Evidence of meeting #10 for Veterans Affairs in the 39th Parliament, 2nd Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was falls.
A recording is available from Parliament.
4:45 p.m.
Conservative
David Sweet Conservative Ancaster—Dundas—Flamborough—Westdale, ON
I agree with you. In health promotion, we have a long way to go not only with veterans and seniors but in every dimension of our culture.
Thank you very much for your information and for clarifying the things I had some concerns about. Good work.
4:45 p.m.
Conservative
4:45 p.m.
NDP
Peter Stoffer NDP Sackville—Eastern Shore, NS
Once again, thank you both very much.
You had indicated that DVA has never contacted you. Your brief says, “With funding from the Falls Prevention Program of Veterans Affairs Canada...”. Did your organizations go to DVA to fund this research, or did they come to you?
4:45 p.m.
Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, University of Western Ontario
It was your predecessor, so maybe you could answer that.
4:45 p.m.
Program Director, Canadian Centre for Activity and Aging
The point I was making was that the Canadian Centre for Activity and Aging, for as long as I've been affiliated with it, which is 15 years, has not had a request or a question from Veterans Affairs Canada asking us where there are programs in place that veterans can attend to maintain and/or enhance their functional mobility. That was the point I was making.
As far as the funding is concerned, perhaps you want to speak to that, Mark.
4:45 p.m.
Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, University of Western Ontario
Clara's predecessor was Nancy Ecclestone, who had contacts with Health Canada. She was aware of the falls prevention initiative and came back to London and told me about it.
I'm not sure that answers your question, though.
4:45 p.m.
NDP
Peter Stoffer NDP Sackville—Eastern Shore, NS
The federal government through two departments funded this research. Those are for veterans who are currently under DVA; they're clients of DVA. Is there any consideration down the road of doing a study of veterans who are not part of DVA?
4:45 p.m.
Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, University of Western Ontario
That was your earlier question.
4:45 p.m.
Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, University of Western Ontario
The only way we could get address lists was through Veterans Affairs.
4:45 p.m.
NDP
Peter Stoffer NDP Sackville—Eastern Shore, NS
The Royal Canadian Legion will give you a tremendous amount too. They have a lot of lists of veterans who aren't DVA clients, and they would be able to help you.
Also, Clara in her paper here talks about the various physical things--imbalance, tai chi, physical exercise--and, sir, the same in yours, but I don't see anything regarding mental health. Or maybe I didn't read it properly.
You said that 40% of veterans tend to fall more frequently than other adults. From my understanding--I can't speak for the committee--the older veterans who I speak to, especially some of the ones who are very frail, seem to reflect a lot on what their wartime experience was and those kinds of things. An awful lot of them are also suffering from maybe dementia, a touch of Alzheimer's, and those things. I don't know how many of those folks would have filled out a survey, but I know that for folks who have dementia or Alzheimer's, filling out a survey is quite challenging no matter how simple you make it.
In your study, did you have an opportunity to study the mental health of these individuals? A lot of times, that could lead to physical problems, which could then lead to falls. So did you have a chance to do that, and if not, would you be planning to do one in the future?
4:45 p.m.
Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, University of Western Ontario
Thank you for the question.
On the front page of my questionnaire, I said that I had exclusion criteria. If there were major cognitive issues for a person--they'd had a stroke or something like that--then they were not to fill out the questionnaire themselves. All fall studies, unfortunately, have to exclude people with major cognitive impairment, because they just can't participate. It's an oversight that we can't find a solution to.
We did ask people to rate their memory compared with other people their own age. People who reported that their memory had changed over the past five years were more likely to fall. So it is a risk factor for falling.
4:50 p.m.
NDP
Peter Stoffer NDP Sackville—Eastern Shore, NS
That kind of reminds me of a joke. Three old veterans were sitting on a park bench when this beautiful woman walks by. The first one says, “I'd like to give that lady a hug.” The second veteran says, “I'd like to give her a hug and a kiss.” And the third veteran says, “Now what was that other thing we used to do?”
That works in the Legion hall. He was talking about memory loss.
4:50 p.m.
Voices
Oh!
4:50 p.m.
Program Director, Canadian Centre for Activity and Aging
I would just comment that the mandate of the Canadian Centre for Activity and Aging is to investigate the interrelationship between physical activity and aging. Most of the work, certainly with various programs, if a study is done, also looks at the mental health benefits.
I can say clearly, from the various older people who benefit from our programs and services, that the people who stick to the program long term are people who have made a variety of friendships and social relationships with other older people who have similar interests, similar challenges.
So the social component is very important, but I was speaking today specifically on the functional benefits of physical activity for veterans.
4:50 p.m.
Conservative
The Chair Conservative Rob Anders
It's very kind of you to respond to Mr. Stoffer's question.
Now over to the Conservative Party of Canada, to Mr. Cannan.
4:50 p.m.
Conservative
Ron Cannan Conservative Kelowna—Lake Country, BC
Thank you, Mr. Chair. That's a hard act to follow.
Thank you to both of you for presenting. I had the chance to review your information. Like my colleague Ms. Hinton, I come from British Columbia. UBC has done some excellent research with gerontology and studying fall prevention. We have five different health authorities, and as you say, one size doesn't fit all veterans. That's the same within the whole country, because there are geographic and demographic differences.
In my riding I have the largest percentage of seniors 65 and older of any census metropolitan area in Canada, so I'm very familiar with the whole issue of trying to reduce hip replacements and knee replacements, not only from aging, osteoporosis, but slips and falls. I've found that we have had pretty good success within our health authority.
