Status of Women Committee on May 30th, 2017

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

I want to start with AFEAS, who is on the phone right now. You talked about making refundable tax credits from the non-refundable. Can you give me a brief summary of what those tax credits are, if there are any now, or things that you think should be implemented?

[Hélène Cornellier]

I don't have that information on hand, but I could send it to you by email.

We worked with an economist here, in Quebec. She analyzed the Quebec and federal tax credits to determine which of them could be transformed.

I could send the clerk that information by email.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Perfect. I really do appreciate that.

I want to move over to Caregivers Nova Scotia. I really do appreciate all you have put in today. Thank you very much.

The thing is that we do have a lot of common ground, but some of the things we're looking at may be a little different. This actually is for both Tamara and the caregivers association. When we talk about it, we talk about the roles of families. It is really important that we find the common ground here. We're not always going to agree on everything, but let's find the common ground.

One of the first things I want to find out is where that line is in the grey zone when we talk about the difference between family responsibility and the role of the state. We can say that the government should be paying for our children to go to child care and should be paying for everything when it comes to families putting family members into seniors homes. Then we talk about housecleaning and maintenance as well. I recognize that sometimes those are additional services. I guess part of my issue is when it becomes the responsibility of a person versus the responsibility of the state. Could you define that? We just need to have that broader discussion, please.

[Angus Campbell]

I'll go first, if I may.

I'd like to back it up a little and state that caregivers are not assessed, so when a continuing care coordinator goes into the home to assess the care recipient as to what the needs are, the caregivers are the invisible half of the dyad. Nobody currently asks them if they are willing, if they are capable—

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

I'm just going to put in here that when it comes to my mom, when it comes to my children, there are people who feel that is their responsibility and so they may not be asked, but there is.... I know somebody said it's not natural to be that caregiver, but for some people it is. I'll be honest. I happen to be one of those, so that's why I just want to find.... It's really important. We recognize that everybody has different opinions, and I appreciate that, but when does it become the role of the state versus a member of a family?

For me, taking care of my mom is my responsibility. Taking care of my children, whether I put them into child care or whatever it may be, is my responsibility. We have to recognize that people have different visions of what the responsibilities are of the family. If we can go back on that, caregivers are not assessed but sometimes, based on the culture of the family, they truly are, and we'll see that whether it's my family or families from across the world. Sometimes people do feel those responsibilities, so the responsibility versus willingness is definitely a good debate.

[Angus Campbell]

It's also capacity. Everybody at our organization is or has been a caregiver, so we've all felt that responsibility and stepped up to the plate.

I'm just going to leave it there for now and let the other person to whom you posed the question answer.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Excellent, thank you.

[Dr. Tamara Daly]

This is a question about shared risk and also about how we live together in a community. For instance, if somebody has a catastrophic illness, something like dementia, at what point does the state take responsibility for that illness? I would say that when we're pulling people out of gainful, paid employment, that poses risks for their own ability to contribute to their pension plans and to save for their own retirement. We are actually putting greater financial burdens and risks on women and on their futures, because it is particularly women who are taking on these roles.

In Denmark, for instance, in a generation, they have made care a shared responsibility between men and women by making both men and women equally responsible and able to enjoy both the benefit and the cost of popping out of the labour force.

In addition to that, when we talk about care for seniors, we need to think about the fact that it's not just health care; it's actually social care. The federal government did play a very large role in funding community support services for a very long period of time. These are small grassroots agencies that were providing things like transportation, Meals on Wheels, friendly visiting, and those types of supports, but that support has slowly declined over the course of the past 15 years. In provinces like Ontario there is more and more of an emphasis on these small organizations providing health care services, as opposed to the types of social and emotional supports that they were intended to provide.

If we want to live together in Canada as a community, then we need to share some of these responsibilities.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Tamara, thank you very much. I think you hit it exactly. That's what we have to look at.

