Status of Women Committee on Oct. 20th, 2011

[Charmaine Borg, NDP, Terrebonne—Blainville, QC]

Yes, and if you've seen any comparable weaknesses in Canada compared to other countries.

[Dr. Gloria Gutman]

In my personal opinion, I think that Canada is doing as well or as poorly as the other countries. It's not that there's anybody else that's done a better job than we have. We're all in about the same boat of not really knowing what the best thing to do is.

Different countries have tried different things. There are a few, for example, that have gone to instituting mandatory reporting, but there is not enough research to know whether that in fact is the best way to go or the best way to go in a particular country.

[Charmaine Spencer]

I'd like to offer a slightly different perspective on that. I think Canada has been very strong in trying to avoid some of the challenges and problems within some other countries. For example, although there are some provinces that have been coming out with a protective approach, Nova Scotia is the only one that's based on a child abuse approach with mandatory reporting, and Newfoundland and Labrador has been modifying its laws and will have that kind of approach as well with its new changes to law. We've actually actively tried to avoid that because we recognize that it substitutes one kind of a taking away of power from the individuals. It is a very paternalistic approach.

In a couple of days, I'll actually be presenting some research that I've done comparing what happened in the child protection area and lessons learned from the adult protection area in the United States. What we find is that a very, very high level--a good third--of the reports that were received and that are investigated by the agencies that are required to investigate them are unsubstantiated. Now, that doesn't mean there's no harm occurring. It means that the agencies themselves have in many cases become overwhelmed with all of these calls that range in a wide continuum of harm, and that they establish significantly higher thresholds in policy and practice and basically treat all the ones that fall below that threshold as unsubstantiated, so those individuals don't get assistance.

The other thing we find is that much of the time our focus in terms of things like mandatory reporting is based on the assumption that there's going be support and services from government to meet the needs of older adults. What we find, however, unfortunately, is that the agencies have the mandate and tend not to have the funding and the resources to accomplish that mandate. We see that particularly when there's an economic decline: there are fewer services available for the individuals.

The other approach, again, that Canada has clearly and historically steered clear of, is trying to set up a special kind of law that tries to criminalize abuse and neglect of older adults. That is an American approach. There is no evidence to show that carving out a special law specifically for older adults in any way protects them more, or safeguards them more, than the general provisions within the criminal law.

[The Vice-Chair (Mrs. Tilly O'Neill Gordon), Conservative, Tilly O'Neill-Gordon]

Ms. Freeman.

[Mylène Freeman, NDP, Argenteuil—Papineau—Mirabel, QC]

Thank you.

Thank you for being here. I only wish we had more time.

On Tuesday we spoke with the Public Health Agency about their awareness campaign. If I understood correctly, Ms. Spencer, is one of the shortcomings of campaigns for awareness and education--if they're solely directed at that--that they are perpetuating a myth that the reason people abuse elders is because they don't know enough?

That's putting a lot of pressure on the individual instead of actually on communities, on systems of health care, on social services, on the criminal justice system--generally, on structural things. I wonder if you could elaborate, although briefly, on why awareness isn't enough.

[Charmaine Spencer]

National awareness campaigns are expensive, just plain out-and-out really expensive. Of the $13 million earmarked for the federal elder abuse initiative, the federal government identified that about $9 million of that actually went to the national campaign.

It's not that the campaign doesn't have its value. It does, absolutely. The thing is, comparatively speaking, and without recognizing the level of resources within the community to be able to respond to that or to be able to work hand in hand with that, communities really feel under the gun, under pressure, to meet a need. The need was always there. It's just that to a large extent it has been hidden.

[The Vice-Chair (Mrs. Tilly O'Neill Gordon), Conservative, Tilly O'Neill-Gordon]

You have 30 seconds left.

[Mylène Freeman, NDP, Argenteuil—Papineau—Mirabel, QC]

Briefly, in terms of structural recommendations you could make to the government...?

[Charmaine Spencer]

Looking at this federally, and particularly on the long-term care side, the big challenge will be those conversations in terms of health care, and so much of that responsibility falls on the provinces and the territories.

We need to be mindful of the fact that long-term care is part of health care. It's separate right now. It doesn't have the same kinds of safeguards and protections that other parts of health care have had in Canada.

