Human Resources Committee on Nov. 2nd, 2017

[The Chair, Liberal, Bryan May]

I call the meeting to order.

Good afternoon, everybody, on this very wet Thursday. I'm glad to see everybody made it from the House. 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's is the first of three panels that will be held on the subject of housing and aging in place. We'll introduce first of all, from the Community Social Planning Council of Greater Victoria and coming to us by video conference from Victoria, B.C., Marika Alberta, executive director. Can you hear me okay?

[Marika Albert, Executive Director, Community Social Planning Council of Greater Victoria]

I can, thank you.

[The Chair, Liberal, Bryan May]

Thank you very much. Also coming to us via video conference from Vancouver, B.C., is Thomas Davidoff, associate professor at the Sauder School of Business. Can you hear me okay, sir?

[Dr. Thomas Davidoff, Associate Professor, Sauder School of Business, University of British Columbia, As an Individual]

I hear you just fine.

[The Chair, Liberal, Bryan May]

Appearing as an individual here in Ottawa is Mr. Ian Lee, associate professor at the Sprott School of Business at Carleton University. Welcome back, sir.

Also appearing here in Ottawa, from the Canadian Urban Institute, is Mr. Glen Miller, senior associate. Welcome, sir.

[Glenn Miller, Senior Associate, Canadian Urban Institute]

Thank you.

[The Chair, Liberal, Bryan May]

Also here in Ottawa, from Langley Hospice Society, we have Susan Westhaver, client volunteer. Thank you for joining us today.

Each of you will receive seven minutes for opening remarks, and then we'll follow that with a couple of rounds of questions from the committee.

To start us off this afternoon, we're going to go by video conference to Vancouver, B.C. and Thomas Davidoff. The next seven minutes are yours, sir.

[Dr. Thomas Davidoff]

Thank you so much, and I appreciate your being environmentally friendly and letting me testify without flying.

In my seven minutes, in terms of seniors' well-being I want to talk about problems and prospects in the reverse mortgage industry, with a little bit of special reference to Canada.

Housing is a very important part of most seniors' retirement portfolios, particularly at the lower end of the income distribution. Of course, should you arrive at retirement without a home, as a renter, that's the lowest end of the income distribution, but for lower-middle-class households, the ones for whom I'm assuming you have the most concern, a house is typically a dominant part of the portfolio.

Reverse mortgages are a tiny industry. Of course, a reverse mortgage lets a senior borrow against their home. If most of your wealth is in a home and you're struggling to pay bills, using some of that home equity seems like a fantastic idea. In markets like Victoria, Toronto, and of course Vancouver, there are countless seniors with enormous home equity holdings but maybe rather meagre retirement wealth and income, so finding a way to use home equity to finance seniors' retirement is something I think you should put considerable thought into.

Home equity represents one leg of the holy trinity of retirement finance puzzles. Life annuities and long-term care insurance are the other two.

Life annuities let you hedge an enormous financial risk, which is, how long am I going to survive in retirement? There are some problems with life annuities, the biggest of which is that they're illiquid. If I'm somebody with a home and very little cash, putting that remaining cash into a life annuity that requires that I sip but never gulp runs into problems if, for example, I have large long-term care needs.

That takes us to the second leg of retirement puzzles, which is long-term care insurance. Canada is a bit different from the U.S., but state-funded retirement or long-term care facilities may not be very pleasant places. If you want to have a comfortable long-term care stay, that of course can be extraordinarily expensive, but because of the existence of the public sector in long-term care, private insurance is very difficult to make work. It's particularly difficult to make long-term care insurance work without a reverse mortgage, because home equity really is a dominant form of long-term care insurance, at least in the United States. Should you need to privately pay for long-term care, it's typically in a state of the world where you will have disposed of your home, so the home is an important buffer stock. Should long-term care expenditures be an important risk in any province, home equity becomes unattractive to spend because it's serving as a buffer.

On the other hand, without long-term care insurance, life annuities are going to be unattractive, and people won't hedge longevity because of the need to go for catastrophic expenditures. What you see is that as long as there's any unhandled uncertainty in retirement, should it be home equity that's illiquid, longevity, or catastrophic expenditure risk, the other products don't work very well.

