Human Resources Committee on Nov. 9th, 2017

[The Chair, Liberal, Bryan May]

Good afternoon, everybody.

I used the gavel softly, Mona, so it wouldn't scare you.

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

Thank you. That's very kind.

[The Chair, Liberal, Bryan May]

Before we get started with our witnesses, we were to meet with Benjamin Fulton on the lawn a few moments ago, but unfortunately, he is running behind. He is going to be here, so we can do a couple of things. When he gets here, I can recognize him, and we can have him speak—we'll just interrupt the witnesses—or we can push it to the end. We are going to do a photo op at 5:40 with Mr. Fulton. We can discuss where we want to do that. It's going to be pretty dark if we do it outside, so we could do it inside somewhere. We can chat about that later. I just wanted folks to know that we are still expecting his attendance.

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 we have the final of three panels held on the subject of housing and aging in place. I'll just quickly remind everyone that the deadline to submit a brief for this report is tomorrow at midnight.

I'm going to introduce our incredible panel.

Appearing as an individual, we have Donald Shiner, professor, Atlantic Seniors Housing Research Alliance, Mount Saint Vincent University.

From the Canadian Association of Occupational Therapists, we have Nicola MacNaughton, president, and Janet Craik, executive director.

From Hospice Care Ottawa, we have Lisa Sullivan, executive director.

From Revera Inc., we have Ron Pike. Is it Ron Pike who's with us today?

[John Beaney, Vice-President, Operations, Revera Inc.]

No, I am John Beaney.

[The Chair, Liberal, Bryan May]

It's John Beaney. Sorry about that. I have Ron Pike on here. At least I knew that was wrong.

From Senior Empowerment Assistance Centre in Peel, Ontario, we have Olufemi Adegun, president.

Welcome to all of you.

For those who have not been to this type of forum before, you will each have seven minutes to give your opening remarks. I will signal when you have a minute left, which is a long time, so you don't have to rush too much. Usually I'll give you a couple of seconds if you need it.

We are going to get started right away. As I said, at some point we are going to be interrupted. We'll make the decision at that point whether we want to pause for a mid-session break to hear from Mr. Fulton.

To kick us off, we are going to hear for the next seven minutes from Mr. Donald Shiner.

[Dr. Donald Shiner, Professor, Atlantic Seniors Housing Research Alliance, Mount Saint Vincent University, As an Individual]

That means I can't waste any time by thanking the committee for inviting me here on the same day that veterans were able to go to Parliament Hill. As a wounded veteran from the Yom Kippur War of 1973 between Israel and Egypt, and receiver of a military pension for life, I can only encourage you to give modern-day veterans the same privilege that I have.

[The Chair, Liberal, Bryan May]

Thank you.

[Dr. Donald Shiner]

Thank you. My statement will begin now.

In my research on seniors, I've had the privilege of studying how members of our aging population in Atlantic Canada view their homes and the challenges they face to continue living in them. The concept of a home is complex. It consists of many parts. To many, it is those simple rituals that link us with the sequences of the day and the patterns of time. These are the rituals that surround the gathering of food, cooking, washing, eating, sleeping, and cleaning, and connect us to almost all of humanity.

The meaning of home, of a protected refuge, is very often connected with comfort, relationships, family, relatives, friends, and all those traditions that give meaning to our lives. Yet we do very little to celebrate or pay tribute to these rituals that centre on and link us to that diverse, but collective, experience of home. This is borne out by the trauma people experience after a break-in, loss of home through a marital breakup or a natural disaster.

People experience both positive and negative emotions about their homes. For example, a place may be important psychologically because it has connections with the past, but it may also offer a poor physical environment that no longer meets a person's physical needs. This is a common experience for many older Atlantic Canadians. Perhaps the most difficult situation comes when an elderly person or couple is forced to move out of their home because they can no longer manage their physical surroundings. Research has shown that people facing a move see this change of environment and living circumstance as a major obstacle. In fact, only 12.6% of Atlantic seniors have even considered any plans to move, and all fear this change.

In terms of moving and changing homes, this fear relates to the seniors' attachment to where they have come from and to the impact that moving may have on their self-identity in relation to issues of belonging, permanence, and security. They feel they will lose control of their life if they move.

Overwhelmingly, our elders want to continue to live as long as possible in their current homes. If they must move, they want to remain in the community they know where they have a network of friends and neighbours so these connections are not lost.

