Evidence of meeting #68 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was need.
A recording is available from Parliament.
Director, Grande Prairie and Area Council on Aging - Seniors Outreach
Yes, of course.
NDP
Rachel Blaney NDP North Island—Powell River, BC
Thank you everybody. I wanted to make sure that was on the record.
First, I'd like to ask questions of the Canadian Medical Association. Your organization is responsible for a lot of the legwork that has enabled us to be here today. I think we must all thank you for that amazing work. It is clear to me that Canadians definitely want to see a plan.
I'll let either one of you answer, depending on the question.
The first question I have is, can you tell us what a strategy would bring to our current system and why you think we need one?
President, Canadian Medical Association
Your question deals precisely with the main reason we are here.
The Canadian health care system was established 50 years ago, and few changes have been made to it since. At the time, the population of Canada was 20 million and the life expectancy was 70. Since the life expectancy was 70, there were not many places for those suffering from chronic illness or for the elderly. Since that time, we have had the same system of health care, which is designed in such a way that we have to go to hospitals to get it.
As I said in my presentation—and it is also well described in the booklet we provided for you—the health care system is not designed to treat elderly people suffering from multiple chronic illnesses who do not want to spend their final days in a hospital bed, or in an emergency room with strangers or people who are not part of their circle. They want to be treated at home, and it is possible to do so.
When we say home care, we are not talking about the home care that involves going to change dressings after being in hospital. We are actually talking about health care that prevents people from going to the hospital. So, if people get up in the morning and do not feel very well, they can access a system without automatically having to go to emergency. They will be asked what is wrong and someone will be sent to the home, depending on the problem described. That is possible.
There have been very positive experiences with that in various parts of Canada. Nova Scotia is a good example. In Quebec, a local community health centre works on people's problems first, so that they are not forced to go to the hospital as soon as the problems arise. They go there as infrequently as they can.
The hospital in Châteauguay, where I was the medical director, has also conducted some experiments, especially with patients with heart failure. We gave the patients a device that looked like a telephone. Each day, the patients had to enter the quantity of fluid they had drunk the day before, their exact weight, their temperature, their pressure and their sugar level. We know that, to maintain cardiac function, you must not drink too much fluid. The device allowed people to see whether they had to pay a little more attention to that on any particular day. The hospital received results from dozens of patients. If physicians saw that something was not right, they would become involved. It also prevented the person's condition from destabilizing.
The experiment, conducted with control groups, showed that allowing people to look after themselves at home resulted in a spectacular drop in hospitalization rates and in the number of emergency room visits.
NDP
Rachel Blaney NDP North Island—Powell River, BC
If you had complete control of the process, how would you implement a strategy in the coming months? What would be the very first steps?
President, Canadian Medical Association
Strictly speaking, the strategy does not actually have first steps.
All the participants have to embrace a seniors' culture, whether it is about financial harassment in the home or about starting the debate on the reality of an aging population. The population of seniors is going to double in the coming years. The aging population is not a hypothetical concept. The seniors are here, and we have to take care of them. As a developed country, Canada cannot allow itself to let seniors die alone at home.
NDP
Rachel Blaney NDP North Island—Powell River, BC
This year there is a gap in residential care. We have an unmet demand in excess of 8,000 beds, and a projected need for 10,500 new beds per year over the next 19 years for a total of 199,000 new beds by 2035.
Do you think the current funding is adequate?
President, Canadian Medical Association
You have to ask yourself whether it is just beds you need. Your question is quite appropriate. We not only need beds, but we also need resources for seniors.
Some seniors will need a bed in a long-term care facility, because they may have major cognitive problems and difficulties with mobility that are so great that they cannot move around. However, all the others should have access to well thought-out and adapted home care. With that only, we can go quite a long way, and with satisfied patients.
We can also get family caregivers involved. Currently, family caregivers are the victims of a poorly organized system. They lose their jobs and they lose their financial resources. They put their mental health and their physical health at risk as they take care of the elderly. They need a little support. This is an important lever in the area of care for the elderly.
NDP
Rachel Blaney NDP North Island—Powell River, BC
We've received unclear messages from both the minister and the Prime Minister in the implementation of this strategy, so I certainly hope this happens because I hear loud and clear that it needs to.
President, Canadian Medical Association
I hope so too.
I hope very much for our seniors as well. Thank you very much.
Liberal
October 26th, 2017 / 4:30 p.m.
Liberal
Yves Robillard Liberal Marc-Aurèle-Fortin, QC
Thank you, Chair.
Ms. Leviten-Reid, what role must not-for-profit organizations, co-operatives and communities in the broad sense play in terms of supporting the population as it ages? In your opinion, how could the federal government come to the assistance of those organizations that assist seniors in return?
Associate Professor, Cape Breton University, As an Individual
That is a great question. A couple of people have already talked about this, but it's really developing partnerships at the local level. You talk about community organizations in partnership with housing developers. Are they sitting down and talking about healthy aging? It's not just about infrastructure development. It's working together to support healthy aging.
I think that's the role that community organizations play. With community organizations, you talk about co-operatives. It could be a credit union, for example, that becomes a partner in a housing project. Certainly in Nova Scotia there's a case of a credit union actually donating land to build affordable housing for seniors. There are those kinds of roles that they can play as well.
Community organizations can be champions in that they may have the expertise required to get a project off the ground, and again, credit unions have played key roles in multi-stakeholder health care co-ops, actually, in the province of Quebec.
With respect to the role of the federal government in particular, I'm not quite sure of the answer to that. Perhaps it's modelling what partnerships look like and presenting best practices for provincial level or community level organizations.
Liberal
Yves Robillard Liberal Marc-Aurèle-Fortin, QC
How must a national seniors strategy be tailored to those who are in pre-retirement? Are their issues different from those who have retired or even from those of seniors who are still working? What should the government's response be?
Associate Professor, Cape Breton University, As an Individual
Is that question for me as well?
Associate Professor, Cape Breton University, As an Individual
With respect to affordable housing, I don't see necessarily that there's a difference between being retired or not and living in affordable housing. Several of the seniors we interviewed were still working but they were living in affordable rental housing, so I'm actually not sure there would be a difference with respect to that kind of unassisted housing.
Liberal
Yves Robillard Liberal Marc-Aurèle-Fortin, QC
Ms. Leviten-Reid, since you teach in Cape Breton, I assume you have very specific expertise in how people from the Maritimes age.
What can you tell us about the conditions of aging in the Maritimes, compared to those elsewhere in the country? What lessons can the country as a whole learn from them? Do you discuss the issue with other experts?
Associate Professor, Cape Breton University, As an Individual
I think I understood your question. Do you want me to compare the conditions of seniors in Atlantic Canada to the rest of Canada?
Associate Professor, Cape Breton University, As an Individual
Okay. For one, the rates of home ownership are higher in Atlantic Canada compared to seniors in other parts of the country, and there is less rental housing available for seniors as a result in rural communities in Atlantic Canada compared to the rest of the country.
Liberal
