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

[Rob Nicholson, Conservative, Niagara Falls, ON]

moved, seconded by the member for Don Valley West, that Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias, be read the second time and referred to a committee.

Mr. Speaker, it is my honour to rise in the House today to formally introduce my private member's bill, Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias. The title of the bill says it all. It calls upon parliamentarians to enact legislation for a national coordinated program for what has been termed Canada's invisible killer.

I would like to take this opportunity to thank the member for Don Valley West for supporting this bill. The member told me that when he was a United Church minister, he spent a great deal of time working with families who were wrestling with this disease. I would also like to take this opportunity to note the contribution of the former member of the New Democratic Party, Claude Gravelle, for his excellent work on this issue.

Alzheimer's and other forms of dementia transcend partisanship. This disease affects over 700,000 Canadians. It is estimated that if nothing changes in terms of a strategic approach, that number will increase to 1.4 million Canadians by the year 2031. Those figures are staggering.

It is heartening to know that in matters of great concern to Canadians and their families, we can work together. This co-operation will lead to positive health outcomes for families across this country. No one is immune from this terrible disease. It brings to mind the late president Ronald Reagan. The former leader of one of the most powerful, wealthy nations on earth could not be safeguarded from the ravages of Alzheimer's.

On November 5, 1994, the 40th president of the United States addressed the American people by writing in part, “I now begin the journey that will lead me into the sunset of my life”. That journey took 10 painful years. His loving wife, Nancy, referred to it as the long goodbye. I reiterate that no one should have to witness the slow and painful deterioration of a loved one or family member suffering from this cruel illness. Far too many Canadians endure the long goodbye.

My own father, Robert Nicholson, whom I cherished deeply, passed away from complications due to Alzheimer's in 1997. Witnessing his decline in health was, needless to say, extremely difficult for everyone who knew and loved him. It saddens me to say that so many other Canadians have a similar story to share. Today, I am joined by many of my colleagues in the House who have dealt with or are dealing with a family member, friend, or loved one suffering from Alzheimer's or one of the varying forms of dementia.

We all understand the emotional impact of this disease on Canadian families. As journalist Candy Crowley said, “I want to tell you how much I miss my mother. Bits of her are still there. I miss her most when I’m sitting across from her”.

As Canada's population ages, the consequences of not dealing with this issue worsen. The bill proposes to establish a national dementia strategy that would improve the lives of those living with this disease, as well as their family and friends. It would do so in a way that would ensure the autonomy of the provinces and territories. This strategy would encourage greater investment in all areas and have the objective of improving the present circumstances of people with Alzheimer's and other dementias by decreasing the burden on Canadian society.

It would seek to assist the provinces in developing and disseminating diagnostic and treatment guidelines based on new research. All of these measures have been thoroughly considered to ensure the successful passage of this legislation. Members will note that the bill does not include restrictive timelines or financial criteria. Again, this is a deliberate intention in order to remove any potential barriers, such as the need for a royal recommendation.

Simply put, the bill is crafted for implementation, achievement of key deliverables, and ultimately, its passage at third reading in the House. At the end of the day, the objective is to enact legislation that would serve to provide solutions and assist those who suffer with Alzheimer's or dementia, in addition to aiding family members and caregivers.

It is commonly believed that dementia is a normal part of aging. This is a fallacy. Dementia can occur in people as young as 40 or 50 years of age, thus affecting them in their most productive years.

While dementia is not a normal part of growing old, age is still the biggest factor. After 65, the risk of getting Alzheimer's or dementia doubles every five years, and three out of four Canadians know someone living with dementia. We still do not understand the cause, nor do we have a cure.

Canada has already agreed to work with neighbouring nations to address this issue. In order to fulfill that mandate, we must develop a strategy to combat the disease here at home.

I want to share the story of one Canadian family who suffered from Alzheimer's.

Norma died of Alzheimer's three years ago today in Carleton, Ontario. She had the disease for seven years. Her daughter recalls not being sure if her mother recognized who she was, or even if she was aware that she was there. After her mother's funeral, a family friend delivered a letter to her along with a bouquet. She had helped Norma craft it while she was still able to say “yes”, and it read in part:

My dearest...[this is] a note to thank you for all your help during the last few years. We were always close—friends even, but during my illness, we grew even closer. I know you bore the brunt of my daily care, not physical but emotional. You were always kind and attentive making sure I was comfortable. Thank you, thank you... I appreciated everything. Role reversal is a funny thing. As your mother, I was proud of you my daughter. As I grew weaker you grew stronger—strong enough for both of us. Remember my love for you is never ending and I will always be with you. Love, Mom.

Almost all of us can relate to this letter. It illustrates just how important family members and caregivers are. To all Canadians and their families struggling to care for loved ones with Alzheimer's, we owe adequate support, treatment options, and early diagnosis.

I would be remiss if I did not acknowledge and thank the Alzheimer Society of Canada for its unwavering support of this bill. I consulted and met with members of the organization a number of times during the course of preparing this bill. That is because we need to get it right from the start.

The Alzheimer Society provides information, resources, education support, and counselling to family members and loved ones. The society is the leading not-for-profit health organization in Canada working nationwide to improve quality of life for Canadians affected by Alzheimer's and other dementias, and advance the search for the cause and cure. Its mandate aligns with the mandate of Bill C-233.

The Alzheimer Society has stated that it was pleased to see parties working together to address the scourge of dementia. It urged all members of Parliament to get behind the bill, suggesting a national strategy focused on research, prevention, and improved care is the only solution to tackling the impact of the disease.

I, too, invite all hon. members in the House to stand shoulder to shoulder in support of this legislation. It is the right thing to do for our friends, neighbours, parents, and for loved ones across our nation. It is the right thing to do for the global community as a whole.

In the words of Martin Luther King Jr., “...there comes a time when one must take a position that is neither safe, nor politic, nor popular but he must take it because conscience tells him it is right.”

Simply put, it is the right thing to do to pass this legislation.