Let me talk about reverse mortgages. Again, they should be huge in Canada, but it is a trivially small market. There's CHIP, the Canadian Home Income Plan, and I think they do a decent job, but it's a very small product. It carries a high interest rate because of some funding problems. Essentially, if you don't have government insurance, it's very difficult to securitize reverse mortgage loans, and that makes them expensive and difficult to fund for the long period they really need to be funded.

There's another reverse mortgage product in Canada, for which there is almost incredibly low demand, and that is property tax deferral in British Columbia. British Columbia has, I believe, maybe the most generous property tax deferral for people over 55. They can defer, and defer not at a spread over the federal cost of borrowing, but at a very low rate. I believe it's 1% per year. My understanding is that take-up is moderate. You hear people complain, “Well, prices are rising and so my property assessment has gone up, and I'm a grandma on a fixed income”, but that's not a serious concern if you take the property tax deferral. Property tax deferral in British Columbia might be seen as the world's most generous reverse mortgage program.

The fact that there's not a 100% take-up is surprising. I don't know the income distribution of the people who use it, and it's something I want to look into, but I think it's worthy of serious consideration because the home equity of seniors is such an important part of their wealth.

Let me talk a little bit about why reverse mortgages are so hard to make work in the private sector. You've got moral hazard—that is, borrowers may behave in a way not advantageous to lenders—and adverse selection, which are very serious problems.

Jeanne Calment, the women who lived to be 123 in France, was a reverse mortgage borrower. The French call it viager. It was the worse case of adverse selection imaginable, you might think, because the guy who contracted with her paid and paid and paid and finally got the house for his grandson long after he was dead and I believe his son was dead. You worry that you're going to lend money to seniors who are not going to make any payments until they move or die, and if they don't move or die for a long time, and the property value declines, it's a big problem.

In the U.S. we saw a horrible geographic adverse selection. Reverse mortgages were predominant in the SAM states, the shared appreciation mortgage states, that saw the biggest housing crashes. They were predominant when prices rose.

Very quickly, reverse mortgages imbed a lot of default option value. Borrowers, unfortunately, are able to under-maintain the home and not move when they should move, and they tend to take the loans at the wrong time in the cycle. They don't understand the default option value. There's a lot of evidence that reverse mortgage borrowers do not understand just how valuable the rights imbedded in a reverse mortgage to default are.

Therefore, in Canada, if you want to expand home equity borrowing among seniors, I strongly recommend you do so in the form of a life annuity, whereby the seniors receive enough income from the property that they get a life annuity with cash, plus enough interest to keep the balance on the reverse mortgage loan constant rather than growing. That would solve a lot of problems. Should the industry expand, it would prevent seniors from consuming more wealth then they have.

I would be delighted to talk more about that because I do think seniors housing is a promising form of retirement finance.

[The Chair, Liberal, Bryan May]

Thank you very much, sir.

Now moving on to the Community Social Planning Council of Greater Victoria, coming to us via video conference from Victoria, B.C., we have Marika Albert, executive director.

You have seven minutes.

[Marika Albert]

We're all going to be seniors someday, if we're not there already, so this is a topic that should be near and dear to each and every one of us. Your committee is doing important work here, and thank you so much for inviting me here to speak to you today.

As a researcher and a community-based social planner in the capital region of British Columbia, I'm focused on housing and homelessness predominantly. In my work, I am seeing an increase in the number of seniors being affected by our current housing crisis. The two most important factors to consider are incomes and the need for supportive, inclusive communities.

We know that maintaining independence is important to seniors in B.C. and across Canada. According to the Office of the Seniors Advocate of British Columbia, “Seniors want to age as independently as possible in their own homes and in their local communities.” Research conducted by the Canada Mortgage and Housing Corporation in 2008 revealed that 85% of Canadians over the age of 55 plan to remain present in their home for as long as possible, even if there are changes to their health. I was talking to my stubborn old dad this morning, and he reiterated that point to me.

