Human Resources Committee on May 13th, 2021

[Laura Tamblyn Watts]

Thank you for the question, Ms. Chabot.

I think Quebec in many ways has been ahead of other provinces and has better integrated community and long-term care. When it had challenges in the first wave, it took dramatic steps, particularly in hiring over the summer, that have shown leadership.

However, when we're thinking about national standards, we're also thinking about things such as the built environment, HVAC systems, air conditioning systems and how big a space is. For these particular items, we cannot leave people to come up with ideas themselves, in the same way that building codes exist for a reason. It's therefore important that we think about making sure we're levelling up all provinces to have a good understanding that the built environment and standards of care need to have a minimum. This doesn't mean Quebec can't exceed that. We have seen, however, that when health transfers have gone to the provinces untethered—and I'll use the example of home care in 2017—the money has simply disappeared into provincial treasuries and hasn't necessarily been applied for the purposes needed.

I think we are in a transformative step and we can learn from our colleagues in Quebec given how well care has been delivered there in the second and third waves. However, Quebec care is quite different from what we can see sometimes in other jurisdictions. This is a moment of transformative change and we need to make sure that the private, public and not-for-profit homes in all provinces have the information and budgetary knowledge to know what they need to do going forward. It's going to be critically important that we draw out these standards and not restrain innovation but promote it.

[Miranda Ferrier]

I definitely agree with Laura.

Congratulations on the great hiring initiative that was done last summer. It actually pushed Ontario to do one as well. Good on you for being the first.

There's a lot more flexibility, it seems, in Quebec than there is in many other provinces in relation to ratios. You guys have really high standards in that way and we all need to learn from that. However, I think that every single province needs to be held to account. We need to know where money goes when it goes to the provinces.

[Louise Chabot, Bloc, Thérèse-De Blainville, QC]

Thank you for your responses.

I'll add to what I said.

Even though I think that you know this, I still want to say that, regardless of the province, most health care spending is allocated to staff. In fact, 80% of costs in our health care system, and even in our social services, are staff costs.

You're talking about standards for improving our infrastructure. I don't know whether you share our opinion, but we think that we need workers and staff to support your objectives. For example, air conditioning is part of the debate in Quebec, but that falls under Quebec jurisdiction. These are choices, which are being addressed.

In terms of the ability to properly support the health care system, we can see that the federal government has abandoned the provinces. Funding for the health care system has decreased over time rather than increased to properly meet the needs.

I have a hard time seeing how standards would fix anything when something more fundamental must be fixed.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Chabot.

Next is Ms. Gazan, please, for six minutes.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Thank you so much.

I'd like to thank both Laura and Miranda for their testimony.

I find it abhorrent how seniors in this country are treated and that so many seniors here live in poverty. It's why I have been pushing for a guaranteed livable basic income. I know the current government has announced increasing OAS rates when seniors are 75, but that's unacceptable to me. It should occur way before then to make sure that all seniors in this country can live in dignity, something that your testimony has clearly confirmed is not happening.

I want you to expand on some of your comments.

My first question is for Laura.

In your testimony, you mentioned the need for a federal seniors advocate. Could you expand on that?

[Laura Tamblyn Watts]

As we have seen in comparator countries, having a federal seniors advocate allows a nation to plan. It can make sure that we are thinking about meeting the needs of our aging population and can hold departments to account in making sure that mechanisms and budgets are being allocated appropriately.

We see this in various provinces. In provinces that have seniors advocates, the conditions of care and the supports have improved. Older adults have a voice for well-being and governments have a resource to ensure that they're moving towards an age-inclusive Canada on a social and economic basis.

This is not an expensive proposition, and it is something Canada should have. We have long needed a seniors advocate. We have long needed a national seniors strategy. That's why CanAge wrote “Voices of Canada's Seniors: A Roadmap to an Age-Inclusive Canada”. There is broad agreement that a federal seniors advocate would be a cost-effective small move that would have a large impact.

[Leah Gazan, NDP, Winnipeg Centre, MB]

From the testimony you provided, Laura, it's very clear to me that there needs to be an advocate in place to make sure there is somebody who can fight for seniors who are not being treated with dignity and respect or being provided with the resources they need. Thank you so much for that.

My next question is for you, Miranda.

We know that across sectors, unionized workplaces provide better conditions for workers. For example, in long-term care in Manitoba, and certainly in my riding of Winnipeg Centre, many of the care workers come from racialized communities. Many are from the Filipino community. They provide front-line services and have put their lives on the line, and in fact have lost their lives, caring for others.

Can you speak about how increased unionization for support workers will enable better conditions for them and for seniors in long-term care?