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

Madam Speaker, I think the member hit it right on, in the sense that this is one of those diseases that draws a great deal of attention and support from all sides of the House as well as the Senate, and justifiably so, as we see with the bill before us today.

The member has given a fairly good descriptive of his thoughts and reflections on the legislation.

We have had a lot of talk over the last hours and days regarding the issue of palliative care. I wonder if the member might want to provide some thoughts on the important role health care professionals play in assisting with this particular disease, and hopefully someday will come up with a cure for.

[Rob Nicholson, Conservative, Niagara Falls, ON]

Madam Speaker, the health care professionals in this country do an outstanding job. They do everything they can to assist patients and families to get them through these difficult times. They see first-hand the ravages of a disease like Alzheimer's on a regular basis. I know that they join with all the rest of us who want to see progress made in this area.

One of the great things that I have seen in my lifetime are the changes that have been made and the progress that has been made. I think everyone will join with me in saying that, yes, we want to make progress, and we can do that.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, as my hon. colleague points out in his speech, it was the NDP that first introduced in the House a proposal to create a national strategy for dementia.

In 2012, former NDP MP Claude Gravelle, the great member for Nickel Belt at that time, introduced Bill C-356, prescribing a national dementia strategy in Parliament. That bill provided a comprehensive and cutting-edge plan for a national strategy to deal with Alzheimer's and other dementia.

Unfortunately, that bill was defeated at second reading in May 2015 by a single vote; 140 to 139. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and critically, as it turned out, a single Liberal MP who failed to stand for the vote.

I must mention that, inexplicably, the member for Niagara Falls, the sponsor of the bill before the House today, voted against the the NDP bill to establish a national plan for dementia. I wonder if the member could stand in the House and explain to Canadians why he opposed a bill that would have brought such a great plan to Canadians a year earlier than his bill.

[Rob Nicholson, Conservative, Niagara Falls, ON]

Madam Speaker, I would be glad to do that. While I had every sympathy and, indeed, empathy with respect to the whole area of doing something with Alzheimer's, I had a number of issues with the bill. I felt it was too prescriptive, the timelines were unrealistic, and I believed that ultimately it would need a royal recommendation and that it might get tossed out.

That being said, I never forgot that this had been introduced in the House of Commons. When I had the opportunity, I had a look at it very carefully. As the member will see, we made changes to make it so it would not too prescriptive on the health minister. In fact, it will avoid needing a royal recommendation.

This bill is an improvement; it is a change. Nonetheless, I have been very clear on every occasion when I have spoken to this. I have raised the name of the NDP member, Claude Gravelle, and I have indicated his interest and the motion he brought before Parliament.

Indeed, I hope this will now have the support of everyone.

[Rob Oliphant, Liberal, Don Valley West, ON]

Madam Speaker, it is a great privilege today to rise in support of Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

I would like to commend the hon. member for Niagara Falls. We were speaking earlier today. He has not had opportunities to bring forward private members' bills as a member of government for many years. I am both pleased and proud to be part of this effort he has engaged in. Sometimes it is the right time to do the right bill, and I believe he has spotted that this is the right time to do the right bill.

As he did, I also want to acknowledge the tremendous work of the former member for Nickel Belt, Claude Gravelle. He had inspiration, tenacity and he did everything right in his bill for that time. However, it did not pass. We now have a chance to have a better bill to ensure that Canada has the appropriate strategy to deal with dementia and Alzheimer's.

I want to begin by talking very personally about my friend and my former administrator when I was a United Church minister at Eglinton St. George's United Church in Toronto. Her name is Marian Ritchie. While she was working with us in the Church, she recognized that there were many people either facing both dementia in their own lives or were caregivers for people who were suffering either early or even advanced signs of dementia.

Marian decided to chronicle the life she had with her husband Edwin and she wrote a book called The Long Way Home. Similar to the The Long Goodbye, The Long Way Home chronicles Edwin's decline from simple mistakes in grammar or vocabulary to eventually having a complete change in personality, not recognizing his family, his friends and not being able to engage in every day life.

This book was profoundly moving for me as it was non-medical and it was not from a professional. It was a book simply written to inspire, to comfort and to encourage people who had family members suffering from Alzheimer's disease.

I have not had the opportunity to do something legislatively about Alzheimer's. I am so pleased the member for Niagara Falls has given me and every member of the House the opportunity to come together to form a national strategy on dementia and Alzheimer's, to ensure that we have a unified approach to this disease and to begin to make important steps that make a difference in the lives of people like Edwin and Marian.

There is a real cost to dementia, an individual cost to families as well as a cost to society. Right now it is estimated that over 700,000 people in Canada have dementia, including Alzheimer's. That is expected to double in the next 20 as our population ages. Even though age, in and of itself, is not the cause of dementia, it is part of it. There are other root causes for dementia, but we still have research that is absolutely necessary so we can begin to understand how we can address this problem.

As everyone in this chamber knows, there is no cure for dementia. We continue to wait for new drugs, new treatment and new understanding of the brain itself.

I would also like to pay great tribute to the Alzheimer's Society of Canada. It is one of several patient organizations and health charities that is working on this important issue. I want to name two people, Mimi Lowi-Young, the CEO, and Debbie Benczkowski, the number two and the one who really runs the operation. These two women have been advocates for people with this disease for many years. I think tonight in the chamber we recognize that often people who work in health charities and work with patients are driving some of the things on which Parliament is often behind.

Last year, the World Health Organization declared that dementias were a public health priority requiring international action. This past October, health ministers at the Pan American Health Organization approved an action plan in response to the predicted rise in dementia cases across the hemisphere over the next 20 years. Among other actions, the Pan American plan encourages member countries, including Canada, to improve investment in treatment for dementias.

Most recently here at home, one of the recommendations of the Special Joint Committee on Physician-Assisted Dying was to establish a national strategy on dementia.

