Evidence of meeting #33 for Justice and Human Rights in the 43rd Parliament, 2nd session. (The original version is on Parliament’s site, as are the minutes.) The winning word was seniors.
A recording is available from Parliament.
Liberal
The Chair Liberal Iqra Khalid
I notice that Madam Marcoux has joined us.
Welcome, again. It's really great to have you here.
We'll now go to Monsieur Fortin for six minutes.
Please go ahead, sir.
Bloc
Rhéal Fortin Bloc Rivière-du-Nord, QC
Thank you, Madam Chair.
Welcome, Ms. Marcoux. I am glad to see you here, as well as Ms. Bérard, Ms. Miller and all the witnesses.
It is very kind of you to participate in this exercise, which is important when we talk about better protecting the elderly in our society. I think it's a mission that we owe it to ourselves to do right.
I liked what I heard from Ms. Miller about thinking about a way to better frame, criminally, the actions and inactions of leaders of organizations that care for seniors. I think that these people have an important responsibility, just like the citizen, the nurse or the employee who takes care of an elderly person, whether well or badly. That's an avenue we need to look at.
That said, I am very interested in Vigil'Ange. You'll understand: it's right in my riding, and I find that this organization plays a major role with our seniors.
Ms. Marcoux, I would like you to tell us about the lookouts. This is not a common or familiar concept.
How do you go about recruiting lookouts? How do you train them? How do you do it?
Colombe Marcoux Coordinator, Vigil'Ange
We currently have 156 lookouts across our territory. A lookout can be a citizen, a business owner, a health professional, someone who works in a community organization or the police department. Basically, they are all people who, from far and wide, have an interest in the cause of seniors. Our lookouts are our eyes and ears on the ground and we try to recruit community stakeholders who have a connection to our seniors.
Abuse is a very taboo subject, but a senior can confide in their hairdresser or someone they have developed a bond of trust with.
These lookouts are the ones who are going to spot trouble. They're the ones who are going to be concerned about someone they've known and dealt with for a long time.
We often say that, ideally, a well-trained lookout who is well aware of our challenges and mission will not send the person to us. She herself will be able to guide the senior in need to resources in the community. This is really beautiful. It involves the community in advocating for our mission. The concept of the lookouts is somewhat inspired by the Block Parent program, and our lookouts have a little sticker on their window. Pharmacists and police officers have one as well.
Bloc
Rhéal Fortin Bloc Rivière-du-Nord, QC
I don't want to rush you, but we don't have much time left.
You just talked about the stickers. Lookouts are people that you recruit who work with seniors. You mentioned pharmacists and hairdressers, for example. I guess different professionals are being called upon.
How are the stickers you mentioned helpful?
Do older adults know what the sticker means?
Coordinator, Vigil'Ange
It's our logo and phone number.
The merchant or establishment identifies itself as a lookout. They will be able to react if they become aware that an older person in their community is experiencing a situation of concern. It could be a notary or a lawyer, a hairdresser or someone who works in a school. There are no limits. Anyone who...
Bloc
Rhéal Fortin Bloc Rivière-du-Nord, QC
Suppose I am a senior citizen dealing with abuse—don't laugh, it may happen to me one day, since I fully intend to live a long life. If I see the Vigil'Ange sticker at the pharmacy, for example, I will know that I can tell the pharmacist that my son or daughter, nephew or neighbour has done something. The pharmacist will offer to help me.
Is that right?
Coordinator, Vigil'Ange
This is really a partnership; we all work together. The lookout will describe the situation to us and share their concerns and worries. On our side, we will act upstream, with the person's consent, of course. We can also guide the lookout with suggestions, certain actions to take. Several types of collaboration are possible. It is teamwork.
Bloc
Bloc
Bloc
Rhéal Fortin Bloc Rivière-du-Nord, QC
How does this improve the lot of the elderly person who has a financial abuse problem? I am not talking about physical abuse, since in that case they will be treated in a hospital.
If an elderly person is being financially abused by her nephew and she tells her hairdresser about it, what will you do?
Coordinator, Vigil'Ange
That's a very good question.
