Veterans Affairs Committee on May 10th, 2007

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

That's really great to hear, because I happen to agree completely with you. I can't answer all of the questions I asked you. I was asking them of you to see if you could give me some facts.

I'm from British Columbia, and I do recognize there are more and more senior veterans, as well as seniors generally, moving toward the west. I think it probably has a lot to do with the weather, but in terms of services, I'm not sure whether we're keeping up with that sort of thing.

With regard to the taxation levels, I don't have an exact figure either, but my understanding is that it's about double what we pay in Canada. They're able to provide all those additional services because they have a much larger tax base from which to do it. A better way to put it is that they take more taxes.

You also made some interesting comments about rural Canada being older than urban Canada. Maybe as you get older, you get wiser and you get out of the city.

[Dr. Norah Keating]

Well, you know, there is some of that migration. It's interesting that we're beginning to see some of that migration of people out of cities to smaller communities at retirement, so there is a bit of that. There is the other direction, of course, too, where young people are leaving the small communities and coming to the larger centres for work. So it works in both directions.

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

It does.

Just touching again on simplifying the eligibility requirements, most MPs spend a great deal of time trying to walk senior veterans through the red tape—and there's a lot of red tape. So I agree that it needs to be simplified.

Are there a couple of pointers you would like to suggest that this committee might recommend to Veterans Affairs to make it simpler?

[Dr. Norah Keating]

Well, I think one of things we tried to emphasize a great deal in this report is that eligibility for services from the department should be based on two criteria. One is military service, and the other is need, period. So if we can do that, I really think people in the department would be terribly grateful. I know that those who are trying to be on the receiving end of services would be greatly relieved also, and it sounds like people like you believe it would reduce their workload as well. So I think it really is something the department has actually wanted to do for a long time.

What I've come to understand over the years is that as the group of World War II and Korea veterans has become older, the way the department has attempted to meet their needs is to add new services as the group has aged. Those services have been layered onto things previously there, and that's where you get this complexity.

So it would be quite a major revamp, but I truly think there's a lot of will to make it happen.

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

Thank you, Dr. Keating.

I think I can speak for all members of this committee, and I know I can speak for government, when I tell you that we'll do our utmost to simplify the system.

[Dr. Norah Keating]

Wonderful. Thank you.

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

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you very much.

I very much enjoyed the idea of military service and need.

Mr. St. Denis, for the Liberals, for five minutes please.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Thank you, Mr. Chair.

Along with my colleagues and their thanks, I thank you for your participation today, Dr. Keating, and for your work in support of seniors.

[Dr. Norah Keating]

Thank you.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

I'd like to focus a bit on the family aspect of support for elderly parents, in our case veterans, but obviously your answers may apply to all such family situations. I may be generalizing by saying that in the generations past, as our parents got old and needed help, we tended to do that at home as much as possible, because the institutions and hospitals weren't as readily available. We've gone through a time when there were the bricks and mortar available for the most part, and that's where we tended to spend our last days.

I guess this is the first part of my question, but I sense that the pendulum is swinging back and more and more people are choosing to spend their final days, weeks, months, at home with family, whether it's a young woman with cancer or whether it's a senior who knows the time is coming. Whether it's a veteran or a senior non-veteran, is there an acceptance in society that this pendulum does exist, the swinging back does exist, and if so, are we really planning for more and more of the home-based final days in terms of caring for our parents? We're going to be there some day, too--to those who may be listening to this on webcast--and we'll be facing that. I am wondering about the overall philosophical approach to where we will be with this in five, ten, or fifteen years.

[Dr. Norah Keating]

An excellent question. I think there is a fairly high level of understanding now that we are in that kind of third era in which families, in particular, are doing the vast amount of care of frail older adults and of younger adults with disability. In fact, in our own work, we and others would suggest that about 80% of the care of older adults is provided by families. And the people who are presently in nursing homes tend to be those who are very old and who have some kind of dementia.

Having said that, I think we're still really beginning to catch up in our understanding of how we might best support families who are providing that kind of care. That's where a lot of the emphasis is now, I think, and that's why this report really is about focusing on not only the individual veteran, but on family members.

There's a lot of interest, I think, in families and caregiving and how to support those family members. I think we can continue to do better by thinking about the variety of caregivers. The kind of support an elderly spouse might need could differ considerably from the support needed by a daughter who's a caregiver, who's trying to juggle her own responsibilities to her children, her labour force engagement, and her care of her mother or father.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Thank you.

I think that 80% figure is a very interesting one.

As a society, we spend resources--maybe not enough--as a community on helping young families learn how to parent, the health aspects of raising children and so on, but I don't know if we do as much of that in teaching ourselves how to prepare for and help others, our parents and family members, in their final days. Is there an educational part of this that is still in evolution?

[Dr. Norah Keating]

Do you mean in terms of the support?

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Well that, yes, I suppose, or more generally, when it comes to aging issues, whether it's for personal health or whether it's for care of a family member.

[Dr. Norah Keating]

Not in a nationally coordinated fashion, or even coordinated at the provincial level. Much of the education and training of people who are caregivers is being provided, I think, through the voluntary sector, NGOs and so on. This is not a job, I think, that most people anticipate, even though we do know that we're all getting older, as are our parents. So often people are not really looking for that kind of education or support until they are thrust into the role of being a caregiver. We could do better, I think, in doing things like supporting some of the national caregiver organizations that are attempting to provide this information in a way that's accessible to people.

[Brent St. Denis, Liberal, Algoma—Manitoulin—Kapuskasing, ON]

Thank you.

If I have a chance, Mr. Chair, to come back, I'll be glad to take it.

[The Chair, Conservative, Rob Anders]

Sure.

Now on to the Bloc. Monsieur Gaudet for five minutes.

[Roger Gaudet, Bloc, Montcalm, QC]

Thank you, Mr. Chair.

Dr. Keating, my first question is the following. Mr. Ferguson told us this week that there were 50 teams in Canada. Do you believe this is enough? What services do these teams provide? Are they doctors, nurses, etc.?

[Dr. Norah Keating]

Unfortunately, I'm not an expert on the departmental numbers of teams and the training that those team members receive. I'm certain that the department would be happy to provide you with that information, but I'm not in a position to do so.

[Roger Gaudet, Bloc, Montcalm, QC]

Thank you.

Earlier you spoke about integrated services for families. Could you tell us more about this program?

[Dr. Norah Keating]

The idea of the veterans integrated services, which we're proposing in the report, is that the veteran could be given services that would range from those that are mostly health promotion—getting information, for example, about making their home safer, or getting connections to a physical fitness program that might help them remain more physically fit and able to do things for themselves—right through services that might help support someone who's quite frail and who may need personal care.

It's the idea of the integration of these services that is particularly important, we think, from the point of view of the department. Many of these services are already available in separate service bundles from the department right now. This means as well that if a veteran has some sort of health crisis or has a change in their status, they can easily move towards a higher or different level of service. So it really is the integration that's particularly important.

[Roger Gaudet, Bloc, Montcalm, QC]

This is my last question. I agree with offering a VIP program for veterans. But would you recommend that we offer this service to all of Canada's elderly?

[Dr. Norah Keating]

I think that this program is certainly the kind of model that those of us who are experts in aging think is ideal, and I would be delighted to see something like this extended to other seniors.

[Roger Gaudet, Bloc, Montcalm, QC]

Thank you.