We're taking somebody who is now personally jeopardizing their income. I think that shared risk is a good way of looking at it when we talk about unpaid work.

I think some of the times it's choice, and sometimes making sure that the state is available. We do recognize, and I see it a lot in my community, that there are not people there to assist. It may be a man and woman who do not have children. What happens? Is it going to be the VON, the Victorian Order of Nurses, or is it going to be the Golden K that takes them to transportation sites? Thank you very much. When we talk about that, I think we have to understand the risk.

Now, what happens when it's a choice?

Tamara, I'm going to go back to you, if you don't mind.

With a person who was not employed, when do we look at it as they had not been employed, that they had always chosen to take care of their children and family first. What do we do there? Where do we find that balance between the difference of somebody taking leave from work and somebody choosing to do that role the entire time? Is there a balance there?

[Dr. Tamara Daly]

I'm not sure that I'm comfortable with the word “choice” here, because I think for single mothers or women who are living in poverty, it isn't necessarily a choice. I think they feel like they're in a situation and the circumstances are dictating it, rather than it being a real choice about whether to participate in gainful employment or not. I think we have to be careful about using “choice”.

I'd also caution you to not think about the VON and these other organizations in the third sector as having the capacity to do this alone. When I say that the federal government and other levels of government provided a lot of support to these organizations, it's really what allows these organizations to do what they do.

We can't just assume that the third sector is going to take on these roles and responsibilities. We can't assume that families have the capacity to do it. Not everybody has strong family connections, or even family to rely on. We always need to think about outliers, and we need to think about how some issues are not really about choice, that they're about circumstance.

[Karen Vecchio, Conservative, Elgin—Middlesex—London, ON]

Thank you so much.

[The Chair, Conservative, Marilyn Gladu]

That's your time.

We're going to Ms. Malcolmson, for seven minutes.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Thank you, Chair.

Thank you to all three witness groups. It's extremely helpful and very powerful.

Professor Daly, in one of your academic publications you described the care gap created by a lack of public funding for seniors, particularly seniors homes. We have a conversation happening right now around infrastructure investment, and it sometimes defaults to the traditional infrastructure, such as highways, as opposed to social infrastructure, such as health care.

I'm hoping you can talk about the neglect to invest in that physical social infrastructure and how that might affect female family members who often, by default, provide that unpaid care.

[Dr. Tamara Daly]

I'm considering a lot of things in talking about this.

One of the first things that we need to understand is that the nursing home today is not the nursing home of 15 years ago, which provided an awful lot of social care, and was there for the frail elderly, mostly people who were quite old and needed some medical support. The nursing home of today is really an alternate for hospital care, so you have people going there who would have been in hospital 15 years ago. We find an increasing medical complexity, people going into nursing homes at the very end of their lives. That's in Canada. That's not necessarily the case in the Nordic countries or the rest of Europe where nursing homes are there to do more social care.

When I talk about the care gap, I'm talking about the gap between the care we are able to provide with public funding and how it's filled. It's filled with families in nursing homes, with student work, with the work of volunteers, or we're expecting the paid staff to volunteer their own time so they're working overtime. Also, families are hiring privately paid companions. They're paying out-of-pocket to have private care in publicly funded nursing homes. These care workers are doing work that's identical to that of the paid staff, so it's creating tons and tons of risks for the staff, for residents, and for families.

Families are also finding that they are under incredible pressure and burden. Maybe mom has become a bit aggressive with her dementia and the nursing home is saying they can't keep their mom there unless they pay to have someone to watch her around the clock.

Families are facing these sorts of burdens and it's an increasing and incredibly difficult challenge and it creates difficulties all the way round.

If we think about the role of the federal government, the Romanow commission talked about home care, and they didn't talk about nursing homes at all. Nursing homes are practically invisible. These are extended health services, so as you know, the federal government sends money to the provinces and they don't necessarily look at how much the provinces are funding nursing home care.