[Miranda Ferrier]

Thank you for saying that. We lost a lot of support workers across our nation due to COVID-19. Those workers stepped up to the plate when everyone else stepped back. Thank you for that recognition.

In terms of unionized workplaces, I know that most long-term care facilities across our nation are unionized. It's just the way it rocks and rolls for them in that area. We find it's good but it's also not good. Work needs to be done there as well. If you have a unionized workplace, you have seniority, and the issue with unionized workplaces is the list of seniorities.

For instance, you are a personal support worker who is working in long-term care and you're only part-time casual. You work all the hours they want you to work. You go in all the time. A line finally comes up that you can get a full-time position. But someone who's been there for nine years ahead of you who wants this position, who never takes call-ins, always just works their hours and goes home and never does the extra will get that full-time position. The person with nine years will get a full-time position over the PSW who puts her heart and soul into it.

Seniority has come up as an issue with unionization. But I will say that unionization gives the workers a voice. It gives them that protection, especially against management or administration in long-term care homes where there seems to be a lot of butting heads, shall I say, where management likes to bully the front-line staff. That is an issue. That's where unions do step in. They are excellent for the workers.

[Leah Gazan, NDP, Winnipeg Centre, MB]

I have less than a minute left and I'm very interested in this, but quickly, perhaps I could ask Laura for some more comments around national standards in long-term care. Then I have a last question.

I have about 30 minutes' worth of questions. I'm like, what do I ask?

Go ahead, Laura.

[Laura Tamblyn Watts]

We think national standards are not the only solution. They need to be backed by supports embedded in law and money and investment. However, they will provide, I think, a clear minimum set of standards across this country. They help to obviate some of the concerns we have around public versus private long-term care, which is a bigger debate. At least if we could get the care standards up to an equitable level, some of those concerns could be obviated.

[Leah Gazan, NDP, Winnipeg Centre, MB]

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Gazan.

Next we have Ms. Dancho, please, for five minutes.

[Raquel Dancho, Conservative, Kildonan—St. Paul, MB]

Thank you, Mr. Chair.

Thank you to the witnesses for their testimony today.

Ms. Watts, I want to pick up on something you shared with my colleague Ms. Falk. She was asking you about the impacts of isolation on seniors. To paraphrase you, you very bluntly said that it has been a misery. Older people are suffering from untold amounts of physical deterioration and cognitive impairment. They're less able mentally. You went on to say that mental health has deteriorated enormously as a result of isolation.

I want you to expand a bit on that in reference to some of the research you did for your pre-budget submission. I'll quote first from your pre-budget submission. You said, “Consequences of isolation, loneliness, and ageism significantly decrease life expectancy, cognitive function, physical well-being, mental health, and quality of life.” You went on to say, “Social isolation can be as harmful to a person's health as smoking, obesity, or hypertension.”

Most of the research, though, was from before the pandemic. Could you elaborate for the committee on how you feel that the research I just mentioned has even been heightened with the tremendous amount of isolation seniors have been experiencing over the past 14 months?

[Laura Tamblyn Watts]

Prior to COVID-19, we saw that social isolation could take up to eight years off the life expectancy of an older person. That was prior to COVID-19. We have seen untold levels of social isolation. Active, healthy 75-year-olds now locked in their own homes, unable to see family and friends, have had profound problems with the physical ability to move around. These are people who previously did not have disabilities, whether physical or mental disabilities, but who now are suffering enormously.

We're starting to see some of the research in the community, but we are already seeing some of the research coming out of long-term and residential-type care. The CIHI report did some reviews. Dr. Nathan Stall has done some. Occupational therapy reviews have also been considered. We saw some of the outcomes in the Maples in Winnipeg, which were referred to as well, and across the country. We are able to measure the fact that people are not able to toilet anymore. They're not able to walk as far anymore. They're not able to understand and appreciate or feed themselves. These are real physical and mental engagements. On top of that, the disconnection and the trauma have now pulled people into mental health spheres that we have not ever seen before at the same level.

When it comes to loneliness and self-isolation, up to 15 cigarettes a day was how bad it was prior to COVID-19. Now imagine we are all chain-smoking.

[Raquel Dancho, Conservative, Kildonan—St. Paul, MB]

Wow. That's really incredible and shocking. Those are very disturbing statistics. I appreciate your sharing them with the committee. They are critical for the research that we are doing in this study.

By way of a personal anecdote, I have a very dear mentor who is a friend of mine. Her mother is elderly, lives in a care home and has dementia. She is the one person, even though they have a large family, allowed to go and see her, but when she goes to see her, of course, precautions must be taken. She wears her mask and her shield. Her mother is already quite confused at this stage. She's not even allowed to touch her mother. She's not allowed to help her go to the bathroom, or really provide any of those supports that caregivers are allowed to provide.

