availability of social services in French; the lack of access to information in French for home support; and, above all, the lack of a residence for French-speaking seniors in the area. The last issue was a major concern for the participants. As they age, it seems increasingly difficult to remain at home. This shows the overlapping concerns about growing old in French in Saint John. For a number of participants, aging means health problems. However, care and services are difficult to access in their mother tongue. If a person had to move to a residence, there was no prospect of a French-speaking residence. Staying at home for as long as possible is, in a way, a safe haven for participants, who want to grow old in French in their own community.
In closing, we feel that the results of this research show the importance of a more holistic and integrated approach to meet the needs of francophone seniors, particularly with regard to health care, community services and social support. Clearly, for francophone seniors to live healthy and independent lives in Saint John, their unique cultural and language needs must be considered. Seniors must also be involved in planning and implementing the programs and services that affect them. Lastly, it’s important to acknowledge the significant contribution of francophone seniors to the Saint John community, and to give them the support and services that they need to live independently and with dignity. Thank you.
The Acting Chair: Thank you, Mr. Paris.
Colleagues, we’ll start the question period with Senator Mégie.
Senator Mégie: I want to thank our witnesses.
Mr. Paris, you spoke about your work at the national and international levels. Have you found any good practices that could be applied to seniors’ care, either abroad or in another province?
Mr. Paris: My research abroad and in other provinces is conducted within the framework of the World Health Organization’s age-friendly communities program. This program has always demonstrated the need to mobilize all stakeholders, including individuals, seniors’ organizations, elected officials, municipalities and various levels of government. The idea is to rally around a common cause. That cause is the aging population in a given area.
In terms of social innovations, I can’t think of any specific examples. On a practical level, we often see stakeholders work together. There’s rarely any talk of pumping money into new services to meet needs. The idea is to say the following: “Let’s redesign our services while working together and placing people’s participation and needs at the forefront.” There’s often talk about the availability of services and the basket of services. However, there isn’t any prior consideration of whether these services meet people’s needs.
In Saint John, a major concern was the need for a seniors’ residence. They don’t have a francophone nursing home. One day, they’ll inevitably need to move to an anglophone nursing home, which really causes problems. How is a residence or a nursing home established? Different levels of government must get involved and work together. It’s many things of this nature. In research, we often see that this collaborative governance is necessary.
Senator Mégie: Okay, thank you. What happens to seniors in Saint John? Do they all go to an anglophone long-term care facility?
Mr. Paris: Different provinces have different care systems. In Saint John, francophone seniors go to a nursing home. My colleague Suzanne will explain it better than I can. There are four levels of care. Quebec’s long-term care facilities are equivalent to level 3 and 4 nursing homes in New Brunswick. In Saint John, there are no francophone nursing homes for seniors. Often, to receive care in French, they’ll move to other predominantly French-speaking areas. In New Brunswick, 30% of the population is francophone, but the francophones are heavily concentrated in certain areas. However, in cities such as Fredericton and Saint John, the communities have a very small margin. The proportion is maybe 4% in Saint John, if I remember correctly. This means that services are very limited.
Senator Mégie: Okay, thank you.
The Acting Chair: I’ll ask my questions. They may be shorter at first, to see where the responses take us.
At one point, in Ontario, long-term care residences were public, meaning that they belonged to groups such as nuns. A number of hospitals in Canada were established because religious people funded the operations and were on hand to provide care.
Over the past twenty years or so, we’ve seen seniors’ residences become privatized. Publicly funded long-term care facilities have been transformed. They aren’t as private as they used to be. Has this happened in New Brunswick? Can anyone answer my question?
Ms. Dupuis-Blanchard: I’ll start, and Mario can continue if he wants.
In New Brunswick, it’s more or less the opposite. However, there’s a move towards privatization in partnership with the provincial government. Nursing homes are managed by boards of directors. They’ve been privatized, so to speak, but by the government, not by companies. They used to be not-for-profit, and so on. Now we’re seeing private companies changing some things, because these partnerships have been created with the province.
