Human Resources Committee on Oct. 31st, 2017

[The Chair, Liberal, Bryan May]

Good afternoon, everybody.

First of all, happy Halloween. I hope everyone is looking forward to trick-or-treating later. We'll try and get through this as quickly and efficiently as we can so everyone can get home to do that.

Pursuant to Standing Order 108(2) and the motion adopted by the committee on Thursday, May 4, 2017, the committee is resuming its study of advancing inclusion and quality of life for Canadian seniors.

Today is the third of three panels that will be held on the subject of inclusion, social determinants of health and well-being.

Thank you, again, to today's witnesses for accommodating the change in the meeting date. We're going to get right into the introductions, and then everyone will have seven minutes for comments.

From Dying Healed, via video conference from Chilliwack, B.C., we have Natalie Sonnen, executive director.

From Seniors First BC, also via video conference, from Vancouver, B.C., we have Mr. Kevin Smith.

Appearing here as an individual, we have Birgit Pianosi, associate professor, gerontology department, Huntington and Laurentian universities. Welcome.

Appearing from the Canadian Federation of Nurses Unions is Linda Silas, president. Welcome.

From the National Association of Friendship Centres, also here in Ottawa, we have Vera Pawis Tabobodung and Sonya Howard. Welcome.

As I said, everyone will have seven minutes and, when I make a signal, it means you have one minute. You have lots of time. We usually try to get everyone to stay within seven minutes, and they do a pretty good job of that. However, when you see me make a signal, you'll want to start to wrap it up.

We're going to start with the video conferencing.

Natalie Sonnen, the next seven minutes are yours.

[Natalie Sonnen, Executive Director, Dying Healed]

Thank you very much.

I want to quickly start off by talking about Dying Healed. What I would like to bring to bear on this committee is the importance of volunteerism and its crucial role in our society, especially concerning matters of elder care and end of life care. I think a spirit of volunteerism in this regard would and should relieve pressure on governmental bodies, especially at the federal level, to spend tax funds on expensive programs that could be better run at a grassroots level. Let me give you some background.

In 2015, I began to put together a program called Dying Healed. The name of the program came from something which Dr. Margaret Somerville, formerly the head of the centre for law, medicine and ethics at McGill University, said at a conference that I attended. I will paraphrase her words here. She said that we have to rediscover the value of life at the end of life and that we must impress upon people the importance of making use of this time, not so much to heal our bodies, but to heal our souls, our relationships, our regrets, and our sorrows.

The term “dying healed” is a concept that explains how a person can use the later stages of life to perhaps accept their physical limitations, but use the wisdom of their lifetime to heal their past wounds and become mentally, emotionally, and spiritually healthy. In practice, however, it became manifestly clear to me that human beings are not islands unto themselves and that the process of finding peace in old age or at the end of life is integrally tied to the other people who inhabit our world. I then realized that to really deal with the looming crisis of an aging population, volunteerism had to be at the very core.

That is why we designed the Dying Healed program. The program seeks to reach out to potential volunteers of all stripes and inform them in concepts around the end of life. It seeks to empower everyday people and give them an awareness of the problem and the confidence to do something about it. However, the doing part is more about being than doing, and this is very key to the dying healed program.

To quote directly from our training manual:

The purpose of the Dying Healed Program is not to create professionals but educated lay people confident in the fact that their presence at the bedside of a lonely or dying person is an invaluable service. If a person is alone, suffering in any way or at the end of life Dying Healed volunteers can simply be there with the conviction that their presence can bring love, hope and a sense of belonging to those who suffer.

I want to be very clear here that this program is not intended to replace any currently existing volunteer training program that is being held in our institutions across Canada. Think of this as a preparatory training and volunteer recruitment program, reaching out through churches, mosques, synagogues, community centres, and home-based visitation programs, to give people a first taste of what volunteerism like this might be like, how incredibly important it is, and most especially, how vital the power of human presence alone is to changing the life of an elderly person struggling with social isolation and all that it entails.

In a 2016 study by the U.S. National Institutes of Health, it was found that a majority of people who died by euthanasia in the Netherlands for so-called psychiatric reasons had complained of loneliness. The researchers found that loneliness or social isolation was a key motivation behind the euthanasia requests of 37 of 66 cases reviewed, a figure representing 56% of the total.