A recent report from the Office of the Seniors Advocate of B.C. from 2015 confirms that up to 86% of B.C. seniors felt that with a combination of home support and some home adaptations, they could remain at home if their care needs increased. This same report also illustrated the fear that seniors are feeling about being forced away from the support of their communities into assisted living or residential care prematurely.

In Victoria, more than one in five people was aged 65 and over in 2016, considerably higher than the national average of 17%. Seniors occupy 50% of the BC Housing social housing units here and account for 40% of applicants on the wait-list for social housing. In the city of Victoria, 14% of senior-led households are renters, and over half of those households spend more than 30% of their monthly income on shelter costs. This means that these senior households are living in what CMHC would consider as core housing need.

In the James Bay neighbourhood here in the city of Victoria, renter households make up over two-thirds—approximately 70%—of the overall households in the area, and half of those are renter households that spend more than 30% of their income on shelter costs.

In addition to immediate needs, rental demand in the capital region as a whole is expected to increase significantly over the next two decades. This is according to the BC Non-Profit Housing Association's projections. Seniors aged 65 and older are the demographic that will experience the most significant increase in rental demand in this region over the next 20 years. There could be an increase of up to nearly 10,000 additional seniors' households seeking rental housing by 2036. That's a staggering number, and one we need to think seriously about.

Of course, we know that there is, even now, a significant rental housing shortage here, and with costs of running a household rising, this leads to increased pressure on seniors' households.

We are seeing an unprecedented demographic shift that requires a thoughtful, timely, and pragmatic response. I'm going to highlight one strategy among many that might address the growing need of seniors.

At the social planning council, we have been working with the Canadian Senior Cohousing network to explore co-housing as a model to support accessibility, affordability, and aging in place. For seniors with higher incomes and who have the ability to invest in new developments, co-housing is an emerging form of supporting accessibility, a certain level of affordability, and, importantly, aging in place. The model of co-housing in Canada is predominantly ownership-based, which makes it inaccessible for middle- to lower-income seniors. However, the model is impressive in that it takes into account all of the factors we think about when we think about supporting seniors aging in place.

Co-housing is a neighbourhood design that combines the independence of private homes—condo-sized units—with the advantages of shared amenities similar to co-operatives, and a village-style support system. The co-housing model provides safe physical surroundings and can be purpose-built to address the needs of residents with dementia, but there is also a focus on social care, or what is also referred to as co-care. It is this focus on co-care that can be replicated in other formats, such as purpose-built rental buildings or other types of residential communities, such as subsidized housing complexes or housing co-operatives.

Quite simply, the co-care model provides a template for organizing care and reducing caregiver fatigue because it is shared across a broader network of people who are neighbours. This model is exactly what we need to see in our communities: neighbours helping neighbours.

We all know the issue is very complex, especially for low-income seniors. There are ways to bring the principles of co-housing to more affordable developments, but seniors may need help in creating affordable co-housing projects.

I'm happy to discuss this and other models at your convenience. Thank you again for the opportunity to speak today.

[The Chair, Liberal, Bryan May]

It's our pleasure. Thank you for appearing here today.

Next we have, appearing as an individual, Mr. Ian Lee, associate professor, Sprott School of Business, Carleton University.

You have seven minutes, sir.

[Dr. Ian Lee, Associate Professor, Sprott School of Business, Carleton University, As an Individual]

Thank you.

I thank the committee for inviting me to speak on this critical issue. I applaud your committee for tackling it. Indeed, I think this is the single most important issue confronting Canada and the western world for the next 50 years.

First I have my disclosures. I don't consult to anyone or anything anywhere—not governments, not corporations, not NGOs, not associations. I don't belong to or contribute to any political party. In approximately 70 days from now, I'm going to pass, and I assure you most involuntarily, into that club called the seniors of Canada.

[The Chair, Liberal, Bryan May]

Happy birthday.

[Dr. Ian Lee]

I'm enthusiastic, as you can tell.

In the last five years, I was the primary caregiver for my late mother in the last days and weeks, as well as the co-caregiver with my wife during the extended passing of her mother and father. We became deeply enmeshed in the Canadian health care system at end of life, and I want to talk about the good, the bad, and the ugly of our health care system as it pertains to seniors.

