Evidence of meeting #34 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 abuse.
A recording is available from Parliament.
Chief Executive Officer, Canadian Indigenous Nurses Association
[Technical difficulty—Editor] to say, “Grandma and Grandpa, you can't go out for a walk on your own because you might get lost.” Do you know how insulting that would be?
Would you try that on your grandparents if they liked to walk around? I hardly think so. However, in order for us to help with the federal responsibility and look at the legislation and the impacts of regulatory and legislative affairs, we need to be able to look at the workforce analysis and how we're going to adjust and identify the onslaught that's going to be required to adequately—not fairly, just adequately—address indigenous health conditions on or off reserve for the elderly population.
Conservative
Chris Lewis Conservative Essex, ON
Thank you very much.
I know I'm out of time. Thank you very much, Madam Chair, for allowing her to extend.
Liberal
Stéphane Lauzon Liberal Argenteuil—La Petite-Nation, QC
Thank you, Madam Chair.
First and foremost, I'd like to wish everyone a happy international nursing day and a happy national nursing week. Thanks to all the witnesses for their excellent testimony, which will be very helpful.
When seniors self-isolate more and don't have access to in-person services—I'm talking about those who aren't necessarily in a residence, but rather who are at home—we've observed an increase in domestic violence— verbal, physical, financial and other types of abuse—in those places.
Based on the information you have, do those seniors really confide in you when they need your services?
Second, what system do we have for managing them?
The question is for anyone who wants to answer it.
Chief Executive Officer, Canadian Indigenous Nurses Association
In regard to the in-person services for those elders who are privileged enough to still maintain their households, we worry about them at the indigenous level, but in regard to what we have instituted, you might have heard of bear patrol or mama patrol, those types of community-level services where they engage as law enforcement.
When incidents happen, and they do occur, the first point of contact with anything that happens in the indigenous community or in the Inuit hamlet is that you run to the nurse, because the nurse knows everyone, their family composition, who's on what drugs, who's doing what treatment, who is doing this and who is doing that.
We can do that because we don't have enough personal staff or skilled staff to be able to treat them. That one nurse is working 24-7, and that's why we have to be careful about their burnout rate.
Getting back to the issue, when elders do confide in a health care professional such as a nurse, we have to be very cautious about who we confide in, in the next steps, to looking at enforcement or some restorative justice for that elder, because then we might lose the trust or the confidentiality of other members within the community.
That's why I said we have to create safe spaces and we have to look at how we're going to train those nurses in that secure situation, how to control themselves so that it doesn't become a situation of chaos and regret.
Thank you.
Liberal
Stéphane Lauzon Liberal Argenteuil—La Petite-Nation, QC
Thank you very much for those very interesting answers.
Chief Executive Officer, Canadian Nurses Association
Madam Chair, is there time for me to comment?
Oh, excuse me.
Liberal
Stéphane Lauzon Liberal Argenteuil—La Petite-Nation, QC
You discussed vulnerable seniors. I'd like to talk about those who are in centres because those who are at home are often slightly more independent or still have a spouse or family member taking care of them.
What tools could the government give you to collect the right data and intervene with vulnerable seniors who are suffering from a disability, Alzheimer's disease or a physical disability that limits their ability to move around independently, for example?
How can the government intervene to assist you?
Chief Executive Officer, Canadian Nurses Association
Thank you, Marilee.
I apologize, Madam Chair, for my connection issue.
I'll just say that there are a number of tools out there that can help nurses and others to recognize when this is happening.
One of the challenges is that we're often operating in someone's home. Whether the home is the long-term care setting or their actual home, there are technologies we could harness, for example, cameras and so on, to help people, or a daily call or daily check-in. There are some pieces that can be put in place to help us make lives safer.
I'm sorry; this may have been covered when my connection dropped, but I will also add that our systems are well tuned to capture quality and safety errors, often errors of omission. They aren't looking for high crimes and misdemeanours, so to speak. You know there's been a terrible example in Ontario of a registered nurse who killed a number of patients and moved from site to site.
One of the things the government could do is push very hard for the health care sector to have unique identifiers so that we can track people across employment settings, careers and so on. That's absent at this time, and, while it might not seem believable, people can move with a bad record to different places. That's something the government could do.
Liberal
The Chair Liberal Iqra Khalid
Thank you very much. That concludes your time, Mr. Lauzon.