It is important, given the vote we just had in the House, to recognize that end-of-life care is complex. That report, of which I was proud to be a part, looked at the need to have a continuum of care. We needed to be sure we had better palliative care. We had to have better mental health strategies. We had to have better dementia care. We had to always be sensitive to specific populations and how they would respond to end-of-life situations.

Therefore, tonight, we are continuing on in that process and ensuring that we have the opportunity to have the very best, state-of-the-art, national dementia strategy of any country in the world.

However, we are not starting from nothing in this position in Canada. I even want to commend the previous government for its work in dementia strategy. It is not as though we have been doing nothing on this. The reality is that over the last 10 years, the Government of Canada has invested almost $300 million on dementia-related research, through the CIHR, the Canadian Institutes of Health Research. We have had many partnerships. We are attempting to do parts of the work all around the country.

This legislation attempts to bring them together in a national strategy so we can form a partnership with research, with caregivers, with people living with dementia, with patient groups, with experts, take international evidence and bring them together to ensure our Minister of Health, our Department of Health, have the best research available so we have the best possible care.

I am encouraged that members on this side of the House, as I believe members on the other side and in all parties, are supportive of the bill. I have been hearing positive stories from each one of them, often told with stories from their own lives. They have had a parent, or a partner or they themselves have had characteristics, so they are worried about dementia in their own lives.

We have a chance, with the bill, to do something historic and to come together to say that there is the possibility that provinces, territories and the federal government and researchers, clinicians and patients, together with civil society, can have the best strategy possible.

The bill is interesting in that it acknowledges the shared jurisdiction of the federal government and the provinces and territories. It is very clear that the delivery of health care will happen at the provincial and territorial level. We are not in any way stepping on anyone's jurisdictional toes with this legislation. Rather, the legislation calls upon the federal government to consult with provinces and territories to ensure we have the best care and know that the provinces and territories have an important part to play in this national conversation.

It also pushes us at research. If there is anything that we need to acknowledge, it is that the brain is the most complicated organ in the body. I am very proud that in Don Valley West we have Sunnybrook Health Sciences, Sunnybrook Hospital, which is attempting to draw together with partner organizations, and there is Baycrest in Toronto and others across the country, to bring research, clinical expertise, and patient experience together.

This bill would foster that information, not only top-down but also bottom-up. We can learn from the people who are working with this every day to ensure we have the best resources provided, that we have the best research happening, and that we take the steps so Canada can be a leader in the world.

I want to close by telling members another story about my church. One of the projects that we did at Eglinton St. George's was to form a corporation that built a housing project in Toronto called “Ewart Angus Homes”. This is one of those creative housing projects that involves having market housing and housing for seniors, as well as two floors of care for people with Alzheimer's and dementia. It is just one example of people getting together to say they needed to be a caring society.

If we are going to walk with people to the end of their lives, we need to have the best supports for them, the best medical research, the best care for their caregivers, the best laws in place and programs in place to ensure that our country is that leader.

Again, I want to thank the member for Niagara Falls for the opportunity to second the bill. I want to encourage every member to read it, as we sometimes forget to do, and to be sure to engage in the conversation on this bill. We look forward to members' support of the bill.

[Don Davies, NDP, Vancouver Kingsway, BC]

Madam Speaker, I am pleased to rise today as health critic for the New Democratic Party, to speak to Bill C-233 and the urgent need to address the impact of dementia and Alzheimer's disease on patients, families, communities, and our public health care system.

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.

Bill C-233 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.

This legislation prescribes a number of elements that must be included in a national strategy, including greater investment in research, the establishment of national objectives for care, coordination with international bodies that fight dementias, assistance to provinces and territories to improve treatment, strengthening of prevention and early intervention, and disseminating best practices. As prescribed in the bill, the details and benchmarks for these elements would be determined at a conference convened by the minister with multi-stakeholder representation.

New Democrats have long believed that Canada needs an ambitious and comprehensive national dementia strategy to improve care for the hundreds of thousands of Canadians suffering from forms of dementia, and to better support their families and caregivers.

As Mimi Lowi-Young, CEO of the Alzheimer Society of Canada, has said:

By implementing a strategy, we will be able to enhance research efforts, raise awareness about the disease, provide support for people with dementia and their care givers, identify best practices for care and improve surveillance of the disease.

Particularly as Canada's population ages, we must prepare our health care systems and our communities for the inevitable rise in the number of Canadians suffering from dementia. To paraphrase Tommy Douglas, the father of medicare and a New Democrat, “Only through the practice of preventative medicine will we keep health care costs from becoming..excessive..”, and the need is pressing.

Recently, the former head of the Canadian Medical Association, Dr. Chris Simpson said:

our acute care hospitals are overflowing with patients [often dementia patients] awaiting long term care placement and our long-term care facilities are understaffed, underspaced and underequipped to care for our most vulnerable seniors. This leaves patients and their families in limbo, struggling to fill these gaps in our system....

The need for national leadership is urgent. Few Canadians are untouched by these diseases that often have shattering impacts on families. The struggle to cope with the deterioration of mental faculties and the loss of memory can be overwhelming and heartbreaking.

According to the Alzheimer Society of Canada, that disease and other dementias now directly affect 750,000 Canadian patients. This number is expected to double to 1.4 million by 2031. Current dementia-related costs, both direct medical costs and indirect lost earnings, have reached $33 billion per year in Canada, and they are projected to soar to $293 billion by 2040.

Currently the burden of care for patients with dementia and Alzheimer's disease falls primarily on family members. In Canada, family caregivers spend an estimated 444-million unpaid hours per year caring for dementia patients, representing $11 billion in lost income and 227,000 lost full-time equivalent employees to our workforce. If nothing changes by 2040, it is estimated that family caregivers in Canada will spend over one billion unpaid hours every year providing care. These numbers are staggering. Taken alone, they make the case for our desperate need for national leadership. Canadians overwhelmingly agree. A recent Nanos survey revealed that 83% of Canadians say that they want Canada to develop a national plan to address these diseases.

