Human Resources Committee on Oct. 17th, 2017

[Yves Robillard, Liberal, Marc-Aurèle-Fortin, QC]

Thank you.

[The Chair, Liberal, Bryan May]

Thank you, sir.

Now for six minutes, MP Fortier.

[Mona Fortier, Liberal, Ottawa—Vanier, ON]

Thank you very much, Mr. Chair.

First of all, my thanks to the witnesses for being here today. What they are sharing with us is really important and will be very useful for our study, in my opinion.

In the constituency I represent, Ottawa—Vanier, social inclusion and housing conditions are major topics.

Like a number of others, I am certain that a safe and dignified retirement begins with the opportunity to remain in one's home for as long as possible. That is one of my basic principles for this study.

In the constituency of Ottawa—Vanier, about one resident in six has reached retirement age, a statistic that is higher than the average. In addition, 40% of households have less than $50,000 in pre-tax income. This is really a feature of my constituency that I have to understand better. Compared to the provincial average in Ontario, it is 10% higher. So it is a concern.

In my opinion, data are always very important, not to say essential, if you want to really understand a situation. I very much liked the presentation by the Statistics Canada people today. So my questions are going to go to them, but if the other witnesses want to reply, they can also do so.

Is it fair to say that household income is a good indicator of the standard of living for seniors? Are there other data that you could use, or that you have looked into, in order to paint a better picture of the situation for seniors?

[Sébastien Larochelle-Côté]

I can answer that quickly.

Certainly, income is one indicator among many of people's economic welfare. There is income, and then there is low income. Certainly, many indicators need to be considered in order to get an overall idea.

Earlier, I was mentioning the coverage rates provided by private pension schemes.

There is also participation in the workforce. When you are working, you have an income. There is that too. At the moment, that is on the rise among seniors, even those 65 and over.

Earlier, Ms. Rooney was talking about levels of debt. There are statistics on debt, but also on net worth. You cannot just look at debt. It is important also to look at whether people's net worth is increasing. The number of seniors with debt has increased, but the value of their assets has also increased. The same coin has two sides.

Of course, there is also the rate of home ownership. That is very important as well. Everyone agrees that the assets one has at retirement play an increasingly important role.

When people age, income is not the only thing to be considered. Of course, income comes from all kinds of sources, including public and private schemes. But there is also the income that can come from one's assets, be they financial or otherwise.

The data on home ownership rates come from the previous census. They are a little old, but in October and November, when the census data are published, we will know more about the new rates of home ownership. That information will allow us to better understand the situation for seniors.

[Mona Fortier, Liberal, Ottawa—Vanier, ON]

I'm bilingual, so I will continue in English.

Just yesterday I met with indigenous leaders in my community, and I find this presentation is perfectly timed. I know you mentioned you would be bringing out the indigenous portion of the census on October 25, but maybe you can share some information now.

Would you agree that income is a strong indicator of living standards in indigenous communities, or would you add other aspects as well, specifically for seniors in indigenous communities?

[Pamela Best, Assistant Director, Social and Aboriginal Statistics Division, Statistics Canada]

I work in the social and aboriginal statistics division. We have produced a report that looks at the situation of seniors in population centres. Among other things, the study looks at seniors who are in a low-income situation. It demonstrates that in 2011, 23% of aboriginal seniors who were living in population centres were in a low-income situation, and this compared with 13% of the non-aboriginal senior population.

We also see differences between men and women in the aboriginal population and the non-aboriginal population. A higher percentage of senior aboriginal women were part of a low-income population compared to senior men: 26% compared with 18%. In looking at the non-aboriginal population, again women are more likely to be in a low-income situation than men: 16% of women compared with 9% of men.

[Mona Fortier, Liberal, Ottawa—Vanier, ON]

Do you mind if I have access? We can share that information with this committee, more specifically.

[Pamela Best]

Yes. This information is on Stats Canada's website, but I will give you a copy of the report.

[Mona Fortier, Liberal, Ottawa—Vanier, ON]

Thank you very much. That's all.

[The Chair, Liberal, Bryan May]

You have about 20 seconds.

[Mona Fortier, Liberal, Ottawa—Vanier, ON]

I'll share those 20 seconds.

[The Chair, Liberal, Bryan May]

All right, now we go over to MP Warawa.

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

Thank you, and thank you for those 20 seconds.

I want to thank everyone for their testimony. It is so good.

I'm hoping, because of the limited time we have to ask you questions, that each of you will provide the committee with a written brief with your recommendations, so that we could then have a fuller input from you. I think it would be very helpful.

I want to focus my questions on Irene Sheppard from Surrey. She hasn't had a chance to answer any whole question, so this will be the time.

Isobel Mackenzie was at our last meeting. She's the seniors advocate for British Columbia. She provided some very interesting testimony too.

There's a large senior population in Langley. I visited the residential care right by the Langley Memorial Hospital. One of the directors there in senior care said that there's not enough time or money to build enough care beds, that they can't afford to build enough and there's not enough time. The suggestion was that if we make it possible for seniors to age in place longer, we can accommodate and afford to provide good care for an aging population.

I'd like you to touch on that, if you would. I'd like you to comment on where the major gaps in care are, which communities are doing it right, and what we can learn from those communities. It appears to everybody I've talked to that we are not ready for this aging population, but that we could be if we were to do the right things and do them smartly.

Also, you touched on home care. You mentioned that one in four has dementia. Having gone through saying goodbye to aging parents, though, I saw that they did not have dementia but did not have the cognitive or physical skills to operate. They needed an advocate. I very often see seniors without advocates and see their social isolation. Yet in another family, one of the senior care providers is burning out because the other person has dementia.

