Status of Women Committee on Feb. 18th, 2021

[Andréanne Larouche, Bloc, Shefford, QC]

There was no interpretation, which is unfortunate. The sound quality wasn't good enough for us to hear the last speaker.

However, you did confirm that the financial circumstances of caregivers, particularly older caregivers, were already difficult before the pandemic. You mentioned all the expenses they had to incur and the fact that prices—rents, groceries and drugs—have risen during the pandemic. You ensured us that these are included in expenses and that some recurring, longer-term assistance should be considered to increase their purchasing power.

[The Chair, Conservative, Marilyn Gladu]

I'm sorry. That's your time.

Ms. Johnson, you will have to hold your mike closer.

MP Mathyssen, you have six minutes.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

Thank you, Madam Chair.

Thank you to the witnesses.

I would like to focus first on the financial concerns of caregivers. As you said, these are non-refundable tax credits in most cases. They are income-dependent and reliant. Moving away from that reliance so it's far more across the board and supportive, that's what I hear you pushing for.

This may be on the policy side, but a lot of what the NDP is pushing for is around universal programs, ensuring that long-term care is affordable and housing is affordable. The idea of universal health care, universal pharmacare and universal dental care would ensure that, across the board, everyone is paying together so that all those costs are already covered. Those out-of-pocket costs that these seniors but also caregivers are incurring would already be covered. They wouldn't have to worry about that.

Have either of you heard from your membership, from the people you advocate for, about potentially those longer-term universal supports that would offset the costs they incur?

[Tracy Johnson]

Thank you, Lindsay. Maybe I will start.

While we don't have a position necessarily on financial aid or universal programs, we do know that to accommodate changing needs, things like adult day programs, respite care, meal delivery, community social supports and help navigating the health care system are all important for caregivers. They tell us this in some of our focus group work. Those are the kinds of things that might be covered by some universal programs.

[Amy Coupal]

I would very much echo those comments in terms of the kinds of programs and supports people are looking for. One of the most common requests we receive on our helpline is how someone can get moved up on a wait-list. If we look at respite support, there's a desperate need for respite support for a caregiver in distress, but they are going to have to wait weeks or months to get it. That was even pre-pandemic. I think alleviating some of the pressure points on the wait-lists for the kinds of services that the other witness has identified would make a big difference.

We also hear from caregivers about other household kinds of supports that don't have an infrastructure. I need somebody to shovel my snow because I'm not able to shovel the snow. I need somebody to help me with some of those household chores. I know that for those of us who are able to do that, that seems like a very simple thing, but if someone is not able to do that, either as a result of their own physical condition or their caregiving responsibilities, those things make a difference.

What we do understand in terms of the financial pressures on caregiving is that they are paying out-of-pocket for both caregiving expenses and general living expenses. They are looking for alleviation in the financial burden they have taken on, which is in addition to the hours they are committing of time that may affect their own ability to work at all, or even how much they are able to work. Caregivers are facing this double impact in terms of their challenges with earning their own incomes and then spending the available money they have on caregiving and related expenses.

[Lindsay Mathyssen, NDP, London—Fanshawe, ON]

One thing that was proposed and asked for by the Canadian Labour Congress was a federal care economy commission that would study and collect that data and would have the ability to collect the data you were talking about, which sometimes is not as available as you would like it to be, or not as specific. They would have that ability, but also would use that data to design and implement a care strategy for Canada.

They talk about the creation of a broad and inclusive labour market that would look at getting to a point where those high-quality, equitable jobs within long-term care are achieved and, actually, in child care as well, because we know that it's at both ends, especially for women.

It would also examine paid and unpaid care work and look at the demands and the increasing demands and what's necessary. They would reduce and redistribute that unpaid care work, and again, leading to a lot more of that access to public care services, and potentially addressing some of the things that we are clearly missing, such as those chores, those domestic ideas, that aren't necessarily covered by traditional programs per se.

Is this something that would be helpful and that you think we should move forward with? Would that be a potential solution or idea?

[Amy Coupal]

Our organization focuses on those unpaid caregivers, so I'm not in a position to speak to other roles that may be professional caregiving roles, such as personal support workers, etc.

What we do find is that people reach out to our organization because there is not information or support consistently across the country. One thing I'd like to highlight from your comments—and it's come up in the CIHI data as well—is the disparity of information or the disparity of support across the country. People come to us because there may not be a provincial organization where they live and—

[The Chair, Conservative, Marilyn Gladu]

I'm sorry. That's the end of your time.

Now we're going back to Ms. Wong for five minutes in the second round.

[Alice Wong, Conservative, Richmond Centre, BC]

Thank you very much. We definitely have learned a lot from both witnesses.

For my next question, in what ways are specific groups of women in particular, such as women living with disabilities, indigenous women—because both of you did mention that—and immigrant, refugee and newcomer women, affected by the unpaid work and care responsibilities? I've lumped a lot of things together there so that you can explore and shed more light on that.

That's for both of you, please.

[Tracy Johnson]

What I will say, Ms. Wong, is that I can't really speak to that. The data we have doesn't break down caregivers by sex or ethnicity at the moment.

[Amy Coupal]

One of the themes we've heard in the questions is, where would we like additional data? I think your question highlights an area where we would all benefit from additional data in terms of the particular needs of people from different communities.

What I can tell you anecdotally from what we hear from caregivers is that one of the challenges they may face in going into different health care settings is barriers to access based on language or based on a lack of understanding, if they're a newcomer, about how the system may work. We find that caregivers need information around system navigation. They need information around how to engage with different health care providers, and that may come with a different cultural context.