We must not forget that dementia also has a disproportionate impact on Canadian women. According to the Women's Brain Health Initiative of Canada, women represent 62% of dementia cases and 70% of new Alzheimer's cases, putting them at the epicentre of a growing health issue. In addition to this, women are nearly twice as likely as men to succumb to dementia, and two and a half times more likely to be providing care to someone with the disease.

Unfortunately, Canada is now one of the last developed countries in the world without a national strategy to address dementia. We have fallen behind countries such as the U.S., U.K., Norway, France, Netherlands, and Australia, all of which have coordinated national plans in place.

In Vancouver Kingsway, I have heard countless heartbreaking stories about the impacts of Alzheimer's disease and dementia on my constituents. Many cannot afford quality home care for their parents or face long delays in accessing long-term care facilities. Many do not even have access to the resources or information they need to make important decisions, as they witness the cognitive degeneration of a loved one. I have heard stories from personal care workers, nurses and physicians, who report emergency wards that are overwhelmed with patients, long-term care facilities that are understaffed, and long, gruelling hours for caregivers, often working for low pay in the homes of dementia patients. These stories underscore the need for leadership in this chamber.

As New Democrats, we are proud of our long history of leadership on health care, and specifically dementia care. In fact, it was the NDP that first introduced a proposal to this House to create a national strategy for dementia. In 2012, former NDP MP Claude Gravelle introduced Bill C-356 in Parliament, prescribing a national dementia strategy. That bill provided a comprehensive and cutting edge plan for a national strategy to deal with Alzheimer's and dementia. Unfortunately, that bill was defeated at second reading in May 2015 by a single vote. It was 140 to 139. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and, critically as it turned out, a single Liberal MP who failed to stand for the vote. Conversely, our New Democrat caucus voted unanimously in favour of Mr. Gravelle's bill.

I must again mention that the member for Niagara Falls, the sponsor of the bill before this House today, inexplicably voted against that national dementia strategy just one short year ago. Most charitably, I might say that wisdom comes so seldom that it ought not to be rejected because it comes late. Less diplomatically, I might say that the hon. member owes Canadians an explanation and an apology for defeating the very concept that he proposes be adopted here today. What is indisputable is that if the House had followed New Democrat official opposition leadership in the last Parliament, Canadians would have a national dementia strategy in place right now. Canadians would not have lost precious time, something that is especially important to those suffering from a progressive illness.

New Democrats do not take lightly the opportunity to move forward with a national strategy for dementia. We believe this bill must be crafted correctly to ensure the best possible outcome for patients, their families, and caregivers. While we support Bill C-233, it is less ambitious in its scope and implementation provisions than the former bill, Bill C-356, the New Democrat bill. Important differences between those bills include the following: an absence of any provision to augment volunteerism for dementia and Alzheimer's-related causes, no remuneration of advisory board members, and only one public report required from the minister versus the yearly progress reports prescribed in the former NDP bill.

New Democrats will work at committee stage to bring about meaningful and substantive amendments to this bill to strengthen the final product. Canadians deserve no less than the best national Alzheimer's and dementia strategy possible. New Democrats have a long and proud history of advocating for federal leadership on health care issues. In fact, we invented it. It is critical that in a country like ours, the federal government works to ensure that all Canadians have access to the health care they need, no matter where they live, no matter what their income, and no matter their background.

New Democrats stood alone in this House unanimously for a national dementia strategy in 2015. We will stand unanimously in this House in 2016 and work so that every Canadian, every Canadian family, and every caregiver can have a world-class dementia strategy, as the NDP has fought for in the last five years.

[Alice Wong, Conservative, Richmond Centre, BC]

Madam Speaker, I am honoured to rise as the former minister of state for seniors to speak to Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias.This bill is specifically close to my heart because 25% of constituents in my riding of Richmond Centre are seniors.

I would like to thank the member for Niagara Falls for bringing forward this very important bill, and the Liberal MP who sponsored it. Bill C-233 would provide 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.

This bill is what Canadians are asking for. The Alzheimer Society and other seniors organizations are very supportive of this bill. Mimi Lowi-Young, CEO of the Alzheimer Society of Canada, had this to say about Bill C-233:

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.

According to Alzheimer Society research, 83% of Canadians have said that they want a national dementia strategy. Here is a summary of the issue.

Alzheimer's 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 less than 20 years. Three out of four Canadians, being 74%, know someone living with dementia. As Canada's population ages, the number of Canadians who are diagnosed with these diseases is expected to double within a generation.

Research, collaboration, and partnership remain the key to finding a cure. An 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 who provide care for them. The Government of Canada, in consultation with the ministers responsible for the delivery of health 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, as well as for their families and caregivers.

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, support, and understanding are in place. Timely diagnosis is important. It opens the door to treatments, connects people with the disease, and connects their families with helpful resources like the Alzheimer Society. While there is no guarantee, Canadians can reduce their risk of dementia by eating a heart-healthy diet, doing more physical activity, trying and learning new things, staying social, quitting smoking, and watching their vitals.

Who is at risk? The answer is largely seniors. While dementia is not a part of growing old, age is still the biggest risk factor. After 65 years of age, the risk doubles every 5 years. Seniors represent the fastest growing segment of the Canadian population. Today, one in six Canadians is a senior. In 14 years, one in four Canadians will be a senior. That has already happened in my own riding.

Dementia also occurs in people in their forties and fifties, in their most productive years. As of 2008, there were 71,000 Canadians age 65 and younger and 50,000 Canadians age 50 and under living with dementia.

What is the impact on families and the economy? For every person with dementia, two or more family members provide 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, representing $11 billion in 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 $33 billion per year from our economy. By 2040, it will be $293 billion per year. When I was minister of state for seniors, we created a portal on the seniors.ca website specifically for family caregivers to outline the kind of awareness and help that is available. I am glad it is still there. I encourage everyone to visit the website. However, more needs to be done.

