National Strategy for Alzheimer's Disease and Other Dementias Act

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

Sponsor

Rob Nicholson  Conservative

Introduced as a private member’s bill.

Status

This bill has received Royal Assent and is, or will soon become, law.

Summary

This is from the published bill. The Library of Parliament often publishes better independent summaries.

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.

Elsewhere

All sorts of information on this bill is available at LEGISinfo, provided by the Library of Parliament. You can also read the full text of the bill.

HealthOral Questions

September 20th, 2017 / 3:10 p.m.
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Moncton—Riverview—Dieppe New Brunswick

Liberal

Ginette Petitpas Taylor LiberalMinister of Health

Mr. Speaker, I thank the member for Don Valley West for his question and his work, along with the member for Niagara Falls, on Bill C-233.

This is a priority for our government and a priority of mine personally, as my mother lives with Lewy body dementia. This is why we are continuing to contribute $42 million to Baycrest Health Sciences to support new research and development, testing, and scale-up of products and services for brain health and aging. Last year we launched the largest-ever study in dementia in Canada.

We will continue to work to improve the lives of those with Alzheimer's and their families.

National Strategy for Alzheimer's Disease and Other Dementias ActPrivate Members' Business

February 3rd, 2017 / 1:50 p.m.
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NDP

Sheila Malcolmson NDP Nanaimo—Ladysmith, BC

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

National Strategy for Alzheimer's Disease and Other Dementias ActPrivate Members' Business

February 3rd, 2017 / 1:40 p.m.
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Liberal

Alaina Lockhart Liberal Fundy Royal, NB

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

National Strategy for Alzheimer's Disease and Other Dementias ActPrivate Members' Business

February 3rd, 2017 / 1:30 p.m.
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Conservative

Rob Nicholson Conservative Niagara Falls, ON

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

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

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

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

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

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

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

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

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

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

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

Alzheimer's DiseaseStatements By Members

February 2nd, 2017 / 2 p.m.
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Conservative

Rob Nicholson Conservative Niagara Falls, ON

Mr. Speaker, I am pleased to rise in this chamber today prior to the third and final reading of my private member's bill, Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

I wish to sincerely thank my colleagues on this side of the House and members across the aisle for their support of this important legislation on behalf of the 747,000 Canadians living with this terrible disease.

Many of us have had to endure the very painful long goodbye to a loved one without the benefit a having a coordinated strategy.

I want to especially thank my colleague, the member for Don Valley West for his backing in seeing that Bill C-233 becomes a reality.

The non-partisan collaboration from all parties is a shining example of what we can accomplish in this House when we work together for the greater good of all Canadians.

HealthCommittees of the HouseRoutine Proceedings

December 1st, 2016 / 10:05 a.m.
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Liberal

Bill Casey Liberal Cumberland—Colchester, NS

Mr. Speaker, I have the honour to present, in both official languages, the fifth report of the Standing Committee on Health in relation to Bill C-233, an act respecting a national strategy for Alzheimer’s disease and other dementias.

The committee has studied the bill and has decided to report the bill back to the House with amendments. I want to say that amendments were proposed by members of all parties on the committee, and we really feel that we have strengthened the bill as we present it.

December 1st, 2016 / 9:40 a.m.
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Liberal

The Chair Liberal Bill Casey

Okay, time is up.

We're going to five-minute rounds now, but the chair has to leave. I'm going to table our fifth report on Bill C-233, and I think that's quite an accomplishment for us. I'm tabling that this morning. When I table it, I'm going to say that every party had amendments that we think strengthened Bill C-233.

I'm going to turn the chair over to Mr. Webber, and I'll go to table Bill C-233.

I want to thank our guests. I'm sorry I'm going to miss the rest of this. It's very interesting, and you're bringing new perspectives that we hadn't heard. Anyway, I have to go.

November 24th, 2016 / 9:30 a.m.
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Liberal

Darshan Singh Kang Liberal Calgary Skyview, AB

Thank you, Mr. Chair.

I'll start again. At the first meeting on Bill C-233 on November 17, Mimi Lowi-Young, former CEO of the Alzheimer Society of Canada, told the committee that women are most affected by the disease, that 65% have the disease and 72% are primary caregivers. Do you anticipate that a gender-based analysis plus assessment will form part of the discussion leading to establishing a national strategy on Alzheimer's disease and other forms of dementia?

November 24th, 2016 / 9:30 a.m.
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Liberal

Darshan Singh Kang Liberal Calgary Skyview, AB

Thank you, gentlemen, for bringing this bill forward.