We need to be really looking at the reasons why abuse and neglect occur within the long-term care setting. We tend to focus in terms of the profile of the residents, but we also need to understand the labour structures within that area. There is the fact that so many of the workers are female workers and casual labourers. That whole idea of continuity of care basically flies out the window in those circumstances.

[The Vice-Chair (Mrs. Tilly O'Neill Gordon), Conservative, Tilly O'Neill-Gordon]

So you feel....

Mr. Holder.

[Ed Holder, Conservative, London West, ON]

Thank you very much.

I'd like to thank our guests for attending today. I find your testimony very compelling. It's a little hard to absorb, if I might say, because you're sharing so much information with us.

I once asked my Cape Breton mum how you would eat an elephant, and she said “one bite at a time”, so I'm going to try to take this in little bites, if I may.

I'll start with you, Ms. Spencer. You mentioned that in terms of the Canadian Network, each jurisdiction is different. I presume you meant provincially, territorially, and federally. How would you rank them in terms of whether some provinces and territories are doing better than others? Do different provincial jurisdictions use different definitions within our own country in terms of how you define abuse and how it's reported?

[Charmaine Spencer]

They do have some differences in definitions in terms of their provincial strategies and things like that, but there are a lot of common elements. They draw fairly heavily on the World Health Organization definition, but there are different kinds--

[Ed Holder, Conservative, London West, ON]

So would it be fair to say that it would be helpful if all the provinces and territories could come up with a common scoring, if I can be that crass about it, in terms of being able to validate your research and report back to those folks who need to be able to utilize that information for the greater good?

[Charmaine Spencer]

Sure. I think Lynn would probably speak to that, but--

[Ed Holder, Conservative, London West, ON]

Ms. McDonald, would you speak to that?

[Dr. Lynn McDonald]

Absolutely: that's the whole point of what we're trying to do.

I would add--Charmaine knows about this, too--that part of this definitional issue is that we took all the definitions that are used in all the provinces, reviewed the case laws, which is what you do when you're a lawyer, and tried to match those legal approaches and definitions with the social science definitions so we could come out with a common view. This was not easy.

A year ago, I guess, we met with about 80 people from all over Canada. People made a lot of changes, but ultimately they all agreed. That's what we're going to try again tomorrow. We'll probably get way more feedback. It will be our last round. Then we're hoping that the various provinces, the researchers, and the practitioners--everybody--starts on the same page.

[Ed Holder, Conservative, London West, ON]

I have some empathy for Ms. Gutman's efforts in terms of this international network, because if we can't even get our own definitions tightly defined--and I'm not sure I even want to say tightly defined--in terms that allow the response to the research given to the caregivers, to the scientists, to the folks we ultimately ask to implement solutions....

I guess where I'm troubled is that if you look at this bigger thing--and internationally as well--it seems to be, from what I heard today, a hodgepodge of different definitions of elder abuse. As I listened to testimony...respectfully, I'm not even sure you even agree yourselves. I'm not trying to provoke, I'm just trying to understand.

Ms. Gutman, you said--and let me get it here, please, because I think it is important that I say this--“Elder abuse is...a women's issue”.

Ms. McDonald, what I thought I heard you say is that we don't know if gender is an issue.

How do you reconcile that? I need to understand that a little better. Could you help us clarify this, please?

[Dr. Gloria Gutman]

I think the point Lynn was making is that in term of looking at risk factors for the different types of abuse, there has been a tendency to homogenize, to put all those different kinds of abuse together. There may be some types of abuse where men are more vulnerable than women and others where women are more vulnerable. If you moosh it all together, what tends to happen is that it is no longer clear which are the important characteristics. In terms of the amount of abuse that goes on, there is no question that more women are abused than men. I mean--

[Dr. Lynn McDonald]

There are more women.

[Dr. Gloria Gutman]

Because there are more women.

[Dr. Lynn McDonald]

There are more women, so more women are abused. But one thing we do know for a fact from the research is that when women are abused it's far worse than when it happens to men.

[Ed Holder, Conservative, London West, ON]

Do you agree with Ms. Gutman? I'm not trying to start.... I'm just trying to understand. When you say that it's a women's issue—

[Dr. Lynn McDonald]

No, no, I noticed that myself.

[Ed Holder, Conservative, London West, ON]

Yes, you might want to talk a bit--

[Dr. Lynn McDonald]

No, we're on the same team--