If the federal government wants to make a big impact, they should be thinking not only about home care, but also about nursing home care. While it is true that people want to remain at home, that's if they have a good home to remain in, and that's if they have sufficient supports to keep them in that home—community supports like Meals on Wheels and transportation, and help with their housing. Some people have no choice but to get round-the-clock nursing care, and they really do need nursing homes. I think by not concentrating on this need, we're neglecting the over 200,000 people who are using these services every year. By understaffing in this area, we're also putting great risks and burdens on the women who mostly provide this work.

[Sheila Malcolmson, NDP, Nanaimo—Ladysmith, BC]

Thank you so much.

Caregivers Nova Scotia, the very powerful personal stories that you told really do help amplify why we're doing this study. I'm very much reminded of a meeting just two weeks ago in my own riding with the Nanaimo Family Life Association. They are just being hammered by having invited community calls for support through their seniors connect project. They're funded for 100 places, and they're looking after 400 people who are isolated seniors in poverty with no public transit. Many of these people spent their lives working in low-paid care jobs and are now having a very hard time getting by.

I want to focus on the NGO side of things, because the Nanaimo Family Life Association described the hoops they jump through to try to find program funding. I note your acknowledgement within your website around the operational funding that your group receives.

Could you talk about how important operational funding is for organizations like yours to be able to fill the gap and support women in poverty?

[Angus Campbell]

Absolutely.

We receive operational funding every year. I was just with the Nova Scotia Department of Health and Wellness yesterday asking for additional funds. Our numbers have increased about 15-fold in the last three and a half years. We have well over 4,600 members in our database. We need that operational funding for consistency such that we're able to hold 21 monthly support groups around the province, as well as using some innovation where we're doing it now. We also have a teleconference base for people who do not have access to transportation or have other reasons that they can't attend in-person support groups.

We offer some educational workshops on everything from caregiver stress management to safer medications, oral care, and advance care planning. Those are just some that we're offering now, but we have more in the works. We need to have that continuity where I can have the same staff staying in their places doing their jobs. It takes between six months and a year for someone to get up to full speed. The project funding is nice when we are able to get it to do a specific project, but it really is the operational funding that we need.

Part of that operational funding, and unfortunately, we don't have it right now—it's one of our recommendations—is to continue to publish hard copies of resources. I can't state that one enough, although many people think it's a simple thing to have a little booklet. There is a 94-page caregiver's handbook that people can sit down with when their caring day may end at about 10 p.m. They can actually sit and read through some of this or keep going back to where it supports them; it helps them get started on things and continue on with their care responsibilities. Personally, I feel that the caregiver's handbook is worth $4 and that we should be funding this. Whether it comes from the federal government or the provincial government, it's something that I come back to.

So operational funding—

[The Chair, Conservative, Marilyn Gladu]

Very good. That's your time.

Mr. Serré, go ahead for seven minutes.

[Marc Serré, Liberal, Nickel Belt, ON]

Thank you, Madam Chair.

I will share my last two minutes with Ms. Ludwig.

I would like to begin by thanking the three witness groups for the work they are doing in this area. I also thank them for preparing and making their presentations before this committee.

For the first time in Ottawa, the Parliament of Canada passed a motion on creating a national seniors strategy. That was two weeks ago. Your testimony is very relevant to unpaid caregivers' work. This is an important issue.

My first question is for Ms. Cornellier.

You talked about Statistics Canada in your recommendations. Our government has reinstated Statistics Canada's long-form census. As we often hear people say that data is lacking, I would like you to tell us whether you think any specific information that would be useful to your organization and the entire field should be collected.

[Hélène Cornellier]

In the issue that concerns us—the recognition of unpaid work—it would mainly be a matter of information provided in response to the question on household activities. We are talking about time dedicated to children or to a loved one in need. So it also has to do with the work of caregivers.

Of course, there were also questions on volunteering, which is another form of unpaid work. In addition, there were subquestions on the time spent on housekeeping or directly dedicated to children, persons in need, and so on.