We’re told that these homes are still not-for-profit. However, we have to wonder how the companies can manage while remaining not-for-profit.
Mr. Paris: I agree with my colleague Suzanne. I come from Quebec, so we’re used to CHSLDs, or long-term care facilities. We’ve had some large public institutions. The largest CHSLD was in Saint-Hyacinthe, and it had 700 residents in the 1980s. The system was then deinstitutionalized, giving way to private residences for seniors. When I left Quebec in 2017 to take a job here and start a family, while becoming part of the New Brunswick and Acadian communities, I noticed quite a change of direction.
In New Brunswick, in the 1980s, the federal government provided public funding for the development of nursing homes for seniors. These homes are not-for-profit organizations. There are very few cooperatives in New Brunswick. However, it’s surprising to see so many not-for-profit organizations that are very small nursing homes. We’re talking 12 to 20 residents. These are very small homes in small communities. It was a totally different model.
What we’ve been seeing over the past 10 to 15 years is openness to the private sector. There are RFPs, or requests for proposals, for care homes now. The private sector is part of the equation. Housing in Canada is a private market, which means that it often wins those RFPs. Nowadays, a lot of new construction is private, with variations and partnerships. Like many people, I am in favour of diverse housing options. There is a lot of diversity, but 10 or 15 years from now, when our homes need renovation and upgrading, what support will there be for that?
The Acting Chair: Here’s a typical example. My mother was in a long-term care home run by nuns. That was before privatization. My father, who died 20 years later, lived in a private long-term care home. There was a noticeable difference.
To be clear, the long-term care wasn’t privatized; it was attached to the Montfort Hospital in Ottawa, but the seniors’ residence he lived in was private. That meant it was very expensive, but when my father transferred to long-term care, the costs came down.
We’re seeing service quality deteriorate in terms of both language and services available in homes. I want a better understanding of the challenges. You mentioned some of them, but there’s also the labour shortage.
I want to talk about funding. What are the challenges related to the funding needed to keep seniors at home as long as possible? What are the challenges associated with access to assisted living facilities? Lastly, what are the challenges associated with long-term care? What challenges are you seeing in your province?
Ms. Dupuis-Blanchard: The biggest challenge when it comes to funding is paying for non-professionals. Housekeepers and home care workers are often underpaid, barely minimum wage. They get very few benefits and very little recognition, and there aren’t many prospects for advancement.
That’s not all. Look at the whole system when it comes to nurses. I’m a nurse myself. We’re seeing a wave of what we call travel nurses, who help address the shortage but get paid two or three times more than our permanent nurses. That raises questions about human resources, if you will.
That said, with respect to funding, we need to identify best practices in our communities. I’m talking about small businesses, small associations, local services that typically get piecemeal funding from one year to the next, often through the federal New Horizons for Seniors Program. Many of our community organizations do a lot of good when it comes to aging in French or in both languages. They benefit from the program, but there aren’t a lot of others that support the work being done. When there are projects or programs in the community, the funding is always for a limited time. When it runs out, people never really know where the next chunk of money is coming from or what will happen to the project even if it does have a positive impact and so on.
Those are my thoughts in response to your question.
Speaking of care homes, in New Brunswick, we also have what we call special care homes, level 1 and level 2. These are for people who can’t necessarily stay at home, but need something transitional because they mostly need help with things like meals. They don’t need nursing care, just access to support. Then we have level 3 and level 4.
Some people say that if we had enough home care services, we wouldn’t even need levels 1 and 2. I’m not so sure. There are a lot of factors involved. Aging in place is my research area. It’s certainly something we need to put some more thought into. Yes, 92% of seniors in Canada do manage to age in place, but there are still some services that aren’t available or are hard to access, and that’s often because of staffing shortages.
The Acting Chair: Mr. Paris, do you want to add to that?
Mr. Paris: I want to emphasize that idea of community. In my specialization and my social work practice, it’s important to create space for the community to mobilize, to become aware of the issues and take action. Government support is important too. Mostly, we need to be creative about programs that can have an impact.