What is making successful aging in place unlikely to happen for many Canadian seniors is that they live in older homes not designed for ease of movement and safety. This challenge is compounded when these homes are in rural communities where there are fewer options for moving to smaller, more appropriate, accommodations. We also know that much of our housing stock is older and not designed for accessibility for any age, particularly when walkers and wheelchairs become part of the equation.

We know that as our population ages, there are challenges with providing appropriate care in the home in our many small rural communities. We also know that if we made homes more accessible, people would be able to live in them longer, yet it seems we insist on acting like Peter Pan, building homes designed for people who will never grow old and never get sick.

Having our aging population remain in their homes and communities for as long as possible is important now, and it's going to be even more important in the future. As the cost of acute care in Canada grows, at already over $1,000 a day, and the number of bed spaces proportional to the growing demand diminishes, our society will be forced to find other solutions.

Another compelling factor is the pending shortage of trained staff to take care of a growing senior population. Despite these trends, the obvious solution for making it possible for Canadians to age in place is not being championed.

The first theme running through my research on successful aging in place is the need to focus on building a sense of community, reducing isolation, and giving the residents control of their everyday living. The friendship and community feeling is what sets apart emerging solutions occurring in other countries, such as co-housing, from typical Canadian seniors housing approaches.

The second theme is that every project incorporating the 16 standards developed by the Rowntree Foundation in the U.K. for the My Home Life project has been judged as having a significant impact on both the lives of seniors now and for future housing stock when and where it has been implemented.

Third, most seniors, nine in 10, are not actively thinking about alternatives to staying in their homes and are not prepared for unexpected life changes. Moreover, most seniors, eight in 10, are not aware of programs and services available to them. They are missing valuable assistance to help rehabilitate, repair, or restore their dwellings. Moreover, my research indicates that one in five Atlantic seniors spend approximately 40% of their income on where they live and that almost half of seniors in Atlantic Canada have an income of less than $30,000.

Part of our magical thinking about the future means that seniors don't plan for life changes and their impact. Most seniors are fully committed to staying in their homes and aging in place as long as they can. In Canada, this is 93% of seniors. In fact, couples often develop compensating skills and abilities that allow them to remain independent by exercising interdependence, but when one of them dies or is institutionalized, it can become increasingly difficult to maintain independence in the community.

Physical solutions, such as attaching grab bars, widening doors, and making behavioural adjustments, such as sleeping downstairs in a two-storey house or taking a sponge bath rather than a tub bath, are common lifestyle adjustments older people employ. Although many home modifications are not without cost, they are often one-time only expenses, beyond the reach of most Canadian seniors.

There are four possible solutions. The first would be a program of education aimed at those over age 70, those under 70, and Canadian home builders and contractors to help them prepare for home changes and modifications.

The second action would be to initiate a national program of home accessibility tax credits for eligible home accessibility expenditures for work performed or equipment installed. The temporary credit would provide an immediate incentive for Canadians to undertake new renovations or to accelerate planned projects.

The third action would be to support a CMHC demonstration project that proved the viability of modern technology to encourage people to age in place safely.

In addition to these three major actions, I would like to have a home accessibility audit program that would certify a home built to lifetime home standards. I would like to see Canadian building codes changed so that the 16 standards of the lifetime home standards were compulsory for all new residential home construction in Canada. Homes could be certified by inspectors drawn from the senior population.

In conclusion, seniors overwhelmingly want to age in their homes and their communities, but this is unlikely to happen. Without action today, our housing stock will only continue to be less suitable for aging in place, and future generations will face the same challenges we do now. As our population ages, the cost of current solutions will only escalate unless we act now to make changes that will encourage and support staying safely in one's home for as long as possible. Thank you.

[The Chair, Liberal, Bryan May]

Thank you, sir.

From the Canadian Association of Occupational Therapists, we have Nicola MacNaughton, president, and Janet Craik, executive director. The next seven minutes are yours.

[Nicola MacNaughton, President, Canadian Association of Occupational Therapists]

Good afternoon, and thank you to the members of the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities for inviting us to speak today. We applaud your efforts in undertaking this study on advancing inclusion and quality of life for Canadian seniors.

Our comments today will focus on the first theme: how to improve access to housing for seniors and, in particular, support seniors aging in place.

