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.

National Strategy for Alzheimer's Disease and Other Dementias Act

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

Mr. Speaker, it is a real honour to be here as official opposition critic for seniors and to speak to Bill C-233, the national strategy on Alzheimer's disease and other dementias.

I would like to begin by thanking, particularly, the member for Niagara Falls for introducing this important bill. The secret to the success of the bill moving forward is his non-partisan approach. This is not an NDP, Liberal government, nor an official opposition Conservative Party issue, it is a Canadian issue on which we need to work together as parliamentarians. It is moving forward because of his non-partisan approach and I congratulate the member for Niagara Falls. He is a well-respected member in this House.

Bill C-233 provides for the development and implementation of a national strategy for the health care of persons affected with Alzheimer's disease and other forms of dementia.

Just to divert for a moment, my understanding of what my NDP colleague said was that people with dementia, with Alzheimer's disease, deserve to have assisted suicide. I hope that is not what she meant because people with dementia already feel bad and they may feel stigmatized.

They realize that their brain is getting a little fuzzy and they are forgetting. It is frustrating for them and maybe even a little bit embarrassing. We would not want them to think people expect them to take the obvious choice, and we heard that from Dying With Dignity, saying that it would be sensible for persons with dementia, lying in bed in the last years of their life with an adult diaper, to ask for assisted suicide.

That would not work in Canada. It is not dignified to expect people to leave this world because they are in a state of dementia. We need to show them dignity, show them love and support, and only in the most extreme cases should assisted suicide be considered.

When someone's pain is intolerable, irremediable, that is what the court said, and in extreme cases, but assisted suicide and euthanasia should not be considered the norm because it is a horrible loss when someone finds themselves in that situation. We should never put this on to people who are suffering with dementia through Alzheimer's disease or any other dementia disease.

As the seniors critic, I have met with the Alzheimer's Society and many other seniors organizations which are very supportive of this bill. Mimi Lowi-Young, the CEO of the Alzheimer Society of Canada had this to say about Bill C-233:

We’re thrilled that parties are working together so soon after the election to address the urgency of dementia. We all need to get behind this bill. We strongly believe that a national dementia strategy that focuses on research, prevention and improved care is the only solution to tackling the devastating impact of this disease. We’re ready to collaborate with our federal, provincial and territorial partners to make this a reality.

I am really thankful to her and the Alzheimer Society of Canada for supporting Bill C-233. According to the research done by the society, 83% of Canadians have said that they want a national dementia strategy.

I would like to give a brief summary on the issue of dementia. Alzheimer's disease and other forms of dementia are progressive, degenerative, and eventually fatal. They impair memory, judgment, and the ability to reason, think, and process information. Changes in personality and behaviour also result from dementia.

Currently, 747,000 Canadians have some form of dementia. This number is expected to nearly double to 1.4 million in my lifetime. Three out of four Canadians, 74%, know someone who is living with dementia. As Canada's population ages, the number of Canadians diagnosed with dementia is expected to double.

Research, collaboration, and partnership remain the key to finding a cure. Early diagnosis and support for treatment can lead to positive health outcomes for people with any form of dementia. Early diagnosis also has a positive impact on the family and friends providing care for their loved ones.

The Government of Canada, in consultation with the ministers responsible for the delivery of health care services in each province and territory, should encourage the development of a national strategy for the care of people living with Alzheimer's disease or other forms of dementia.

What is dementia? Dementia is a difficult disease, but it does not define the person who has it. People with dementia are people first. They can lead happy and vital lives for a long time, especially when the right care and support and understanding is in place. Timely diagnosis is very important. It opens the door to treatment and connects people with the disease and their families with helpful resources like the Alzheimer's Society.

While there is no guarantee, Canadians can reduce their risk of dementia by eating a healthy diet, doing more physical activity, learning and trying new things, staying socially active, quitting smoking, and watching their vitals.

While dementia is not a part of growing old, age is still the biggest risk factor. After age 65, the risk doubles every five years. Seniors represent the fastest growing segment of the Canadian population. Today, one in six Canadians is a senior. In thirteen very quick years, it will be one in four. That is a major demographic shift. Dementia also occurs in people in their forties and fifties, in their most productive years.

A good question that needs to be asked, and is asked, is this. What is the impact of dementia on families and the Canadian economy? For every person with dementia, two or more family members will be providing direct care. The progression of dementia varies from person to person. In some cases it can last up to 20 years. Because of its progression, caregivers will eventually provide 24/7 care.

In 2011, family caregivers spent 444 million hours providing care, representing $11 billion of lost income and about 230,000 full-time jobs. By 2040, caregivers will be providing 1.2 billion hours of care per year.

Dementia is a costly disease, draining approximately $33 billion per year from our economy. By 2040, it will be very close to $295 billion every year.

There is a need for a strategy that includes awareness and research.