There is a great need for a strategy that includes awareness and research. Here are the reasons. It is commonly believed that dementia is a normal part of aging. It is not. This kind of attitude means too many Canadians are diagnosed too late and caregivers seek help when they are in crisis mode. We still do not fully understand the causes, nor do we have a cure. Effective treatments are lacking and there is no proven prevention. Dementia can lie dormant in the brain for up to 25 years before symptoms appear. Alzheimer's disease is the most common form of dementia. It accounts for over two-thirds of dementia cases in Canada today.

I would like to thank the sponsor of the bill for acknowledging that the former government got the ball rolling. We did a lot of work in research, like the longitudinal study which for a period of time follows people from the age of 45 to age 65 at every step. Some day that useful data will help us find out the where and why of dementia inclination in detecting this kind of brain disease, and hopefully we will be able to generate good ideas for a cure.

We have been asked why we did not support the former bill. My colleague has already mentioned that. It is not important just to get the bill passed. We wanted the right bill passed, which is also very good in a sense that it can be carried. I do not wish to list all the things which we cannot do under that bill. However, I am so glad that we are able to do it now, because now we have time to consult the general public.

A national strategy would ask the minister or delegated officials to 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.

I strongly encourage every member of Parliament to support Bill C-233.

[Kamal Khera, Liberal, Parliamentary Secretary to the Minister of Health]

Madam Speaker, as the Parliamentary Secretary to the Minister of Health, I appreciate the opportunity to speak about Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias. I would like to thank the hon. member for Niagara Falls for introducing the bill, and the member for Don Valley West for his continued advocacy on this very important public policy.

Dementia is an issue that is close to the hearts of many Canadians, including my own. Indeed, many of my hon. colleagues know someone who is living with dementia or who is providing care and support to a friend or family member with dementia.

This is a piece of legislation that I am pleased to inform the House the government will support. I would like to take this opportunity to speak about our government's efforts on this very noble cause.

As the population ages, Alzheimer's disease and other forms of dementia are expected to increase. Canadians are concerned about how they will care for and support their loved ones should this happen to them.

Fundamentally, we ask ourselves how we as a country can do more to address the challenges presented by dementia and are we doing enough.

Living with dementia means progressively losing the things that we hold most dear: memories, independence, communicating with others, and doing the activities that we enjoy most. Over time, independent living and daily routines become more challenging.

As the title of Bill C-233 suggests, there are many types of dementia. Alzheimer's disease is the most common cause of dementia, accounting for approximately 60% of all dementia cases. Other types, such as vascular dementia, which can result from strokes and other cardiovascular problems, also need our attention.

Recent estimates indicate that about 395,000 Canadians 40 years of age and older have dementia. Due to the aging population, this number is expected to double by 2031. Similarly, direct health sector costs are projected to double to $16.6 billion by 2031.

Unfortunately, currently there is no cure for dementia and no treatment that will stop its progression. It is important to understand that, as stated by my colleagues, dementia is not a normal consequence of aging. It can result from a variety of diseases and conditions.

The frequency with which the issue of dementia comes to our attention speaks to its importance to Canadians.

In calling for the development and implementation of a national dementia strategy, Bill C-233 entails a number of complex activities that require close co-operation with the provinces and territories. Clearly, addressing the significant public health challenges posed by dementia requires co-operation between all levels of government as well as with other sectors of society.

While a national strategy in and of itself does not guarantee success or progress, we are committed to advancing this work in a manner that will be meaningful for the hundreds of thousands of Canadians affected by dementia. This is consistent with the concrete steps we have already taken to address this pressing issue. We are treating dementia as a priority.

Bill C-233 aligns closely with much of the work currently under way.

At the federal level, we are developing an in-depth action plan that sets out federal goals, guiding principles, and priority areas for action, as well as current initiatives and future directions to guide our efforts and investments on dementia. Our action plan will be released shortly and it will help us mobilize even more partnerships and action on dementia. I know the minister looks forward to discussing this further in the weeks and months ahead.

I would like to share some of the federal investments and initiatives well under way to advance collective efforts on dementia. Many of these initiatives involve the public, private, and not-for-profit sectors, including different levels of government within Canada and other countries.

Budget 2016 extended funding for the Canada brain research fund with up to an additional $20 million over the next three years. Established by the Brain Canada Foundation with government support, this fund leverages matching funding from private donors and charitable contributions to support collaborative, multidisciplinary brain health and brain disorder research projects, including on Alzheimer's disease and other forms of dementia.

In addition, through the Canadian Institutes of Health Research, the Government of Canada has invested over $297 million in dementia-related research.

The Canadian Consortium on Neurodegeneration in Aging is supported by government and partner funding of $32.1 million over five years. Partners include the health research organizations of several provinces. By combining scientific talent and funding, we can accelerate discoveries and their use to benefit Canadians.

The international component, the International Collaborative Research Strategy for Alzheimer's Disease, facilitates Canada's participation in key international partnerships, and has over $14 million in commitment investments between 2010 and 2019.

Surveillance activities are also being strengthened. As an outcome of the Public Health Agency of Canada's collaboration with a consortium of neurological health charities and researchers, the first comprehensive analysis of the rates of neurological conditions and their impacts on families and communities was developed. We are providing also $42 million over the next five years to Baycrest Health Sciences to help establish the Canadian Centre for Aging and Brain Health Innovation. Funding for the centre will support the development, testing, and scale-up of products and services that will have a positive impact on aging Canadians, with a focus on those living with dementia.

Similarly, through the networks of centres of excellence program, the government is supporting the AGE-WELL network with a total investment of $36.6 million from 2014 to 2019.

In collaboration with the Alzheimer Society of Canada, Dementia Friends Canada is receiving an investment of more than $2 million over two years. This digital engagement campaign targets individuals where they live and work to increase understanding of what it is like to live with dementia and how those affected can be better supported in day-to-day activities.

We are cognizant that while a national dementia strategy can help guide Canadian efforts, it cannot replace the need for integrating dementia into a comprehensive approach to health and health care.