There are so many issues. Again, I look forward to a written brief with recommendations, but could you just touch on the major gaps in our communities? Is there another model we could look at, or another community that's doing it right?

[Irene Sheppard]

That's a large question. I'll make a few comments in reflection.

Without a doubt, if you were to consider creating collective dwellings and care facilities for all older adults—85 years plus—we simply don't have the land, the capital budgets, or the people to care for them. I also don't think it would serve them very well. In moving away from their familiar setting and away from being connected with the real world, they might be fed three meals a day and kept warm and dry, but it isn't necessarily going to add to the quality of their life.

Within the health care system, having listened to the seniors themselves, we're all working extremely hard to set up systems that support people in their own homes. I think that is where our focus has to be for the next few years, around how we do that.

Some of it is daunting for the health care system, because we are putting personal care workers into homes, with professional staff to supervise, oversee, and provide some additional help. Are we, however, going to be able to find the human resources to hire? That's one of our big questions. I think our advanced education system can ramp up a bit to create the programs, but can we fill the seats? Can we train the people so that they're there to hire? We also need leaders. You can have people in the trenches, but you need leaders who have the skills.

A lot of research has been done. I'm probably most familiar with the work out of the University of Alberta, the TREC study. This is very practical research within a residential care setting. What it shows overwhelmingly is that you get the best quality of care when you have clinical leadership that engages the staff, helps them to discern what they should be focusing on, and makes it easy for them to follow that knowledge. I heard some of those principles on financial literacy. If you have simple goals and you make it easy, you can then make things work better.

I think our focus has to be on supporting people in the home. The physical built environment plays a huge part in allowing us to support people in the home. People's own preparation of their own environment—their money management, their routines, bills being paid, and so on—the more simply they design their life, the less energy it consumes as their energy wanes. It also makes things easier for caregivers.

I think we're going to have to have some real dialogue as a society. There's always going to be a range among people's values, awareness, and skills, but what I see is that informal caregivers have a real struggle with a variety of things. They either feel responsible for absolutely everything in their family member's life and exhaust themselves or they expect the government to do everything and aren't prepared to step in with anything.

Within that range, there is a whole lot. I see family members exhausting themselves unnecessarily. There's a societal shift in thinking, and we have to challenge ourselves and have the conversations. It's going to be interesting to watch what happens around this issue over the next five to 10 years.

Seniors themselves have to shift some of their expectations. We certainly run into clients in the home who expect their daughter to come over, do their grocery shopping, do all their cleaning, and drive them to every medical appointment, and it creates a lot of tension in the family. How do you have those kinds of conversations? How do you have the ones about quality of life versus quantity of years? The fact that the medical system can do some fairly miraculous things doesn't mean that they're actually the right thing for individuals.

There are individuals themselves and there are families who feel that they should do everything to keep mom and dad alive, without a consideration of the quality of life. That's another conversation that, as a society, I think we need to have.

[The Chair, Liberal, Bryan May]

I have to step in. I'm sorry. I've given Mr. Warawa two extra minutes on this one.

[Irene Sheppard]

My apologies.

[The Chair, Liberal, Bryan May]

I know we cut you off before, so I wanted to let you go on for a bit, but I have to go to MP Sangha now. Thank you.

[Ramesh Sangha, Liberal, Brampton Centre, ON]

Thank you, everyone, for coming today and giving your input to the committee regarding this poverty reduction study for seniors.

My question again is for Irene Sheppard. On your website, we read that in any living space, whether home, condo, or anywhere that we can live separately or jointly with others, you are providing services for the long term and short term. My question is regarding those people who are just on CPP, OAS, or GIS. They don't have extra savings that they can spend on their well-being, and you provide services to them.

My question is twofold. If they are staying in the home and you are providing the services to them, can you share your experience, in one example, regarding that situation? How hard is it to provide services and to give them better services?

[Irene Sheppard]

I'm sorry, but I'm not quite catching that. I can certainly think of many examples of people we are providing services to in the home, but are you wondering how we can make it better for individuals now?

[Ramesh Sangha, Liberal, Brampton Centre, ON]

Yes. Rather than going to the hospital, they are living in their home, and you are providing the services.

[Irene Sheppard]

Yes. In our health authority, we're doing that for probably 15,000 to 17,000 individuals. We are going into their homes and supporting them, and doing so very readily. The area in which it makes a difference is in whether, in terms of people's ability to get their groceries, they have friends who can get them, or whether they can get them delivered. If they can get them delivered, our workers can help to support them to eat, to get dressed, etc.

What we cannot do at the moment is take them out and help them engage with other people. The social isolation issue is a very real issue, I think, and for us as human beings it's quite significant.

We can do a lot in the home to support their medical needs. We can contact their physician by phone using Skype, have them diagnosed, and get their blood tests, etc., all done in the home. I think we're going to expand that further in the future. So we can look—

[Ramesh Sangha, Liberal, Brampton Centre, ON]

Another example is of cases in which they are being provided services in the home by their family members. Are family members' services better than your services, or are your services better than the family members'? How do they compare?

[Irene Sheppard]

Certainly we often have people who get services from their family, but the way in which we can help them is in helping them know how to do it. For instance, maybe mom or dad has dementia and is acting out. Our specialists can help them understand how to not provoke the behaviours or how to settle them down, how to think about doing things differently. That professional consultative aspect is still of value to the families.

[Ramesh Sangha, Liberal, Brampton Centre, ON]

Can we mix both of them, such that you provide the services as professionals and some services can be provided by the home caregiver? But the home caregiver should also be compensated.

Do you think that concept can work?

[Irene Sheppard]

Are you asking about having family members in essence be hired to take care of their family member?