I'm Nicola MacNaughton, an occupational therapist and the president of the Canadian Association of Occupational Therapists, or CAOT.

[Janet Craik, Executive Director, Canadian Association of Occupational Therapists]

My name is Janet Craik. I'm the executive director for CAOT. I'm also an occupational therapist.

CAOT is the national organization representing 16,000 occupational therapists across Canada. Our mission is to advance excellence in occupational therapy, and our vision is that someday occupational therapy will be valued and accessible across Canada.

For those who don't know, occupational therapists are regulated health professionals who work with people who are unable to participate in important activities of daily living, ADLs, due to a range of challenges or conditions. For our seniors, these conditions often involve declining mobility, dementia, or vision loss, and they create barriers to everyday living. Occupational therapists are here to create solutions for living.

Today we really want to talk to you about the problems confronting seniors, and low-cost, high-impact solutions that will enable them to live at home, minimize the risk of injury, in particular falls, and save on expensive hospitalization and institutionalization. We want to focus on solutions to help seniors live at home, improve the quality of their lives, and save the health care system money.

We also want to talk about the challenges associated with accessing these solutions in homes and communities across Canada. We share a common goal, which is to keep seniors in their homes, active and engaged, contributing to their families, their communities, and our society. We can offer recommendations for health care system improvements and innovations.

Our current health care system is oriented to helping seniors once they have experienced a health decline and have landed in hospital or the doctor's office. We can do better than this. Preventative measures can be done, such as home modifications and ADL training, so that injuries and falls do not happen. This enables seniors to remain in their homes, connected to their families and communities, and out of hospital.

[Nicola MacNaughton]

Let's talk about Karen. Karen is an 81-year-old woman who lives alone and has experienced many falls in the bathroom. Due to her fear of falling, she has now stopped bathing in her tub and avoids going out of her home. She is depressed and socially isolated.

An occupational therapist working with Karen recommended bath adaptations to help her gain independence and confidence in bathing. These recommendations included the installation of grab bars, a bath lift chair, and a transfer pole to help support Karen during her daily bathing routine, in turn reducing her reliance on personal support workers and home care nurses.

As highlighted in Karen's story, occupational therapy interventions can decrease the need for home care, saving up to $50,000 a year. Occupational therapists can also be involved in home modifications, collaborating with renovation professionals to improve the accessibility and safety of homes.

The Royal College of Occupational Therapists recently shared an example of an occupational therapist who recommended a walk-in shower renovation for a client. The total cost of the therapist's time and the shower renovation was $11,000, compared with an annual cost for a personal care support worker of $35,000 if the shower had not been put in place.

We know that appropriate prescription and training regarding adaptive equipment and suitable home modifications have the potential to reduce hospitalization costs. For seniors in Canada, these upfront investments and results are a significant health care savings, as seniors age 65 and over record the highest rates of hospitalization: 20 in 100,000 are hospitalized.

[Janet Craik]

Now let's talk about Pierre and Marie. Pierre is 89 years old and Marie is 87. Pierre has been diagnosed with dementia. Their children have great concerns about how their parents are going to remain safely living at home, and they wonder how they're going to manage when Pierre's condition deteriorates.

Again, an occupational therapist can work with Pierre and Marie, recommend environmental adaptions, and provide memory aids and strategies to help them with important ADLs such as taking their medications. These interventions have the potential to postpone entry into residential care, with savings up to $48,000 per person per year.

[Nicola MacNaughton]

Elizabeth is 82 years old and has vision loss. She was experiencing a general decline in her health and had been in and out of the hospital several times. On her last visit to the hospital, she was seen by an occupational therapist. Elizabeth's occupational therapist assessed her needs for support at home and referred her to an OT in the community.

A recent study by Johns Hopkins University identified that occupational therapy was the only category of health care spending within hospitals that resulted in reduced hospitalization readmission rates. This is because occupational therapy's focus is on assessing whether a client can be discharged safely, and addressing potential barriers in the home and community environments.

The Royal College of Occupational Therapists estimates that occupational therapist services result in avoidance of unnecessary hospital admission and/or reduced hospital stays, saving an average of $15 million annually.

[Janet Craik]

I'll be brief.

