Bill C-233 (Historical)

National Strategy for Alzheimer's Disease and Other Dementias Act

An Act respecting a national strategy for Alzheimer’s disease and other dementias

This enactment provides for the development and implementation of a national strategy for the health care of persons afflicted with Alzheimer’s disease and other forms of dementia.

The House proceeded to the consideration of Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias, as reported (without amendment) from the committee.

National Strategy for Alzheimer's Disease and Other Dementias Act

[The Assistant Deputy Speaker, Anthony Rota]

There being no motions at report stage on this bill, the House will now proceed, without debate, to the putting of the question on the motion to concur in the bill at report stage.

[Rob Nicholson, Conservative, Niagara Falls, ON]

moved that the bill be concurred in.

(Motion agreed to)

[The Assistant Deputy Speaker, Anthony Rota]

When shall the bill be read the third time? By leave, now?

[Some hon. members]

Agreed.

[Rob Nicholson, Conservative, Niagara Falls, ON]

moved that the bill be read a third time and passed.

Mr. Speaker, it is a great honour to rise in this chamber to address my bill, Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias, on the occasion of its third and final reading. I am most gratified that, to date, this proposed legislation has had the support of the majority of the members of the House.

Alzheimer's disease currently affects three-quarters of a million Canadians and their families, and that figure is expected to double within a generation. In addition, three out of four Canadians know someone who is affected by Alzheimer's or dementia. That is 75% of all Canadians.

It is imperative as we prepare to cross the finish line with this legislation that we complete this task together. Canadians are counting on it. It is most heartening to know that in matters of great concern to the citizens of our country and their families that we, as members of Parliament, can work together across party lines to unite and advocate for research, collaboration, and partnerships to find cures, provide timely diagnosis, and offer support for treatment. This co-operation will lead to positive health outcomes for Canadians who suffer from Alzheimer's and dementia, and will reassure their loved ones who provide care. Canadians expect that parliamentarians will work on their behalf to resolve these critical issues.

Members from across the aisle have demonstrated their willingness to work together to ensure that a national coordinated strategy is put in place to alleviate the suffering of Alzheimer's victims and their families. They have brought the very best of Canadian principles to the floor of the House of Commons to ensure that Bill C-233 will be passed for the greater good of Canadians.

I reiterate that no one should have to witness the slow and painful deterioration of a loved one or a family member suffering from this cruel illness. Far too many Canadians endure the long goodbye.

I know that I do not stand alone, as I am joined by many of my colleagues in this House who have dealt with, or are dealing with, a family member, a friend, or a loved one who is suffering from various forms of dementia.

Alzheimer's is no respecter of persons. From former President Ronald Reagan to our next-door neighbour, this terrible disease knows no bounds. It takes a terrible toll among its victims and their families.

It is important for me to once again acknowledge and express my gratitude to the member for Don Valley West for seconding this legislation when it was introduced in Parliament. The member has shared heart-wrenching stories of parishioners he dealt with in his work as a United Church minister, and I know he shares my desire to see this bill become a reality. I thank him for his support. I want to acknowledge as well the work of former member Claude Gravelle on this important issue. It once again demonstrates that we can work together in a non-partisan manner. When we do that, we can accomplish much for Canadians.

It is in this vein that I once again ask my colleagues in the House to walk shoulder to shoulder with us to ensure that Bill C-233 is passed into law for the millions of Canadians who will depend on it. We have come too far to let them down now. By acting now, we are remembering those who cannot.

[Guy Caron, NDP, Rimouski-Neigette—Témiscouata—Les Basques, QC]

Mr. Speaker, I thank the member for the work he has done on this extremely important file, which was also very dear to the heart of one of our former colleagues, Claude Gravelle.

Claude introduced a similar bill in 2012, Bill C-356, which sought to create a national strategy for dementia. Unfortunately, the bill was defeated by a single vote in 2015. Those who opposed it were mainly Conservative and Bloc Québécois members. In the end, because one Liberal member forgot to stand up and vote, the bill that Claude had been working on for a long time was defeated.

I would like the Liberal member to tell me why he wanted to introduce this bill. What is the difference between this bill and the bill that our colleague introduced a few years ago?