It is commonly believed that dementia is a normal part of aging, but it is not. This kind of attitude means too many Canadians are diagnosed too late, and their caregivers seek help when they are in crisis mode. The causes of dementia are still not fully understood. Nor do we have a cure for dementia. Effective treatments are lacking and there is no proven prevention. Dementia can lie dormant in the brain for up to 25 years before the symptoms appear.

Alzheimer's disease is the most common form of dementia and accounts for over two-thirds of dementia cases in Canada.

What would Bill C-233 achieve? It would achieve a national strategy. The minister or delegated officials would work with representatives of the provinces and territories to develop and implement a comprehensive national strategy to address all aspects of Alzheimer's disease and other forms of dementia. Within two years of passing the legislation, every year after that the minister must prepare a report on the effectiveness of the national strategy, setting out his or her conclusions. The national objectives need to be given priority. A report will be tabled in the House during the first days of the sitting after the report is complete.

A number of western countries have a national dementia strategy: the United States, Mexico, Argentina, Belgium, Denmark, the United Kingdom, Finland, France, Luxembourg, the Netherlands, Norway, Switzerland, Japan, Israel, South Korea, New Zealand, and Australia. It is Canada's time to have a national strategy.

I again want to thank the member for Niagara Falls for bringing this forward. Together, if we work as a Parliament, we can pass the legislation quickly. It is needed in Canada.

[Cheryl Hardcastle, NDP, Windsor—Tecumseh, ON]

Mr. Speaker, I am pleased to speak today to Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

The New Democrats believe that a national strategy for dementia is long overdue. In fact, one should already be in place, and would be, had the current sponsor of this bill, the member for Niagara Falls, and his party not voted down a similar yet more comprehensive NDP bill that was tabled in the previous Parliament.

Dementia disease is a progressive degenerative disorder that attacks nerve cells in the brain, resulting in loss of memory, thinking, language skills, and behavioural changes. The disease forms lesions in the brain cells of patients, causing nerve connections to sever and nerve cells to die.

Alzheimer's is the most common form of dementia, which is a general term used to describe a group of systems, such as loss of memory, language, motor skills, and other brain functions. Alzheimer's is not part of the normal process of aging, and currently has no cure.

The New Democrats ardently support the need for national leadership to develop and implement a comprehensive strategy across Canada to address Alzheimer's and other dementias. Our caucus unanimously supported former NDP MP Claude Gravelle's bill in May 2015 to create a national dementia strategy. Further, in election 2015, the NDP committed $40 million toward the implementation of a national Alzheimer's and dementia strategy.

Our party recognizes the crisis facing Canadian health care as our country's population ages, including the growing prevalence of dementia among the elderly. We believe immediate action must be taken to tackle these serious challenges on a comprehensive basis. Accordingly the New Democrats are concerned by the decision of the Liberal government to abandon its home care promise in budget 2016. By abandoning the necessary investments now, the Liberal government will only further exacerbate the costs and suffering down the line .

A national strategy for Alzheimer's and other forms of dementia must include mechanisms to ensure that staff have the necessary knowledge about the disease and the skills to deal with it. This means that people have to share information. The purpose of a national strategy is to share that information. People should not be working in isolation.

We have to find a way to ensure that everything we learn, everything that might be useful, such as best practices, is communicated to people struggling with the same problems. It is essential for people to have ways to talk to each other. The goal is not to step in for the provinces, but to ensure that communication channels remain open and people work together. Real collaboration needs to happen so people can share best practices. We have to ensure that nursing staff, doctors and other professionals, such as police and emergency responders, know and understand how to deal with dementia. They need to have the right skills and knowledge to work with people with dementia and provide them with quality care that is appropriate for their situation.

They are often forgotten, but the volunteers who work in this field need to be able to understand the reality of a person living with dementia. It is not always an easy thing to do. There are certain situations that are very difficult to go through on a daily basis, and it is hard to know how to intervene. The volunteers who work at these centres must have access to the knowledge and skills they need to properly understand the reality of the field they have chosen to work in.

As far as research is concerned, we have extraordinary Canadian researchers. However, we could also form international partnerships to further our knowledge. In my opinion, the quality of daily life for people with dementia is an essential area of research. Lately, a lot of research has been done on daily life, and we have learned how significant and deeply impactful this research can be.

In many places there has been a shift from a very medically-based approach to one focusing on the daily experience of dementia sufferers. The goal is for the transfer to long-term care to go as smoothly as possible. For that to happen, the person with dementia needs to be able to create reference points.

A lot of advances have been made because of these various approaches that focus on quality of life and ways of providing care and intervention. Not only is this helping those living with dementia to live much more happily, it is enabling families to be an integral part of the care process.

There is a lot to do. With the challenges this will present in the coming years, it is essential to share information in order for us to adopt an effective national strategy for dementia. According to the Alzheimer Society of Canada, as we heard earlier tonight, the disease and other dementias now directly affect 747,000 Canadian patients, and this number is expected to double to 1.4 million by 2031. Current dementia-related costs, both medical and indirect lost earnings, of $33 billion per year are expected to soar to $293 billion by 2040.