Our government appreciates that Bill C-233 continues to bring attention to the challenges presented by dementia and the need for collaboration. While legislation is not required to support pan-Canadian action or strategies, it can serve to highlight a matter of significant importance to Canadians.

Bringing Alzheimer's disease and dementia more fully into our collective consciousness and mobilizing action on a topic of such profound importance to Canadians is a goal we all share. While Bill C-233 as drafted presents some challenges for implementation, the importance of the issue at hand cannot be overstated.

Dementia is a significant public health challenge and it will continue to be a priority for our government. Considering the significant federal investments in dementia and current discussions with the provinces and territories towards a new health accord, it can be stated with assurance that a comprehensive approach to addressing dementia, as well as other intersecting chronic diseases and healthy aging overall, is well under way.

I am convinced that we are moving in the right direction, and I am inspired by what we can continue to accomplish together. In closing, I would like to note that I very much appreciate the opportunity to speak about this very important issue. I encourage my hon. colleagues to support Bill C-233 as it aligns with the current federal direction on Alzheimer's disease and other forms of dementia.

[Christine Moore, NDP, Abitibi—Témiscamingue, QC]

Mr. Speaker, I am pleased to rise to speak to the strategy for Alzheimer's disease and other dementias, especially because I had the opportunity to speak to the bill introduced by my colleague Claude Gravelle, who was the member for Nickel Belt. He was a very dear friend of mine. I want to say hello to him, if he is watching the debate. This is an important issue.

In my riding, Abitibi—Témiscamingue, memory disorders and cognitive impairment generally affect roughly 15% of the population. In 2012, the number of people 65 and older was 22,517. Roughly 3,355 people in Abitibi—Témiscamingue had Alzheimer's and other related diseases. In 2031, it is estimated that over 40,000 people will be 65 and older. It is possible that roughly 6,064 people in my riding will have Alzheimer's disease and other dementias.

Numbers like that make us realize how important it is to have a national strategy for Alzheimer's disease and other dementias.

A national strategy is important because we are talking about a disease that develops over a long period of time. People are often sick for 10, 15, or 20 years. Treatment is administered over a number of years. There could be lengthy hospitalizations, and we know that the cost to society of a lengthy hospital stay is quite high.

Having a national strategy for Alzheimer's disease would allow people to stay at home longer. Families might be able to live much more harmoniously and together. Children could grow up with their parents and have bi-generational homes, for example. The national Alzheimer's strategy offers a lot of possibilities for us to live much more harmoniously with this phenomenon that is only going to amplify.

It is not easy to have a loved one who has Alzheimer's. Often, in the early stages of the disease, the person suffers some memory loss, and at other times, the person is more aware of what is happening. There is a great deal of anger and denial when people realize they have deficits.

The onset of the disease is really hard for family members to cope with. In many cases, individuals with the disease will get angry at people around them, and the situation becomes very unstable. After diagnosis, the situation gradually becomes more complicated. Family members want to keep their loved one at home, but they realize that means constant supervision. It is not always easy. Sometimes, it is a little like having a child in the house, but a child with the strength of a man and all that that implies.

This situation can be so hard for family members. They get worn out because the individual can go on living with the disease for many years and services are hard to get. It is not unusual for people to be on a waiting list for a placement. It can take months, years even, to get a bed in a specialized facility. Health care services are another challenge in those facilities. It is not like at home. Many such facilities are working toward creating a home-like environment for patients, but it is far from perfect. Many things, such as mealtimes, are not like at home.

What is very difficult for the loved ones of Alzheimer's patients is that these patients gradually forget their families. They slowly forget their children. The children come to visit their parents, but their parents do not recognize them and no longer have any idea who their visitors are.

Then, it is the turn of the spouse and relatives. It is an extremely difficult and painful situation. When they try to communicate with the Alzheimer's patient, the person does not recognize them any more. Pooling all of our resources to develop a national strategy for Alzheimer's disease can only be a winning strategy.

As I explained, this is about more than just care. We also need to consider support for informal caregivers and the way they live. For example, the loved ones of a person with Alzheimer's need a two-generation home and a proper security system to take care of that person, particularly to avoid the risk of accidental fire. Such a strategy therefore goes beyond professional medical care and hospital services. It is worth taking the time to talk about this.

There is also the whole issue of culture. We need to ensure that indigenous communities get care that takes their culture into account so that they are not separated from it. When people are hospitalized because they have a mental illness and they are losing their memory, they often regress. As the disease progresses, they remember more about their childhood than about more recent events. At a certain point, many people from first nations forget how to speak English and French because their mother tongue is their indigenous language. They then find themselves in an environment where the health care providers are unable to communicate with them. Because of their memory loss, they sometimes only remember how to speak Cree or Algonquin, for example.

In developing this strategy, we need to understand the challenges, talk to provincial stakeholders, and look at the situation from an overall perspective, not just the medical angle, which is a mistake that is often made in the context of debilitating diseases that affect a large part of the population.

Last time, we were just one vote away from adopting such a strategy. With this strategy, people suffering from dementia, and in particular their loved ones, would be understood and would get the support they deserve from their government. We could integrate an approach that takes cultures into account when caring for people with Alzheimer's or other mental illnesses.

I sincerely hope that this time, members will vote decisively in favour of this motion. Even though it was moved by a Conservative member, it is largely inspired by the work of the NDP and my former colleague, Claude Gravelle, whom I salute once again.

[The Deputy Speaker, Conservative, Bruce Stanton]

If the hon. member for Abitibi—Témiscamingue wishes, she will have another minute and a half when the House resumes debate on this motion.

The time provided for the consideration of private members' business has now expired, and the order is dropped to the bottom of the order of precedence on the Order Paper.

The House resumed from May 4 consideration of the motion that Bill C-233, An Act respecting a national strategy for Alzheimer’s disease and other dementias, be read the second time and referred to a committee.

[Dianne Lynn Watts, Conservative, South Surrey—White Rock, BC]

Mr. Speaker, I rise in the House in support of Bill C-233.