[Rob Nicholson, Conservative, Niagara Falls, ON]

Mr. Speaker, there are a couple of changes in this. I was very careful to make sure that the bill did not require a royal recommendation, which in effect would kill the bill here in the House of Commons. As well, I wanted to ensure that it did not in any way restrict the jurisdiction that applies to health care issues. There are provincial jurisdiction issues here, and we wanted to be very careful.

That is why I sat down with my colleague across the aisle. I let him have a look at it and told him the reasons there were some challenges with the previous bill, which was well-intentioned. He had a chance to look at that. He spent a couple of days with it. He agreed with me that with the new wording, we would not have the worry about a royal recommendation. We would also make sure that there was nothing too restrictive with respect to the health ministers across the country.

[Kevin Lamoureux, Liberal, Parliamentary Secretary to the Leader of the Government in the House of Commons]

Mr. Speaker, it is great that we have wonderful support from the House, but I am sure the member would agree that it is also great to recognize that there are many organizations, non-profit groups, and individuals that have put an incredible effort into supporting this legislative initiative and providing advice on an important issue that affects so many Canadians.

As the member has pointed out, over a quarter of a million Canadians are affected, and that number is going to continue to grow. We know that in excess of $250 million has been invested in research on dementia over the last decade. These are all positive things. There are a lot of people we should be recognizing who poured their hearts and souls into such an important issue, which I believe all Canadians recognize. Would he not concur?

[Rob Nicholson, Conservative, Niagara Falls, ON]

Mr. Speaker, that is actually a very good point. I will start off with the Alzheimer Society. It has been very supportive and encouraging. I recognize the effort it has made to get information out about this particular piece of legislation. It has acknowledged, as well, how important it is that we move forward on this. It is important for individuals and groups to make sure that these issues are not buried or lost here in Ottawa. I, for one, have been very appreciative of groups like the Alzheimer Society and others.

I am quite appreciative as well of the many people who have contacted me, or even stopped me on the street, to raise this issue with me. As I indicated in my opening remarks, three-quarters of Canadians know or have a family member, a neighbour, or someone they know who has suffered from Alzheimer's or other types of dementia. They know what a toll it can take.

I want to tell you, Mr. Speaker, and the House how appreciative I have been that so many people have reached out and supported what we are doing here today. I particularly wanted to mention the Alzheimer Society and other groups for their support on this.

[Alaina Lockhart, Liberal, Fundy Royal, NB]

Mr. Speaker, it is an honour to rise today to speak to Bill C-233 and to have the opportunity to speak about dementia.

I want to praise the hon. member for Niagara Falls and heartily agree with his sentiment that this issue does transcend partisanship.

Dementia is a syndrome caused by a variety of brain diseases, the most common of which is Alzheimer's, which is characterized by slow and progressive deterioration of cognitive function. It affects memory, thinking, language, and judgment, along with mood and personality. This is a most curious and mysterious disease.

As our population ages, dementia is of growing concern in Canada and internationally. From 2011 to 2030, the number of Canadians with dementia will double. Right now, more than 7% of Canadians over the age of 65 are affected by dementia. Over 35% to 40% will be affected by the time they reach 85.

My home province of New Brunswick is particularly sensitive to this issue. As it stands, New Brunswick has the highest proportion of population over the age of 65 compared with other provinces. Dementia is on the rise in New Brunswick with over 16,000 people diagnosed and another 3,000 diagnoses expected this year. The impact is compounded by the fact that many seniors are also dealing with additional chronic diseases.

Keeping seniors in their homes helps them to thrive. Knowing this, I am reassured that the provincial and federal governments have made home care a priority when addressing health care in New Brunswick. The Government of Canada has committed over $125.1 million over the next 10 years for home care in New Brunswick.

The fact that there is no current treatment to cure dementia can be devastating to people with dementia and their loved ones. However, we know that research can help find a cure or a way of altering the course of dementia.

I cannot emphasize enough that our government believes in the power of research evidence, which is what we have signalled strongly in the last months. The Government of Canada will undertake and use research evidence to make informed decisions concerning health care. Investing in health research is an investment in a healthier Canada and healthier Canadians.

Research drives the way we diagnose, treat, and care for those with dementia and their caregivers. It has not only helped improve our understanding of dementia and the neurodegenerative diseases causing it, but it has created new possibilities for better diagnosis, treatment, and quality of life for patients and their families.