I first became interested in this subject after reading Gray Dawn: How the Coming Age Wave Will Transform America—and the World. It was written by Pete Peterson in 1999, the former commerce secretary under President Ronald Regan, and later the founder of what has become the very prestigious Peterson Institute in Washington, D.C. He documented, with incredible statistics from the U.S. Census Bureau, the gray dawn, the gray tsunami that's coming.

In the years since, a plethora of authoritative empirical studies have been published by the OECD, the World Bank, IMF, and reputable think tanks such as Brookings, Peterson, C.D. Howe, and MLI on the effect of aging on the macroeconomic economy, on tax receipts and on economic growth and productivity. I'm sure most of you or all of you are very familiar with this.

Both the IMF and OECD have produced increasingly dire studies and warnings about the increasingly serious squeeze on fiscal revenues caused by the smaller percentage of the workforce that is employed and paying taxes, and the concomitant dramatic increase in health care costs for the exploding number of seniors.

As one American demographer recently noted, in approximately 20 years all of North America is going to look just like Florida, but without the warm weather. In other words, one in four will be over 65 years of age.

In a recent study, the IMF has argued that the aging crisis is going to impose much larger costs on society than the 2008-2009 financial crisis.

Closer to home, former Bank of Canada governor Dr. David Dodge—and former deputy minister of Health Canada, if I can remind everybody—published a superb report called “Chronic Health Care Spending Disease” in 2011, through the C.D. Howe Institute, using StatsCan data and CIHI data. It showed the gargantuan amount of health care per person for those over 75, and we all know the numbers over 75 are skyrocketing. Very recently, the PBO published a report showing that provincial budgets are going to become increasingly bleak going forward because most costs associated with aging are funded by the provinces, and these costs are going to skyrocket.

Having read and absorbed a number of these excellent studies, I've come to the conclusion that the cost of pensions will not be the problem the OECD argues they will become in Europe, precisely because of Canada's prudent, responsible, risk-diversified, four-pillar pension system criticized by some of my colleagues in academia. This is not to minimize the drag and loss of productivity and economic growth caused by the gargantuan loss of workers caused by the exodus of the boomers. Indeed, every serious macroeconomic study, including from Finance Canada, shows long-term GDP declines of around 1% to 2% annually, which is going to cause a serious hit to the federal and provincial revenues.

No; I've concluded that the vulnerability in Canada, and likely elsewhere, is health care. As Dr. Dodge demonstrated in his report, using very hard CIHI empirical data, the older we are above 65, the more and more health care we consume per person. As we move from our 70s into our 80s, we consume an average of around $25,000 health care per person per year. They, or should I say we, will be consuming a new Honda Civic every year.

Do we believe the young people in this room and across Canada are shouting “Whoopee—I get to pay a lot more taxes in the future to support Ian Lee in the years ahead”? For these reasons, the overarching purpose of government policy concerning seniors should be an absolute focus on keeping seniors in their homes for as long as possible, in my view.

I'll briefly highlight, then wrap up, because we're going to have time to talk, I hope. I'm going to focus on two very highlighted areas.

We need financial pension reform. The overarching policy should endeavour to keep every worker in the workforce for as long as possible by eliminating early retirement before 60 across the Canadian economy and by penalizing retirement between 60 and 65. Indeed, we need pension policy reform to eliminate incoherence and pension bankruptcy.

Fred Vettese is chief economist at Morneau Shepell. I should add as an aside that I have met him several times at pension conferences and I consider him to be highly intelligent and probably one of the single most important pension experts in all of Canada on this subject of pensions. As he noted in his recent blog, our national pension policy system is incoherent. Number one, OAS allows retirement and pension only at 65, while CPP allows a range from 60 to 70 and employer pensions under the Income Tax Act allow retirement as early as 55.

He suggested, and I completely agree, standardizing the flexible CPP model that allows a range between 60 and 70, with penalties for early retirement below 65 and pension top-ups for those who postpone their pension above 65.

