Veterans Affairs Committee on May 10th, 2007

[Roger Valley, Liberal, Kenora, ON]

One last issue I'll raise is that we do serve in both official languages. One of the challenges I have--and I haven't raised it here before--is that different languages are spoken in my riding. It's not so much a case of the veteran's not being able to speak English or French, but it's his caregiver's not being able to. As he ages, if his caregiver speaks Ojibwa or Cree, it's very difficult to deal with. I don't have the answer for that. I just wanted to flag that issue.

Thank you very much, Doctor.

[Dr. Norah Keating]

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you very much.

Now we're over to Monsieur Perron with the Bloc for seven minutes.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

Good morning, Dr. Keating.

I am pleased to see that you have experience with the elderly. But one thing you have not mentioned at all is that the elderly must be kept in their regular environments as long as possible, with informal caregivers such as family members.

To give you an idea of what I think, I will give an overview of Quebec's policy on the elderly. There is a program in Quebec to help build or modify what we call multi-generational homes. The government provides financial aid to sons or daughters who want to modify their houses to provide a home for their parents in their later years. In addition to providing money to help purchase concrete, bricks, etc., the program offers financial aid such as tax deductions, etc.

It also provides nursing help from a CLSC, a local community services centre. The nurses provide home care regularly, once a week or more often, when one of the two parents is sick.

According to Quebec studies, because of this approach, the elderly are less sick. They are no longer isolated. I always joke about this and say that when we are alone, the only thing left to do is think about our past sins or the ones we have yet to commit. We are giving them a new view, and the results seem very good. This program has existed for 10 or 12 years now in Quebec, and we keep it going year after year. We are building more and more multi-generational homes in all corners of Quebec, especially in rural areas. My friend Roger had this concern.

I would like to hear your thoughts on the Quebec system. Does this already exist in Canada? If not, would it be possible to do it? I would like to hear your views on this.

[Dr. Norah Keating]

Thank you.

Certainly the areas you touch on are ones that are very important. As we have over the last decade or two in Canada focused much more on the family members and friends who are providing care to frail seniors, we've begun to think about what kinds of things would support them in the work they are doing. Fewer and fewer older adults in Canada are in nursing home settings. So as you say, most of the care is being offered to people at home. Many of the services that you talk about that are being offered in Quebec certainly are things that can make a tremendous difference to families in their ability to take on this task.

One of the things that we highlight particularly in the Keeping the Promise report is the question of housing, which you talk about, and that having more housing options, including the ability to adapt one's own home or the home of a child, if that's where you're living, can make a very big difference in people's ability to stay out of nursing homes. What we'd like to avoid, if possible, is people's placement in higher levels of care than they need.

As you know, the services available to caregivers vary tremendously across the country. So I cannot comment specifically on what is available in which locations, but this is a very important issue on the agenda, I think, of most provinces, and certainly of Veterans Affairs, which is to think about families and support those members who are providing care to older adults and to veterans.

[Gilles-A. Perron, Bloc, Rivière-des-Mille-Îles, QC]

Thank you, Dr. Keating.

[The Chair, Conservative, Rob Anders]

Thank you, Monsieur Perron.

Now we're on to Mr. Stoffer, with the NDP, for five minutes.

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

Dr. Keating, it's an honour to meet you via the radio. It must be fairly early in Alberta now, and thanks for getting up and helping us out.

[Dr. Norah Keating]

You're most welcome.

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

I appreciated your presentation on the fact that a veteran is a veteran is a veteran. As we heard the other day, a widow is a widow is a widow.

I have a couple of questions for you. You work on international collaborative research projects. Are there any countries now that have a better or a more advanced program in looking after veterans and their elderly caregivers than we have? Is there anything we can learn from countries like Britain or Australia or the States, or are we the leaders so far in this particular aspect?

[Dr. Norah Keating]

There are huge differences around the world in programs that are available, for example, to support caregivers. Some of the models we see in Scandinavia, for example, spend more effort on things like providing financial compensation to caregivers, including things like pensions for caregivers.

An issue that's going to come up more and more in Canada is the question of how people who are caregivers manage if they need to leave the labour force and their own income is greatly reduced. That's less of an issue in this report because we're talking primarily of caregivers who themselves are elderly and are no longer in the labour force.

So that is some of the work going on in our research team to look at these models of support to caregivers around the world.

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

Thank you.

Does your organization do any kind of financial analysis of the costs of these extended services? As you know, everything has a particular cost to it, and governments, and particularly departments, are all going after the same dollar.

For example, if we extended the VIP program to every widow and every veteran, would you have an estimate of what that would cost? We hear figures of anywhere from $280 million to $320 million. But we also heard the other day from Mr. Ferguson that having the VIP program actually saves the government money.

I'm wondering if you've done any cost analysis--or is that part of your mandate?

[Dr. Norah Keating]

It hasn't been part of the mandate of the committee, so we have not done program cost analyses.

I think the general comment would be that services provided outside a formal care setting are less expensive in public dollars than services provided in a community or a home setting. I think that would probably have been the principle on which Mr. Ferguson was making those comments.

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

You indicated that not all veterans would be eligible for various services. As you know right now, one of the eligibility requirements is income. If you're a veteran with a fairly high income, you're not entitled to services, whereas if you are a veteran with a lower income, you may be eligible. I've always thought that was wrong, because when you sign up for the armed forces they don't ask you how much money you make.

[Dr. Norah Keating]

Right.

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

So I figure when you're a veteran and you're elderly, regardless of your income, if services are provided, you should all be equal.

Is that the direction your organization is advising VAC, or would you still put in that income eligibility requirement?

[Dr. Norah Keating]

The principle in the report is that of need. So, for example, if you're an older veteran, regardless of your income, and you're socially isolated, then you may be identified or express a need for being better connected. So there could be an intervention on the part of the department to help you get connected to others, to have friendly visitors, or to get engaged in whatever things would help reduce your social isolation. It would not be income dependent.

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

Thank you very much.

[The Chair, Conservative, Rob Anders]

Now, on to Mrs. Hinton, for seven minutes.

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

Good morning, Dr. Keating, and thank you very much for being here.

[Dr. Norah Keating]

Good morning. Thank you.

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

You've made some really interesting comments today.

The one thing I think we sometimes lose track of is that government doesn't generate any income. Its only income source is taxpayers.

You spoke about Scandinavian countries. Could you give me an idea of what the income tax levels are in the Scandinavian countries versus Canada? That's the first question.

And secondly, in your opinion--this may not be fair, and if you can't answer it that's okay—

[Dr. Norah Keating]

Okay.

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

What is the best province to be a senior veteran right now, because of the fact it's provincial as well as federal?

And thirdly, if you could personally change one aspect of the system today, what would it be?

[Dr. Norah Keating]

Okay. I can't speak to the question of income caps in Scandinavia. Unfortunately, I don't have those sorts of data available. It's a good question, but I can't help you in that respect.

On which province it's best to be an older veteran, the nice thing about the Veterans Affairs mandate and programs is that they fill gaps. The whole idea of Veterans Affairs is that wherever you're living, you should have the same access to services provided by the department. So I think, in general, and particularly with the implementation of the recommendations in this report, that veterans across the country should be equally well served.

As for the one aspect I would change in the present system for veterans, I would say, absolutely, the simplification of all these eligibility requirements. I've consulted with the department for ten years, and I'm still not sure if I could fully pass the test of knowing what all the current eligibility requirements are for programs. So that would be the number one change, I think.