Health Committee on Oct. 24th, 2011

[The Chair, Conservative, Joy Smith]

Thank you so very much.

Now we'll go to Mrs. Block.

[Kelly Block, Conservative, Saskatoon—Rosetown—Biggar, SK]

Thank you very much, Madam Chair, and thank you to our witnesses for being with us today.

Throughout this study we've heard a lot of things. We know we have an aging population and that we are living longer but not necessarily healthier. We also know it is inevitable that as our population ages some will develop the chronic conditions and diseases we've been talking about.

Following on my colleague's questions, we touched on the important role of the caregiver, which is why the government supports caregivers through a number of tax relief measures, including one that was most recently introduced, which is the $2,000 non-refundable family caregiver tax credit.

We've also recently launched a three-year external research program to fill in important knowledge gaps on key caregiver issues. In 2012 the Government of Canada will also run a national caregiving survey that will refresh the national data to help us better understand the challenges that caregivers face.

What continues to rise to the surface during these discussions is the need for individuals to take or at least increase personal responsibility for their health. It's unfortunate that sometimes we don't do what we should do until we have to—I guess that's human nature.

I do have a couple of questions for Ms. Eng.

In a report issued by CARP in February of this year, members were asked how they could best increase personal responsibility for their health. I think 54% indicated it was adopting a healthy lifestyle. Has CARP followed up on this study? Does a majority of the CARP membership actively pursue a healthy lifestyle? How did they define “healthy lifestyle”, and what kind of guidance does CARP provide in this regard?

[Susan Eng]

We certainly encourage healthy aging, in all of its aspects. Through our membership benefits we try to encourage them to join fitness clubs. We get them member discounts, to ensure that people who are in fact selling these kinds of services to help people stay healthy and engaged also provide them with financial incentive to get involved.

In our chapter network across the country, for example, one of them introduced Nordic pole walking in their community. Some have taken advantage of the New Horizons programs and so on, to introduce programs for their local neighbourhood. There certainly is a great deal of support for active aging initiatives.

We have people in our membership who do say that government has a role in supporting and incenting activity, but they certainly take responsibility for their own health themselves. However, when they cannot do so, they do see that government has a role in assisting them and assisting their caregivers and so on.

Now, in terms of bringing forward that aspect of our work, we do encourage it, but it is one of those kinds of priorities where you're encouraging the positive; we concentrate on defending against the negative much more in our advocacy.

We do weigh in favour of providing support for family caregivers to recognize the challenges they have, and they're grateful for the support for family caregivers in the latest budget. But they also say there's a need now to drill down on those who are providing the heaviest level of care so they are able to help with that as well.

[The Chair, Conservative, Joy Smith]

Mr. Racine, did you want to make a comment?

[Jean-Luc Racine]

Yes, quickly.

I would simply like to say that I think that to encourage or promote physical activity among seniors, it's good to talk about it and advertise it. But a little structure also needs to be given to help this clientele continue.

We have a big challenge to accept. We are seeing it within our federation. For example, it is much more difficult for the baby boomers who come to join senior citizens clubs. Our challenge will be to put structures in place that will help this upcoming young clientele to continue to be involved and active in the community. We already have very interesting plans in this respect. But these are big challenges for the next few years.

[The Chair, Conservative, Joy Smith]

I don't think there's enough time, Mrs. Block. I'm sorry about that.

We'll now go to Dr. Sellah.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

Thank you, Madam Chair.

Thank you to everyone and all our guests here who came to answer our questions wherever possible. I have a question for Ms. Eng.

A survey by your association indicates that some of the priorities of your members were access to doctors and a reduction in wait times. I have two questions for you. The president of the Canadian Medical Association told us when he appeared before our committee that many seniors ended up in long-term care facilities permanently. Now, we all know the repercussions that these long stays have on the health system in general. The reasons for this situation are economic, meaning that these people cannot afford a residence for independent or semi-independent seniors. He told us that the situation was caused by the lack of places administered by the public system in facilities for seniors. Do you think that's a good point of view, particularly when it comes from the president of the Canadian Medical Association?

My second question is what do you think of the effort being made to recognize foreign diplomas? Is this part of the solution? If so, how do you suggest we speed up the process for this human resource that is available and that cost Canada nothing?

I have another question. I'm making the most of it. It's for Mr. Racine. How are your members received when they discuss needs in terms of services in French with the authorities involved?

[The Chair, Conservative, Joy Smith]

Let's start with Mr. Racine, and then we'll proceed with the other questions.

Mr. Racine, go for broke.

[Jean-Luc Racine]

We have seen a big improvement over the past ten years, meaning that there is more and more comprehension. It still varies from region to region and province to province, but increasingly we are beginning to understand that these are important elements. But the tangible solutions are often slow in coming. Obviously, a leopard never changes its spots. So things get a little difficult. This is what we're noticing. But the dialogue is more and more interesting. The various communities are open.

I would like to add that Health Canada funds the Société Santé en français and the Consortium national de formation en santé, which has enabled us to take giant steps in recent years. We are very happy about that.

[The Chair, Conservative, Joy Smith]

Thank you.

Who would like to go next?

Ms. Eng.