While occupational therapy is well suited for supporting seniors in communities across Canada, and minimizes hospitalization and institutionalization, access to this is patchy at best. Publicly funded systems, as well as our extended health insurance, do not support universal coverage of occupational therapy. Without coverage, seniors, particularly those on fixed incomes, do not seek our services, and doctors and other health professionals do not refer them to occupational therapy despite the known benefits.

Investment in cost-effective, clinically effective solutions in the community to enable our seniors to age in place, which include home safety assessments, home modifications, adaptive equipment, and ADL training for caregivers and seniors, is needed now. It is all possible through low-cost, high-impact solutions.

Our recommendation is simple. Part of the $5 billion in federal transfers to the provinces that has been earmarked for home care should be allocated to ensuring that occupational therapists are an integral part of the health care teams that provide services to seniors so that seniors can age in place in their homes and in their communities.

We're not asking for more money, simply a better use of our existing resources.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you both very much.

We're now going to Lisa Sullivan, executive director of Hospice Care Ottawa.

[Lisa Sullivan, Executive Director, Hospice Care Ottawa]

Thank you for giving Hospice Care Ottawa the opportunity to make this presentation today.

I'm here today to increase your awareness, I hope, about what hospice palliative care is and to ask you to address the growing need to support and fund hospice palliative care services in our community, whether they are at home or in some other setting.

Hospice palliative care is a philosophy of care that aims to relieve suffering and improve the quality of living and dying. There are many different settings for care, including people's homes, residential hospice, long-term care homes, retirement homes, and other institutions.

Our definition and understanding of hospice palliative care is adapted from the Canadian Hospice Palliative Care Association's “A Model to Guide Hospice Palliative Care”. It defines hospice palliative care as “appropriate for any [individual] or family living with, or at risk of developing, a life-threatening illness due to any diagnosis, with any prognosis, regardless of age, and at any time they have unmet expectations and/or needs, and are prepared to accept care”. It is a person- and family-centred approach respecting social, spiritual, and cultural practices. It includes end-of-life care, although it's not limited to that, and it's also not limited to the time immediately preceding death, so it can include bereavement and grief support.

This philosophy is perhaps best summed up by a quote by Dame Cicely Saunders, who is the founder of the modern-day hospice movement in London, “You matter because you are you, and you matter to the end of your life. We will do all we can not only to help you die peacefully, but also to live until you die.”

Who is Hospice Care Ottawa? Hospice Care Ottawa was formed in 2013 by the amalgamation of two smaller hospices in our city. We're a small, non-profit, community-based organization and we provide residential hospice care, volunteer in-home visiting, day hospice, bereavement support, and caregiver support. Our mission is to accompany and support individuals and their families through their end-of-life journey by providing compassionate, high-quality care. Our goals are to improve the quality of life for palliative care clients and their caregivers, and to reduce the burden on the health care system from unnecessary hospitalization.

All of our programs and services are provided at no charge to patients or their families, and we work closely with our local hospitals' home and community care organizations to provide and coordinate that care.

Currently we have some residential hospice beds in the city at two sites, but most of our programs are community-based programs. Last year we served over 360 people in residence and over 1,500 clients in the community. We provide our services with professional staff, but we do it primarily with the help of over 1,000 volunteers who last year provided over 50,000 hours of service and community support.

Hospice services in Ontario and in most provinces are not fully funded. At Hospice Care Ottawa, we receive less than 60% of our services from the local health integration network. That translates into us needing to fundraise almost $2 million a year just to provide our existing services. That's quite a feat for a small community organization. In addition, we have to fundraise the entire amount for any new builds or capital costs.

Last year Hospice Care Ottawa spent the majority of its budget, 76%, on direct programs and services rather than administration. As all charities know, fundraising is becoming increasingly difficult. This increases the administrative costs of charities. If we cannot raise sufficient funds from private donations, our existing services are in jeopardy. If we cannot increase our private funding, we cannot offer additional services such as those that are needed by particular communities of need, like the francophone communities in our area. It's inappropriate that the ability of Hospice Care Ottawa to provide palliative care in our community, which is an integral part of our health care system, should be in such a tenuous position.

Hospice Care Ottawa can and does provide a variety of alternative end-of-life services, but all of these options are underfunded, as I mentioned. In a recent study, Canada ranked ninth globally in a quality of death index. It is shocking to observe that only 16% to 30% of Canadians who die have access to or receive hospice palliative or end-of-life care services. Despite significant progress to advance hospice palliative care both locally and provincially, there continues to be this inadequate and inequitable access to comprehensive care. It is estimated that in our community there is need for hospice care bed services for six people out of 100,000 population. In Ottawa we have only 19 beds for a population of close to one million. Although we work really closely with our partners to ensure hospice care in the community, this continues to be a struggle.