A tireless advocate for the vulnerable members of our society, Jean Vanier, wrote:

To be lonely is to feel unwanted and unloved, and therefore unlovable. Loneliness is a taste of death. No wonder some people who are desperately lonely lose themselves in mental illness or violence to forget the inner pain.

As we know, Jean Vanier set up homes for the disabled in Canada and around the world.

Dying Healed volunteers are given training and formation in the issues surrounding palliative care, medical aid in dying, the meaning of human suffering, and the power of human presence to heal and bring dignity to others.

I want to share with you my own personal experience of visiting a young man from Algeria who had been a child soldier and prisoner of war from the age of nine to the age of 16. He lived in Downtown Eastside, in a filthy hotel room. I worked with a group of volunteers who went every Saturday morning just to sit with him. His isolation was so severe that at first he could only stand facing the wall, with his back to us, while a colleague and I would sit, barely saying a word. But he wanted us to be there. Over a period of two years, he slowly began to talk to us, and soon, through our regular visits, he began to share his story, and then seek advice and help. Eventually, he got a job and became a functioning member of society. It all began with us simply being there, through the power of human presence.

We must reach out to those who feel that life has no value, to the elderly and the dying, those most at risk of giving up and most susceptible to the new ideas that have come with the advent of assisted death. I am particularly concerned about suicide contagion in nursing homes where one person makes a request for medical aid in dying. How does that affect the others who are struggling with loneliness and its attendant sense of despair?

I feel that society must cherish our elderly, who have done so much for so long for society, yet elder abuse is definitely on the rise. The elderly live longer. With demographic challenges that result in fewer family caregivers than in previous generations, the future may easily tend toward an ever more precarious situation for those most vulnerable people.

The Dying Healed program was launched officially in June of this year and is now in 15 communities across Canada. We are just now getting feedback on the training program itself and the experiences of the volunteers who have gone on to spend time with those most in need.

In short, I want to emphasize that the reliance on grassroots programs such as the Dying Healed program, already working in communities to identify and meet the needs of seniors, will be much more effective than a government-sponsored project. With more funding for our own work, we could, for example, hire a director of outreach and get this program into tens, if not hundreds, of communities across Canada. I do believe that this is a more reasonable and responsible use of our tax dollars.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much.

From Vancouver, B.C., we now have Mr. Kevin Smith from Seniors First BC.

[Kevin Smith, Representative, Seniors First BC]

Thank you, Mr. Chair and members of the committee, for the opportunity to address this important and timely issue.

As noted by the International Federation on Ageing, the number one emerging issue facing seniors in Canada is keeping older people socially connected and active. An estimated 30% of Canadian seniors are at risk of becoming socially isolated. Seniors First BC is a non-profit agency serving the people of British Columbia. We work to prevent elder abuse, to provide assistance and support to older adults who are or may be abused, and to those whose rights have been violated. Our programs include an information referral support phone line, a victims services program, free legal advice and representation, and public education outreach programs. Our staff are from various professional fields, allowing us to offer a mix of supports, with expertise about elder abuse issues from a unique, holistic, and multidisciplinary perspective.

Social isolation is a recurring issue in our work. Elder abuse, neglect, and financial exploitation of seniors can result from or be exacerbated by the social isolation of the older adult. The likelihood that an older adult will not accept help, and whether that help is easily available, is also in part determined by how socially connected that older adult is. There has been much research and reporting on the dramatic ways that these forms of elder mistreatment can affect the health, safety, and quality of life of older adults. We do not intend to review this material. We understand this committee wants to look at advancing inclusion of seniors, keeping them socially connected and active. This requires an active action plan or strategic plan. We agree with the brief from the Coalition for Healthy Aging in Manitoba in supporting the use of the framework from the global strategy and action plan on aging and health of the World Health Organization.

Strategic plans require an aspirational vision. We want to suggest a vision for how inclusion may play out for one of our socially isolated clients. We will call him Dave. We have chosen an example of a very isolated rural senior. We recommend the brief from our sister organization S.U.C.C.E.S.S. regarding a culturally sensitive and linguistically appropriate way to advance inclusion for diverse urban populations.