As we discussed before, almost everybody is affected by some kind of mental disease in their family or friends. This is a good bill, and of course you're going to have my support.

At the first meeting on Bill C-233, on November 17, Mimi Lowi-Young—

November 24th, 2016 / 9:25 a.m.
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NDP

Rachel Blaney NDP North Island—Powell River, BC

Then I think it should be removed from the legislation.

I want to get on to another issue. Unlike Bill C-356, the national strategy for dementia act, this legislation doesn't contain any provisions to augment the capabilities of the voluntary sector. Can you explain why you chose to exclude any mention of the voluntary sector from Bill C-233?

November 24th, 2016 / 8:50 a.m.
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Conservative

Rob Nicholson Conservative Niagara Falls, ON

Mr. Chair, vice-chairs, and members of the committee, it's an honour to be here today to present my private member's bill, along with my fellow colleague, the member for Don Valley West, Mr. Rob Oliphant.

Bill C-233, is an act respecting a national strategy for Alzheimer’s disease and other dementias. This bill calls upon parliamentarians to enact legislation for a national coordinated strategy for what has been termed Canada's invisible killer. Alzheimer's and dementia are major health problems that transcend partisanship and are affecting a staggering number of Canadians currently. I believe you have heard that 740,000 Canadians currently suffer from Alzheimer's, and ever more concerning is the fact that this number is expected to double in the next 20 years.

This is why I believe Canada needs to have a plan. I'm certain Mr. Oliphant will touch upon his experiences with Alzheimer's and dementia when he speaks, so I would like to take a moment to note the work on this topic by a former member of Parliament, Claude Gravelle. It's most heartening to know that in matters of concern to Canadians and their families, MPs can work together across party lines to unite and advocate for research, collaboration, and partnership, to find cures, timely diagnoses, and other support for treatment. This co-operation will lead to positive outcomes for Canadians who suffer from Alzheimer's and dementia, and will reassure their loved ones that people who are suffering from this will have the proper care. Canadians expect that their parliamentarians will work on their behalf to resolve these critical issues.

The impact on families whose loved ones are suffering from Alzheimer's or dementia is extensive. Three out of four Canadians know someone living with dementia. I can't tell you how many people have approached me over the last couple of months to tell me the stories they have experienced within their families. This not only takes an emotional, psychological, and physical toll on those who are providing support for loved ones, but it also has a severe financial effect.

In 2011, caregivers provided 444 million hours of care, 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, over two and a half times the number of hours they provide today.

Alzheimer's and dementia are no respecters of people as they rob them of their dignity, independence, memory, and time. They know no bounds and are not restricted to social or economic factors. No one is immune to these terrible diseases and the suffering that follows.

It brings to mind the late United States President Ronald Reagan. The former leader of one of the most powerful and wealthy nations on earth could not be safeguarded from the ravages of Alzheimer's. On November 5, 1994, I remember him as the 40th president of the United States, addressing 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 slow and painful years. His loving wife Nancy referred to it as the long goodbye.

Far too many Canadians endure the long goodbye. My own father, who I cherished, passed away from complications due to Alzheimer's, and I am joined by many who have dealt with or are dealing with a loved one suffering from one of the various forms of Alzheimer's and dementia. Again, we know that this is going to increase.

The bill I have put before you, first of all, proposes to establish a round table to receive input from all Canadians. It would develop a national strategy, while ensuring the autonomy of the provinces remains intact. Second, it would encourage greater investment in all areas related to Alzheimer's and dementia, in addition to coordinating with international bodies to fight against the disease. Third, it would seek the assistance of 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.

Importantly, please note that this bill does not restrict timelines or financial criteria. This is a deliberate intention to remove potential barriers, such as the need for a royal recommendation. Simply put, this bill is crafted for implementation, achievement of deliverables and, ultimately, resilience at third reading. The objective is to enact legislation that would provide solutions to assist those who suffer from Alzheimer's and dementia, and to aid family members and caregivers.

The World Dementia Council was created by the G8 in 2013 as a global coordinating movement against Alzheimer's and other dementias. It's trying to harmonize those efforts and bring together global know-how.

Canada, along with its G8 partners, had convened a meeting in London, England, in December 2013. The sole purpose of that meeting was to provide a structure for a worldwide response to this crisis. It was the first time that the G8 countries had gathered together to address a health care issue. It's clear that Canada has already agreed to work with our partners to address Alzheimer's.

