Health Committee on May 27th, 2020

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Excellent. I wasn't thinking about this, but you prompted a new question by me.

One other thing I think is very important are organizations for men. We know that many of them are the perpetrators. Are you familiar with community organizations that have received funding to assist men who are trying to move forward—a change in ways type of program?

[Angela MacDougall]

Interestingly, the first part of my professional life was working with men who were court ordered to what we call “batterer's treatment”. That is a piece of expertise I have, and I pay close attention to it, but there has not been an investment in that. There has been an investment in bystander intervention.

It's good for us to have a healthy level of appreciation for those services, but the biggest message within Canada is to recognize on a broad scale how endemic gender-based violence is and that this should be front and centre all the time. It should be part of all COVID-19 advertising that comes through the federal government. It should be front of mind for everybody right now; this is a key moment for us. Changing culture involves services and recognizing the social inequality, and the role men and boys play.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

As I said, I've heard so much about this. Across the country, we've seen these increases. We know there is the financial stress, but the biggest issue is that women are stuck with their abusers, because they're not going to work or to school. Even a moment to have a breath is gone for these women.

For many of the women you're speaking to, what are some of the greatest challenges right now to their ability to escape their abusers, specifically with COVID-19?

[Angela MacDougall]

We wanted sufficient advertising and media attention to this issue. Every time we had media or did campaigns through social media, our calls increased, and we're not the only ones who had that experience. That was really important for women to find a way. If they knew that services were available, they found a way to reach out.

We've been able to help women to leave, and I have to honour their courage. Imagine leaving your home and an abusive partner during a pandemic. Hundreds of women have done that in British Columbia, and we've been able to support many of them through Battered Women's Support Services.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Gosh.

Mr. Chair, how many minutes do I have left?

[The Chair, Liberal, Ron McKinnon]

Just under two minutes.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Fantastic. Thank you.

Just carrying on with that line—

[The Chair, Liberal, Ron McKinnon]

Correction: just under one minute.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

That's not a problem.

Thank you so much, Ms. MacDougall.

Switching over to the Peel region, you've been offering a lot of places for shelters. What specifically are you doing for those domestic abuse cases?

[Nancy Polsinelli]

We're doing a couple of things. Through our community response table, we have a group working on domestic violence. That group is also linked with our community safety and well-being team. In that team a group of community agencies have come together. They are working actively on domestic violence. Through our agency partnerships, we are providing on-the-ground support to anyone who comes forward with those issues. A campaign is also in the works to ensure that we're capturing as many of those cases that may exist across the Peel region.

While Peel is a funder of some of those community agencies, we truly are working through those community agencies to get to the community and to those residents who need our help. We're also working with the Peel Regional Police. They too are part of the community safety and well-being group.

We're really trying to build a web of support. Even with this group, it really depends on what residents' needs are. We're trying to look at how we can provide for needs based on individual cases as opposed to blanket support.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Thank you so much.

Thank you, Mr. Chair.

[The Chair, Liberal, Ron McKinnon]

We will go now to Ms. Sidhu.

Ms. Sidhu, please go ahead for six minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Mr. Chair.

I'd like to thank all of the witnesses for being here with us.

Like many Canadians, I was deeply horrified to read the Canadian Forces report. One of these homes is in my riding. The abuse allegations described in these homes should alarm all of us. I worked in the health care field for 18 years. I know how important it is to administer compassionate care. We need to do a better job of caring for the people who built this country and who need our help during the crisis.

My first question is for the CEO of the Region of Peel, Nancy Polsinelli.

First, Nancy, thank you for all the work you are doing. The Canadian Armed Forces report identified numerous issues in long-term care. As an operator of five long-term care homes, what do you think are the underlying causes of these issues? What has the region been doing to address the needs of seniors living in region-administrated homes? Do you think there's a difference in the quality of care between region-administrated homes and private care homes in the Peel region?

[Nancy Polsinelli]

Thank you for the question. Through the chair, I'm going to separate the question in two and speak first to what I think are the underlying causes of these issues. Then I will certainly provide some comment on your question about the private homes with respect to municipal homes.

The first question is a very important one because, if anything, COVID-19 has exposed various issues in long-term care. When we look at the issues, certainly we will hear about things like staffing ratios, funding and increased complexity of resident needs, which are part of an ongoing discussion about change in long-term care. These are very important, and they're absolutely necessary. However, I want to dive a little deeper, because there are also cultural issues that are at the core of how we approach long-term care. These, I'd like to highlight a little more for the committee.

For a variety of reasons, long-term care has become inherently task based. Our staff rush to bathing, to feeding and to documenting. It's one resident after another, on a very strict schedule, with very little time for anything further. The issue is that when we approach long-term care like a set of tasks—a checklist, if you will—we make the needs of the person who's living in that home secondary to the completing the task. In many cases, it becomes fear-based care by the staff member and not the emotional-based care these seniors deserve.

Here are some thoughts about solutions. We hear a lot about person-centred care; it gets tossed around all the time. But at the core, it does offer solutions, so while we're looking at funding, we also need to look at creating a culture that enables staff to understand and meet the needs of unique people, the people living in the home, for their physical and emotional well-being. This is what helps to improve well-being, and it certainly avoids problems before they arise.

One example I'll give is that of a person living with dementia. We know that people with dementia sometimes wander or pace endlessly. This is an issue, both during the outbreak, because wandering can put them at risk of exposure, and in general, because they can become exhausted and it's a detriment to their own health in increasing their risk of falling.

A task-based approach looks at the wandering as a problem. The wandering becomes the problem. A person may recommend to put this individual on an anti-psychotic medication, or to restrain them, or to allow them to keep on walking all day.

A person-centred approach looks at wandering as the symptom and tries to understand why the person is wandering. We're not fixing the wandering. We're trying to understand why the person is wandering.