While Dave's situation is perhaps extreme, we believe choosing an extreme example can be informative and the solutions may have broader application. Dave's living situation displays many of the risk factors associated with social isolation. He lives alone in a semi-remote cabin. He's 80 years of age, has multiple chronic health problems, no children, little contact with other family members, recently lost his spouse, recently lost his driver's licence, lacks access to transportation, is of low income and low education. Dave is socially isolated, potentially exposed to exploitation, vulnerable to financial abuse, to frauds and scams, to self-neglect, but let's look at what Dave's situation might be five years hence.

Dave is awakened by his alarm and the smell of coffee brewing. After a few sips, he speaks to Connie. Connie is his personal digital assistant developed by the connecting Canadians program and the private sector. Connie functions as Dave's connection to the outside world through a free broadband connection and a hands-free interactive speaker hardware provided to low-income seniors by connecting Canadians. Connie is more than just a hands-free browser, search engine, and scheduler. Connie provides specific curated information from the community and the Internet for Dave and functions as an e-health adviser, and through Dave's Fitbit bracelet, monitors Dave's health with connections to a community nurse practitioner, occupational therapist, and pharmacist.

While interacting with Dave, Connie is monitoring his cognitive functioning. Connie monitors his browsing, warns Dave about potential phishing and online frauds and scams. Connie monitors his finances, warns about shortfalls or questionable transactions, simultaneously warning his attorney. Connie learns what Dave likes, recommends activities based on its learning, and interacts with “body language” and subtle expressions to simulate emotion.

Dave has made informed decisions about these various ways Connie is monitoring his life and has, to his surprise, developed a bond with Connie. As it is Monday, Connie goes through the coming week with Dave while he eats his breakfast. The self-driving community bus, a school bus used between school hours, will be coming by today to take seniors to the seniors centre for various programs.

The Government of Canada developed these self-driving buses in a public-private consortium with Bombardier and BlackBerry. Canada is now a world leader in the development of these buses. They display public service announcements on the side, in this case the federal government’s latest anti-ageism campaign.

The Canadian government and the provinces also subsidize self-driving cars and “taxi-bots” for low-income seniors who have lost their licences and have traded in their cars, and for those who have a disability that's preventing them from driving.

Tomorrow the medical home self-driving bus will come by for Dave’s monthly checkup. On board is a nurse practitioner, occupational therapist, pharmacist, dentist, and dental hygienist. A doctor is available by teleconference. Dave will get his prescription refills. Connie will be advised to set up an appointment with a heart specialist in town and schedule a taxi-bot so that Dave can attend the appointment. Tuesday afternoon a Better at Home volunteer, accompanied by the self-driving firewood supply and splitter truck, will come out to help Dave split and stack cords of wood. Wednesday the social club on wheels comes by. Friday the grocery bus comes by.

After this, Connie leads Dave through his calisthenics and reminds him of an upcoming online meeting of his circle of support to help him make a supported decision about a request by his nephew for a loan. Connie talks about other possible events to consider attending in town—a widower peer support meeting, a lunch gathering of the blues society, a community kitchen event—and about an incoming call from his neighbour Doug about travelling to the seniors centre together.

That's our presentation. Thank you, Mr. Chair.

[The Chair, Liberal, Bryan May]

Thank you very much.

We now have, appearing as an individual, Birgit Pianosi, an associate professor in the gerontology department at Huntington and Laurentian universities.

You have seven minutes.

[Dr. Birgit Pianosi, Associate Professor, Gerontology Department, Huntington and Laurentian Universities, As an Individual]

Thank you very much. Excuse my accent. I'm German, so if you don't understand me, please ask.

I thought of talking about aging and older adults from a different perspective. I thought it important to point out that the majority of older adults today are healthy and that has an impact, of course, on how we view and what kind of policies we introduce to older adults that we will have in the next couple of decades. As a professor, of course, that also includes education in gerontology, so I will split my presentation into two parts, healthy aging and education gerontology.

My two main thoughts, as I just said, are really to look at the generations today of older adults. They are very different from previous generations and we need to increase our education of the public and the people working with older adults about the current issues of aging. I will talk about the demographic reality, the status quo of health and social service education, and then some consequences and solutions, and the summary. I will try to do that in seven minutes.

Today is different from the past. Older adults of today and the future will be much healthier, wealthier, and better educated than those of previous generations. Declining fertility has led to greater female labour force participation. Fewer children mean healthier, smarter, and better educated children. Demographic projections indicate further gains in longevity, including gains in healthy life expectancy, so we really need to look at older adults from a very different perspective. Also, the increase in legal retirement age and change in pension policies will also entice older adults to work longer because they are healthier.