The Alzheimer's Society continues to promote the benefits of early diagnosis. As a 2011 study revealed, 50% of Canadians live for more than a year with their symptoms before seeking diagnosis. We need to do better.

Canadian research has highlighted a link between dementia and stroke. Dr. Sandra Black of the University of Toronto has been collecting brain scans of patients with dementia since 1995. These scans uncovered the prevalence of silent strokes, or strokes that leave small holes in the brain without any obvious symptoms. This research has opened the door to the possibility for earlier diagnosis for Canadians using brain scans. It suggests that reducing the risk of stroke may help prevent dementia. Continued research like this is vital. Our investments in this area are essential to changing the course of dementia and unlocking a cure.

The Canadian Institutes of Health Research, or CIHR, is the Government of Canada's primary vehicle through which we support research and move results into practice. In the last five years, CIHR has invested more than $193 million in dementia-related research. This funding supports the best, most intriguing research questions that Canada's brightest and most promising scientists have to offer. This is research that has the potential for big impacts for Canadians and the Canadian health care system.

For example, Halifax researcher Dr. Janice Keefe has spent 20 years focusing on at-home family caregivers, whom she calls "the backbone of our current health system". As Canada's aging baby boomers increasingly care for a spouse or parent with dementia, these family caregivers need support to avoid becoming patients, and not necessarily for dementia. Dr. Keefe co-developed a groundbreaking, evidence-based questionnaire that captures the diverse and complex needs of family caregivers.

The C.A.R.E. tool is influencing policy development and support programs for this often overlooked but vital population. First piloted in Quebec and Nova Scotia, practitioners are now using C.A.R.E. in Ontario and Alberta and it has been culturally adapted for use in France and New Jersey. As the prevalence of dementia increases in Canada, so will the number of caregivers. A tool like this, which helps identify needs and therefore support programs for those who are dedicating themselves to others, is invaluable.

I am pleased to say that by leading its dementia research strategy, CIHR is acting strategically to focus research efforts not only in Canada but internationally. This approach brings together partners from different sectors to support the latest dementia research related to three specific themes: prevention, treatment, and quality of life for those affected by the disease and their caregivers.

The domestic component of the strategy, the Canadian Consortium on Neurodegeneration in Aging, is known as Canada's premier research hub on neurodegenerative diseases affecting cognition, including dementia. The number of funding partners CCNA has brought together is now up to 15.

With these funding partners from across Canada, CCNA helps accelerate the development of dementia treatments and care for Canadians. To do this, it involves over 350 researchers, who are examining issues important to all Canadians, including specific vulnerable groups, such as indigenous people and those living in rural communities. In this regard, dementia rates in Canada's indigenous communities have been steadily increasing for the last seven to 10 years. Alarmingly, the onset of dementia is now occurring an average of 10 years earlier than in non-indigenous communities.

Drs. Kristen Jacklin and Carrie Bourassa are leading research into how indigenous culture and community affect how people experience dementia. Their team is working with indigenous communities to develop culturally grounded approaches to dementia diagnosis, care, and health education. This research will produce a range of results to help clinicians. It will help them adapt their approach to ensure that indigenous people feel more comfortable and safe when meeting with health professionals. It will also help build appropriate community and cultural strengths into existing programming for people with dementia and their partners.

The dementia research strategy developed by CIHR also has an international component, which has enabled Canadian researchers to participate in key international partnerships across its three themes. Through this component, Canadian researchers have been able to collaborate with colleagues from across the globe.

Canada is recognized as a leader in this domain. For example, Canada was the first country outside of Europe to join the joint program on neurodegenerative disease, the largest global research initiative tackling the challenge of neurodegenerative diseases. Let me give members concrete examples of the research funded through the international collaboration.

This program funds the work of Drs. Jörg Gsponer and Paul Pavlidis from the University of British Columbia. They are working on an international team with researchers from Germany, Norway, and the Netherlands to shed light on the genetic risk factors of neurodegenerative diseases like Alzheimer's. This fundamental research will help us find new biomarkers as ways to measure deviations from healthy aging, along with novel treatments and diagnostic tools.

