Evidence of meeting #112 for Indigenous and Northern Affairs in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was facilities.
A recording is available from Parliament.
Liberal
UW-Schlegel Research Institute for Aging
It's a wide range.
An example of some of the work that we do is this particular work supporting indigenous culture and long-term care. We have a program supporting cultural diversity, which is ethnicity, gender, and sexual orientation resources. It helps support homes to deliver individualized care.
We also do various programs. We have educational programs. One is living classrooms, where we train personal support workers and practical nurses in long-term care. There's a huge shortage of staff in long-term care, personal support workers in particular. It's important to train them and to expose them to long-term care. Partnering with colleges to deliver care is an example of an education program that we offer. We have lots of different educational tools.
The idea is to identify resources that are out there so as not to recreate things that are already out there, and then to develop ones that the sector identifies as being needed. That's the purpose of the program.
Liberal
Dan Vandal Liberal Saint Boniface—Saint Vital, MB
Okay.
I have a question for Bonita Beatty.
You've been researching long-term care. Have you done any research on the importance of home care and keeping people in their homes from an indigenous perspective?
Professor, University of Saskatchewan, As an Individual
Yes, absolutely.
As I said, indigenous seniors tend to fall into three areas during their care and continuing care life. One is at home. Another is during the transition, when they're moved to a long-term care facility. The third is at the long-term care facility. Each of those steps in that journey has specific needs. Often, home and continuing care is kind of a limited program on reserve. It's only offered for the work-day hours. There are no evening hours or weekend hours covered for it.
Liberal
Dan Vandal Liberal Saint Boniface—Saint Vital, MB
Is there nothing after office hours or on weekends?
Professor, University of Saskatchewan, As an Individual
No.
What came out in our caregiving research is that this is oftentimes when they need the help. Fortunately, in our case, we have 24-7 health clinics. Primary health care nurses are on site, so they're the ones who usually get called when a medical emergency arises. We also have ambulances in some parts of it.
For the isolated communities, whether they are three or four hours away from the hospital, for instance, it's very difficult for them to be able to keep their people at home. By and large, in almost every bit of literature that you'll find anywhere, both for indigenous and non-indigenous people, they want to stay at home. They want to be with their families and they want that support. Caregivers want that, too.
Liberal
Dan Vandal Liberal Saint Boniface—Saint Vital, MB
I have one more question.
Our government understands the importance of home care. We threw in an extra $6 billion for the provinces. I seriously doubt that any of that will trickle down to the reserves, however.
Liberal
Dan Vandal Liberal Saint Boniface—Saint Vital, MB
I only have about 20 seconds.
Do you have any advice to give the government? What should we be doing more of, or what should we be changing?
Professor, University of Saskatchewan, As an Individual
You need enhanced home care programs. You have no palliative care. There's no respite care, and there are no additional hours for the home care. Home care addresses chronically ill people, who are not just seniors. There's a whole pile of people with chronic health issues, and seniors tend to get isolated sometimes. You need a focused, strategic plan within the home and continuing care program that targets the seniors so that they're a focus and so that program gets enhanced. There's no getting around the enhancements. That's only to make it comparable to what the province has.
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Welcome, all.
I'm going to continue with that topic that we're talking about—elders who want to stay at home.
To what extent do the current federal programs for home and community care allow elders to remain at home in their communities?
We're going to continue with you, first of all, Ms. Beatty, because I think you have a connection with the Peter Ballantyne Cree Nation. You were talking about that.
What current federal programs are helping? Are they helping?
Professor, University of Saskatchewan, As an Individual
In Peter Ballantyne, we only have the home and continuing care. We had done a lot of work trying to get a long-term care facility on reserve, even a downsized one, so that we could maintain some assisted-living facility or something like that, because there's no support funding, no operational funding, or maintenance funding for that within the policy envelope or the budget envelope within that home and continuing care package. Facilities are part of it. You keep people at home or as close to home as possible.
The other thing is the non-insured capital benefits. They're limited in what they provide as well. A lot of the at-home maintenance and renovation of access, even the rails on the houses, those kinds of things are not possible. Families are really struggling to maintain their elderly at home with even the types of beds that an elderly person needs to pull themselves up, or even the lifting things, especially when they're immobile. There are a lot of issues.
As I said, dementia care is an area that really needs to be looked at, because it's growing in our communities, and it's really at that frail elderly stage. Even in our band, just within our community, there are four of them in the personal care home who we would have wanted to maintain at home. It's usually the last resort that puts people in long-term care home facilities away from home. If you look at the Canadian stats, that's also what happens with Canadians in general. People generally don't go to these long-term care facilities unless it's a last resort because they're medically at risk. The same with—
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Yes. I'm going to go to Teresa now, if you don't mind.
Can you comment on this? You have 50 beds, I see. Can you talk about the federal programs for the home and the community? Do you get any of that to keep your elders at home?
Vincent Lazore
One of our strengths in Akwesasne is that we have these services. We have home support where they're dealing with 85 to 90 clients right now. We have holistic health. We have all these programs, and yes, they are funded, but one thing we find lacking is training. We're short on nurses, we're short on RPNs, and we're short on PSWs. In order to keep these services going, we need more training for staff to keep them up on the latest whatever. It's just that we need more training.
Teresa Doxtdator David
If I could add, on the standardization of PSWs, you have PSWs coming to work in long-term care who maybe took a correspondence course and have no real consolidation experience. They get burnt out, and then they're gone. Then we end up with issues of abuse in our homes, so standardization, I think, would be key for the education process.
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Yes. I think we're all learning. Palliative care has just come up since 2015. Mental health is a big issue. We haven't even peeled back the onion on this. These are other issues.
Now, let's just take the federal government. Would you recommend a one-size-fits-all, or are we going to have 10 different ones for the provinces plus three different ones for the territories? How does the federal government get around some of this palliative care that we've talked about, dementia problems, and mental health problems? What recommendations would you make for us to take forward in our report to deal with this? If you don't mind my saying, it's kind of new and we're just dealing with this.
We'll start first with Tammy, if you don't mind, then we'll go to Teresa and then over to Ms. Beatty.
UW-Schlegel Research Institute for Aging
Are you asking whether it should be provincial-specific or across the country?
Conservative
UW-Schlegel Research Institute for Aging
My sense is no, because the structures are so different within each province for long-term care. That would be my sense. I'm not an expert on how the federal government is funding it. We're a provincially funded program.
I would like to add, though, that everyone wants to be at home as long as possible, but long-term care is inevitable for some people, because they need that type of support. In Ontario, we're desperately trying to improve the perception of long-term care. We have made strides in moving from an institutional model of care to a social model. There's still a lot of work to be done, but there is some incredible care being provided in the province in some homes that are doing amazing work, and the only thing that gets shared are those negative stories.
Yes, giving good quality care is a boring story, because that's what we're supposed to be doing, but we need to showcase those examples because people are so fearful of going into long-term care because they think they're going to be in a hospital.
Conservative
Kevin Waugh Conservative Saskatoon—Grasswood, SK
Go ahead, Teresa. With the federal government, how would they disburse this money? Is it one-size or are we going to do it differently, 13 different ways?
Teresa Doxtdator David
Working in recreation and leisure, we're constantly looking for materials. I would be happy with a one-size-fits-all, and then we modify it to suit our needs.