[Susan Eng]

I'm not sure that I entirely understood the question. I was trying to listen to both languages, and that was a mistake.

On the issue of foreign credentials, most certainly there is a need to recognize foreign credentials. Foreign-trained professionals provide an opportunity to broaden our base of professional and cultural skills. That is something I have particular knowledge of in my other work with the nursing homes we helped put together in Toronto. There are four locations now, offering service in the Chinese language and also South Asian and Japanese. In fact, in those cases, language was important, but food and cultural behaviour were equally important.

When we talk about foreign-trained doctors, we're not doing them a favour; we are actually bringing their expertise and cultural competencies into our system, which is a major opportunity.

Wait times are an issue the Canadian Medical Association talks about. I'm looking for their solutions. They talk about expanding the numbers of their profession, but I think they need to focus harder on services to seniors and geriatricians, and to put the weight of their organization behind that approach.

The number of people waiting for long-term care is actually criminal. It has been shown that when they are waiting for long-term care they cannot manage at home. There are no options. There isn't enough home care, and they are deteriorating while they wait.

[The Chair, Conservative, Joy Smith]

Thank you very much.

Dr. Sellah, you have about 20 seconds if you have something else you'd like to make comment on.

[Djaouida Sellah, NDP, Saint-Bruno—Saint-Hubert, QC]

I'll give up my 20 seconds.

[The Chair, Conservative, Joy Smith]

Thank you.

We'll now go to Dr. Carrie.

[Colin Carrie, Conservative, Oshawa, ON]

Thank you very much, Madam Chair.

Ms. Clark, I wanted to ask you a little bit about your organization. Your website indicates that it encourages older Canadians to “maintain and enhance their well-being and independence through a lifestyle that embraces physical activity and active living”.

Could you describe how your organization promotes a healthy active lifestyle for seniors? As well, how do you measure your success? How would you measure that?

[Patricia Clark]

That's a really good question. I've been asking that, and I've been with ALCOA for four years.

What we do is we take the research of the day, we create resources for older adults, and we disseminate them through our membership. Our role really is to inform and educate and hopefully motivate older adults to make a change in their lifestyle. We do that through brochures and we do it through training seniors to speak to seniors. We really try to get down to the grassroots. We have an older adult speaking to a group of older adults, because we know it's their preference to have information shared that way.

We are by no means a programming organization, but we create resources for the local community leader to create programs in their community. To give you an example of what we're working on now, we have something for diabetes for older adults, getting them to understand how it's a lifestyle disease and how they can make changes in their lifestyle. We'll provide that information to community leaders to offer it within their community. We're hoping to be able to determine the impact of that, when this program goes out, to see what the change has been.

A lot of this information is simply resource-based. The only thing we have is the dissemination and how much we get out there. We don't know what the impact is, but we do know that they're constantly in demand. People do want our information.

[Colin Carrie, Conservative, Oshawa, ON]

So you're saying it is difficult to actually measure what's working and what's not working?

[Patricia Clark]

From our capacity, with what we have, yes, it is. We predominantly create resources.

We do get a lot of good feedback from individuals and older adults--i.e., I like this, I would like more, I want to share it with my friends--but we haven't any solid evidence to say what change has happened, except that, as I said, we hope to know from this new document, based on feedback after the courses are over, if they've made a change and how it's affected their lives.

[Colin Carrie, Conservative, Oshawa, ON]

Maybe I can follow up with Dr. Joanette.

Do you have surveillance programs in place to monitor, for example, the chronic conditions specifically related to aging? How would you say the different programs out there are impacting seniors? Are seniors getting the message from different organizations on how they could improve their specific conditions?

[Dr. Yves Joanette]

The Institute of Aging is not responsible for the delivery of these services. It's there to provide the knowledge that is then implemented. The kind of evidence that is used by ALCOA is based on research that shows, based on hundreds of seniors, that physical activity will have an impact and so on.

Now, the way we do this kind of surveillance is we partner with other agencies in the health portfolio of the government. That's where we have these discussions. Of course, through speaking and exchanges with these other agencies, we have a clearer picture of what's going on.

So we're not monitoring, ourselves, but with StatsCan, with the other agencies, we certainly make sure that we address these gaps and these priorities.

[Colin Carrie, Conservative, Oshawa, ON]

Are there any statistics relating to different chronic diseases and how different chronic diseases may affect the different sexes, male and female, as we get older? Do you have information on that?

[Dr. Yves Joanette]

That's a good question.

We know that life expectancy is a little bit greater in females than in males--unfortunately for me--but we know that a healthy life expectancy is not that different. The difference is in this period where there's a lack of functionality and good life. This is something we have to understand and address. Currently research is being done to understand why there is this gap between men and women in the portion of life expectancy that is not healthy.

[Colin Carrie, Conservative, Oshawa, ON]

Do I have time for another question?

[The Chair, Conservative, Joy Smith]

Yes.

[Colin Carrie, Conservative, Oshawa, ON]

The CIHR's Institute of Aging strategic plan for 2007 to 2012 notes the implementation of a Canadian longitudinal study on aging, beginning in 2008. What do you expect we'll find when we take a look at that? Do you have preliminary findings that you might be able to tell us about?