Together the scientific efforts through the strategy's domestic and international components have defined Canada as a leader in dementia research. We are proud to support world-class researchers as they participate in the global pursuit of finding a disease-modifying treatment for dementia by 2025.

Dr. Alex Mihailidis, from the University of Toronto, has developed a mobile robot to help people living with dementia. Sometimes people with Alzheimer's disease have a hard time remembering the sequence of steps required for everyday tasks. Dr. Mihailidis has created an automated prompting system, called the COACH, which helps them remember the steps required in basic tasks like handwashing. Already working well in long-term care facilities, his team is now adapting the COACH to help those living at home.

As members can see, the results of research provide hope that new tools, services, and treatments will soon be available to better prevent dementia and improve the outcomes for Canadians living with this terrible disease.

I am pleased to say that through CIHR, the Government of Canada has established a clear research strategy on dementia. This government will continue to invest in dementia research. We know that our investments in research will go a long way to improving the lives of Canadians living with dementia, their families, and caregivers.

It was an honour to participate in today's debate, which highlights the challenges and growing concerns surrounding dementia. My father, and by extension, my mother and my entire family, is currently struggling with the impact of this terrible disease. Knowing that such amazing research is happening right here in Canada is not only comforting but provides hope for all of us that we may someday find a cure that will allow more Canadians to live a longer, healthier, and happier life.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Mr. Speaker, the Nanaimo Alzheimer's walk raised $18,000 last year to promote critical research to reduce the effects of Alzheimer's, to provide services for those living with or assisting those with Alzheimer's, and to ease the personal consequences that exist for people and their families every day. I hope people in my region will come to the fundraising walk in Nanaimo on May 7.

It is in that spirit that I speak today on Canada's responsibility to improve care for the hundreds and thousands of Canadians suffering from dementia and to better support their families and caregivers. I support Bill C-233, which calls for the development and implementation of a national and comprehensive strategy to improve health care delivered to persons suffering from Alzheimer's disease and other forms of dementia.

Here is a call from Susan Barr, who wrote to me from the riding of Nanaimo—Ladysmith. She wrote, “I am a senior with Alzheimer's on my father's and mother's line, and am now starting down that dark path of dementia myself.... Unless a dementia patient has sufficient means they have to share rooms with others who often are difficult to live with and/or are violent. I urge you to go and spend two or three hours in a government funded senior's care home with a closed dementia ward and ask yourself — do you want to be treated like this?”

She also describes her brother-in-law, who used to be the gentlest, kindest soul. He has been held in hospital with Alzheimer's for long periods of time because there is no space for him in a care unit elsewhere on Vancouver Island. He has been tied on stretchers and denied showers because of fears about his aggressive behaviour. This is bad for caregivers, for families, and, of course, for the patients.

The need is great. Three-quarters of a million Canadians lived with dementia in 2011, which is 15% of seniors, and this costs our economy $30 billion each year in medical bills and lost productivity. Left unchecked, that number could skyrocket to $300 billion within 25 years.

Canada has fallen behind countries such as the U.S., the U.K., Norway, France, the Netherlands, and Australia, all of which have coordinated national dementia plans in place. Canada is one of the few G8 countries without one. As our population ages, we must prepare our health care system and communities for the increasing number of Canadians suffering from dementia. It is expected to double by 2031. To paraphrase Tommy Douglas, the father of medicare and a New Democrat, “Only through the practice of preventive medicine will we keep the [health care] costs from becoming...excessive...”

In talking last night with the Canadian Association for Long Term Care, I was reminded that Canada has had 40 years to get ready for this wave of aging baby boomers and yet our country had no strategy and failed to plan. The Canadian Association for Long Term Care notes that the proportion of long-term care residents with Alzheimer's disease or other forms of dementia has grown steadily, with 87% of residents affected by the disease since 2010. It also notes that modern home designs and increased privacy are increasingly important for residents with dementia, who could become upset and aggressive when they are unable to get the personal space they need.

Canadians have lost precious time on this, something that is especially important to those suffering from a degenerative and progressive illness. This has had real human impact. I have heard countless heartbreaking stories about the impacts of Alzheimer's disease and dementia on my constituents.