Moreover, the tax act requirement to collapse all pension plans by 71 years of age is arbitrary and unreasonable, and should be pushed back or eliminated. This will allow much greater flexibility and encourage citizens to remain in the workforce. This will not have an excessively negative impact on government, because it will continue to receive its share of the deferred taxes once the pension is drawn down or the citizen passes away.

Finally, I'll wrap up on health care and hospitals.

We need to completely invert the paradigm of health care to a model where we should assume health care is delivered within the home in the first instance, including death and dying, and in the second instance in local, decentralized regional hospitals or community clinics, again to encourage seniors to remain in their homes. Our large legacy hospitals should be institutions of last resort for the most serious cases, rather than for warehousing elderly people.

In conclusion, policy can ameliorate but not eliminate the grey tsunami that is inevitable.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you, sir.

From the Canadian Urban Institute, we have Mr. Glenn Miller, senior associate.

You have seven minutes, sir.

[Glenn Miller]

Good afternoon, and I'd like to thank you for the opportunity to participate in this important gathering.

Deciding what constitutes an acceptable quality of life for older adults is no small undertaking. Most observers agree that two of the most important determinants are good health and sound finances—areas where the trends are relatively positive. For example, today's seniors are living longer and generally healthier than previous generations. Thanks in part to long-standing government programs such as old age security, the guaranteed income supplement, and the Canada Pension Plan, most older adults are in relatively good shape financially, notwithstanding my colleague's comments.

To good health and economic well-being I would add access to housing that fits with the senior's individual circumstances. For some, the issue is affordability; for others, it's the type of housing or its location. Where you live in many instances determines how you live. The physical design of the built environment—that's the neighbourhoods and transportation networks that determine how we interact with our physical surroundings—is a key determinant affecting quality of life for seniors. I'd like to explain that.

A few years ago, CMHC's “Housing for Older Canadians” publication, which the CUI, Canadian Urban Institute, helped to write, noted that today's seniors prefer to age in place until poor health or economic circumstances force them to relocate to retirement homes or long-term care facilities. Postponing or even avoiding such decisions is an option for some, but as the number of elderly seniors continues to grow, the question arises as to whether housing and neighbourhoods can be successfully adapted to meet the needs of an aging population.

The most challenging of these built environments are the many car-dependent suburbs constructed since the Second World War. Neighbourhoods where people must drive or be driven to work, school, or shopping work well for successive generations of households during their family-formation years, but as residents age and become less mobile, many lose the ability to drive or cannot afford a car. When amenities such as grocery stores, medical facilities, or community centres are too far away to reach on foot, older adults who no longer drive become less active and are at risk of becoming isolated. Canadians are living longer, but most of us will outlive our ability to drive. We must find solutions. From this perspective, our current suburbs are no place to grow old.

A positive step was taken in 2007 when the Public Health Agency of Canada launched the age-friendly communities initiative, a World Health Organization initiative dedicated to promoting active aging. Since then, more than 500 cities and towns across Canada have made commitments to become age-friendly. The CUI's research shows, however, that although cities are using the age-friendly concept to engage effectively with seniors to identify local needs and priorities, little progress has been made to upgrade the quality of the built environment. Our survey of the 25 largest Ontario cities committed to becoming age-friendly indicated that none of these cities has yet acknowledged their commitment to become age-friendly in their land-use plans.

I'm nevertheless pleased to report some progress being made on the policy front. The Ontario government's latest growth plan for the greater Golden Horseshoe explicitly directs cities in the region to recognize age-friendly design and development as a municipal priority. At the local level, the City of Toronto recently agreed to acknowledge age-friendly design and development in the city's official plan when the process of updating the plan begins next year. This kind of acknowledgement is an essential precondition for a municipality's ability to begin the time-consuming process of retrofitting car-dependent suburbs and ensuring that no opportunities are missed to improve the quality of the built environment when neighbourhood plans are recalibrated as part of the development process.

Our research has also identified the value of identifying best-practice examples of neighbourhoods and individual developments that can contribute to an age-friendly city. These places can be used to inspire proactive planning policy, attract the attention of private sector developers, and, more importantly, demonstrate to the buying public that age-friendly options are available.