We'll go to Monsieur Fortin for two and a half minutes now.
Bloc
Rhéal Fortin Bloc Rivière-du-Nord, QC
Thank you, Madam Chair.
My question is for Mr. Villeneuve. I like to hear what he has to say about what's considered to be the best way to treat our seniors. I understand that there are problems everywhere. They occur when seniors live in an institution, in a seniors residence and with their families. Problems arise no matter where they are; we agree on that. They may be financial problems, physical abuse and so on.
What model should we favour?
In view of all that, should we focus on keeping seniors with their families?
If not, do you think older adults are treated better or lead better lives when they're in seniors' residences?
Perhaps there's another arrangement that you could recommend.
Chief Executive Officer, Canadian Nurses Association
I'll try to be very brief.
Only about 7% of people in Canada ever go to long-term care, typically the most vulnerable and most frail, often with dementia. That leaves the other 93% of us. At the back end of the baby boom at 62, I'm getting to that place.
We in nursing believe that the best thing we could do is help people to age safely and with quality of life in the place where they want to be, which is typically, when you survey people, the home in which they live. That can make them vulnerable for sure if they're with an abusive spouse, for example, or an abusive child.
In the main, people say they want to be home. If you're asking where we target our efforts, what can every Canadian expect as they age in their house or in their church basement? What services are there? What do we get from Meals on Wheels? What can we get in palliative care? What is the roster of safeguards and services? These are not all all high priced. Some is technology to check in on people and sort of track them through their aging.
Our focus has been very much hospitals, institutional long-term care and, to some degree, post-operative home care. We believe that ramping up home care, including simple things like drone delivery of groceries, is going to play a big part in keeping people in place safely as they age.
I hope that's somewhat helpful.
Liberal
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
Thank you, Madam Chair.
I know we have very little time left, and Mr. Villeneuve was unfortunately disconnected for technical reasons.
I'd like to go back to something we were talking about while he was offline. That is the question of staffing in long-term care that turned into an enormous crisis during COVID, and—as I have said many times before—how the operators acted as if the staffing problem fell from the sky.
My question really relates to the necessity for national standards in health care, particularly when it comes to nursing staff in long-term care situations, and whether his association favours such a move.
Chief Executive Officer, Canadian Nurses Association
We strongly favour it and have been advocating for that for some time.
I apologize if I've shared this example with you before, but one of the elements that makes hospitals safe is a set of standards everybody follows. If you find yourself in the emergency room in Winchester, where I live, or in Grande Prairie, when you you walk through the door, it looks the same. It smells the same. They ask you the same questions. They use the same technology. You can predict exactly what's going to happen in every emergency room, depending on what your issue is.
Long-term care is a free-for-all. Strong staffing, very strong standards of care in acute care and so on, highly accredited, regulated settings.... We believe that the same must be held true for long-term care where the staffing is often very sparse. We can't forget that safety in nursing care is often vigilance in the number of eyes, but you can only see so many people. If the staffing isn't great, whatever the categories, it tends to lead to trouble.
NDP
Randall Garrison NDP Esquimalt—Saanich—Sooke, BC
In the experience of your organization, have you noticed a difference between profit and not-for-profit long-term care in terms of the number of nurses who are on staff?
Chief Executive Officer, Canadian Nurses Association
There are some reports that for-profit settings, because they are for profit, tend to sometimes skimp on some of the services. When we look at the actual science, it's not that simple a story.
It's tempting for us, because we tend to land on the side of medicare, to say there shouldn't be anything for profit, but you do find that actually some of the for-profit places are very good and some of the not-for-profits are not. It's to tease out what elements work in those settings and put those in place in both.
Liberal
The Chair Liberal Iqra Khalid
Thank you very much, Mr. Garrison.
At this time I'd like to thank our witnesses for your very compelling testimony today. I really appreciate your time. If there are further clarifications or additions that you would like to provide to the committee, please do send a note to our clerk, so that he can distribute that to members.
For members, I would ask that we quickly disconnect and rejoin in an in camera meeting. You have been emailed the link, so please do that. Hopefully, it will be a very brief meeting in camera to discuss draft instructions for this elder abuse report.
Bloc
Rhéal Fortin Bloc Rivière-du-Nord, QC
Madam Chair, before we leave, I have a point of order.
I haven't received the email containing the link for the in camera meeting.
Would it be possible to send it to me, Mr. Clerk?
Liberal
NDP