In order to fulfill this mandate, we have to develop similar programs here at home. Bill C-233 would help achieve this outcome through the national strategy. I would reiterate that Bill C-233 would respect the health care accountability of each province. I was very careful in the drafting of this bill to ensure that it does not require a royal recommendation.

I would be remiss if I didn't acknowledge and thank the Alzheimer Society of Canada for their unwavering support of this bill. Their mandate and the objective of this bill closely align and support one another. The Alzheimer Society stated that it was pleased to see political parties working together to address dementia. It urged all members of Parliament to get behind this bill, suggesting that a national strategy focusing on research, prevention, and improved care is the only solution to tackling the impact of this disease.

I believe that support for this bill is the right thing. Alzheimer's and other dementias are major health issues that impact hundreds of thousands of Canadians, and it is a problem that is growing every day. Canada needs a strategy now, so Canadians can be prepared to take on this health crisis in the future.

Thank you for your support.

I'd like to now turn it over to my colleague, Robert Oliphant.

DementiaPetitionsRoutine Proceedings

November 22nd, 2016 / 10:05 a.m.
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Conservative

Rob Nicholson Conservative Niagara Falls, ON

Mr. Speaker, today I am pleased to present to the House of Commons a petition with respect to my private member's bill, Bill C-233. The bill supports developing strategies for patients and families of Alzheimer's and dementia victims. It has been certified by the clerk of petitions. I am proud to present this petition.

November 17th, 2016 / 9:55 a.m.
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NDP

Rachel Blaney NDP North Island—Powell River, BC

First, I want to thank you all so much for your amazing work. A special thank you to those of you who are in B.C. I am a B.C. MP, and I know exactly what time it is there, so I thank you so much for being here with us so early in the morning.

I want to first mention that in 2012, former NDP MP Gravelle introduced Bill C-356, a national dementia strategy, in Parliament. Unfortunately, his bill was defeated in May of 2015 by a single vote. It was a vote of 140 to 139. I think it was a really sad day for many of us. The Canadian Medical Association called this defeat “a lost opportunity to make lasting progress in the serious and growing problem of dementia in Canada”. The bill was opposed by a majority of Conservative MPs, including the member for Niagara Falls, who is the sponsor of today's bill, Bill C-233.

New Democrats, we will support Bill C-233, but it is less ambitious in its scope and implementation provisions than the former Bill C-356. Some of the concerns we have are around the establishment of the advisory board. In Bill C-233 there's a statement that says: “The board is to advise the Minister on any matter related to the health care of persons living with Alzheimer’s disease or other forms of dementia.” But unlike Bill C-356, the legislation offers no remuneration for the work of the advisory board members, nor any reimbursement for travel costs.

I come from a very rural riding, and I understand that the experiences of people across the country are very different. In your view, could this impact the formation and work of a national advisory board?

November 17th, 2016 / 9 a.m.
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Dr. David Henderson President, Canadian Society of Palliative Care Physicians

Thank you very much, Mr. Casey, honourable members, and guests.

It's with great pleasure that I'm here to speak on this, because not only am I the president of the Canadian Society of Palliative Care Physicians but I am also the son of a lovely lady with dementia. It's very timely for me to come and speak on this.

Today we have several members here who will be speaking about personal experiences and such, so I'll keep my comments to the palliative care aspect of this issue.

Our society is made up of around 500 physicians from across the country, and that includes regional leaders in palliative care, residency directors, clinicians, educators, and family physicians with a special interest in palliative care. Our society is proud to say that we support Bill C-233. I'm going to start off by giving you a few of our key messages that we want to get across.

Alzheimer's disease and other dementias are a tremendous challenge for many Canadians and their families. The needs of caring for someone with dementia are many. A national strategy clearly identifying and developing mechanisms to help Canadians manage the needs is essential, given the expected increase in the diagnosis with our aging population. Clear direction, goals, and funding for further research is imperative. Education on prevention needs to be expanded, and education on a palliative approach to care for dementia patients and families needs to be enhanced.

As we've just heard, Canada has an aging population, with one in six people having reached their 65th birthday by July 2015. That number is going to exponentially increase over the next few years. By 2024 the number of people over 65 will be more than 20% of our population. Again, as we've heard, the number of people up to age 14 is less and less. What that's telling us is that the baby boomers are climbing, we have an exponential rise in people over 65, and we don't have the same number of youth, coming up behind, to become caregivers. That will be quite an added load for everybody to be carrying.

