Status of Women Committee on April 30th, 2019

[Michael Udy]

No, and it's more complicated in Quebec, because you have to operate in two languages. It's interesting that you asked this question. At the moment we're working on preparing an entire-day conference on this very subject. Recently we had a brief presentation on just the programs—the revenue programs and the deduction options that are available for seniors and that are available for caregivers—and it's much more complicated than I ever realized. People really do need their hands held, to some extent, just to understand what's available and how to access it. Very definitely there's a need to sensitize both the providers of those programs but also those in the community who want to provide assistance to seniors. It's pretty hard to provide assistance if you don't understand it yourself. There's a definite need for that.

[Rachel Bendayan, Liberal, Outremont, QC]

I don't know whether you have anything to add, but I was just going to ask whether, in your one-day conference or in other programs in which you try to sensitize older people to government assistance, there are accountants or other financial professionals to do that kind of work with you—the hand-holding you mentioned.

[Michael Udy]

In brief, in the preparation for the conference, yes, there will be experts who will provide that help, but I think you're talking about what happens after that. That's harder to organize. Community organizations in Quebec play a pretty big role in the English-speaking community, but they need to access these kinds of expertise.

[Rachel Bendayan, Liberal, Outremont, QC]

Ms. Tsotsos, do you have anything that you want to add?

[Dr. Lia Tsotsos]

I think the point about navigating the system is really an important issue that we see very frequently. People may know little bits and parts of it, but the systems that connect all the different services and all the different things that one might need to consider is the challenge. How do you match and integrate across all of the different providers? Supporting them—the hand-holding, helping people better understand what the whole system looks like and what all the parts are and what things they can access—is one challenge.

We've seen it in community-based events we've been involved in or have hosted as well. There's a lot of informal sharing of that kind of experience. For example, how did you get through the application process to receive home care? What was it that made the difference and led people to finally understand that you needed support and weren't just relegated to a year-long waiting list? Everything that Michael said, I agree with completely.

[Rachel Bendayan, Liberal, Outremont, QC]

I note that between 2005 and 2015, the number of senior women in the workforce actually doubled. I wonder if you've seen, over that period of time or recently, a kind of new economic empowerment among senior women and how that impacts their lives.

We know about the wage disparity for senior women in particular. That's a real issue, but at least in my community, I see that this type of economic empowerment also has a very positive effect on the social well-being of senior women. They really feel as though they're contributing again to society, and it also gives them a social network. I wonder what your experience is with senior women in the workforce.

[Dr. Lia Tsotsos]

I could say something on that.

[Vanessa Herrick]

I think all of the things you're saying are absolutely true. I think in many cases it's really empowering for women. It helps them feel more engaged with society. It helps them have access to other people and to make new friends and new connections. As was mentioned, it also helps with that informal information sharing. They get to speak to people who can help them navigate whatever they're facing in their lives.

I do think, though, that some of it is out of necessity. Some of it is out of the fact that 50% of them are living on under $20,000 a year and don't have a choice. So while I think on one hand it can be very empowering and a very positive thing, I think we also have to be aware and have to look at that doubling of women in the workforce later in life as maybe a bit of a flag and we should be making sure that they have enough. Are they working because they want to, or are they working because they absolutely have to, and is that maybe a risk to their health or...? It does bring up some other questions.

[Dr. Lia Tsotsos]

We finished a study about senior entrepreneurship, and all of the factors that Vanessa just mentioned came up as well. People sometimes undertook starting a small business or some kind of a side gig very much out of necessity, or they just needed that additional engagement for one reason or another. But then they were finding a mismatch between wanting to engage in the entrepreneurial pathway and finding that programs were available exclusively to youth under the age of 30. There was this sort of balancing act between their wanting to engage or their needing to engage and then not having those supports available for their age group or for what they were trying to accomplish. That was something we saw in some entrepreneurship work we did as well. All of those factors came out in that discourse, too.

[Rachel Bendayan, Liberal, Outremont, QC]

That's very interesting.

The points you raised lead me to ask—

[The Chair, Conservative, Karen Vecchio]

You have time for a very short question.

[Rachel Bendayan, Liberal, Outremont, QC]

—whether there are any niche areas in which the federal government could play a bigger role. You mentioned senior entrepreneurship. Are there one or two others that come to mind that you'd like to raise before the committee?

[Vanessa Herrick]

I just think it's really important to echo the point made that we have some fantastic programs in place to support youth who are trying to develop and do things, yet I see a real lack of that kind of support and service for senior women who would like to go out and start their own business, or who have particular skills that could be developed. That could allow them not only to have more income but also to engage better with society on their own terms, with which they might be more comfortable.

[The Chair, Conservative, Karen Vecchio]

Okay. That's excellent. Thank you very much.

We're now going to start our five-minute round, and I'm going to pass the floor over to Kellie Leitch.

Kellie, you have five minutes.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Thank you very much.

Thank you all for taking the time to come in to present to us.

I am a practising physician, but on the other end of the spectrum. I have pediatric patients, but they frequently show up with their grandparents, so I hear about their issues as well.