Lynn Myette gave me permission to read this note. She said:

Our Grandfather suffered from Alzheimer' an now our Mom is in a secure unit with Alzheimer's, too. We know what it is like to watch a loved one decline and lose all of their dignity to the point that they are no longer their former being. To be tied into a wheelchair and left to fall asleep sitting there, to lose all their appetite and not eat, to wear diapers and lose control of bodily functions, to no longer recognize close family members, to develop anger, these things along with drugs to numb their being to the point of comatose, happen.

Many cannot afford quality home care for their parents. I talk to so many people in my riding who are trying their very best to look after their aging parents at home. They are not getting the support they need. The smallest amount of support would make a big difference to them. They know they are saving the health care system money, and yet it is shameful that the Liberal government abandoned its election promise to invest $3 billion in home care.

The Liberals promised $3 billion over the next four years during the 2015 campaign. They separated this from the health accord. That means the money should have flowed in 2016, but it has not been delivered almost two years into their mandate. Instead, the Liberals are using home care dollars to try to lever agreement around the health accord. Provinces representing 90% of Canadians still have not received a nickel of this promised home care support. The need is pressing. The burden of caring for patients with dementia and Alzheimer's falls heavily on family members.

In Canada, family caregivers give millions of unpaid hours each year, caring for dementia patients. That represents $11 billion in lost income, and one-quarter of a million lost full-time equivalent employees in the workplace. If nothing changes by 2040, it is estimated that family caregivers in Canada will spend 1.2 billion unpaid hours per year caring for their loved ones. A quarter of family caregivers are seniors themselves.

Long-standing under-investment in care homes means that the alternatives can be dire. Lori Amdam from my riding writes the following:

Why does Canada need a national dementia strategy? We need one because the baby boomers I know are scared to death of developing dementia—they believe that life in a Canadian nursing home would be a fate far worse than death.

When I teach dementia care to students, I often ask them to bring to mind the worst care facility they have seen. They describe an old, hospital-like unit with narrow corridors, paint chipping off the walls and no access to the outside. Then I ask “What if we exchanged the twenty people with dementia who live on this unit with twenty children dying of cancer? Would this place be an acceptable environment for them to live out their last months?” Of course the answer is a resounding no. Why, then, is it an acceptable place for persons with dementia, who have no voice and no power, to live their last years?

...I see more and more incidences of unsafe and unethical practices in acute care. Recently, I had to intervene on behalf of a 90 year old woman with dementia when the hospital tried to admit a young man into the other bed in her double room. She was terrified, yelling “Get that man out of my house! Get him out!”

Creating the framework which would mandate provision of dignified and respectful care for this population of vulnerable people is simply the right thing to do. It is no less than they deserve—they deserve to live in comfort and safety—they built this country.

I can think of no better testimonial for the need for Canada to have a national strategy on Alzheimer's care. Canadians deserve no less. The New Democrats have a long and proud history of advocating for federal leadership on health care issues. We stood unanimously in the House supporting an NDP bill on a national dementia strategy in 2015.

We stood in the House in 2016 and will stand in 2017, despite the fact it was voted down by the previous Conservative government. We are very much encouraged that the member is bringing this bill forward today, even though he voted against our version of it.

We will stand in the House this year and we will vote in favour, and we will work so that every Canadian, every Canadian family, and every caregiver can have a world-class dementia strategy. All parliamentarians should continue to fight for this good cause.

[John Nater, Conservative, Perth—Wellington, ON]

Mr. Speaker, it is indeed a great honour to rise in this House today to debate this important bill brought forward by my friend and colleague, the hon. member for Niagara Falls. I do want to thank the member for Niagara Falls not only for bringing forward this bill, but for his years of service in this place. I think his service to this august chamber is a testament to his hard work. Certainly as a new and younger MP, it is a great honour to receive guidance from people like the member for Niagara Falls. I thank him for his great service to this institution and for bringing forward the bill.

The bill, an act respecting a national strategy for Alzheimer's disease and other dementias, is an extremely important bill. I think all Canadians, no matter where they may live, will be in one way or another affected by Alzheimer's disease or other dementias. Certainly this is true for places like Perth—Wellington.

In Perth—Wellington we are lucky and quite privileged to have great organizations like the Alzheimer Society of Perth County and the Alzheimer Society of Waterloo Wellington. These organizations provide great opportunities and services to individuals suffering from Alzheimer's and other dementias, and also to their families and their loved ones.