In addition, we all know that our population is aging—indeed, that's part of the work of this committee—with the number of those age 65 and older to double in the next 20 years. Having increased numbers of seniors leads to more people using hospital and emergency rooms, which of course increases the cost to the systems and wait times. Those who are older are going to experience more chronic and life-limiting illness.

Hospice palliative care in the community is far less expensive than is hospital care. The Auditor General of Ontario noted that in 2014, hospice beds cost the system $460 a day, while acute care hospital beds cost over $1,100 a day. Hospice palliative care frees up much-needed acute care hospital beds and services. In Ottawa, our current services save the health care system approximately $4 million a year. Just imagine what we could do if we had more services.

Within the spectrum of hospice palliative care, there are some subpopulations with special concerns and unmet needs. For example, the lack of funding has made it very difficult to reach populations such as francophone, multicultural, and indigenous populations in our community.

In terms of the level of palliative care needs, we know that about 10% of all deaths are sudden and from an unexpected cause, such as an accident or a homicide. A further 30% will die with a steady decline in health status from a predictable or progressive disease such as cancer. The remaining 60%—and I would suggest this is a large part of our senior population—are people with advanced chronic illness, and they represent one of the main areas of unmet needs in palliative care. The vast majority of deaths arise from advanced chronic diseases such as heart disease, stroke, chronic obstructive pulmonary disease, renal failure, and Alzheimer's. The population is often the elderly experiencing a general decline secondary to physical and cognitive issues. They tend to be frail and unstable and to have those high-care and medical needs that sometimes require acute care. They are the large proportion of our seniors.

These are the patients who are filling our acute care beds. They do not need the expertise provided by acute care but are often too poor functionally or have symptoms issues that are too difficult for them to be properly managed in long-term care settings. When they are stabilized, they go back to long-term care, but as soon as they have an issue, they're packed into an ambulance and sent back to emergency rooms. The acute need is for services to care for patients within so-called chronic palliative settings, which I suggest is the majority of our senior population.

Most of what these patients need is personal care, such as washing, dressing, feeding, and toileting intermittently because they come symptomatic in some way. Our existing health care services are not responsive.

I'm probably done. Am I?

[The Chair, Liberal, Bryan May]

If you want to conclude that's fine, but—

[Lisa Sullivan]

No, I have a bit more.

[The Chair, Liberal, Bryan May]

We'll get you at questions.

We'll go now to Mr. John Beaney, vice-president of operations for Revera Inc., for seven minutes.

[John Beaney]

Good afternoon, Mr. Chair, and members of the standing committee.

Thank you for inviting me. It’s a great honour for me to be here today on behalf of Revera. I have worked in the senior sector since 2005, and know how important the partnership between government and industry is in delivering on our shared goal, which is to provide the best possible living options for seniors.

Let me begin by sharing some background on Revera. We are a leading Canadian-owned company, with over 55 years' experience as an owner, operator, and investor in the senior living sector. We own or operate, either directly or through partnerships, more than 500 properties across Canada, the United States, and the United Kingdom. We serve more than 55,000 seniors and employ more than 50,000 staff, who are dedicated to providing exceptional care and service.

In terms of senior living options, we have two fundamental models. First, our retirement residences work on a private-pay, social model. Retirement living offers seniors a safe residence with access to care, meals, and their choice of social services. Some of our residents live independently, but many need assistance with the activities of daily living and medications. Increasingly, we are home to seniors with various forms of dementia, such as Alzheimer's disease, who need to live in a secure memory care area In Canada. We have 97 retirement residences, which are home to 10,000 residents, served by more than 7,000 staff in six provinces.

Second, our long-term care homes operate on a public-pay medical model, where residents, most of whom are seniors, require a significant amount of care. Approximately 80% to 90% of the residents have some level of dementia. Governments at all levels, depending on the province, assess and place residents in our homes, manage our wait-lists, and fund the care we provide.

Revera provides care for over 10,000 residents in 76 long-term care homes, served by 12,000 staff in four provinces. We actively support today’s vibrant seniors as they live their lives to the fullest every day. We also care for vulnerable seniors, those who need help eating, bathing, dressing, toileting, and taking medication.