Sadly, the burden of caring for patients with dementia and Alzheimer's falls primarily on family members. In Canada, family caregivers spend 444 million unpaid hours per year caring for dementia patients, representing $11 billion in lost income and 227,760 lost full-time equivalent employees in the workforce. Providing millions of hours of unpaid caregiving has forced people to cut back or leave work altogether, which harms them and our economy. I want to talk about that this afternoon.

I learned from the Canadian Medical Association that 15% of scarce acute care beds are occupied by people who could be placed elsewhere, and half of them are dementia patients. Beyond those statistics, I have learned the real face of the problem. The real face of dementia is not just older people. I learned that 15% of dementia patients are under 60 years of age. I learned that we have a health care crisis and a social and economic crisis that we must address.

This is therefore an issue that cries out for leadership from Ottawa, working with the provinces and territories, which of course, have primary jurisdiction duties for health care delivery. I want the leadership from Ottawa to tackle five main elements: early diagnosis and prevention; research; a continuum of care for people and families in the home, the community, and institutions; real help for caregivers; and training for the dementia workforce.

Alzheimer's disease puts enormous emotional stress on millions of families in Canada and costs our health care system billions of dollars every year. Delaying the onset of Alzheimer's by two years could save our health care system $219 billion over a 30-year period. A national strategy for dementia may be able to make an astounding difference in advancing research to work toward achieving this goal, which would diminish this enormous economic hardship and subsequently, and most importantly, improve the lives of those affected Canadians.

The challenge caregivers face needs to be discussed. Over the years, I have known people who have been forced to take a leave of absence without pay to take care of a loved one suffering from dementia, sometimes for several years. In such situations, money gets tighter as families try to keep their loved ones in their homes for as long as possible. They often have to draw on savings that were meant for their own later years.

Canada needs a national strategy for dementia that comes from Ottawa but one that respects provincial and territorial jurisdiction over health. One strategy tailored to the needs of each province or territory would be far better than 13 separate strategies implemented in isolation. We want a national strategy that goes beyond research to also help those now living with the disease, their caregivers, and the dementia workforce.

[The Deputy Speaker, Conservative, Bruce Stanton]

Resuming debate.

Accordingly, I invite the hon. member for Niagara Falls for his right of reply. The hon. member has up to five minutes.

The hon. member for Niagara Falls.

[Rob Nicholson, Conservative, Niagara Falls, ON]

Mr. Speaker, I would like to thank all members of the House who have contributed to this debate. I appreciate, in particular, my colleague from Don Valley West for supporting and seconding this piece of legislation. He has a great career, among other things, as a United Church minister. As a pastor, he was constantly challenged by the personal and social consequences of Alzheimer's and dementia.

One of the stories that he passed on to me was about one particular woman, Mae MacMillan, who was a vibrant, intelligent, committed, and compassionate woman. She was trained as a nurse and was ahead of her time in promoting women's rights. She loved strong and powerful women and she was one herself. However, dementia slowly crept up on Mae.

At first, she thought it was just part of the normal aging process, which I have heard before. She was slightly forgetful and misplacing objects, but as she moved on in age, she moved from being the object of affection to being the object of attention. Family, friends, and professional caregivers helped her to live with some independence for as long as possible. Sadly, this is a case of where the mind cannot remember, the heart never forgets. So many of us can relate to that sentiment.

When I introduced the bill, I told of my own family experience with this and one thing that has moved me over the last couple of months since introducing the bill is all the stories and experiences that people have shared with me. The members for Steveston—Richmond East and South Surrey—White Rock shared their encounters with this terrible disease, and all of us were moved by it.

In one sense, I was surprised, after introducing the bill, that so many people either contacted my office or sent emails and letters. People stopped me on the street, even when I was not in my hometown, to tell me about their experiences with these diseases.

The bill before us was very carefully drafted. When I showed it to my colleague, we were very concerned about ensuring that there was no restriction on provincial autonomy and that it was not framed in a way that would require a royal recommendation, which, as we know, would stop the legislation.

Again, I am pleased that so many colleagues have moved forward on this. I believe this is the right thing to do. I believe that we can make progress on these things. In all of our lives, we have seen the terrible consequences of diseases. There are cases where we know that changes can be made. I always remember, as a small child, what a terror polio was in this country. Then I remember hearing the news—I do not think I was any more than five—that a cure had been found for it. Every child in Niagara Falls went to the arena to get the vaccine.

I can appreciate that some diseases are very complex and it is not just a question of coming up with a special potion, but as my colleagues have said, there are so many different parts of this in terms of care, diagnosis, support, and working together. I firmly believe that supporting the legislation is the right thing to do, and again, I am deeply appreciative of all those who have indicated that they support it.

[The Deputy Speaker, Conservative, Bruce Stanton]

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

[Some hon. members]

Agreed.

[The Deputy Speaker, Conservative, Bruce Stanton]

Accordingly, the bill stands referred to the Standing Committee on Health.

(Motion agreed to, bill read the second time and referred to a committee)