All of you have mentioned health concerns, particularly you, Vanessa. You told a story, and I will say that I have heard those stories as well. I think many seniors really are at risk because of their lack of ability to communicate. We, as physicians, have a tendency to speak in a different language that seniors don't speak. Quite frankly, I don't think many Canadians speak it.

I believe there should be some degree of accountability for health care, whether it be through the federal government through the Canada Health Act, or through the provincial governments, which, because of that act, have taken on a responsibility for providing health care. They state that others should not be allowed to do that, but that doesn't provide for patients. It has become very bureaucratic.

Could you give me a sense of what you think that accountability to patients really is for seniors? What accountability should the Government of Canada and the governments in the provinces have to seniors? They've taken on the responsibility for care, so how should they be accountable for providing patients good care when they've taken on that responsibility?

[Michael Udy]

This is not the main answer to your question, but I'm reminded of an incident that happened with my mother when she was about 78 or so. I had met her family doctor, and I agreed with her that he didn't seem that interested in her. She simply called him on it one day when she saw that he wasn't listening. She said, “I can see you're not that interested, so I think I'll just go.” That got his attention.

Empowering people to ask questions and to know what they want to know and to receive the kind of attention they want to receive is an important part of it.

The other part of my answer is related to the fact that not just seniors but so many Canadians, and so many Quebecers, in particular, don't have access to a family physician, period, no matter what their age. If we can address that, then I think we can address, among other things, some of the needs of seniors in that process.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

I agree. There are upwards of five million Canadians who don't have access to a family physician. In addition to family physicians, what do you think are some of those other issues about accountability to patients that we should be addressing? One is family physicians. Another, some people say, is wait times, which I'm sure seniors are experiencing. I have seniors who come in and ask me about hip replacements, where they have to wait 24 months.

What should be part of that patient accountability? Do you have other thoughts on that?

[Vanessa Herrick]

I think that physicians in Canada face a lot of challenges. I think governments are doing what they can in many ways to support them. I want to echo what Michael said earlier around some of the work that we're doing. I think it is really important for the government to help advocates to educate seniors to make sure that they.... Often, time is wasted in the medical system because they don't know what questions to ask. They end up in the emergency room, which is really not where they need to be. I think more work needs to be done on empowering and encouraging seniors to really try to ensure that they are an active part of their own personal health care. That's probably not happening as much as I think it could.

[Michael Udy]

Do I have time to add something?

[The Chair, Conservative, Karen Vecchio]

Yes, you have a minute and a half.

[Michael Udy]

I think there needs to be a particular focus on medication. Getting older means taking more medication—not for absolutely everybody, but in general it does. I watched my parents experience that. I've experienced that myself. I take things now that I didn't take when I was 25 years old.

I saw with both of my parents this growing pharmacy in front of them, which was not understood by any one person because pieces of it were contributed by different health professionals. No one actually had the overview. I don't know how, in medicine, one can get a hold on that, but I really do think it needs to be gotten hold of.

[Kellie Leitch, Conservative, Simcoe—Grey, ON]

Dr. Tsotsos, do you have any comments from abroad?

[Dr. Lia Tsotsos]

I agree with everything that both Vanessa and Michael said.

Speaking about accountability, the other piece of it might be education for all the health care providers right from the start. “That happens with age” may not be an appropriate response to any patient's concern. Integrate more geriatric training into all levels of health care, whether that's the physiotherapists or social service workers or the physicians themselves. It's recognizing that just because most people will develop a level of hearing impairment doesn't mean that should just be brushed off because they're getting older and they can't hear as well.

Integrating a level of education and understanding of how to prevent more serious chronic conditions from the start may help with the accountability process later on down the pathway if the answer that we revert to is not, “Well, that just happens” or “ You're getting older.” With that patient empowerment, those two together may help prevent a lot of more serious adverse outcomes.

[The Chair, Conservative, Karen Vecchio]

Excellent. Thank you very much.

We're now going to move over to Eva.

Eva, you have the last five minutes.

[Eva Nassif, Liberal, Vimy, QC]

Thank you, Madam Chair.

My thanks to the witnesses for their presentations.

I am the member for Vimy, in Laval, where a quarter of the population are seniors. In another life, I was a nurse. So I know how things are for our seniors, especially in a riding like mine where there are many cultural communities. I would like to mention that Ville de Laval has been providing free public transit to seniors since 2014. Laval also has the new Agape's English-speaking Seniors' Wellness Centre, which opened last year. I had the pleasure of visiting it. Those involved are doing an incredible job in the English-speaking community, whether in terms of culture, health care, conferences, and so on. It is an incredible centre focused on the English-speaking community; there are many communities in Vimy.

I know that health care services fall under provincial jurisdiction, but I would like to know what our government could do in addition to the new horizons for seniors program, which has already been mentioned by several of my colleagues. It is actually an incredible program that provides many grants, especially in my riding, downtown Laval. We can certainly improve our engagement with seniors, especially women.

What can we do at the federal level, even though the matter is in provincial jurisdiction?

I'll start with you, Ms. Tsotsos.