Revera therefore brings a unique vantage point for how we can improve the aging experience for Canadians. It is from this perspective that we approach our participation in your study on advancing inclusion and quality of life for Canadian seniors.

We have four considerations to share with the committee today.

First, we believe that choice and flexibility are key to any discussion around senior living options. Housing is a very personal choice, and this does not change as you age. Seniors need and want the ability to choose the housing solution that best suits them, whether that is living in their family home, downsizing to a condo or rental apartment, opting to live in a seniors apartment, a retirement residence, or ultimately moving to a long-term care home. Only seniors know first-hand the importance of flexibility in a system focused on seniors housing. We must find a way to accommodate their individual needs and incorporate their wisdom. All too often our staff are faced with the heartbreaking task of informing seniors who have lost their health that we are not able to accommodate their specific needs. We often have to tell long-time couples, people who have been married for 50 or 60 years, that they must now live separately because one member of the couple needs to move into a long-term care home and there is no place for their spouse.

Second, it is imperative that the committee understand that the delivery of care, particularly medical care, is fundamental to any discussion focused on seniors housing. Often we see access to care as one of the most important considerations for the seniors who choose to move to a retirement residence and, of course, care is the single deciding factor that brings someone to live in a long-term care home. Mental health is also an important consideration, particularly for seniors who live alone and therefore face social isolation, which often results in depression. We frequently see this condition affecting seniors who have limited mobility due to either physical or financial limitations, yet are still living in single family homes.

Third, we believe that Canada's private sector is a key player in the future of seniors housing. Companies like Revera play a key role in advancing the innovation required to meet the growing demand for senior living options. The private sector is part of the solution because we are motivated to drive innovation. We take risks and adopt new approaches to housing and care delivery, and we do this by investing our own capital.

Finally, as I mentioned earlier, we believe that seniors themselves need to be at the centre of any discussion regarding housing. Often, housing options for seniors who need care are tied to complex regulatory frameworks and government policies, making it difficult to understand the choices available. Housing, support and care services are often organized more around government, regulatory and organizational imperatives rather than around the needs and wants of seniors and their families.

We strongly urge the committee to speak with seniors who are currently facing decisions regarding housing or who have already made their decision. Revera would be happy to arrange for the committee to speak with residents living at Revera to understand first-hand the challenges the aging experience places on such decisions. As a leader in the sector, Revera is happy to be part of the conversation today and in the future to help shape a national strategy focused on senior living options.

As you may know, our company is a leading advocate against agism, which is the most socially accepted form of discrimination in Canada. We actively advocate for seniors to be respected as relevant, vibrant, and valued contributors to society. We have earmarked a significant innovators in aging fund, through which we invest in new products and services designed to help make the aging process more comfortable. We have dedicated significant resources to research and raising awareness around how society, and Canada’s business community specifically, can lead in the fight against agism.

Let me conclude by saying that Revera shares the core beliefs that underpin the committee’s efforts to advance the inclusion of, and quality of life for, Canadian seniors, and we thank the committee for undertaking this important work.

[The Chair, Liberal, Bryan May]

Thank you very much, sir.

From the Senior Empowerment Assistance Centre, Peel, Ontario, we have Olufemi Adegun, president.

Welcome, sir.

[Dr. Olufemi Adegun, President, Peel, Ontario Branch, Senior Empowerment Assistance Centre]

Thank you very much, Mr. Chairman, for giving me this opportunity to be part of this conversation. I would also like to thank members of the committee for inviting me to this forum this afternoon.

These conversations could not have come at a better time in view of the fact that 25% of the current working population is going to retire in the next seven to 10 years. I'll be speaking as the president of the Senior Empowerment Assistance Centre in the Region of Peel, which is composed of Mississauga, Brampton, and Caledon.

I'm here this afternoon to share with you how we can go about tackling the problem of senior exclusion, and advancing their quality of life in Canada. I'll be talking about the consequences of social isolation and the benefits of social inclusion. I'll also be talking about how our Senior Empowerment Assistance Centre has devised a five-point strategy, which we are using in the Region of Peel, to address this problem with seniors in our society. I'll also be talking about how organizations such as ours, composed of NGOs, the private sector, and the government—because the government cannot do it alone— can collaborate to address this problem with seniors. It is very important, because what we are seeing right now is what we call the wisdom of this age. There's a kind of generation gap whereby seniors above the age of 60 or 65 who retire cannot pass down that wisdom to the younger generations, and so there's a drift.