As Suzanne said, funding tends to be project-based. You can have a great initiative that lasts a year, and then you have to show the outcomes, the results. Everything has to be measurable. People don’t always bother to listen to the folks on the ground who say a project is working and is making a difference. Funding tends to disappear after. I can think of many examples of projects that were funded and started up but didn’t get long-term funding. They fail because there’s no financial support.
Social innovation is a term that’s a bit overused, but I believe in it. It is possible to find ways to work together. I’m not just talking about communities and governments. Police services, paramedics, municipal government and elected representatives can be part of it too. The idea is to break down these silos and have everyone pitch in. This demographic shift is structural. We’ve been talking about it for 30 years. We’ve been talking about a labour shortage and a health care crisis for 30 years, but we wait until it really hits before we get moving. By the time we get moving, it’ll be behind us. That’s what’s going to happen.
The Acting Chair: It’ll be a few years before it’s behind us.
Mr. Paris: You might be surprised. This is going to go on for another 30 or 40 years. We have to rethink our philosophy around working together. Our funding mechanisms should force us to do that. Calls from certain ministries — There’s a great example in New Brunswick. So far, I’m not seeing a lot of interdepartmental cooperation. We have a Seniors and Health Aging Secretariat that is starved for human resources and funding. People say how great it is that there’s funding for programs like age-friendly communities, but once we have an action plan in motion — If something happens in housing, for example, if speed limits are lowered on certain streets, the ministries aren’t stepping up. People eventually realize it’s a never-ending battle, and individuals and small municipalities run out of steam. We have to do this work, rethink how we collaborate and coordinate what we’re doing.
Senator Clement: Good evening, and thank you for joining us. My first question is for Professor Dupuis-Blanchard.
You made recommendations to the federal government, and I’d like to follow up on that. Are you satisfied with existing data collection? I get the impression Canada is weak in that department. Can you comment on that? You talked about a common data collection policy. I’d like more information about that. Every committee talks about how data collection is a problem. Without data, it’s hard to propose and justify long-term funding.
Ms. Dupuis-Blanchard: That’s an excellent question. Thank you for the opportunity to respond. As researchers, we get asked questions, even leading up to meetings like this one. We try to get data. Part of each project involves seeing what information is already out there. In many cases, we find that the language component isn’t there or the data aren’t available. Availability of data is an issue. People always talk about making decisions based on evidence, data, and research, but information isn’t always gathered. Sometimes information is so hard to find that we can’t use it.
We’ve made progress on the language front, but it will take more work. Take something as simple as a health card. I know that’s under provincial jurisdiction, but couldn’t we standardize what information we ask people for? Just checking the health care system would be enough to identify people who want access to services in French without making anyone uncomfortable or making a big deal out of someone asking for service in French.
I would even go so far as to say that, as part of research funding requests, the language component should be part of basic information gathering, just like gender. There’s been a lot of progress on gender, and for good reason. I think we can learn from the changes that have been made. Research funding applications include questions about gender and sex. They ask, “Have you taken the required training?”
I think these are ways to help people understand why it’s important to get this data. Data collection goes a long way. It gets us the information we need, and it clarifies things. Sometimes we don’t realize the information is already there or paints a picture of the francophone community in whatever sector. Often, though, we don’t have access to that information.
Senator Clement: Thank you for your answer. Have you discussed this with the provincial government? Have you made this recommendation formally to get a response?
Ms. Dupuis-Blanchard: I have because I co-chaired the implementation of the provincial strategy on aging, and there were certainly discussions about that. That strategy has been in place since 2017, but nothing has been done yet. That says a lot.
Senator Clement: Thank you for your answer.
Ms. Dupuis-Blanchard: I’m not the only one who has put these requests to various provinces. I have colleagues in other provinces who have done so as well. We think it would be easy for health cards to indicate which language of service people prefer. That information can then be used to create databases. This is the researcher in me talking, but that’s what we need.
Senator Clement: Thank you very much. I have a question for Mr. Paris.