The bill calls for the development and implementation of a national strategy for Alzheimer's disease and other dementias. We need to develop and implement concrete plans and actions to address the needs of those suffering from these diseases. As well, we need strategies to support those who care for family members and friends who are living with and struggling with these diseases.

It is a staggering number, with almost 750,000 Canadians living with Alzheimer's or other forms of dementia. Of that, 72% are women. Equally concerning is that 70% of the caregivers are also women. My mother was one of the 72% and I was one of the 70%.

I can personally say that my journey with my mother was an extremely difficult one, especially because she lived in Alberta and I lived in British Columbia. Initially, she refused to believe that she had Alzheimer's, but knew that something was wrong.

She like many others are often afraid to confront the disease. She found ways to mask the daily symptoms, wanting to give the impression to her loved ones that everything was okay. It became very problematic because my mother was a diabetic and she could not remember how much insulin she was giving herself or if she had taken any at all.

As the caregiver, trying to navigate the medical system in another province was simply a nightmare. I tried to get her transferred from Alberta to B.C., but I had no other choice, no other alternative, than to take her from her home and into the emergency department where I knew the hospital system would keep her safe. That was in the month of September. By November, she was placed in a facility, and by April she had died.

During that time, I flew to Alberta every few weeks to see her for a few days. However, during those times, I came to realize that there was no standardized care, nor a full understanding of Alzheimer's or dementia at staff levels.

When she fell and broke her collarbone, they waited two days to get her to the hospital for X-rays. The nurses and caregivers would ask her if she was in pain, and she would say no because she did not remember falling. She did not remember breaking her collarbone, so they gave her nothing. A broken collarbone and no pain medication.

I can list hundreds of times when they asked questions about her well-being and they took the answers to be the truth. The only problem was that she had Alzheimer's and did not know who these people were nor why they were asking her those questions. When I came to visit, she always wanted me to stay with her because she knew me and I was her sense of security and comfort.

I tell this story because of the many others across this country where loved ones are suffering with this terrible disease. We need a strong national strategy because of the 750,000 Canadians who are currently suffering, but also for those yet to come.

Early detection, research, collaboration, and partnerships remain key to early diagnosis and treatment, and to ultimately finding a cure.

Research is currently underway in my community between the Simon Fraser University and an incredible partnership with the Sagol Neuroscience Center at Sheba Medical Center in Israel to identify the correlation between diabetes and Alzheimer's. As this begins to be proven out, one can only imagine the impact of Alzheimer's and dementia on those suffering from diabetes.

We need to be ahead of the curve. We need to put measures in place to assist those who are potentially at risk. There is excellent research being done currently right across the country, but a national strategy will bring all of those pieces together to ensure a solid plan is in place.

I have walked down this road with my mother. I have seen and experienced significant gaps within the system. I have lost my mother to a terrible disease that many do not fully understand.

This is the first step of many more to follow, and I am proud to give my support to Bill C-233 today.

[Joe Peschisolido, Liberal, Steveston—Richmond East, BC]

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

Just like the member of Parliament for South Surrey—White Rock, I was in a similar situation. I was not the caregiver, but my parents were the caregivers to my beloved grandma, my beloved nonna. As was eloquently, passionately, and poignantly pointed out by the member for South Surrey—White Rock, there are 750,000 people suffering from all types of dementia. As the proposed act properly states, it is Alzheimer's and other forms of dementia. Our family's situation was a bit different from that of the member for South Surrey—White Rock. My parents were able to give everything up and basically they became the caregivers. I would try to get home as much as I could to see a bittersweet situation. I always referred to my grandmother as Nonna Me, because as a little boy I was unable to say her name, Domenica. I saw first-hand where my grandma became a child. My mother and father had the resources and the time to stay home. My aunts and uncles also had the time to take care of my nonna.

However, a lot of folks are not blessed. We have many situations throughout Canada of different family dynamics and situations from coast to coast to coast, and that is why I am very pleased to rise today in full support of Bill C-233.

I am also very pleased to note that this bill has bipartisan support. I listened to the eloquent and passionate presentation by my colleague from South Surrey—White Rock and also to the member of Parliament for Niagara Falls who put forth this piece of legislation; as well as to my colleague, the member of Parliament for Richmond Centre. The Parliamentary Secretary to the Minister of Health also spoke eloquently as did the co-sponsor, the member of Parliament for Don Valley West and the member of Parliament for Vancouver Kingsway.

As well, I believe the member of Parliament for Abitibi—Témiscamingue spoke eloquently about not the exact bill but a similar bill put forth by the former NDP member of Parliament, Claude Gravelle, back in 2012. While not exactly the same approach, it was a similar bill to deal with a national strategy on dementia. We need a national strategy on dementia because Canada is big.

As others have done, I will talk about the elements of the bill. After 180 days, the Minister of Health would put forth a conference, bringing experts from all the provinces and territories, from all the stakeholders and people. There would be an advisory board of no more than 15 folks from different sectors of Canadian society who would advise. As well, every two years the minister would report to Parliament on the approach and the success of the national strategy.

There are big buzz phrases such best practices and evidence-based. Ultimately, what this means is that the Parliament of Canada would work with the provinces and also with the levels of government closer to the people: the municipalities, health boards, and universities.

Kwantlen College in my riding of Steveston—Richmond East is also doing research. Yes, we need a national strategy to deal with the folks who are suffering from a horrific disease. I saw that with my nonna, my grandmother. We also have to figure it out. Dementia or Alzheimer's should not be part of the natural process of aging. It does not have to be that way. It will be tough. It will require the investment and the research. I am not a scientist but it requires research with respect to how the brain works and how everything is connected.

This strategy would do that. It is the first step, but it is a very important step. I urge all members of the House to fully support the bill.

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

Mr. Speaker, last month, I joined my community in Nanaimo on the walk for Alzheimer's where our community walked in support of Alzheimer's patients and their families.

The honoree this year was the late Dale Horn. She was born in 1933 in Australia and she came to Canada at the age of 24. She was such a strong part of Nanaimo's community boards and the life of its community spirit.