In every census, that data allows us to provide an overview of unpaid work. That is not necessarily the most complete overview, as Statistics Canada says, but it does give us an idea of what is happening in Canada. As a result, those who have to fill out the long-form census—20% of the population—can acknowledge the work they do at home for their loved ones.

According to Statistics Canada, the best tool would be the General Social Survey on Time Use. Statistics Canada conducted one of those surveys in 2015. As the case was in 1992, we want the survey to be used to show the value of that unpaid work done by Canadians in the gross domestic product. That way, everything Canadians do would become visible.

[Marc Serré, Liberal, Nickel Belt, ON]

Okay, thank you.

As I don't have a lot of time, I will ask my second question.

Ms. Daly, thank you for the work you do as a research chair. I'd love to get your thoughts on how to get more women as research chairs in universities across Ontario. Perhaps you could submit that separately later on.

I want to focus today more on the dementia side, as personally my mom's taking care of my dad right now at home. From your experience on the research side and best practices, you indicated home care. We as the federal government are working with the provinces to establish more best practices. You mentioned nursing homes. Do you have specific recommendations on best practices that we could look at as we're developing a national strategy for seniors?

[Dr. Tamara Daly]

We tend to think in terms of promising practices, and around dementia care one of the things that works quite well is day programs, but along with day programs, you need to think about some of the infrastructure that's required, such as transportation to get people to and from those day programs. You can imagine, particularly as people age, that their partner may no longer be capable of helping them into a car or getting them out of the house. When we talk about care work, there are a lot of very physical aspects to care work that can't be forgotten. An older person may no longer be capable of driving themselves.

There is also an issue with the cost of these programs. While for some people maybe $30 to $40 per day is not prohibitive, for other people it is a lot of money.

Finally, there isn't sufficient space, so we are outstripping our capacity in terms of spaces for these day centre programs. This is particularly in communities that are growing rapidly. I think about York region which surrounds York University as one of those areas. This is one strategy that the Alzheimer Society has taken upon themselves. There are other organizations that provide this as well, but again, this is a community support service. This is an area in which the federal government, through their horizons program, was quite keenly involved, but over time that amount of funding has shifted.

I think the Nova Scotia organization talked about having operational funding. It's not enough to ask organizations to have year-over-year funding and project funding, because then you get into a situation where it's just one project after another, as opposed to knowing that you have the capacity to plan long term for some of these services.

[Marc Serré, Liberal, Nickel Belt, ON]

Thank you.

Ms. Ludwig.

[Karen Ludwig, Liberal, New Brunswick Southwest, NB]

Thank you.

I have one question, and it's for Professor Daly.

We heard from Professor Bakker from York University. She said that one of the ways of addressing the challenges of economic security could possibly be through tax policy.

I'm wondering if you could speak to the two-thirds of seniors living in private households. I've heard from a number of seniors in my riding. Some of them have the income, certainly. They want to stay in their own homes, but their homes are too large. I'm wondering if you could possibly speak to the opportunity for a tax policy or a tax credit for seniors who are in their own homes to make accommodations. Maybe there's an opportunity for them to rent some of the space and gather some income, but still stay in their homes, which are more amenable. Perhaps that would offer more round-the-clock nursing care to those who really need it the most and maybe are less able to pay for it. Thank you.

[Dr. Tamara Daly]

It sounds really interesting. I would say that probably, in terms of tax policy, it's not my area of expertise, and so I wouldn't want to comment on that.

[Karen Ludwig, Liberal, New Brunswick Southwest, NB]

Do you see there is an opportunity to help seniors to stay in their own homes longer? I live in a rural area in New Brunswick, and many of the homes are two-storey homes. There are stairs. There are challenges. There are not washrooms on the first floor. They want to stay there longer, but their homes have to be accommodated for them to stay there and for someone just quickly to come in and out.