You talked about municipalities, which is interesting to me. In Cornwall, there was a project sponsored by the Alzheimer Society to build dementia-friendly communities. It was an excellent initiative involving a conversation with the community. All the recommendations were geared toward making the city friendlier, more accessible and more welcoming not only for seniors, but for everyone.
When I was on city council, I observed a constant lack of communication and collaboration between the municipal, provincial and federal levels of government. I don’t know if you’ve noticed the same thing. Municipalities are so close to the communities that they often have a hard time getting the federal government’s attention. We’re always being told that health care is a provincial matter or that a given issue is a federal matter. Collaboration is exactly what’s missing. Can you comment on that and suggest some solutions?
Mr. Paris: Everyone loves the word “solution.” Collaboration among different levels of government can look a lot like “out of sight, out of mind.” For municipalities, the only time I’ve seen the federal government get involved was in age-friendly communities, and that was for funding. We launched an action plan after that, and that’s when the federal government recognized age-friendly communities, which lent some credibility to the community undertaking, to collaboration and to priorities.
That’s what they did in Quebec. Portions of ministerial budgets —infrastructure, say— were set aside for the action plan. The thinking was, “You’ve developed an action plan, you want to transform your park, change the sidewalks so they’re better for seniors? We acknowledge the steps you’ve taken, and we’re giving you some money.” There’s buy-in, and there’s a way in. It’s like recognizing that the community has taken the time to talk about this, to get on the same page, reach a consensus and set priorities. When the time comes to fund something, those priorities get the funding because the community is familiar with the issues. Some cities have advisory panels, or an elected representative has an idea they want funding for and makes a few calls. At ground level, if community members haven’t been consulted, that can cause conflict, friction or tension, and things won’t go well.
As far as solutions go, I would envision programs that recognize initiatives related to age-friendly communities, which can improve access. This isn’t about getting more than other communities; it’s about understanding. In many cases, they can say, “If you go through this process for your community, you can access this funding.”
Sometimes it was also research funds where there were concerted calls on problematic situations. That was Quebec’s strength. They had action plans, as we do in New Brunswick. Very often, they saw common projects and determined what would be cross-cutting in the communities and in the province. In the housing sector, for example, research calls were made to find solutions. That’s another example. I’m talking here only about age-friendly communities.
The only federal agency I’ve seen revolving around age-friendly communities is the Public Health Agency. It has done good community work in terms of practice. It has brought together all the provinces, federal players, levels of government and their provincial counterparts around the age-friendly communities project, and everyone will be meeting on an almost monthly basis to talk about what’s been done. There’s a real dialogue going on between the different provinces. We see less of this dialogue at the municipal level. This is a comment I made to a public health colleague. I was saying that it would be good for you to get out of this provincial-federal relationship and turn to the communities and community organizations to establish this community of practice.
Senator Clement: Thank you very much.
Senator Mockler: This is very interesting. I would be remiss if I did not make comments to the two university professors from my region.
I would like to congratulate you on your leadership. You are heard from often, and that’s important. You have a lot of respect, and people respect you. The aging population is a very important issue. Keep up the good work.
Sometimes it’s shocking, but we can go back and knock on those doors more often to take advantage of opportunities. I used to wear the social development hat in New Brunswick. With regard to nursing homes, based on the answers you gave, are foyers de soins spéciaux special care homes?
My question is for Mr. Paris. You say that there aren’t any French-language special care homes in Saint John?
Mr. Paris: Yes, that’s right.
Senator Mockler: I remember the late 1970s and early 1980s. As part of the Official Languages Act program, New Brunswick became involved in the community school centres that led to the creation of the Centre scolaire Samuel-de-Champlain in Saint John. I could name the others, but the chair is looking at me, and I want to make sure I get my three or four quick questions in.
The program was used by our leaders in the 1970s to provide better French-language services to our small minority communities. Couldn’t we use the same program or think of a similar one for nursing homes? I’m thinking of the example you just gave for Saint John, and there are others.