I thought of giving you an imageto have in your head. When we look at older adults, 65 years and older—I use older adults on purpose as a term, not seniors, as seniors implies frailty and, as you can see, over 90% of our older population today in Canada live independently and therefore are healthy enough not to have to move into long-term care or in any assisted facilities. So please remember, older adults and not seniors. That's what I tell my students anyway.

The graph that I found quite interesting indicated that almost 80% of older adults today are feeling quite healthy. However, some of the older adults do feel lonely, as we have heard in previous presentations, and their life satisfaction might not be as great. Their concern about life satisfaction is almost 20%. Most older adults participate in social activities, but many older adults would still like to be more involved, and I think that really has to reflect the policies that we introduce, such as age-friendly environments, age-friendly communities, and such.

Many healthy older people represent not a liability but a great asset of experience, skills, drive, that the country should learn how to exploit. We really have to make use of these older adults and that is what they want, as you have seen in the previous graph.

What is our status quo now in education? What do we really know about older adults? What does the public know about older adults, and especially our social and health care providers? Health, social and community human resources need to be better prepared and supported to meet the needs of our aging population. The fact that we don't require any of our schools that train our future health, social and community care providers to formally teach content related to caring for older adults is concerning. Youths who are not exposed to caring for or working with older adults will be less confident in their knowledge and skills working with these patients and less prepared to meet their needs or even to choose these areas as a career.

A strategy that provides the right education and training opportunities will ensure that Ontario and Canada gain an informed workforce that will have the necessary knowledge, skills, and confidence to identify issues of need amongst older adults while delivering them the right care, in the right place, at the right time. That is not only care, but also services. I always include this because, again, we're not only talking about frail older adults, but the majority who are healthy and are looking for services rather than care.

What is the status quo? We know that most of our older adults are cared for by people who are not educated properly. That is a global issue. It's not just a Canadian issue. It's a worldwide issue.

We have different health and social service programs. They are very different from each other. There are no real guidelines about what should be part of the education.

Research shows that 70% of respondents feel that gerontology content in their programs should improve, so any kind of health and social service programs in Canada. Programs do not have sufficient gerontological expertise. Even the teachers and faculty who are teaching gerontology issues are often not educated in the area.

In 2012, seven Canadian universities offered specific three- to four-year undergraduate degree programs in gerontology. I'm teaching at one of those programs at Laurentian and Huntington universities. The consequences are that those who work in the field with older adults often have negative attitudes toward older adults. They don't really know what older adults are, because they haven't learned the realities of aging during their course content.

Ageism is a barrier in curriculum development. We need more applicable and practical applications of gerontological knowledge, competencies, and training. Providing relevant, ethical, safe care, and services to older adults is paramount not only in creating and maintaining their quality of life but also in the development and changing of attitudes toward health, aging, and end of life care. I also think to create policies.

Movement toward professionalizing gerontology and gerontologists, aging specialists, like myself, may well aid the continuity of aging services both in the health care and social care domains.

I would like propose some solutions. We need to have better education that includes health promotion, financial security, and so on, but I'm focusing here on education. We need to encourage students at an early age to specialize in gerontology, and that shouldn't start at the university age. That starts at a much younger age, often at the elementary school age. We must enhance capacity of existing faculties, making use of train-the-trainer approaches for increasing faculty capacity. Both older adults and their care partners must be integrated into the team, and provided information and training. Education includes all older adults and their care providers. We need to initiate social change by introducing new ways of thinking.

We need to have special knowledge if we want to care for older adults, and provide services to them. It is important that we adjust our curricula in social services and health sciences. Gerontologists do have special knowledge they can provide, creating age friendly environments, and so on. Many jobs require registration with professional bodies. Gerontologists at this time do not. Registration has now started in the United States. Actual programs are now being accredited. We need to include the expertise of this profession in our policies to move forward.

Thank you very much, Mr. Chair.

[The Chair, Liberal, Bryan May]

Excellent, thank you.

From the Canadian Federation of Nurses Unions, we have Linda Silas, president.

The next seven minutes are yours.