At this Alzheimer's walk a month ago, her son, John Horn, honoured her at the walk for all the hundreds of participants ready to get started, saying: “Dale was a fantastic companion, fully engaged, witty and keenly observant. She drew you in and made you feel lucky to be included in her world.” With “a steely resolve and genuine grit,” Dale was unfazed by her disease, said John. “When affected by Alzheimer's, she insisted on helping others with the disease. She retained a wicked sense of humour and immense grace, right up to the end of her life.”

This year's Nanaimo Alzheimer's walk raised $18,000. This is to promote critical research to reduce the effects of Alzheimer's, but also to provide services for those living with, or assisting with Alzheimer's. This is really to ease the personal circumstances that exist for the people suffering and for their families every day.

It is in that spirit that I am pleased to stand and speak today in favour of the bill at hand and to speak about Canada's responsibility to improve care for the hundreds of thousands of Canadians suffering from dementia, and to give better support to their families and caregivers.

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 and other forms of dementia is something we can and should all support. Canada has fallen behind other countries such as the United States, the U.K., Norway, France, the Netherlands, and Australia. All of these countries have coordinated national dementia plans in place already.

Past president of the Canadian Medical Association, Dr. Chris Simpson, spoke to this when he said:

We have the dubious distinction of being one of the few G8 countries without a national dementia strategy. Meanwhile, our acute care hospitals are overflowing with patients awaiting long term care placement and our long-term care facilities are understaffed, underspaced and underequipped to care for our most vulnerable seniors. This leaves patients and their families in limbo, struggling to fill these gaps in our system.

He also said:

The reason your father has to wait nine months for a hip replacement is that the beds are being used by dementia patients.... That is the single biggest reason why elective surgery wait times are so long.

Now, it was the NDP that first introduced a proposal to the House to create a national strategy for dementia. In 2012, former NDP MP Claude Gravelle introduced Bill C-356 in Parliament, prescribing a national dementia strategy. Unfortunately, that bill was defeated at second reading a year ago by a single vote. The bill was opposed by a majority of Conservative MPs, Bloc MPs, and, critically as it turned out, a single Liberal MP who failed to stand for the vote. I was watching it on CPAC. It was heartbreaking because it would have made a big difference in our communities.

Inexplicably, the member for Niagara Falls, the sponsor of the bill before the House today, voted against the national dementia strategy just a year ago. If the House had followed New Democrat leadership in the last Parliament, Canadians would have a national dementia strategy in place right now. Canadians would not have lost precious time, and that is something that is so precious to people suffering from a degenerative illness.

This has had real human impact. I have heard countless stories in my riding about the impacts of Alzheimer's disease and dementia on my constituents. Many cannot afford quality home care for their parents and it is especially shameful that the Liberals abandoned their election promise to invest $3 billion in home care.

I have heard stories from personal care workers, nurses, and physicians who report emergency wards overwhelmed with patients, long-term facilities that are understaffed, and long gruelling hours for caregivers. These are very often offering low-pay work in the homes of dementia patients.

These stories underscore the need for real leadership in this chamber. So many are affected. Three-quarters of a million Canadians were living with dementia in 2011. That is 15% of Canadian seniors. That might double by 2031. This costs our country $30 billion a year in medical bills and lost productivity. Left unchecked, that number could skyrocket to $300 billion within 25 years.

As Canada's population ages, we must prepare our health care system and our communities for the inevitable rise in the number of Canadians suffering from dementia.

To paraphrase Tommy Douglas, the father of medicare and a New Democrat, only through the practise of preventative medicine will we keep health care costs from becoming excessive.

The need is pressing. The burden for caring for patients with dementia and Alzheimer's falls primarily on family members. In Canada, family caregivers give millions of unpaid hours each year caring for their parents and family. That is $11 billion in lost income and a quarter million lost full-time equivalent employees from the workforce.

If nothing changes by 2040, it is estimated that family caregivers in Canada will be spending 1.2 billion unpaid hours per year providing care, and a quarter of family caregivers are seniors themselves.

Dementia also has a disproportionate impact on women. Women are two and a half times more likely to be providing care. Women themselves represent 62% of dementia cases and 70% of new Alzheimer's cases. That puts them at the epicentre of a growing health care crisis. Also, women are nearly twice as likely to succumb to dementia.

Another group of vulnerable patients are affected by another bill in the House, and that is the government's physician-assisted dying bill. We keep hearing arguments again and again that people with a dementia diagnosis should have a real choice over how their lives end. The federal government's legislation for assisted dying would not allow Canadians with a dementia diagnosis, while they were still of sound mind, to make an advance request for physician-assisted dying. This puts up an enormous barrier for thousands of Canadians with dementia or other degenerative illness.

Without the right to make advance requests for assisted dying, Canadians with a dementia diagnosis are faced with what the courts call a cruel choice between ending their lives prematurely or, potentially, suffering immeasurably and unbearably. This is completely unacceptable. To us it looks as if those who most need physician-assisted dying may inexplicably be excluded from it. We remain optimistic that amendments will be made to ameliorate that very serious flaw.

Let us go back to the national Alzheimer's strategy.

The New Democrats believe that the bill must be crafted correctly to ensure the best outcome for patients, their families, and their caregivers. While we support Bill C-233, it is less ambitious in its scope and implementation provisions than last year's New Democrat bill.

We will work constructively at committee stage to bring about meaningful and substantive amendments to strengthen the final version of the bill. Canadians deserve no less than the best national Alzheimer's strategy possible. The New Democrats have a long and proud history of advocating for federal leadership on health care issues.

In fact, as my colleague, the member forVancouver Kingsway likes to remind me, we invented it. The New Democrats stood alone in the House unanimously for a national dementia strategy in 2015. We stand in the House in 2016 and work so every Canadian, every Canadian family, every caregiver, can have a world-class dementia strategy, as the New Democrats have fought for in the last five years.

[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)