Mr. Paris: That’s the strength of some New Brunswick communities, especially if they are very much minority communities. They have concentrated the services at the Centre scolaire Samuel-de-Champlain from birth to, until recently, old age. Amazingly, that was one of the things we didn’t expect. In Saint John, there was the community service centre, with the school, daycare and even health care, some health care, a health clinic. Next door was the seniors’ club. For many years, these two centres hadn’t talked much to each other. This was an observation that was made, and especially in our community consultations, we’ve included at the table the Association régionale de la communauté francophone (ARCf), which manages the Centre Samuel-de-Champlain.
Seniors are looking for space, they want to do things, but we weren’t aware of that. As a result, they said, “Let go of your premises. You say they’re too cramped and difficult to get to, and come to the centre.” Just recently, they moved the seniors’ club to the Centre Samuel-de-Champlain. We’d been promoting the importance of community housing for seniors, and we can see that that it’s come a long way. Now, they’re passing each other in the halls, and they can talk about it, and I have the idea that, yes, this will be one of the ways to build a residence for French-speaking seniors, and it will take place through the Centre Samuel-de-Champlain.
Senator Mockler: Because this program certainly exists under the Official Languages Act. Having said that, I want to ask a question about the Nursing Home Without Walls program. Ms. Dupuis-Blanchard, could you give us more information and results on this program? If I remember correctly, since we were the creators of Medavie New Brunswick Health Services, can you tell us about those benefits?
Ms. Dupuis-Blanchard: I call the Nursing Home Without Walls program my very successful baby. We put a lot of effort into it without really knowing what the outcome would be. It’s a project that was funded by the Public Health Agency of Canada and the federal government, in collaboration with the New Brunswick government, in Budget 2018, I believe. The Nursing Home Without Walls program is the result of research projects that have demonstrated the need for seniors — not just francophone seniors — to remain in their own homes. In study after study, people told us that there was a lack of services, that it was difficult to stay home, that there was no support, and we kept hearing much the same thing about transportation and maintenance inside and outside the home.
Then, at one point, we said to ourselves, in co-operation with the New Brunswick Association of Nursing Homes, that we had to find a solution, that we had to stop talking about the same problems over and over again. We had to take action. By that point, there was already a lot of talk about home support, and the idea came to us to ask, “What already exists in our communities that we don’t need to reinvent?” It’s often said that we shouldn’t reinvent the wheel.
We figured there were nursing homes, and they do have expertise, knowledge and resources. They don’t have all the resources, but they have some. What if they were given additional resources specifically for seniors in their communities, so that the nursing homes themselves could support home care?
I’d been invited to a conference at the annual general meeting, and I thought that the directors of the homes would all want to shoot me and say, “What’s she doing when she comes and tells us we need to do more?” On the contrary. Afterwards, almost all of them came to talk to me and said, “We know so many seniors in our communities that we could help, but that’s not our mandate right now. We aren’t here to help seniors in the community.”
We were reassured to see that the idea didn’t seem so crazy; with the money received in the province and the work that had been done with a few nursing homes that were interested…. Some of them called me and said, “Let’s move forward.” I told them that nothing existed yet, and they said, “Let’s go ahead, let’s try something.” I can tell you that after four years, this pilot project has been a great success and that the Department of Social Development — which deals with seniors and aging in our province — has just adopted it. We’ve seen results in terms of reducing seniors’ isolation and feelings of loneliness; we’ve seen that people now know where to go for information on services.
In fact, we have a navigation service we call “accompaniment,” because it’s so much more than just navigation. We really want to make sure that people get the service and that the service is satisfactory. We also had about 33% of our respondents tell us that because they knew where to go for non-urgent matters, they avoided going to the ER and out‑patient department for questions we had asked them: “Why would you have gone there if it wasn’t urgent?” They said that they wouldn’t have known where to go, and that they knew this place was open, so we were able to ask our questions about home support.
That made us realize that people are looking for services. I can tell you that the services exist for the most part, but that people don’t know about them. It’s so hard to get home care services that people eventually give up — not wanting to give the wrong answer, they decide it’s too complicated. Nursing Home Without Walls was successful precisely because nursing homes were involved and staff were hired. I do want to say a few words about staffing. Senator Moncion, you said something earlier that made me think: You need the right people for the right jobs.