We go at the person's pace and take the time to fully understand what's going on. Even if it's abusive, the relationship can be an important one. For instance, the nephew, son or grandchild may be the only person in the senior's life. That person may actually have needs, as well.
We try to build trust. We offer the individual help by educating them and referring them to the appropriate resources.
Liberal
The Chair Liberal Iqra Khalid
Thank you, Mr. Fortin.
We'll now go to Mr. Garrison for six minutes.
Go ahead, sir.
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you very much, Madam Chair.
I want to direct my questions to Ms. Miller, and I thank her for raising the question of holding the least-paid workers responsible for what happens in long-term care homes. I think a phrase that I have come to respect is that, in long-term care, the conditions of work are the conditions of care.
Ms. Miller, in your experience, have you found that the precarious nature of work in long-term care homes is a contribution when it comes to the failings that lead to elder abuse?
Partner and Lawyer, Howie, Sacks and Henry LLP
Thank you so much for that question, Mr. Garrison.
I couldn't agree more with that comment. It's a comment from Pat Armstrong, one of the leading experts in long-term care. I see it, unfortunately, every single day of my practice. I held a series of town halls with my group, Canadians for long-term care standards, and we had PSWs and nurses come and speak. I've spoken with countless of them over the last year. Natalie Stake-Doucet spoke at Parliament Hill at my demonstration, Broken Hearts, Empty Shoes. She's the president of the Quebec Nurses' Association. She said, “We're not heroes; we're just nurses.”
These people are overworked, underpaid and are lacking the resources they need to do their jobs. What I've heard consistently over and over again is that they want to do their jobs properly, and they are leaving at the end of the day knowing they are not. It's heartbreaking for them, and it's heartbreaking for the residents.
The reason it's so detrimental is that these very simple things snowball into cataclysmic issues, like knowing how a resident likes to take their food or knowing that they don't want to come from the left versus the right because of Parkinson's or being hemiplegic. Those are very small, nuanced elements of care that you can't just have written down on a massive piece of paper. It comes from knowledge. It comes from knowing the residents, spending time with the residents and having consistency of the staff with the residents rather than this revolving door of underpaid contract workers who are trying to come in and learn about every single resident on every single shift. That's how things fall through the cracks.
These very small deficiencies in care are what snowball into horrible conditions. That's how we see bedsores that lead to necrotized tissue developing into bone infection, dying of dehydration or choking on food because they were supposed to have liquids. These are things that are happening every single day across Canada, and it is predominantly because the staff do not have the ability to do their jobs properly.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Do you think that the limited number of hours of staff time to provide care per resident is a big contributor to these problems that we're talking about today?
Partner and Lawyer, Howie, Sacks and Henry LLP
Absolutely, and that's extremely variable from province to province and territory across Canada.
In Ontario, for example, prior to the pandemic, we were at 2.75 hours of direct care per resident per day, and now we're at 2.45. The experts unanimously agree across the board that the bare, bare, bare minimum should be four hours per day, although we do have some provinces that have over five hours per day or even closer to six. That should not include RSW or resident care aid workers. That would just be for personal support worker and nursing support. It wouldn't include physiotherapy, nutrition, occupational therapy and things like that.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
One of the possible solutions that has been suggested is to have national standards written into the Canada Health Act for long-term care. I'm presuming I know the answer to this question, but how do you feel about that? Would that help address these problems?
Partner and Lawyer, Howie, Sacks and Henry LLP
If you ask most experts, and I have—as I said, I did a series of town hall meetings—most of us agree that the Canada Health Act should stand alone and that a separate piece of legislation should be legislated incorporating the five governing principles in the Canada Health Act with some additional principles.
The predominant reason we need to have legislated standards is, where you have standards legislated for health care, which is governed provincially as we know, that is legislation that's governing doctors and nurses who already have their own regulatory and licensing bodies that they answer to. We do not have the same thing for personal support workers across Canada, so it is incumbent upon the federal government to implement additional standards that stand alone separately in the legislation and operate exactly as the Canada Health Act does to ensure that provinces are complying with those standards in order to receive federal funding.