Finally, I'd like to suggest how the federal government can help. As I've noted, the Public Health Agency of Canada already coordinates and promotes age-friendly communities at the national level. If the CMHC's capacity to undertake innovative research in areas such as age-friendly development were to be restored, these two federal institutions could then combine their efforts to work collaboratively with communities, developers, and the public. This would enable them to accelerate our collective understanding and appreciation of the need for age-friendly housing and neighbourhoods at a scale that makes a difference in quality of life for Canadians as they age in place in those familiar neighbourhoods.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much, sir.

Finally, from the Langley Hospice Society, we have Susan Westhaver, who is a client volunteer. Welcome. You have seven minutes.

[Susan Westhaver, Client Volunteer, Langley Hospice Society]

Good afternoon. Thank you for the invitation.

My name is Susan Westhaver. I'm a client volunteer with the Langley Hospice Society. Earlier this year, I was asked by the society to share my personal hospice experience at a fundraising announcement and press conference for their new 15-bed free-standing hospice residence for our community. I would like to share that speech with you now.

When you hear the word “hospice”, you think of a place where people go to die, and it is, but it is so much more than that. Hospice care is an experience not only for the dying, but for the family and friends who are left behind when their loved one has moved on.

Bob was dying of cancer. Dr. Adamson came to our home and met with us. Part of the conversation was about where Bob wanted to die: home, hospital, or hospice? We had heard of hospice but really didn't know much about it. Dr. Adamson encouraged us to visit the hospice residence and see how Bob felt about it. We did go and visit, although he was not yet ready to be admitted; we were still managing at home. We were given a tour by a hospice volunteer and afterwards felt very good about the decision to go there when the time came.

Well, that time came in a very few short months. It was becoming more challenging caring for Bob at home. Medications were getting more complicated and frustrations often ran high. Bob was admitted into a shared room on a Friday afternoon. The nurses and volunteers were amazing and made us feel welcome. Leaving that evening to come home without him was very difficult, but I had a good sleep that night, the first in a long while, and so did Bob. The nurses had his pain under control. We knew he was in good hands and well looked after.

Eventually, Bob was moved into a private room. This allowed our family and friends to come and go without interrupting the other patients, and gave us privacy when quiet time was needed. That room became our new home for more than four months. Going into hospice was the best thing that happened to us during that difficult time. Being a caregiver isn't an easy job, and having the opportunity to leave his medical and physical care to the nurses gave us quality time together in those last months of his life. That was truly a blessing and allowed us to bring our relationship back full circle.

Because of the care we both received during Bob's stay in hospice and the support I continued to receive after his death, it was an easy decision for me to take the hospice training and become a volunteer at the hospice residence. Going through those doors always brings me a sense of peace, but as much as I love that residence and its special warmth, I look forward to a new residence where each of our patients and their loved ones will have a private room and access to the outdoors and common areas. There they will be in beautiful surroundings with the loving care from volunteers and staff to help them along as they experience together that final journey that is so personal and sacred.

I was 56 years old when Bob died. It was a six-and-a-half-year journey of radiation, chemo, remissions, more chemo, and then hospice care. That experience was difficult enough for a reasonably young and healthy person; our seniors cannot process the stresses that caregiving for a loved one with a terminal illness can bring. As I age myself, and in my experiences as a volunteer supporting patients who are dying, and their caregivers, I know how important it is to provide support and ease their stress during this difficult journey.

In hospice, we have young people, old people, and in-between people. The one thing they all have in common is that they still have some life left to live. It is my honour to walk with them through this time and hopefully ease some of those stresses.

Some people are transferred from hospital to hospice. Palliative care is provided to individuals who have a terminal illness at different stages of their journey at home, in the hospital, or in hospice environment.

In the hospice residence, caregivers and family can stay 24 hours a day with their loved one. There is a sofa bed in every room for overnight stays. This brings great comfort, oftentimes more for the spouses, as they can witness the care given to their wife or husband and feel relief. They can stay by their side.