It’s important to recognize that we don’t need nurses, social workers and such to do work that could be done by a community development officer. I say that knowing full well what a health care professional brings to the table. I’m a nurse, so it takes a lot for me to say that having Mario as a social worker, for example, would be ideal, but there are tasks that don’t necessarily require our training and skills, tasks that are also beneficial. That’s where we need to focus on choosing the right human resources.
I’ve gone on way too long. Thank you.
The Acting Chair: Was that done only in French?
Ms. Dupuis-Blanchard: It was done in both languages. The pilot was implemented in four communities in New Brunswick. Three of them were on the Acadian Peninsula, where the program was delivered in French, and one was a rural community in southeastern New Brunswick, where the program was delivered in English.
By next month, we hope to expand the program to some 20 communities. We are at 15 or 16 currently. I should also say that other provinces have shown an interest in the program.
Senator Mockler: Those communities will be getting a nice Christmas gift, then?
Ms. Dupuis-Blanchard: Yes.
Senator Mockler: I would like to hear both of you talk about French-language post-secondary institutions. Are French-speaking researchers in minority communities at a disadvantage when it comes to government funding? There are three levels of government. I always say that the level of government closest to people is their local government. Then comes the provincial government, followed by the federal government.
What do you think?
Ms. Dupuis-Blanchard: I’ll go first, Mario, since Senator Mockler was looking at me, and then I’ll turn it over to you.
Thank you for your question, which was put to the first panel in a somewhat similar way.
For researchers like us, federal funding is what matters. It gives us standing, if you will, in terms of the importance of our work. When one of the three granting councils gives us funding, it helps us stand out. I have to say that the experience I had at the beginning of my career was positive. The Canadian Institutes of Health Research, or CIHR, used to have a competition specifically for official language minority communities, OLMCs, and I was awarded funding under that stream. That funding or competition ended, and we were told that it would be brought back. A pretty reliable source told me that a program was in the works for this fall, but unfortunately, I found out that there won’t be a specific competition for OLMCs because of budget cutbacks in various departments. Apparently, the competition was folded into the regular competitions, and we were told that we could still apply, of course.
The problem is that the committee members evaluating the applications, the reviewers, don’t always recognize the inherent differences of an application that concerns a community where people live in the minority language. Yes, we can apply, but when that awareness is lacking, it’s quite challenging.
On a provincial level, in New Brunswick, I have to say that I have received a lot of funding for projects carried out in both languages. I, myself, I can’t complain. Support at the municipal level is more in the form of non-monetary cooperation, frankly, but there is interest, of course.
Mr. Paris: What more can I say? I can’t really put it any better. That has also been my experience with federal funding. I think Suzanne said this, but for researchers, it’s really the gold standard, even in terms of career advancement.
I came from the Université de Sherbrooke, in a very large research centre, where we were carrying out international research. We were going quite strong and winning major competitions. When I got to Moncton, I noticed that major competitions did not take into account the human resources required, mainly in terms of students. OLMC funding was not something I had been familiar with. When I apply for major competitions, the fact that I work in a general institution that provides small programs in philosophy, geography and history is not taken into account. Nevertheless, it’s important to understand that we are an institution, that we contribute to the community’s institutional vitality, and that we have to offer that programming. Even though they practically have budget deficits, if these programs and this capacity are eliminated, our community would be invisible. We have a lot of undergraduate students, but not very many master’s or PhD students, so we have fewer people building research projects and providing that support.
I have good cooperation with the province, which is very amenable to cooperation. I received funding from the federal government that is administered by the province to set up health care pilots for seniors. I don’t really have any complaints. I’m closer to the beginning of my career than, say, Suzanne is.
