Status of Women Committee on Nov. 1st, 2011

[Judy Sgro, Liberal, York West, ON]

Thank you very much.

Ms. Wahl, on the issue of abuse amongst the elderly, you referred to those in hospital being charged a per diem. Could you elaborate a bit on that? I'm hearing that a lot in my particular area.

[Judith A. Wahl]

I'm going to talk about the Ontario situation, but it's comparable in other provinces. I don't know the details on other provinces. So the senior goes into hospital with an acute episode. She's at the hospital and has now gone through the acute episode. Now she's ready to leave the acute care but she can't go back home, because there isn't sufficient home care to meet her continuing needs.

The hospital under the Ontario health insurance can charge a per diem, but that per diem is limited to $53 a day, approximately, with rate reductions. Most hospital policies say if you don't take the first available bed in any home for long-term care anywhere, usually within 200 kilometres, you may be charged between $600 and $1,800 a day. That charge is illegal under OHIP. You can only charge the $53, and seniors have the right of choice. They can choose up to five homes offering long-term care. They do not have to put on their list of choices places that the hospital is directing them to. Often the hospitals will say they must choose from a short waiting list.

Please understand, I'm not naive. We encourage people to look closely at all the different alternatives, but this illustrates, first, that we don't have the home care supports for some of these people at home, and second, that we are ending up telling people they have to go 200 kilometres away from their home base, away from family and friends. This is to me systemic abuse.

[Judy Sgro, Liberal, York West, ON]

I've had several constituents come in to my office. I'm an Ontario MP. I've had to contact the hospital and at that point they have backed away from charging. But these people knew enough to come to me. I've had to put out some outreach so people know that you can't just let the hospital do that. I think they're now backing off that hospital policy because of what I did.

You mentioned 43% violence against caregivers, Dr. Armstrong. Would you elaborate a bit more on that?

[Prof. Hugh Armstrong]

We asked a question similar to what had been asked in the Nordic countries--namely, have you experienced physical violence from a resident or a resident's relative, and how often? The highest answer was daily or almost daily. The next answer was weekly. The next was monthly. It was seldom never. The 43% is daily or almost daily.

[Judy Sgro, Liberal, York West, ON]

Do we have something that oversees the caregiver? We're talking about elder abuse and it works both ways. I've seen that happen too.

Frankly, other than the Labour Code, when it comes to a caregiver there really isn't anything that helps to go in and work between some of these people who are having these issues; there's no go-between who's going to go in and try to settle these things.

[Prof. Hugh Armstrong]

I think that's quite accurate. One of the difficulties is that the workers are reluctant to report, for a number of reasons—the paperwork, the blame that gets assigned to them, a desire to protect the residents, and a culture that suggests that this is normal, that if you sign up as a PSW in long-term, you're going to get bitten, scratched, punched, or whatever.

[Judith A. Wahl]

I can tell you that in the Ontario legislation, there are supports for the workers, but I totally agree with Dr. Armstrong that they can't really use it. The legislation provides for supports for them; it's just not implemented because of the culture.

[Judy Sgro, Liberal, York West, ON]

But in both ways, it can be a difficult relationship--for both people.

[Prof. Hugh Armstrong]

Yes.

[Judy Sgro, Liberal, York West, ON]

Thank you.

[The Chair, NDP, Niki Ashton]

Thank you.

We'll now move on to Ms. Truppe.

[Susan Truppe, Conservative, London North Centre, ON]

Thank you, Madam Chair.

My thanks to Mr. Armstrong and Ms. Wahl for attending. I have a couple of questions here.

In 2008 we launched the federal elder abuse initiative, a successful, $13-million, multi-departmental, three-year initiative to help seniors and others recognize the signs and symptoms of elder abuse and provide information on available supports. This has gone to great lengths to raise awareness of elder abuse across Canada.

Can either of you explain the impact of awareness campaigns concerning reporting elder abuse crime?

[Prof. Hugh Armstrong]

I'll take the first run at it.

Until a year ago, I was on the board of the Council on Aging of Ottawa, joined by, among others, Vern White, the chief of police in town. At the initiative of the council, we established an elder abuse network that involved the police and a number of agencies.

I think it works well. It has had some public money. I'm not sure, but I think it was Ontario money rather than federal money. In a sense, that doesn't matter much.

One of its difficulties for it is a difficulty so many social agencies face. I teach in a school of social work, and some of my students tell me about this all the time. Much of the money comes in on a project basis rather than as core funding. The agencies, including the elder abuse network in Ottawa, spend so much of their time justifying their existence, writing grant proposals, sending in interim and final reports, hoping they get the next one, and worrying about whether they have to lay off staff because they haven't heard yet.