[Linda Silas, President, Canadian Federation of Nurses Unions]

Mr. Chair and committee members, thank you for inviting the Canadian Federation of Nurses Unions to present to this committee. On behalf of close to 200,000 nurses who I represent, I'm very pleased to be here. As mentioned, my name is Linda Silas. I'm president of the federation and a registered nurse.

Congratulations for undertaking this important study, and congratulations especially to those presenting via Skype. It is quite hard to present to these committees.

As all of you know, in the last census, for the first time in history, the share of seniors in our population exceeded the share of children. What does it mean for society? We know that most seniors want to stay in their home as long as possible. That means that the demand on continuing care services within the community will continue to increase. You have all read the studies and you know that by 2026 it is expected that the number of seniors needing continuing care will increase by 71%.

Our Canadian health care system needs to recognize the new realities of the home, especially looking at hospitals without walls. From the front-line nurses' perspective, staying in one's home might present many challenges, both for the client and for the caregiver. Assessing all the necessary medical and social services while ensuring clients' safety can be difficult. Rather than recommending a home-first policy, CFNU is calling for a safe-at-home policy.

What are the elements of a safe-at-home policy? We tried to answer this just two weeks ago at the annual meeting of the provincial and territorial health ministers on this topic. We highlighted “Safety at Home”, a pan-Canadian home care safety study. The report identified many things in the home environment that put the safety of the clients, caregivers, and health care providers at risk. For example, initial assessments of the clients might be done, but they might not be reassessed in a timely manner, and the coordination of their care is also an issue. What emerged is that many of these home care challenges were overcome when one primary provider, usually a nurse, was given the job of having the complete picture of the client and family situation and coordinating timely care, communication, and teamwork. The role of the primary provider can be effectively performed by a nurse practitioner or registered nurse. Ultimately, system failures led to adverse events and increased use of our health care resources, such as increased use of hospital beds, as well as increased risk of disability and death.

CFNU recently conducted a poll to confirm some of the safety-at-home observations. That poll was conducted just this September. Nine out of 10 home care nurses surveyed said the acuity of clients at home has increased. Nurses reported that the main reason for the decline in the quality of care was an increase in the client population. Current staffing was reported as insufficient to do the job. About 90% of home care nurses said their workload has increased over the last three years. The majority who reported frequently work overtime, and despite this, necessary work is being omitted. About half of home care nurses said essential tasks, such as reassessing clients and families, are not being done. Around 50% said that the service coordination is also left undone from the previous month.

The message is clear: there is not enough staff, not enough training for both paid and unpaid caregivers, and not enough time in the day to provide essential home care services. These numbers are from one poll, but what we are talking about are real people, real seniors, and real families whose care is not met.

To add to the complexity of home care, most seniors are taking multiple medications. Nearly two-thirds of seniors take five or more prescription drugs. About 40% of them take a drug from the Beers list that is potentially inappropriate for use by seniors.

Last week, you heard from our colleagues at the Canadian Medical Association, when Canada's doctors presented before this committee. CFNU is also supportive of expanding discussions to include income security, affordable housing, and other related issues, but for now, as Canada's nurses, we believe we need to stay focused on the health services that the seniors of today and tomorrow need.

To reiterate CMA's presentation on October 26, we are also long-time supporters of a national pharmacare program. A national pharmacare program would allow for improving, monitoring, and evaluating prescribing practice. It would do so much to eliminate inappropriate prescribing to seniors. It would also help ensure that seniors would have equal access to the necessary and safe prescription.

CFNU's recommendations, which we have distributed to the committee members along with the backgrounder, are as follows. First is a safe-at-home policy; second, senior patient appropriate and timely nursing assessments and interventions supported by the full health care team; third, continuity of care provided by primary nurses to ensure timely and seamless access to care providers; fourth—and you've heard it from different presenters today—education and support for all members of the team, including unpaid caregivers; and fifth, a national pharmacare program.

I will be pleased to answer questions.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much.

Now we'll go to the National Association of Friendship Centres, with Vera Pawis Tabobondung, senator, and Sonya Howard, policy officer.

The next seven minutes are yours.

[Vera Pawis Tabobondung, Senator, National Association of Friendship Centres]

I want to give my greetings and thanks to the Creator for this wonderful day today, and I want to acknowledge the peoples whose traditional lands I am privileged to be a guest in today.