We hear from caregivers that culture really matters in terms of how they've taken on this caregiving role and how it's navigated within a family. Certainly, we hear that within certain cultures there is an automatic expectation that caregiving roles will be taken on by women, so women feel an additional burden of expectation within their caregiving role, but this isn't an area where we have clear demographic data in order to provide significant insights.

[Alice Wong, Conservative, Richmond Centre, BC]

My next question will be about the sandwich generation, the younger ones, you know, in the middle. They have to look after children, of course, and just like my NDP colleague said, there's a child care side. I'm not commenting on that side, but more on the care of the elderly.

How do you see the kind of help...or the stress levels. You both talked about the stress levels. How can we—in whatever way—help these caregivers who have double duties, especially during this time of COVID? It's so important right now to help them to be healthy, because again, I'm going back to my theme of caring for the carers. Can both of you shed light on that, please?

[Tracy Johnson]

I'll start by saying that it's a combination of things.

Improving home care services overall across Canada would enable us to care for the carers, as you say, in a better way. Right now, some of the other things they lack, as we talked about before, are things like adult day programs, respite programs, meal delivery or community support.

First and foremost, access to the system and what's available to them is different across all of the provinces. A better understanding of what is available when people need it would be really helpful to care for the carers.

Then, when they need—

[Andréanne Larouche, Bloc, Shefford, QC]

I have a point of order, Madam Chair. I unfortunately can't hear the discussion.

[The Chair, Conservative, Marilyn Gladu]

Ms. Johnson, I think you have to put your microphone up closer.

All right. Let's try again.

[Tracy Johnson]

I'll start by saying that to care for the carer we need to have, first of all, a way they can understand and access home care services in a much more equitable way across the country. I'm talking about the data we have, which is around carers or caregivers of people already on home care. These would be long-term home care clients, so greater than 60 days. They often have multiple chronic conditions, could be palliative with cancer and could also have things like lung disease or Alzheimer's. We have home care across the country, but how it plays out and what's available to you is very different across the country. Geography plays a part.

In order to care for the carers, we need to be able to ensure that there is information on access, but then that they understand what access they get. If we beefed up home care, we would be better able to care for those carers.

Some of those ancillary programs—

[The Chair, Conservative, Marilyn Gladu]

That's the end of your time. Sorry about that.

Now we're going to Ms. Sidhu, for five minutes.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Madam Chair. Thank you to all the witnesses.

My first question is for Ms. Coupal.

I note that your organization has a helpline and live chat services. What are the benefits of virtual support that you have observed during this pandemic? What kinds of calls are you getting? What impact does the burden of unpaid work have on women's mental health?

[Amy Coupal]

Thank you for that question. I'll draw on different sources of data.

In terms of the helpline, we have a 24-7 helpline available in English and French that people can call. It actually speaks to the comments that were just made to the previous question on what supports are available in my community and how to reach them.

We can actually help to facilitate a warm hand-off to some of those organizations. Of course, what we're not able to do is accelerate any wait-lists or anything like that. That is one of the pieces of feedback we receive on the helpline. Someone will say, “Okay, so you've referred me to the organization, but they say it will be six to eight months before I can get what I need.” That's a frustration for caregivers for sure.

What we have found through the pandemic is that there has been an increased demand for our helpline as well as our online chat by caregivers, particularly because the services they are looking for are often changing in terms of whether they moved to virtual or shut down, or what a person should do now that the kinds of supports they've been looking for may not be available.

Another significant concern for caregivers during the pandemic has been that they're not sure they feel safe to access the services that they previously accessed, because they're concerned about infection prevention and control, whether that's home care or even going into appointments. It's been an important education tool to talk with caregivers about what's available to them and how to communicate their needs.

In terms of your other question, I think what we've certainly heard from caregivers out of province through these resources, because they don't have these types of tools available across the country, is that they need additional support with system navigation. When you call our helpline we can help make those referrals and pass them on, but sometimes people actually need to understand how all the pieces of the puzzle fit together. Especially with patients who may have multiple diagnoses or have complex care needs, it becomes the caregiver's role to be the system navigator, to become the project manager. That's an area where they need assistance as well.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you for your important feedback.

Ms. Johnson, one thing I want to highlight is the federal government investment of $240 million into a virtual care solution that includes Wellness Together. Do you think it's effective? I'm getting lots of positive feedback from my residents, but I'd like your views on that.

[Tracy Johnson]

Across Canada, provinces with respect to health have been trying to move towards more virtual care. When we looked at physician billing during the pandemic, we saw that while physician visits dropped significantly in April and May and June of last year, for the visits that physicians did do, up to 50% were virtual. There was a huge increase in virtual care. Some provinces, such as Newfoundland, very specifically used virtual care to deviate people from the hospital. They wanted to ensure that they freed up beds.

Virtual care is being seen as very important. I can't comment on whether the money is appropriate or not. One of the other things that we're working towards and that we need to work towards with virtual care, if we're targeting this money, is measuring it appropriately, understanding whether or not it's effective for patients and they get the care they need—

[Andréanne Larouche, Bloc, Shefford, QC]

Madam Chair, I still can't hear the interpretation.

[The Chair, Conservative, Marilyn Gladu]

Let's try it with the mike closer.

[Tracy Johnson]

With respect to virtual care, while I can't comment on the absolute dollars to be put into it, we recognize it as being an important component of the health system going forward. All provinces do. There was a very large increase in it during the pandemic. Over 50% of physician visits for family doctors were done virtually.

We do need, however, standards for measuring that care across the country and understanding how the experience works for patients and physicians so that the outcomes are just as good with virtual care as they are with a face-to-face visit.

[The Chair, Conservative, Marilyn Gladu]

That's your time.

Ms. Larouche, you have the floor for two and a half minutes.