This is incredibly inefficient. It's what the economists sometimes call “transaction” costs, but it's also a human cost for the people who work in this sector and who receive services from it.

So I welcome initiatives of the sort you describe. It is all too often a hidden issue. Judith and her colleagues occasionally find out about it—or MPs find out about it—because somebody happens to know a number to phone. A lot of it is hidden. It's partly a cultural thing; we have to bring it out into the open and make sure that it's not a matter of stigma. We also need more secure, stable places where people can go.

[Susan Truppe, Conservative, London North Centre, ON]

Sorry, I only have five minutes, and I'm trying to get in a couple of questions.

Regarding the $13 million that we spent, you said it works well, but you feel, based on your comments, that there could be more awareness raised.

[Prof. Hugh Armstrong]

I'm sure there could be more awareness. I wish that kinds of funding were somehow more stable, more regularized.

[Susan Truppe, Conservative, London North Centre, ON]

Okay. Thank you.

[Judith A. Wahl]

My problem with the awareness campaign is that it has raised some awareness, but it's more focused on having others report somewhere rather than helping seniors and supporting seniors to reach out to get the support.

So it's not what I'm going to call the “talk to the senior” program, and I think that's where the next round of things needs to focus more on rather than concentrating on others reporting it to someplace where.... That's not going to help the senior, in the way it is, because some of those people doing the reports are, in fact, the people who need to be doing the helping. They're not talking to the seniors.

I encourage the federal government to shift the focus, to be more senior-focused rather than portraying seniors as all vulnerable and unable. Most of my clients out there are capable, able seniors, and they are vulnerable, but not in the way that's portrayed in some of the awareness campaigns, as being incapable or unable to speak up. We need the supports for them to speak up.

[Susan Truppe, Conservative, London North Centre, ON]

Thank you.

With all the different funding we've been providing to help combat elder abuse, we hear from you and some of our other witnesses that everybody wants money to help with the problems. We're also looking at other options that could be done from the ground up, from a grassroots level.

Does anyone have suggestions on what else we could do as a federal government, in addition to the funding?

[Judith A. Wahl]

I personally want, as I mentioned in the proposal I'm making to you about amending the bill that's amending PIPEDA, to really look at how these players can better support the seniors and get them, as the customers or victims, to be heard more. Instead of the banks reporting off to the family, how do the banks deal with their customer service? How are they helping the individual seniors?

My own mother was told that if she didn't do a banking power of attorney, the government was going to get all of her money. Well, that's not true in law; I know that.

[The Chair, NDP, Niki Ashton]

Thank you.

We'll wrap it up there. We have two minutes left for Ms. Freeman.

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

Thank you, Chair.

Thank you so much, Professor Armstrong and Ms. Wahl, for coming.

I would like to hear from Professor Armstrong. Am I right to think that you said standardizing and equalizing seniors health care will positively affect the reality of senior abuse?

[Prof. Hugh Armstrong]

I'm not sure I said exactly that, but I would certainly sympathize with that as a perspective.

One of the problems with long-term residential care is that it's below the radar. It's below the radar in part because it's not part of what we call medicare--the things that are covered under the Canada Health Act.

So I would welcome minimal national standards in this field. As to how to achieve them, I'll leave that to you politicians. I know there are federal-provincial-territorial issues involved.

I think more federal leadership to provide more recognition, less stigma, and less a sense of failure in long-term residential care would be most welcome.

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

Thank you.

Could you also briefly elaborate on how funding is being cut in social sciences, and how there is virtually no research being done on long-term care facilities?

[Prof. Hugh Armstrong]

Well, I won't say there isn't any being done. Some researchers are creative enough to have a proposal accepted for consideration by SSHRC, despite the fact that it's really about health care, because they call it something else.

I know that CIHR, the other more prosperous funding agency, does support some social science in this field. It's a matter of how much. I know from my colleagues who work in studying health care that there are enormous frustrations at having to go to CIHR.

I should say that this survey we conducted was with CIHR money, so it's not that it never happens; it's just that there are more roadblocks for social scientists and humanities scholars.

[The Chair, NDP, Niki Ashton]

Thank you very much.

That wraps up our time.

I'd like to very much thank Dr. Armstrong and Ms. Wahl for joining us here today.

We'll break for a few minutes and then be back to carry on our discussion.

Thank you.

[Proceedings continue in camera]