Just last night, in fact, I was speaking with my sister who works at a long-term care home in the small town of Milverton in my riding. She told me about a program at that facility called iPods for Memories. It is a great program that provides an individual with Alzheimer's or dementia with an iPod that has music and memories from the individual's younger days which the person can listen to and have a spark of memory. To see the smiles on their faces, to see the laughter of those individuals who all of a sudden have a happy recollection, a happy memory of their younger days is so important. My sister said that anything we can do as a federal Parliament to encourage programs like that, to encourage the ability of those suffering with this terrible disease to have that spark of memory, to have that opportunity to go back to some of those great memories from their younger days is so important.

Just last month I met with board members from the Alzheimer Society of Perth County. We talked about the importance of the bill and the importance of other opportunities that we as parliamentarians and as Canadians can do to help those who suffer from Alzheimer's and help those whose families are also suffering from the effects of having a loved one with this terrible disease.

One way I am hoping to help, and my office is helping, is by becoming a dementia friend. My office staff and I will be undertaking training to make us more aware of the challenges of dementia and how we can serve our constituents that much better by being aware of the challenges of individuals who may come to our office for service who may be suffering from dementia.

We think about the challenges of Canadians who are suffering from Alzheimer's, and also their loved ones. I think we are all impacted by it in one way or another, to see a loved one slowly slipping away, losing their memories, and almost losing a sense of themselves as well.

The unfortunate thing is that each and every year, as many as 25,000 more Canadians will be diagnosed with Alzheimer's or another form of dementia. While we as individuals often assume this is a disease that affects only seniors, unfortunately, we are seeing a growing trend of younger and younger Canadians being affected and being diagnosed with early onset dementia and Alzheimer's and the unique challenges that face younger Canadians, whether it be a loved one, whether it be a husband, a wife, or a parent, who is being robbed of those years of fellowship and comradeship and family that they are no longer able to experience because of the impacts of this terrible disease.

In fact, as many as 747,000 Canadians are currently suffering from Alzheimer's or some form of dementia. I think of Canadian seniors, those who built our country, those who are often referred to as the greatest generation, who have developed so much of our history and who, within themselves, have such great memories, such wisdom, but who, because of the tragedy of this disease, are having these memories, this wisdom stolen from them, taken away from them. When they lose those memories, when they lose that wisdom, we all lose something.

I am very proud to speak in favour of this important bill. I know the Alzheimer's Society of Canada has encouraged all members of Parliament to support the bill, and I am extremely heartened to hear members on all sides of this House speak in favour of the bill.

It is a testament to not only the work that the hon. member for Niagara Falls did on this bill, but to all Canadians and all members of this House who are impacted, and who listened to their constituents and loved ones who suffer from this disease.

Therefore, I am proud to speak and to vote in favour of this bill.

[Rob Nicholson, Conservative, Niagara Falls, ON]

Mr. Speaker, I would like to thank all of my colleagues in the House of Commons for their support for this bill. The support is across the aisle and throughout the chamber, and one that I very much appreciate.

As a cabinet minister for about 10 years, I was not able to introduce private member's bills. Even though I have been here for close to 22 years, this is the first bill that I have had pass. Even when I was not in cabinet, back in the eighties, one had to have unanimous consent of the House of Commons to proceed with a private member's bill. My private member's bill was to have a national holiday for Sir John A. Macdonald at around this time of year, and I could not get unanimous consent on that. Nonetheless, I was proud to have the opportunity.

One of my colleagues around that time, the Hon. Pauline Browes, introduced a private member's bill for a statue of John Diefenbaker. She gave me the honour of seconding that bill. Much to our surprise, to a certain extent it was supported by all members of the chamber, and the statue of John Diefenbaker is outside here. I remember that Prime Minister Mulroney was so pleased and excited, he said, “Make sure you let everybody know and we'll put one up to Lester Pearson as well.” It is appropriate to have the statutes of those two prime ministers.

My colleague from Don Valley West, a member of the Liberal Party, was good enough to support this. He had a look at it and was in favour of it. I very much appreciate that. This is a great example that, on many occasions, this chamber can work together in the best interests of all Canadians.

[The Assistant Deputy Speaker, Anthony Rota]

The question is on the motion. Is it the pleasure of the House to adopt the motion?