From your experience, do you find there's been some good dialogue between Veterans Affairs and Health Canada in working on educational programs, or do you see an area for improvement there?
4:50 p.m.
Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, University of Western Ontario
If I could just answer briefly, when the fall prevention initiative was under way it was clear that the two agencies were communicating very clearly and it was a great partnership. My understanding was that the Department of Veterans Affairs approached Health Canada because Health Canada had more experience in actual health research, but when the program ended, as far as I know, so did the collaboration. That's my impression. I wish it had continued.
4:50 p.m.
Conservative
Ron Cannan Conservative Kelowna—Lake Country, BC
Let's see if we can figure out where it broke away and see if we can bring the parties together again, because definitely from your information you've shown there is proof that the prevention education works.
In your studies, have you been able to come across, as my colleague Mr. Sweet alluded to, health prevention, whether it's in diabetes or with aging, and in this case, with veterans, that there are dollars invested in prevention that will actually save down the road in health care? Have you been able to quantify that in any research?
4:50 p.m.
Professor, Department of Epidemiology and Biostatistics, Faculty of Medicine and Dentistry, University of Western Ontario
It's very difficult to do, because it's difficult to show that something was prevented. It's easy to show that something happened. To my knowledge, that's sort of the third rail of primary prevention research, to show that if I spend $10, I can save $100; and even if we can come up with that number, how long is it going to take to save the $100?
4:55 p.m.
Conservative
Ron Cannan Conservative Kelowna—Lake Country, BC
I can understand. That's a challenge we all face. You have only so many dollars and you want to make sure you get the largest impact with those investments.
The last one has to do with exercise. We all have a responsibility to look after our own self at whatever age we are, and we want to make exercise fun. I commend the video-gaming companies and the Christmas rush for the Wii. Some veterans and seniors in my community have purchased them. You go to the senior centres and now they're suffering from different injuries from playing too much bowling, and fighting over who's going to play tennis.
Do you have any ideas on how we can make exercise more fun and challenge people? Some people are limited as far as their mobility is concerned because of incidents they've had serving, as a veteran, as a member of the Canadian Forces. A lot of times it's stimulating the heart and keeping the mind active, because some of their limbs may have less mobility. From your studies, have you come up with some interesting ways you can maybe pass along as well?
4:55 p.m.
Program Director, Canadian Centre for Activity and Aging
Sure. I'd be pleased to let you know that the Canadian Centre for Activity and Aging has been doing extensive work with Vancouver Coastal Health and the other health authorities in British Columbia to translate some of the knowledge from various studies we've done, primarily in care facilities, to help to maintain and restore the functional abilities of frail older people living in care facilities in British Columbia.
Instead of those regional health authorities reinventing the wheel, they looked at who was doing research, brought in the people who've done the research, applied it, and trained the staff. So you'd be happy to know they're not reinventing the wheel; they're actually looking at where the research is and putting it into place. I commend Vancouver Coastal Health for that direction.
As far as your question goes, how can you make physical activity more fun, I would add, how can you make it more enjoyable so that people actually stick to the program? All of us in this room, whether we're older people or not, know what the health benefits of physical activity are. We might even know where to go, what to do, and so on, but sticking to the program, the adherence, is the tough part.
Certainly incorporating a spoonful of sugar, a recreational component to make it somewhat enjoyable for the older person, is essential to keep them coming, but what's critical is that they become aware of what the functional gains of the program are for them specifically, and that over time the program does not become a recreational diversion, especially if the outcome of the program is intended to help the person maintain or restore their functional gains.
That's where many programs nationally fall short. They start off as evidence-based programs, and then they're reduced to recreational fun: let's everybody sit in a circle and have a good time. So that messaging to older people has to be clear. I think that recreational component is critical but shouldn't be the be-all and end-all of the physical activity intervention.
4:55 p.m.
Conservative
Ron Cannan Conservative Kelowna—Lake Country, BC
Thank you very much for your passion and interest. It's going to help us all in the end.
4:55 p.m.
Conservative
The Chair Conservative Rob Anders
I think I've exhausted the list of those people who want to ask questions.
I want to thank our witnesses. You've been a spoonful of sugar to us. Thank you very much for your testimony today. We're of course incorporating all this into the things that will come out with regard to health care for our veterans, so I appreciate it.
Just as you wrap up and what have you, there's some other committee business I want to deal with for members of the committee.
I know there was an exchange between Mr. Cannan and our guests with regard to health issues. On Thursday we're going to have Health Canada come in, so we'll continue that discussion.
There are some other people our clerk is looking to get in. One is Maggie Gibson, who is standing in for Howard Bergman, from the National Initiative for the Care of the Elderly, or NICE, as it's called.
There's also Terry Wickens, national president of the Korea Veterans Association of Canada; and Dr. Gloria Gutman, from the Department of Gerontology, Simon Fraser University. You were on our list, and now you have appeared.
There are some other people who wish to appear: Cathy Moore, national director, consumer and government relations, Canadian National Institute for the Blind; Bernard Nunan, researcher-writer for the Canadian National Institute for the Blind; and the Aboriginal Veterans Association of Canada.
We have those down.
As well, I have a quick update with regard to the trips on this matter. We're looking to do Comox, Cold Lake, Shearwater, and Goose Bay just before the break, the week of February 11; Valcartier on February 28; and Petawawa on March 6--just to bring the committee fully up to speed.
That's that.