In the Region of Peel, which I represent, that gap is present right now. This wisdom cannot be passed down to the younger generations. The seniors need to tell their stories other than to their kids and down the lines. A lot of them have worked for over 25 years to 35 years, and a lot of the younger people are struggling trying to enter the system. There must be a bridge of that gap between seniors and the younger generations. This is part of what our organization is doing to address this problem.

Social inclusion is defined as the process of improving the chance of participation in society, particularly for people who are disadvantaged, to enhance opportunities, access to resources, and to voice their respect for rights. On the other hand, social exclusion is described as a state in which individuals are unable to participate fully in economic, social, political, and cultural life, as well as the process leading to and sustaining a social state.

If we look at the consequences of social exclusion or isolation, it leads to poor physical and mental health, to loneliness and emotional distress. In the Region of Peel that I represent, seniors wake up in the morning and go to Tim Hortons or McDonald's and sit there reading newspapers. We call them the boys and girls club. A lot is being done to address these issues, but I believe the government can do more by collaborating with the private sector as well as end users such as us. When seniors who can still contribute positively to society end up sitting in Tim Hortons or McDonald's for almost eight hours wasting life and tangible wisdom that can be passed on to the younger generation, then there is something wrong in society.

This leads to confinement and lack of contribution to society. When they are not educated about government, social services, and support, there is no way the mission of the government can succeed if these seniors are not engaged and included in programs and policies that would enhance their life. The engagement of seniors is very crucial to whatever programs and policies the government is setting up.

Also, there is disengagement from social networks. It reduces social participation, induces poverty and depression, and reduces their quality of life. I'm going to share some statistics from years back from the Region of Peel. Now, after taxes, the median household income in Peel is about $84,000, and 47% of families aged 55 to 64, according to research done three years ago, have no accrued employee pension benefits.

We have a lot of immigrants coming through the system. We are so blessed in that region, because when people migrate, let's say, from India, from Asia, they come with their extended families. They sponsor them, and an outcome of that is that when this group doesn't have the means to support themselves, of looking forward to retirement, that becomes a problem. On the other hand, we have, even within this family structure, caregivers, family caregivers, who render tremendous help in managing and helping these seniors.

Let me quickly talk about the five-point strategy we are using. We are using education, enlightenment, empowerment, engagement, and entrepreneurship. These are the five key points of the strategy we are using to address the problems of seniors in Peel.

I'll be discussing more later. Thank you very much.

[The Chair, Liberal, Bryan May]

Thank you very much.

We're going to move on. We apparently have an update. Mr. Fulton is here; however, his guide dog has not done its business all day, so Mr. Fulton has gone for a walk. I just want to get that on the record. I just want to give you an update, in case you're worried. He's over an hour late.

First up is Mr. Warawa, please.

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

Thank you very much for that presentation.

I want to thank the witnesses for being here, for their heart, for their dedication to the Canadian aging population, and for the incredible work they do.

The challenge we have at this committee is how we can help federally, and I would appreciate your input on how we can help. How important is it that we help now, or is it something we could do over the next 10 years?

We've heard from Ms. Sullivan, and I saw the program on The National. It's heartbreaking, but it's part of life, to see a death in the family and to see that brave woman and her husband and daughter. It gives us a glimpse into the reality of the end of life. To watch that program and think of hospice care being provided here in Ottawa...if you weren't there, what would be the options for that family?

So, God bless you. Thank you so much for the work you do.

We had a volunteer from hospice care in Langley here last week. She shared the challenges they're having with funding, too. Occupational therapists have also shared with us their challenges with regard to funding.

Funding paradigms are very difficult to change, so how do we do that? You've both highlighted the importance.

Mr. Shiner, thank you for your testimony on the importance of housing. How do we change the paradigms we have? How necessary is it to do it now, or can we wait 10 years? What type of leadership does the federal government need to provide? Should this committee, now that the windows and doors are open and we see the major crisis before us, move on and discuss another topic, or should we finish this topic and finish well?

I'd like your input, Ms. Sullivan, Ms. MacNaughton, and Ms. Craik.