Our family room provides a homelike environment where meals can be shared and birthdays celebrated. It's a place for singalongs, piano playing, and oftentimes fellowship and support from strangers who are experiencing this journey at the same time.

The Langley Hospice Society's mission is to provide compassionate support to help people live with dignity and hope while coping with grief at the end of life. As a hospice volunteer, I know dying with dignity can mean different things to different people. In my volunteer role, I try to bring dignity to our patients through personal care, which can involve listening to their life stories. Our seniors were once young and have many stories to share. Their stories are part of the legacies they leave behind.

Hospice isn't just about dying. It's about living right to the end. These individuals have things to share and advice to offer, and we need to honour and respect their voice.

I can help in all kinds of ways, such as getting their dentures for them so they have their teeth in when company is coming, offering that company a cup of tea as she would have done if she were in her own home entertaining guests, perhaps shampooing her hair so she feels better, and as things move along, making sure her blankets have not moved to expose a body part that she would prefer to keep covered.

I used to sit guard outside Bob’s room when he was in a deep sleep and was wide-open mouth-breathing. He would not have wanted people to see him like that. I felt I was protecting his dignity.

Being a senior brings many changes in life, and new challenges. The huge challenge of continuing on without the person you have spent your life with can be overwhelming. Seniors are even more vulnerable to loneliness and seclusion. The care and support that the hospice society provides for those who have experienced the death of a loved one are invaluable. The grief support programs and services offer a chance to share one-on-one with a counsellor or in a group setting. Care continues. Life continues. Honouring that life up to the last moment is the most we can give a dying person, just as we would want for our loved ones and ourselves.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you very much.

I think I can speak for all of us here. Thank you for sharing that, and thank you for the work that you do.

With that, we are going to start with the first round of questions.

Mr. Warawa, you're up first.

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

Thank you, Mr. Chair.

Thank you to the witnesses. You've shared so much with us. It becomes overwhelming at some point. We appreciate your being here, and we appreciate your testimony. If you haven't presented a brief, please do provide a brief with your recommendations. It would assist us in the report recommending a national seniors strategy.

I'm going to ask some questions of Ms. Westhaver.

My understanding is that you have just come back from Europe, so you are probably suffering a little jet lag. Thank you for being here with us.

What is unique about you.... Each of us provides a unique perspective, but you had a loved one: your husband Bob, who passed away. You said he spent the last four months of his life in hospice care. After his passing, you took the training and are now giving back and providing that type of care. I assume you are doing that because it was a blessing to you, and you are now providing that blessing unto others.

Could you tell us about the training? Did you have to pay for it? How long was the training? How important is it that others in our communities also participate in this as volunteers?

[Susan Westhaver]

The training was a 10-week program, three hours a week. It was $150 to take the training.

Sorry; what was your other question?

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

Do we have enough volunteers, or do we need more people volunteering and getting the training?

[Susan Westhaver]

I don't think you can ever have too many volunteers. The more volunteers are out there, the better. I'm not sure whether the $150 is a deterrent to some people, or whether, if they really want to do this, they are going to find a way to do it. There are a lot of seniors in their homes who can't get out anymore and who could really use volunteers to come and visit them. If a person wasn't comfortable working in the hospice environment, there could be some form of training to train people how to go and sit with elderly people for a couple of hours a few times a week, or whatever, and even just do that for them. A lot of them are very isolated and can't get out anymore.

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

We've heard that isolation is a huge problem. People being able to age in place sounds like a great idea. It may be the only realistic way we can house our aging population. To provide that as an option, we need to deal with the isolation. If people feel good about themselves, if they are happy and they have people visiting them and caring for them, they will live a much more fulfilling life.

Palliative care could be provided at home for somebody aging in place, and hospice care is part of the end of palliative care. It's maybe the last month of a person's life. Is that correct?

[Susan Westhaver]

Yes. You can die at home if you want to. You don't have to go to a hospital or a hospice. If you choose to die at home, you can die at home. There will be services provided for that, but it's the caregivers I have a soft spot for, because I know how difficult it can be to be a caregiver. I can't imagine how some seniors cope with it, because it's a very difficult thing to do. Just to have the support in the hospice environment is huge.