Mr. Chair, I recognize the valuable work that you and the committee have done, and I am grateful for the opportunity to bring a message from the National Association of Friendship Centres. We're working on what we believe to be very important work; work that's been very much a part of the being of the friendship centres for the past 50 years. We know there's a difference between an elder, a senior, and a nice old lady. I have presented before about seniors and inclusion and exclusion, and on having accessible programs and services. I'm going to talk about some of the the things that we brought forward before.

We still have a great population of seniors. They are very much the biggest component of our communities across the nation, in all of 117 communities where there are friendship centres. We know we're matched in size by the young people, and that we have real work to do in terms of how we make that match work. How do we ensure that the young people are going to be able to look after their grandparents?

We know that in the world in which we live today...housing, access to water, having food, and the quality of life that is, I guess, all-Canadian. There have been great gaps in our society and in our history, and in the development of our friendship centres to address those gaps. We hear and understand all of the words from our colleagues, but most certainly, in the community that I come from, and the ones I have worked in, and that I participate in now as a senior, they're very vocal. They're very confident in being able to say what it is they want, what strategy they would like to design that's going to be community-based and able to address their needs, because it's not all the same. From my community to Sonya's community or any other community.... We must know the importance of having to work together to ensure that there is a quality of life that is most acceptable to the indigenous people and the friendship centre movement.

I wanted to share those words so you know that it's important to have an understanding of the work that we do in the friendship centres, that the programming and services are culturally appropriate and designed by seniors, and that they have a say in what they want. It's not something that I think is good for me; it's something that we collectively agree on. I know that's going to be a hard task, but I think as an organization and as community-based friendship centres, we need the capacity to bring people together as we do now in a social setting—weekly, monthly, and daily.

Some programs are designed to be in-house, in the friendship centres, and some of them are outreach. I think we can be a little more collaborative in terms of how we work on addressing the isolation, the disability, and the social well-being of indigenous communities. We know for sure that we have success. We know we can help in terms of culturally sensitizing people who are going to work in the programs and deliver the services, whether it's an institution, another program, or a collaboration and partnership in looking at these issues. We understand that we're very diverse. Across the country, we know there are many that.... When I first started this work, the average life expectancy of an indigenous person was 47 years, so we've come a long way. That's a recognition of our resilience, and being able to live a good life and understand what that good life is.

We want to be able to ensure that our young people understand what that good life is...that we can overcome all of that, like the low-income population and the food insecurity, and that we will thrive. In doing that, we're asking that there be continued support for friendship centres, the programs that are run by friendship centres, and of course, always collaboration in how we can do that.

As diverse and as wonderful as we've gotten to be, there are still seniors who look after seniors. There are grandparents who look after and are raising their grandchildren. It's a whole different spectrum from maybe what I thought I was being brought up to be. It was more than just kindness and understanding the role of grandparents in our communities. Some of us are fortunate to have grandparents. Some of us are fortunate, today, to have grandparents.

I still bring that forward. We do need those kinds of programs. We do need to continue to look at the housing, water, food, and the culturally appropriate programming that's designed and delivered by indigenous people in the indigenous communities. There still has to be accessibility. We still have to be able to hold people's hands and be human beings, so that this loneliness that kills us all...it doesn't matter our colour or stripe, that loneliness is there at the end of everybody's day. If we don't learn how to co-operate, collaborate, and build partnerships, it doesn't matter....

It's not a cellphone that's going to keep me company, but it is. I can attest today that I can call home tonight and see my grandchildren and great-grandchildren in their Halloween costumes. It certainly isn't going to be the human touch. That would be different because then you're there to hear them say “trick or treat”.

Thank you for listening. I wish you well on all of the work. Meegwetch.

[The Chair, Liberal, Bryan May]

Thank you for that wonderful holiday note.

We're going right into questions. First up, we have Ms. Wong.

[Alice Wong, Conservative, Richmond Centre, BC]

Thank you very much to all of the witnesses who came all the way from different parts of our nation. Hello to those I've visited and worked with. I personally have witnessed many of the things mentioned. Thank you, senator, for coming.

I still remember the time when I went to Nunavut, Yukon, and the Northwest Territories to meet elders and listen to them. It is definitely important that we be very much aware of the sensitivity of the culture and also the kind of supports in these rural communities, especially in the first nations, that require a lot of our attention. Thank you to all the friendship centres. You've been coordinating. We definitely appreciate that.

