Justice Committee on May 15th, 2023

[Dr. Marie Beaulieu]

Thank you, Mrs. Brière.

It's clear from the bill that it captures only organizations. That brings me to reiterate a very important point that was made earlier: most seniors do not live in those settings. When the bill was drafted, the decision was made to capture only places where seniors live in a congregate setting. What sticks out to me is the fact that, despite the many alternatives seniors have to living at home, the bill appears to target only one of those environments: long-term care facilities. They provide the most care-intensive services to those who are the most frail. I wonder whether that's really a good idea.

My recent research on congregate living settings for seniors has shown not only that elder abuse is directed against residents, but also that elder abuse occurs between residents. Something I found interesting, and you brought it up, is the fact that, all too often, elder abuse is associated solely with interpersonal dynamics. Increasingly, though, we are coming to understand that the phenomenon is broader than that and can include the mistreatment of seniors by communities and organizations. That necessarily leads to a more systemic look at the issue.

I listened carefully to my colleague Laura Tamblyn Watts. She highlighted how important it was to reconsider how these settings are managed, funded and structured. I completely agree with her. When I read the bill, however, I was looking for what was expected of these facilities. What I saw was greater accountability from owners and managers. What I didn't really see was greater accountability from the various people who work with seniors day to day, workers, and that point was made by others as well.

To my mind, that's very different. Instead, the bill seeks to crack down on organizations and their administrators. One of the things the COVID‑19 pandemic taught us was that we didn't always know who was in charge of these places.

[Élisabeth Brière, Liberal, Sherbrooke, QC]

Thank you.

Something else you raised was the fact that the bill refers to vulnerable adults. You think it should instead refer to adults in a vulnerable situation, because that would make it clear that their condition was not inherent. I was quite glad you made that point. Again, I'd like to give you a chance to provide more information. Could you talk about that for us?

[Dr. Marie Beaulieu]

Yes, certainly.

More and more work is being done right now on vulnerability. We realize that vulnerability is not limited to a health problem or the presence or absence of disabilities. Vulnerability is a much broader and more circumstantial concept. We realize that people may find themselves in a vulnerable situation at some point in their lives, which makes them vulnerable. However, that does not mean they will remain in that state forever. So designating some people as vulnerable becomes a way to label them, and that can be very ageist and very reductive.

However, taking into account the whole situation and looking at the characteristics of the person and the environment in which they find themselves is important. One of the things we've learned over the years through studies on elder abuse is that the context and, more importantly, the characteristics of the abuser or the abusing organization often tell us a lot more than the characteristics of the senior. So I think it's important to reintroduce the nuances stemming from all these analyses.

[Élisabeth Brière, Liberal, Sherbrooke, QC]

Since I have only 30 seconds left, I will take this opportunity to thank you for your insight and congratulate you on your career and all the research you have conducted to help improve the cause of seniors and reduce elder abuse.

[The Chair, Liberal, Randeep Sarai]

Thank you, Ms. Brière.

Next we go to Ms. Larouche for five minutes.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you very much, Mr. Chair.

I would like to thank the witnesses for being here to talk to us about Bill C‑295, which deals with the very sensitive issue of elder abuse.

Ms. Beaulieu, I had the opportunity to meet you and exchange with you in my former life, at the Université de Sherbrooke, when I was working as project manager on raising awareness of elder abuse and bullying. I thank you for what you brought to my work, and I acknowledge your expertise and your commitment.

If I understood you correctly, you said, in the second point of your presentation, that you were surprised by the fact that Bill C‑295 does not apply to private seniors' residences and does not refer to them. That could even be one of its shortcomings. Given the reality in Quebec, where seniors' living environments are becoming increasingly diverse, could you tell us more about that?

[Dr. Marie Beaulieu]

Yes, certainly.

Apart from their traditional home, which they can own or rent, seniors can now find themselves in a host of congregate living settings. I think the notion of community is just as important as the notion of a care environment. In congregate settings, services are normally provided.

As a result, seniors who find themselves in private seniors' residences, either for-profit or not-for-profit, can experience situations of abuse, as I was saying earlier. They may also live in intermediate resources or in family-based resources.

Consequently, if, as seems to be the case, Bill C‑295 is limited to residential and long-term care facilities—CHSLDs in the Quebec nomenclature—I think a number of situations created by this notion of a community of care and services could be excluded.

[Andréanne Larouche, Bloc, Shefford, QC]

Thank you, Ms. Beaulieu.

I would now like to come back to the fifth point in your presentation, where you talk about the great difficulty in applying the concept of criminal negligence. Having worked closely with the Quebec police community in the context of collaborative response processes, I agree with you that this concept is very difficult to apply right now. I would like you to tell me more about this difficulty, in relation to the work and testimony of police officers.

[Dr. Marie Beaulieu]

I have worked closely with a number of police services as part of these collaborative response processes, as well as other programs. What was really striking was that the Criminal Code could be used to deal with a certain number of cases, but it was very rarely a case of criminal negligence. That led me to ask my colleagues some questions, and they told me that the evidence was very difficult to obtain in order to prepare these kinds of cases. As a result, very few formal complaints were filed, and they rarely made it to the courts. When that happened, criminal negligence was very difficult to prove and there were few convictions. Without going so far as to say that the police seemed to give up, it was clear that the evidence was very difficult to find in order to build a criminal negligence case.

