Veterans Affairs Committee on May 10th, 2007

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Thank you, Mr. Chair.

Dr. Keating, thank you very much for your work. As Ms. Hinton has already mentioned, we're very grateful. I understand from Dr. Marshall last time that ten months went into the working of this report. I'm certain that I can speak for all the Canadian people in saying that we're grateful for your work towards veterans.

[Dr. Norah Keating]

Thank you.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

I wanted to ask you whether it was strictly the mandate of Veterans Affairs that kept the study limited to the World War I, World War II, and Korean veterans? Is there a reason why the study didn't go as far the veterans from Bosnia, some of whom would be entering their older years now?

[Dr. Norah Keating]

Yes. The committee on which I serve is the gerontology advisory committee, so our mandate always has been, from the beginning, to direct our attention to those older veterans. There is another committee of the department that addresses these kinds of issues related to younger veterans. So that period definitely was the mandate for our committee.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

I asked Dr. Marshall last time whether he felt the new veterans.... I was at a retirement party for a general last week, and, of course, being on this committee, you look at a soldier entirely differently. You look around the room and just see how physically fit everybody is. I'm wondering, although I know you've been focusing on older veterans, whether you see a difference in attitude towards health in the younger veterans now who are aging.

[Dr. Norah Keating]

Because I'm a gerontologist, and that's where my focus is, I really can't speak to that question. In terms of the way the committee structure in the department is organized, Dr. Marshall will be sitting on the younger forces, new veterans charter committee. There's going to be, I think, a fair bit of crossover in direction between the two committees. I would certainly expect that the Keeping the Promise document and the work we've done will be part of the consideration of that other committee, but I just don't have the information on the younger veterans.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

I'm certain that other committee would be able to determine through their studies some recommendations concerning how decisions that are made earlier in life impact how a person ages later. That would be critical in Veterans Affairs' dealing with them at a younger age.

I looked at the study and I didn't see this indicated. How many veterans were interviewed for this study, doctor?

[Dr. Norah Keating]

The Keeping the Promise document was not specifically based on our going out and doing direct interviewing. We drew on a large number of studies of veterans and older adults that have been done both by committee members and other people in North America and elsewhere, to put together the report. So the work was based on research done by the department, on work done by other organizations, and by input from the veterans organizations, particularly those that are members of the advisory committee.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

I asked that because we're on another round of study on post-traumatic stress disorder and I want to find out the psycho-social aspect of what these veterans are wrestling with right now.

I was fascinated, and I mentioned this to Dr. Marshall, how you drew out in the study the accessibility of places where the veteran can stay physically fit and well. I had an example of that in my own family. Do you also see that capability from the psychological-social aspect, that if they have those services close at hand they'll also be able to stay psychologically well?

[Dr. Norah Keating]

Yes. I think the fundamental principles we began with were these ideas that aging well is an aggregate of physical and mental well-being--having sufficient income and social connections. Those principles are well established in research. We've seen lots of evidence that, in combination, those are going to help people age well, across the life cycle. Certainly the social and psychological elements of one's life are as important as those other elements--definitely.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

I don't know if you have an ongoing dialogue with Veterans Affairs, but we had the assistant deputy minister in the other day.

I'm referring to page 21, where you talk in your study about being proactive rather than reactive. There's a tele-effort right now to reach veterans in order to make sure they are aware of services and that they have access to them. Is that part of what you're talking about with the, for lack of better words, one-stop shop kind of integration? Maybe you can flesh it out, because it has been asked about a couple of times.

[Dr. Norah Keating]

We work very closely with the department. One of the things they're trying to do--and the veterans organizations are helping considerably--is to make contact with veterans who are not currently clients of the department. That's part of that effort.

The integration is the one-stop shop. Yes. Once you have made contact with the department there is an effort to determine the nature of your needs. With these integrated services, there would be a much better ability to meet those needs in a coordinated fashion.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

That's great.

So that we're not assuming anything, you've used the term “aging well” in the study, as well as here in the questioning. Can you give us a brief description of what you would consider is aging well?

[Dr. Norah Keating]

Yes. I think Dr. Pringle will speak more to this issue when she meets with you.

We use the term “best fit”. Aging well is really having the best fit between who you are, the resources you have, your goals in life, and the setting in which you're living. For you to age well might mean living in a rural area surrounded by your family and being connected to nature. For someone else it might mean living in an urban environment, being as independent as possible, and so on. There's no one formula. It really is about one's personal preferences, resources, and the setting in which one lives.

Because they become somewhat less resilient, what happens as people grow older is that it's more difficult for them to work that match out. That's where the support comes in.

[The Chair, Conservative, Rob Anders]

Thank you.

Now we'll go to Mr. Stoffer with the NDP for five minutes.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you very much, Mr. Chairman.

Thank you again, Dr. Keating.

I have a couple of questions.

You indicated that one of the criteria should be military service and/or need. Is that correct?

[Dr. Norah Keating]

And need.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

I'll take you to a story that happened a couple of years ago in my riding, with an individual who was a war veteran. He was becoming very frail. He liked to stay in his basement near his wood heater and do his crosswords. At night he would have to go up the stairs in order to go to bed. He found it difficult to get up those stairs, and he asked if he could get a lift for his house. DVA's initial response was no, because his elderly wife could help him up the stairs. The definition of “need” was different there. What he thought he needed and what the DVA individual thought he needed were different.

Who should determine the need? Should it be someone from DVA with the flexibility to say yes or no? I'm thinking of various prescription drugs, hearing aids, whatever it is that they require. In order to facilitate better conditions in their home, for example, their home may have to be modified, outside or inside. Who determines that need?

[Dr. Norah Keating]

I think it's an excellent question and something the department is going to be wrestling with over the next little while as they begin to put the practical detail to the report we've written.

As you know, the report is written at the level of the principles and overall models. It's not written at the level of the detail, which is something that certainly the department is going to work out.

Of course once you move to thinking about families as the focus, the other thing that certainly we found in our work with families is that what a daughter might think is relevant or important may not necessarily be what dad thinks. So there's a lot of work to be done in fine-tuning that whole question that you raise.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

When you were accessing your report, was Mr. Sweet's question about what consultations were there with veterans...? Does your report also go on the premise of the benefit of the doubt? As you know, the new charter states that, and the previous minister and the current minister and many of us have said the same thing: that the benefit of the doubt should go to the veteran and/or the family. But of course that's easy to say and maybe fiscally difficult to do. So was your report based on that premise?

[Dr. Norah Keating]

From our interaction with the department, that's the idea on which they'd been attempting to provide services to veterans, given their complex eligibility criteria these days. So I think the benefit of the doubt is something they have been trying to use over the last number of years to do that.

I would think the same principle would apply, but perhaps be somewhat less important. If we can really work out this whole needs-based approach, the department won't be having to wend its way through all of these sometimes almost contradictory criteria about eligibility. If those are swept away, this benefit of the doubt will become less of an issue.

[Peter Stoffer, NDP, Sackville—Eastern Shore, NS]

Thank you very much.

[The Chair, Conservative, Rob Anders]

All right, thank you.

Now on to Mrs. Hinton, for five minutes.

[Betty Hinton, Conservative, Kamloops—Thompson—Cariboo, BC]

One of the things you'll note if you come to this committee again is that we have wonderful research people as well, and we have staffers who can actually get you answers when you ask for them.

I'll just give you the answer to the question I asked you earlier. I received a report on the OECD official statistics for 2006.

[Dr. Norah Keating]

I'm impressed at the timing of your research.