As we've heard, dementia is a progressive deterioration of memory, reasoning, communication, orientation, judgment, and abstract thinking capacities, leading to the loss of ability to perform independent activities of daily living and eventually all activities of daily living. These are life-limiting conditions, and there are no curative treatments. Only about a third of people get a formal diagnosis. Changes in behaviours and emotions are common reasons for placement in residential care. Often these people receive very poor end-of-life care.

There are several dementia subtypes. Alzheimer's disease makes up about 47%. You can have a mix of Alzheimer's disease with other types of dementias, accounting for about 27%. There are vascular dementias, fronto-temporal dementias. With Parkinson's, you can get a Lewy body dementia. These all carry different sequelae with their symptoms.

The illness trajectory can often be long, with great disability along the way compared with that of other life-limiting conditions. From a physician point of view and from a health care point of view, communication with the person and their family early on is essential to determine their values, wishes, and goals. Within palliative care education, we spend time teaching approaches to having these conversations with primary care physicians, home care nurses, long-term care nurses and physicians, PSWs or personal support workers, and social workers.

Recently we had a wonderful education tool developed through Pallium Canada. There is education material we've been using for palliative care called “LEAP”, or learning essential approaches to palliative and end-of-life care. They recently developed “LEAP long-term care”. We were part of a pilot project with them, this being a country of pilot projects. It's amazing, even for someone who's been working in palliative care for a number of years, to look at the difference between what we're teaching for an adult and youth population versus what we're talking about for a more geriatric population. There are significant differences. You don't tend to see cancer near as much in that elderly population, basically because they have outlived the time when they are most likely to develop some of the cancers. Much more often, you're seeing multiple comorbidities such as heart disease, lung disease, and certainly cognitive diseases with dementias.

It is a wonderful nationally recognized and nationally accepted education tool. The key is to get that education out there so more practitioners and health care providers get that education. It's also multidisciplinary. This isn't something that just physicians need to be dealing with—we need our social workers, our pharmacists, our nursing staff, our PSWs, who make up much of the workforce in long-term care, to truly understand how to manage these conditions.

With palliative care in general, we're talking about a health-discipline focus on improving quality of life for people living with serious life-threatening illnesses. We have something now we've developed nationally, called the palliative approach to care. We will never have enough specialty palliative care teams to be able to care for everyone who needs access to palliative care, and nor should we. A palliative approach is really coming back to the grassroots and ensuring that we educate up our home care nurses, our family doctors, our nurse practitioners, and also our specialists, even within gerontology, to help ensure they have good palliative care knowledge and skills to be able to translate that care to the community and the home. Our cardiologists, our nephrologists, our oncologists all need to have these skills.

Grief and bereavement is something I want to make sure we bring up with too. It was alluded to earlier. As you can all imagine, if you get a diagnosis of cancer, that's a pretty shocking thing to hear. Most people will automatically think they're going to die, and you start on that trajectory and you may or may not. We don't often get told of a diagnosis of dementia until quite far into the diagnosis. So the person sometimes has a harder time understanding and coping with it.

You can only imagine what somebody goes through with a diagnosis of dementia. We all forget where we put our keys sometimes, but sometimes we start to recognize that this is getting worse and worse as time goes on. You go through repetitive losses with that. You're starting anticipatory grief earlier on, starting to recognize that you've experienced this, especially more and more now that perhaps you've seen somebody else in your family, a grandmother or great-grandmother, go through this. So you kind of know what to expect. That can be pretty devastating.

In my family, we are scattered across the country. I have sisters living in British Columbia, Alberta, and New Brunswick, and I'm in Nova Scotia. Families are more typically scattered now, and often lack the family support required to care for people. So now you often end up with a single caregiver, who is often elderly as well, often with comorbidities of their own, other health issues, trying to care for somebody with dementia. They're going through anticipatory grieving as well, and their entire lives end up being changed. There's much that needs to be done to help support these people.

I also want to point out that men who lose their wives, whether through cancer or dementia, are at a much higher risk of suicide. It's often not recognized that way. Our health system isn't necessarily responsive to that and doesn't always recognize it. It is a population to which we have to give a little extra care and do good risk assessment for bereavement.

To conclude—to take Mr. Trudeau's comments—we're palliative care and we're here to help. Our society is committed to help support Canadians with life-limiting illnesses, especially with Alzheimer's and dementia. We're happy to be part of any strategy that moves forward to try help develop a good system for Canada.

Thank you.