Status of Women Committee on May 2nd, 2019

[The Chair, Conservative, Karen Vecchio]

Am I good? Did I say everything fine?

[Terry Duguid, Liberal, Winnipeg South, MB]

Madam Chair, I didn't know whether you were going to recognize Margo Goodhand as being from Winnipeg originally. Her father was my family doctor as well, but I would just commend her book. It's very heartwarming. It tells the story of these very brave and inspiring women, and how they began the shelter movement way back in the early 1970s.

Thank you.

[The Chair, Conservative, Karen Vecchio]

You're welcome.

I'd like to thank you for all the work you did.

We're now going to turn back to our excellent panellists today. Rachael, I'm going to give you the floor for seven minutes.

[Rachael Thomas, Conservative, Lethbridge, AB]

Ms. Brayton, I'm going to start with you. You mentioned medical assistance in dying and your concerns about the lack of palliative care available to those who might choose it rather than medical assistance in dying. You also talked about your concerns that medical assistance in dying is and could in fact become increasingly available to those who have a disability, and that a decision in that regard could even be made by a family member on behalf of an individual. You commented that this speaks to the value of these people who live with a disability, and that society is perhaps not placing the level of value on these individuals that we should.

I'm hoping that you could comment on that a little bit further in terms of women who live with a disability, particularly as they enter into their senior years, and your concerns based on your experiences in the field.

[Bonnie Brayton]

Thank you so much for bringing this back. I really think it's important and appreciate this opportunity very much. I know it's an important discussion for lawmakers because it is a law that I know was passed with concerns and with a real preoccupation going forward for how it would take shape. Indeed, a couple of years in we certainly, in terms of a disability community, know of and are beginning to hear of cases of concern. I'm not going to cite them today because I'm not really prepared to do that, and again, I wanted to bring this forward.

I will say in response to what you're speaking of that the stigma, the devaluation, essentially the isolation, of women with disabilities, particularly senior women, makes them particularly vulnerable. I talked about suicide prevention and how important it is and how rarely we think of that instead of an end-of-life process, and that sort of thing. I think the palliative care issue is one, and I know Dr. Leitch is also here, who knows very well that we have some work to do in our medical system to really improve the care for seniors, particularly at the end of life. That's one of the key ways we can mitigate the risk of somebody being offered medical assistance in dying rather than either palliative care or, indeed, an opportunity to think of something rather than medical assistance in dying as their only option.

I think one of the things that we want to make sure that we do, and again I spoke to this, is the vulnerable persons standard. This is something that's been widely supported by the national disability community and Canadians with disabilities as something that we think would be an important to put in place. I have provided a link in my speaking notes and would invite the chair to share that link with more information for the committee on the vulnerable persons standard. I think the review is next year, 2020, and think that that it would be a good point to look at whether or not the vulnerable persons standard is something that we can actually put in place soon.

I can share, again, not a senior example, but an example of the vulnerability of women with disabilities. In this case I think it's even more compelling because the woman was 24. She was from Newfoundland, a young woman who presented at the hospital with her mother who was in medical distress at the time, but it had not been....

Sorry, I just want to refocus and tell the story properly. She came into the hospital with her mother; she's not a verbal person, so her mother was with her. The physician who received them leaned in to the mother and said, “There's something we can do to help here”, and implied to the mother that medical assistance in dying was something he could offer to her daughter. I'm happy to say that this mother's instinct and reaction was to tell him immediately that she wanted to see another physician, and was referred to another physician. An investigation ensued of this doctor. I want to say this about this young woman and make the point why the medical assistance in dying issue is so important. My point is that a year later she was placed in a supportive living environment, and that's where she is to this day and, of course, she's thriving now.

My past president was in an induced coma due to pneumonia, again an older woman with a disability, and when she came out of the coma—and some of you may have actually met Ms. Hutchison when she was our president—the first thing that happened was the nurse leaned in and began implying to her that she might want to consider medical assistance in dying.

What I'm trying to say is that it's not a perfect system and that it's very important we understand that one of the things we have to accept is that there are going to be risks and that our duty is to reduce those risks at this point, because the legislation is in place.

Thank you so much for letting me bring that forward. I appreciate it very much.

[Rachael Thomas, Conservative, Lethbridge, AB]

Can you go into that a bit further? Having expressed your concerns about medical assistance in dying, the alternative then would be offering an adequate palliative care system or....

[Bonnie Brayton]

Quality of life.

[Rachael Thomas, Conservative, Lethbridge, AB]

Quality of life, exactly.

Can you talk about what could be done, particularly at the federal level, to make sure there is greater accessibility to this for these women? And, of course, with that comes overall quality of life and a higher living standard.

What would it look like if we as a society were to embrace that to a greater extent?

[Bonnie Brayton]

I think one thing we heard an awful lot about already from that other panellists is the issue of poverty. The economic situation of older women, particularly older women with disabilities, is something you need to address at a national, provincial, territorial and local level. As a society we need to address income inequality, writ large. I think that's probably one of the first things I would say.

I think we need to understand that we need to begin to address the caregiving issue in this country. It's a critical issue, both on the giving and receiving end. It's critical to understand that the level of stress on families of caregiving is one thing that's not being addressed.

In terms of the overall question, though, I think it would probably require another hour for me to get into all of the different issues we have around social inequality of women and girls with disabilities. But fundamentally the social determinants of health are something that all Canadians are entitled to, and sadly, many Canadians, including women with disabilities, do not have that.

I will remind this panel that as of November 2018, the new statistic for women with disabilities in Canada is 24%. So 24% of women in Canada live with a disability. The idea that we do not and have not inserted disability into every single social and economic policy speaks to the fact that we have yet to really achieve equality for all Canadians.