Through our work at the Region of Peel, we've implemented the innovative butterfly model of care for dementia care. For people who wander, what we've realized is that they wander because they need something. They're looking for something. They're looking for engagement, affection, security or love. They're also wandering because we put them in environments with long corridors that look endless to them, and they just keep walking. By understanding how we can support them through activity and conversation, we are creating a home environment, a safe one.

To close this, I'm going to suggest that when we enable true person-centred care, it isn't easy. It's not about the surface. It's actually about getting deep into the way we work and the way we think as the staff in those long-term care homes.

Some things need to be considered. We certainly need better staffing ratios so that staff have time to spend getting to know who is in their care, meeting with them, holding their hand and sitting with them. We need regulations that are less focused on documenting the completion of tasks and more focused on measuring the emotional care and well-being of those individuals. We need training programs and the funding to undertake them so that staff can have a better understanding of complex conditions like dementia and how to understand and meet individual needs.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

On a different topic, as you said, currently the region is using hotels to house 51% of shelter residents and at-risk Canadians. Many of these residents include women fleeing domestic violence. How will the federal government's investment of $157 million in organizations that support the homeless help the region and help women in particular?

[Nancy Polsinelli]

The federal funding provided to the region to date, under the reaching home program, has been critical and essential to the entire regional response. This money has supported region-led initiatives, such as expanding the shelter capacity into vacant hotels—and we have just over 350 homeless individuals in hotel rooms right now—and the development and operating costs of isolation and recovery sites in the program. It has also increased outreach into the community to support safe public health practices. It's all made possible through federal investment.

The region has been able to support funding applications from community agencies as well, so that we can work directly with the homeless population for basic needs like food, cleaning services, enhanced staffing requirements, transportation, as well as supporting those women who are in trepidation and in difficult situations at home.

Further funding will allow these regional programs to run until approximately the middle of August. Further to that, we know that the pandemic is not going anywhere anytime soon. Even as we get into recovery, whether these individuals are homeless or are in domestic violence situations, they will need support, whether it's financial support, food support or general well-being support, far longer than when the emergency is declared over. That's where the funding needs to go.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

[The Chair, Liberal, Ron McKinnon]

Thank you, Ms. Sidhu.

We'll now give the floor to Mr. Thériault.

Mr. Thériault, you have the floor for six minutes.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Mr. Chair, I'll be speaking instead of Mr. Thériault. Mr. Thériault won't be here today. I'll be speaking three times, if that's fine with you.

I want to thank all the guests and witnesses for being here. Every day, we have the opportunity to hear from witnesses like you, and this really gives us valuable food for thought.

I want to take the time to remind everyone that this week is paramedic and pre-hospital emergency care week. I want to acknowledge their front-line work, which is essential in the current difficult period caused by COVID-19.

My first questions are for Mr. Sauvé. The federal government provided almost $100 million to meet the new requirements created, whether we like it or not, as a result of COVID-19. I believe that this funding is also meant to meet other needs that fall within the purview of your organization.

I want to know how much money is being directly or indirectly invested in connection with COVID-19 and your organization.

[Conrad Sauvé]

A large part of the funding announced supports COVID-19 activities that are already in progress, as I said. The Red Cross, together with Health Canada, has significantly increased its support for people in quarantine. These are obviously past operations. There are also the current operations in all airports and the purchase of additional equipment to replenish the mobile equipment deployed, which we'll need for the future. Lastly, there has been an increase in the level of emergency preparedness. As we know, the Red Cross has significantly increased its involvement in emergency operations across the country, particularly in cases of fire or flooding. Since this is taking place in the context of the current pandemic, more training and more volunteers are needed to support people.

I'll digress for a moment. The Red Cross is supported by thousands of volunteers that we train each year and that provide assistance in emergency situations. Many of these volunteers are new Canadian retirees. This creates an additional challenge in the context of COVID-19, since some of these people are more vulnerable. We must recruit younger people for these operations. This contributes to the significant growth and the particular context surrounding COVID-19.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

Thank you.

The third area of focus that you referred to earlier was the deployment of personnel directly to the centres or on the ground.

Could you elaborate on this, but with respect to the city of Montreal? Are you talking about deploying personnel to CHSLDs?

[Conrad Sauvé]

For Montreal in particular, the answer is threefold. First, the main focus is on supporting the integrated university health and social services centre, or CIUSSS, on the West Island of Montreal. There are three areas of action.

First, we help them recruit personnel. We know that there's a significant need. As a result, we've set up teams to help them with recruitment.

Second, there's also personnel training. We trained about 800 military members, in addition to all the people heading to these different centres.

Third, we've deployed specialized teams to the facilities. Infection control in facilities is obviously an issue. We've deployed teams of two or three people per facility. These teams often remain at the facilities for up to nine days, to help the management team strengthen infection control and limit infections. This type of assistance, which was initially provided in eight facilities, is now available in 40 facilities on the Island of Montreal. The demand could increase to 80 facilities. Right now, there's also demand for the same type of support in Ontario facilities.

We're also discussing the possibility of providing training or training materiel to the Government of Quebec to help it train the people heading to the facilities and the teams of experts that it wants to deploy. This sums up all our efforts.

We're also looking at the situation in the Montreal North community to see how we could meet the demand from local organizations.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

What type of support are you receiving from the Government of Quebec or the health department in this case? What type of relationship do you have?

[Conrad Sauvé]

We have very close ties with the West Island of Montreal CIUSSS and the Government of Quebec. We're in constant contact. We work all the time, in every province, with provincial and regional authorities. It's an ongoing relationship. The demand has increased in Quebec government facilities.

[Luc Desilets, Bloc, Rivière-des-Mille-Îles, QC]

So you're telling me that—