Also, to our two witnesses from B.C., we appreciate all the great work you've done. Again, I think I've met some of you before and worked with you.

I would like to ask some of the organizations about the new horizons program. With all the priorities that you've been looking at, we definitely understand that the original purpose of the new horizons program was to encourage seniors to be volunteers and to have them stay active and engaged. Healthy, active aging is part of the work which the former government had been promoting. Hopefully the current government can move on with that as well.

Do you see the need for a sharing of experiences with other organizations so that we are not reinventing the wheel? The testimony of these witnesses is really hopeful.

Professor, what do you think of the need for sharing the experiences and making them part of your curriculum?

[Dr. Birgit Pianosi]

Do you mean including the adults in the curriculum?

[Alice Wong, Conservative, Richmond Centre, BC]

Yes.

[Dr. Birgit Pianosi]

We do that already. I think it's very important because we need to ask all the adults what they want. We can't just assume we know what they want and how they age. I'm not sure what your question is. I'm familiar with new horizons, but....

[Alice Wong, Conservative, Richmond Centre, BC]

Should it also focus on helping volunteers, especially senior volunteers, to stay active? A lot of our services depend heavily on seniors. Then we have seniors helping seniors. I just wanted to hear your thoughts.

[Dr. Birgit Pianosi]

Yes, for sure. I think that older adults today want to be involved. They want to be asked to provide whatever they can, and they often don't need to be paid. However, especially when they are caregivers for their loved ones, there needs to be some kind of help for them so they can do that volunteer work.

When it comes to curriculum, there are really good ideas from other countries, especially the Netherlands where they do include older adults in all the decisions they make at the university and college level.

I think there are a lot of different opportunities where we can include older adults, and we should. I love older adults. They are there to provide their services and help younger generations.

[Alice Wong, Conservative, Richmond Centre, BC]

We understand that when we look at seniors we are looking at those who are the most frail and vulnerable. That is why we wanted to make sure prevention of elder abuse is very important. Then, of course, family and unpaid caregivers are also important, because they play such an important role. It's culturally needed, or it's for some other reasons. Even friends who are looking after other seniors do need our support.

I would ask our witness from Seniors First BC how much he sees the need for programs that do exactly what I just mentioned.

[Kevin Smith]

I certainly agree that volunteerism is a big part of advancing inclusion for seniors. There's the new horizons program. In B.C. we have, as I mentioned, the Better at Home program, which is through the United Way. It's being expanded around the province. It's a way to coordinate volunteers to help older adults with tasks like shopping, cleaning the yard, maintaining the house, etc. I think there's a huge opportunity there as more seniors come into their retirement years and are looking for ways to contribute. As was said earlier, this is a rich resource we have to tap into.

[Alice Wong, Conservative, Richmond Centre, BC]

You also mentioned the story of an elderly person and all those techniques. I believe it's your vision that in the future, support for these seniors should go along that way using technology instead of just the human touch. Is that what your presentation was about just now?

[The Chair, Liberal, Bryan May]

That's time, but I'm going to leave it open for just a very brief answer there.

[Kevin Smith]

Very quickly, I'm not saying that's in place of human touch. Absolutely, human touch is much better than any robot, AI, computer interface, or Skype call, etc.

[Alice Wong, Conservative, Richmond Centre, BC]

Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much.

We'll go to MP Fortier, please.

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

Good afternoon, everyone, and thank you so much for being here this afternoon and for appearing today.

As you know, we are looking today at advancing inclusion and quality of life for seniors. I had the opportunity last week of hosting two consultations in my community of Ottawa—Vanier on this very issue. I must say, this is a very interesting and enlightening exercise to do, because what you are sharing today resembles a lot of what was said in my community. I must say, Mr. Chair, that we have great witnesses today, and I want to thank the committee for identifying these great witnesses. I've heard many ideas and suggestions, and I think we have to look at these as being results in our study.

I would like to dive a little bit further into the topic of indigenous friendship centres, because I know in Ottawa, and especially in Ottawa—Vanier, the work these centres do is absolutely incredible and critical in our community.

Senator, you mentioned that we have to address those gaps. What are the resources you need to be even more successful in supporting seniors in your communities?