I’ve never received any municipal funding, but the cooperation is there. There is communication, in many cases, for both communities. I can tell you that, as far as the Université de Moncton goes, I have heard that the City of Moncton would like for us to play a bigger role in the city and, sometimes, for us to be more of a bilingual institution than a francophone one, just to give you an idea. It goes with the territory in the city of Moncton: We are a francophone university, not a bilingual one. Consequently, we don’t always have close ties with the English-speaking community.
However, I’ve never encountered any tension or issues with funding, other than trying to get the specific nature of our community recognized. When you think about it, the Université de Moncton is still a big French-language university outside Quebec. It’s not the only one, but it is the only such institution with general programming. We do have over 5,000 students.
The Acting Chair: Thank you, Senator Mockler, for those excellent questions. I did allow the discussion to go on a bit longer.
Senator Mégie, you get to be the one to close out our meeting this evening.
Senator Mégie: I won’t take long, because I got most of the answers I was looking for thanks to Senator Mockler.
My question was about research funding, but I do have a sub-question. You address research funding in your recommendations. Given what you and Mr. Paris said, there isn’t really an issue with the competitions you’ve been in or your ability to access to funding.
If we were to include any such recommendations in our report to the federal government, should we call for more funding or the same?
Ms. Dupuis-Blanchard: My recommendation is to reinstate the competition specifically for francophone minority communities, so that more than one competition is available through the granting councils. That would allow for a dedicated focus on those communities, so francophones outside Quebec and anglophones in Quebec. What that funding does, in my view, is show that the granting councils are committed to supporting official language minority communities. That is what’s missing.
It’s also important to break it down. We need to find ways to recognize — and Mario made this point — that, in small universities, most of the people doing the research on francophone minority communities are professors or researchers. We certainly aren’t given the same level of consideration. I did my PhD at the University of Alberta, so I know. We aren’t looked upon in the same way that the University of Alberta, the University of Toronto or other universities in major centres are seen. We are already at a disadvantage by virtue of working at a small university. If, on top of that, the focus of our research is francophone minority communities, it’s almost as though we are doubly… I won’t say doubly stigmatized, but it does put us at such a disadvantage that I, myself, write most of my applications in English, albeit reluctantly. That’s well known throughout the academic community.
The Acting Chair: Yes, it’s unfair.
Senator Mégie: Would it lower your chances if you wrote them in French?
Ms. Dupuis-Blanchard: Yes, it would lower my chances. That is well known.
The Acting Chair: Do you have anything to add, Mr. Paris?
Mr. Paris: I’m still young and idealistic. I submit my applications in French, all the while knowing that I would have a better chance if I submitted them in English.
It would be a shame to say that we don’t really need more money. We can always use more money, but I don’t think a further injection of funding would solve our problems. Sometimes, we need new funding programs that take our unique features into account, as was mentioned.
There’s another thing, and we see this at the Social Sciences and Humanities Research Council, or SSHRC. The council developed a program called Partnership Engagement Grants. It was the first program I took part in here, and it supported partnered research, usually with organizations. It has to involve a community or even private sector partner, but the idea is to carry out the research in partnership. The grants are small but can go up to $25,000.
There may be a way to design programs that also support basic research, without being exclusively tailored to a community’s problems. It’s important to focus efforts in a way that addresses a community’s problems and needs. Coordinated measures can be taken to address homelessness, for instance. Researchers could examine the issue and come up with solutions in partnership with stakeholders in the community. There may be a way to design funding programs that have a more direct impact on people. Universities are in a pyramid. They are part of the ecosystem, but there are a lot of people who do not see us working and do not know what we are doing. They don’t see the advantages the university offers. I think it’s important to try to show how we can play a useful role through projects that have a very concrete impact.
The Acting Chair: Thank you very much.
Thank you to the witnesses. You were very forthcoming in your answers. The committee is very pleased with this evening’s meeting. We didn’t have as many senators, so we appreciate the fact that you were so indulgent with our lengthy questions. You allowed us to really dive into certain issues. I’d like to thank everyone who helps the committee run — our staff and everyone on our support team, the interpreters, the page who is here this evening, making sure we are okay. On that note, thank you and have a good evening.
(The committee adjourned.)