When she told me this story, she was very emotional, obviously. As a daughter, she can't even hug her mother. I'm wondering if you have any recommendations, for the next number of years if we have to live with the pandemic, on how we can better support seniors, particularly in that situation, and have their family, perhaps.... I don't know. I'm not a medical expert. I'm not a seniors expert. I'm just wondering what your perspective is. Is there anything more that we could be doing to help women and men in that situation?

[Laura Tamblyn Watts]

One of the reasons we put forward the recommendation for a national adult vaccination strategy is that we let epidemics come to seniors every single year in the community and in long-term care, and we do very little about them. It's so simple to vaccinate, but we leave it up to provinces and local health units to order the seniors-specific flu vaccine, the pneumonia vaccine and the shingles vaccine. This time we saw the federal government step up and actually purchase and distribute the seniors-specific flu vaccine to long-term care. That was transformative.

We could take small steps like that on an ongoing basis. Doing that would reduce these yearly epidemics, and hopefully the pandemics, and it would make sure we would never be in some of these circumstances again. That's a very tangible thing to do.

The other piece I would offer is that once people are vaccinated against COVID-19, we need to loosen these restrictions. They are now being stuck because of concern around liability and concern around insurance. Violations of seniors' rights are happening all across this country. There's no reason, if the mom has had two doses of vaccine and precautions are in place, that she shouldn't get a hug and a walk outside.

[Raquel Dancho, Conservative, Kildonan—St. Paul, MB]

Thank you.

[The Chair, Liberal, Sean Casey]

Thank you, Ms. Dancho.

Next is Mr. Long.

Go ahead, please, for five minutes.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Thank you, Chair, and good afternoon to my colleagues.

Good afternoon to Ms. Tamblyn and Ms. Ferrier. Thank you very much for your presentations. It's great that you're both here.

Ms. Tamblyn, obviously you're right across the Bay of Fundy, as we talked about earlier. I can almost see you on a clear day.

There's no question that this is an incredibly important study.

One of the things that would really break my heart, when I was doing door to door back in 2015 in my first campaign, was seeing seniors in their homes, and how seniors were so vulnerable and were forgotten. You roll that into what's happened during this pandemic with the isolation and just the travesty that it's had on all Canadians, but in particular seniors.

Certainly from our government's standpoint, as MPs, we're always lobbying and making sure we do the right things. It goes without saying that we certainly raised the GIS to 10% for low-income single seniors, and we rolled back the increase in age that the Harper government was going to bring for the age of eligibility for benefits from 67 to 65. I'm thrilled in this budget that we are increasing the OAS for seniors who are 75 years and older. Sure, there are people who would ask, well, why not 65 to 74, but we deem that seniors 75 and up are more vulnerable and have more health care costs. I'm certainly thrilled that our government is moving forward with those initiatives.

I'm in a province that has more people over 55 years of age than under 15. There was a study in 2018 which said that in our country now, one of two Canadians is over 40 years of age. It's a pressing problem, a challenging problem.

I want to talk about home care for seniors, but also kind of roll that into—if I said a NORC, you would know what I mean, obviously—a naturally occurring retirement community. These communities are popping up. These communities are forming, not really even forming deliberately, if you will. They're not designed that way, but over 40% of the people are 55 or older, and so on and so forth.

I read an interesting article the other day that was talking about a concept of needing to get better as government. MP Dong talked about the levels of government and how we need to co-operate better. The article I read basically said that we can do a lot better job of also bringing more services to seniors in these communities. Obviously that rolls into home care, and we're going to talk about specific home care.

I'll start with you, Ms. Tamblyn.

Could you talk about alternative types of care which would bring more care to seniors in their communities?

[Laura Tamblyn Watts]

Aging in place and making age-inclusive communities have to be our priority. We will always need long-term care, because as we live longer and are more fragile, there will always be some people who need 24 hours of nursing care. However, about 20% of the people in long-term care could move home if services came to them. Whether those services are shared amongst a community, like a naturally occurring retirement community or not, depends on what the needs are of that community.

Services to people in place are absolutely where we need to focus as a key priority in government.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Can you give me any examples of a gold standard, or a community or province that has something that's working?

[Laura Tamblyn Watts]

We have NORCs that are very well established in a network across this country. I can provide the committee with more detailed information about an entire association of naturally occurring retirement communities—where they live, how they work, and what the best standards are—as a follow-up piece of information.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Thank you.

Ms. Ferrier, could you comment on that?

[Miranda Ferrier]

Quickly, I can say that there are many good ways to bring all that seniors need into one community. Home care is easier, believe it or not, to organize at times than long-term care, so it's much more doable.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Thank you.