[Rachel Harder]

I'm done.

[The Chair, Conservative, Karen Vecchio]

I want to add one thing. We have shown that on April 11 the document you submitted was circulated. We just wanted to clarify that for you as well.

I'm going to pass the floor over to Wayne Stetski now.

Wayne, you have seven minutes.

[Wayne Stetski, NDP, Kootenay—Columbia, BC]

I would like to thank you for being here today on this very important issue.

From my perspective personally and from my party's perspective, we need a national seniors strategy that will incorporate many of the aspects we're talking about today. I really do see that as the way forward.

I want to start, though, with Ms. Majowski on prevention of elder abuse, which does relate to a national seniors strategy.

A couple of months ago I attended a training session in Cranbrook on recognizing and dealing with elder abuse. I'm from Kootenay—Columbia in southeastern B.C. At the end of that, I asked the group a question. We have legislation that protects many aspects of Canada, including children and pets, and so I have to raise the question of whether there should be legislation protecting seniors.

I'm interested in whether you have thought about that and what your view is on it.

[Kathy Majowski]

Absolutely. Thank you so much.

It's very difficult to paint it as a black and white issue. My day job is working front-line in community health care as a nurse. I've come across situations on many occasions where we suspect and are almost sure there is been abuse, but the individual who is being abused, or potentially being abused, remains cognitively intact and autonomous, so we have limitations.

When we talk about potentially having a seniors strategy for abuse prevention or abuse reporting, we need to be very careful, because there is that really fine balance of autonomy versus somebody else stepping in and making decisions.

It's a little more cut and dried when we have individuals who are more vulnerable, who have cognitive concerns or cognitive impairments. It becomes also a little easier with some of the legislation around the Protection for Persons in Care Act, in particular in Manitoba.

As a health care professional, when I suspect something is happening in a facility in regard to abuse, I have a duty. I have an absolute duty to report. But when it comes to community settings, it becomes much greyer and much less clear.

I would support a standard or a standard communication about what are the roles of individuals who come across these situations. What can you do? This is part of what our organization does. We provide resources on our website for local, provincial and territorial organizations and the kinds of things they do, because, unfortunately, there is no standard across the country. Each province and territory has slightly different things they do and they recommend, and slightly different kinds of resources available.

In my opinion, speaking for the CNPEA, we would like to see more standards across Canada so that the people who are living in Nova Scotia have access to the same services and supports as the people living in British Columbia.

[Wayne Stetski, NDP, Kootenay—Columbia, BC]

Would legislation help with that, do you think?

[Kathy Majowski]

I would hope so. I believe that standardization has to come from a higher level. Provinces and territories are most definitely free to do what they feel is right and to fund programs that they feel are important, but some direction from the federal government would go a long way, I believe, towards standardizing these types of programs, resources and services, which need to be considered mandatory for our older adults.

[Wayne Stetski, NDP, Kootenay—Columbia, BC]

Okay. I'll turn to Ms. Ryan for a minute but will start by recognizing that I come from the unceded territory of the Ktunaxa, Shuswap, Okanagan and Sinixt first nations in southeastern British Columbia.

We often hear of the differences between on-reserve and off-reserve living and life for indigenous people. Could you share with us whether there's a difference for seniors as well?

[Chaneesa Ryan]

Certainly there is.

Before answering any other questions, I want to use this as an opportunity to point out something that I didn't get to in my speech. There is a complete lack of data on indigenous seniors and aging, and the data that does exist is often not disaggregated. While I am going to attempt, then, to answer your question, much of it will be based on anecdotal evidence.

At the same time, I know now that 52% of indigenous seniors are living off reserve. That's important to consider as well, when we talk about the need for services on reserve. While this need is certainly there, we need culturally safe supports—gender-based supports and trauma-informed supports—in cities as well, knowing now that over half of the indigenous senior population lives off reserve.

I don't know, Roseann, whether you want to add anything to that.

[Roseann Martin]

No.

[Chaneesa Ryan]

Could you just ask the question again?

[Wayne Stetski, NDP, Kootenay—Columbia, BC]

I'm wondering whether there is a difference for indigenous seniors living on reserve versus off reserve in terms of supports. You mentioned, for example, that there are very few seniors' homes on reserve, so basically you're forced to live off reserve. I'm wondering whether there are other differences and challenges as well.

[Chaneesa Ryan]

Yes. While there may be more access to home care supports or long-term care supports off reserve, there is still a lack of access to culturally safe supports. We had an engagement session recently with seniors living in Ottawa who pointed out their experiences of racism in the health care system within long-term care and of not feeling comfortable—not being able to smudge in hospitals and many long-term care centres, for example. Even though they have access to services, this lack of cultural safety within those services is still really an issue. While there may be greater access off reserve in one sense, it's still not necessarily meeting indigenous seniors' needs from a holistic standpoint.

[Wayne Stetski, NDP, Kootenay—Columbia, BC]

You released a statement on April 29 announcing the release of—

[The Chair, Conservative, Karen Vecchio]

Wayne, you have 20 seconds left.

[Wayne Stetski, NDP, Kootenay—Columbia, BC]

—employees as a result of a lack of core funding. What would you like to see from the federal government around securing your future?

[Chaneesa Ryan]

With regard to seniors, we currently have no funding. We've applied to ESDC's new horizons program and have recently applied to the Public Health Agency's dementia community investment fund. However, I would really like to see an investment in the aging indigenous population, specifically with a gender-based focus, given that indigenous women are living longer than men and that there are gender-specific needs. I would really like to see a dedicated effort to this area. As well, I would like to see indigenous organizations be involved in the decision making about what funds will become available and how they may be used.