If a new provision was added to the Criminal Code introducing the nuance of criminal negligence, I think objective criteria will also have to be established that will be used to prove it in order to ensure a certain degree of success. Otherwise, this new provision may end up being used very infrequently.

[Andréanne Larouche, Bloc, Shefford, QC]

Many witnesses who have appeared before the committee have expressed some reservations about the fact that Bill C-295 does not address the problem of ageism. What would you have to say about that?

[Dr. Marie Beaulieu]

I did not see anything about ageism in the bill. What we are seeing is a concern for people who may be among those who have the most needs and who require more protection.

Again, we have to be careful. This does not concern all seniors. They are not all in a vulnerable situation, they are not all in a position of disability, they do not all need to be protected. It is always the famous issue of the balance between protecting people and respecting and strengthening their self-determination.

[Andréanne Larouche, Bloc, Shefford, QC]

Ms. Tamblyn Watts, I have only 10 seconds left. How critical is health transfer funding to give you some breathing room, so you can take action on seniors' living environment?

[Laura Tamblyn Watts]

We would like to see a designated seniors care bucket of funds that is then negotiated with the provinces and territories, not just for health but for all issues related to our aging demographic, including elder abuse.

[The Chair, Liberal, Randeep Sarai]

Thank you.

Last we have Mr. Garrison for five minutes.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thank you very much, Mr. Chair.

I want to thank all the witnesses today who have done a good job of reminding us of the larger context within which this private member's bill sits.

What I can say, of course, as a New Democrat, is that we are concerned and have made part of our confidence and supply agreement with the government a commitment for a safe long-term care act to be introduced to take care of the fact that long-term care is not covered in the Canada Health Act. That would allow us to address some of the broader issues in the way the system operates, the funding and the standards. We are aware of the Liberal promises, and we are aware of the agreement we have with them, so we look forward to that coming forward.

What we have is this private member's bill that I think clearly responds to the large number of COVID-19 infections and COVID-19 deaths during the pandemic. What I'm wondering here is whether there is something useful that this bill can still do, even if it doesn't address those broader issues that this committee addressed in its study on elder abuse or the larger needs of the long-term care system.

We heard testimony on—and I'm going to ask Ms. Hajek, as I think she made reference to this—the conclusions of the studies of the crisis during COVID-19 that caused the Canadian military to have to enter long-term care homes. They found a significant difference in the performance of public and not-for-profit long-term care homes and the performance of for-profit homes when it came to the number of COVID-19 infections and the number of COVID-19 deaths, both among residents and the staff.

I wonder, Ms. Hajek, if you could comment on those conclusions.

[Marta C. Hajek]

Thank you, Mr. Garrison.

I think it brings us back to the point of accountability. Whether it's for-profit or not-for-profit, the same rules have to apply. The persons residing in these homes are suffering from neglect and abuse. The staff are definitely overworked or understaffed. The challenges were tremendous, and I think, as a global community, we were responding to the novelty of what this pandemic meant. People living in congregate settings certainly paid a higher price.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

I think I saw you react. Would you like to respond on the same topic?

[Laura Tamblyn Watts]

Yes, thank you very much.

I think it's important to remember that we didn't include it with the Canada Health Act mostly because, in 1987, we didn't live as long as we do now, and our frailty wasn't as frail. I think it would have been a very good thing to include it, and I think now it's going to be very difficult.

We have been very interested in pushing forward with the Liberal promise for a senior safe act to create legislation that will be thinking about these issues in a substantive and funded way. While we are very concerned about the equitable care of people, I think it's very important as well to fund our new national standards. Many of us participated; I think everyone on this call participated in it. We gave hundreds and hundreds of hours to create new national standards, and we need to have those funded. Those people need to be held to account, whether they be municipal homes, not-for-profit homes or for-profit homes.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thank you.

Given that time is about to run out, maybe I'll go around the table and invite Dr. Beaulieu and Dr. Hirst to make some concluding comments at this point.

[Dr. Sandra P. Hirst]

Perhaps I'll go first.

I think amendments need to be addressed recognizing that older adults need to have quality of life and recognizing the value of their human rights. You're looking, in the act, at the consequences. You're not dealing with the causes of the problems, in my view.

Thank you for the opportunity to comment.

Go ahead, Marie.

[Dr. Marie Beaulieu]

Thank you, Ms. Hirst.

The purpose of the bill is really to respond to very specific situations. It does, however, have the merit of looking at the problem a little bit, but we are far from getting a complete picture of the situation. So we must not think that, if these amendments were adopted, the problem of abuse in Canada would be solved and the Criminal Code would no longer have to be reviewed. Many other things could be done.

[Randall Garrison, NDP, Esquimalt—Saanich—Sooke, BC]

Thanks once again to all the witnesses.

Thank you, Mr. Chair.

[The Chair, Liberal, Randeep Sarai]

Thank you, Mr. Garrison.

That now concludes our meeting. I want to thank all the witnesses for attending. We appreciate their time and in-depth knowledge from academic or real-life experiences. We appreciate that.

I believe Mr. Brock has something he wants to ask.

[Larry Brock, Conservative, Brantford—Brant, ON]

Thank you for the opportunity, Mr. Chair.

The vice-chair of this committee brought to my attention that the main estimates are due at the end of this month. If we want to speak to them, which we do, we have an opportunity on the 29th and we'd like that to be scheduled.

[The Chair, Liberal, Randeep Sarai]

Does anyone else have any comments on that?

We'll check the calendar.

Go ahead, Mr. Anandasangaree.