Veterans Affairs Committee on Feb. 5th, 2008

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

Thank you, Mr. Chair.

Thank you, Ms. Moore, and Mr. Nunan, for being here.

First, let me say that no doubt all of us within our ridings have the CNIB present in one form or other, whether it's an office...or if not an office, certainly many volunteers, if we are in a rural area. I know somebody close to my own organization was a local chapter president for a long time. So kudos to you and your organization for the work you do on behalf of your constituents.

Over the course of this study we've heard from a number of witnesses, and the thought came to mind as I listened to you that veterans have a range of illnesses, disabilities, and medical requirements that they present to Veterans Affairs as they apply for assistance. For example, those with operational stress injury, as it was once called, or post-traumatic stress disorder have had the hardest time convincing the powers that be that their mental injuries came as a result of military engagement somewhere in the world.

Can you speak about the veterans in your constituency? Is their access to veterans services dependent on whether they can trace their vision impairment directly to service, or are there issues in terms of whether or not you have a precondition or predisposition to a certain condition, so that you don't qualify? Talk a little bit, if you can, about access, including the questions put to vision-impaired veterans as they attempt to get help. Or is the help unconditional, such that you're vision impaired and we're going to help you?

[Catherine Moore]

To start with the end of your question, it is unconditional. From CNIB, our mandate is to work with anyone with vision loss.

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

I'm sorry if I misled you, but I'm thinking about access to Veterans Affairs.

[Catherine Moore]

As we access Veterans Affairs, no, I can say there is not a requirement by Veterans Affairs for the person to prove the blindness was a result of a war injury. So there is not that requirement. For example, if someone was hale, with 20/20 vision, when they returned from World War II, but as a result of age-related blindness they now have vision loss, they are eligible for some services through Veterans Affairs—with the obvious provisos that the province pays first, and those sorts of things, which I'm sure I don't have to go into here.

However, the issue becomes the level of service the person has done and what conflict the loss occurred in, etc., which speaks to their eligibility for levels of services through Veterans Affairs. That is the issue. So it's not that the blindness needs to be traced back to a war injury. In this sense, it's a little bit more straightforward than it is with post-traumatic stress, but there are still levels of eligibility for services based on years of service, combat wounds, and exposure, etc.

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

Thank you.

Back to the question of accessing Veterans Affairs programs in general, impaired vision means that the materials we'd normally be able to read would not be available to an impaired veteran. Maybe I should know this, but does the department provide vision assistance in some form, either audio presentations of programs, and so on? In other words, while I can read a brochure, can somebody else who can't read it for reasons of impairment—even dyslexia or illiteracy—hear something instead? Are there alternatives to the written word for information from the department?

[Catherine Moore]

No, generally not. That's not to say that if it were repeatedly requested, it would.... And I'm not being facetious here. That tends to be a chicken and egg thing in the sense that quite often the veteran doesn't know they're entitled. All departments have a commitment through Treasury Board policy to provide materials in alternative formats upon request, but the reality is that generally information, letters, etc., will come in regular print and will often be inaccessible to somebody with vision loss.

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

Would you know--or maybe Bernard, as a researcher, you might know, but if you don't, that's fine—the number or percentage of veterans we're talking about with vision impairment? I don't mean minor vision, correctable, but impairment that is serious enough that it is a life-altering situation. Do either of you have any idea of the percentage of veterans facing that?

[Catherine Moore]

I can give you two figures. The one we know statistically is that one out of eight persons over the age of 75 will experience significant vision loss. At this point, CNIB is directly involved with 1,800 veterans who have a severe visual impairment.

My point is that the numbers don't line up. There are more people out there who probably could benefit from CNIB services. Right now it's not a high number--it's 1,800.

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

I'll conclude with this. One tries to imagine the life of a vision-impaired or blind person. Those for whom it was an early-life experience, either at birth or in early childhood, would have had a period of youth through which they could adapt to the impairment or vision loss. If it happens later in life, either as you get very old or as a result of an injury at work or in the service, and you're adapting as an adult.... Are the needs in the final years different for those who have become blind later in life versus those who have been blind since their earliest years?

I know with language, if you learn a language early, you learn it, but if you try to learn it late.... We all know how difficult that is.

If my premise is true, does it mean that we have to respond with programs a little differently?

[Catherine Moore]

Yes, even if we just do the cut-off date at working age versus retirement age, let's say over 65 or 70. For someone with vision loss prior to that, it's about returning to work and retraining. It's about communication skills, in the context of learning Braille, learning adaptive equipment, computer equipment--voice-activated computers and that kind of stuff. Those are the requirements for someone younger.

I'm happy to report that Veterans Affairs Canada is in the process, and it's my understanding they have approved, in a proactive manner.... If someone returns now from Afghanistan with--God forbid--vision loss, we have determined what would be a reasonable rehabilitation...I'm hesitant to say “package”, because it sounds so cold, but a process that would help us, CNIB, and Veterans Affairs enable a person to go back to work.

For someone over 65, clearly the requirements are different. There are social requirements and independence requirements, such as being able to stay at home and cut the grass when you don't see very well. And maybe we'd love to not be able to shovel the sidewalk, given the snow we've had in Ottawa lately, but those are the home care things. It's also about being able to manage your medication, being able to see it, and being able to manage your correspondence and finances--being able to do it yourself as much as possible, rather than have someone else do it for you.

The real challenge for someone over 65 is maintaining their independence, their integrity, and their dignity, rather than, “We'll do everything for grandma or grandpa”. Of course, the last thing grandma or grandpa wants is to have somebody do it for them.

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

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you.

We now go over to the

Bloc Québécois with Mr. Perron, who has seven minutes.

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

Good afternoon madam, good afternoon, sir. So that you can put a name to a voice, once again my name is Gilles Perron.

It would seem—

It's okay? You have the translation?

Can you hear the interpretation, madam?

[Catherine Moore]

Yes.

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

It would seem nowadays the trend is to keep the elderly or sick at home as long as possible, and this seems beneficial for them. However, when it comes to people with either a partial or total visual impairment surely natural caregivers would require training and new techniques and technologies.

Are we ready to move in that direction? Is it happening? Is there a way of improving the system?

[Catherine Moore]

Absolutely. We are experiencing the same shortages in terms of rehabilitation people that other health care professions are experiencing. It's not as chronic as the shortage of doctors, but the availability of trained home care workers and of community workers is an issue. We could do better in terms of training people. We could do better in terms of training courses available through universities and community colleges, and we could do better in terms of on-the-job apprenticeships and training in situations.

That's a very good point.

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

I don't know what the situation is elsewhere in Canada, but in Quebec, guide dogs are very much in demand. Do you have any guide dogs? Are they available? Is the cost borne by the Department of Veterans Affairs? MIRA Foundation dogs aren't free, they cost about $10,000 each. Are any such arrangements made for veterans or the blind?

[Catherine Moore]

The best guide dog school is in Montreal, sir.

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

You are referring to the MIRA Foundation in Saint-Hyacinthe.

[Catherine Moore]

Exactly.

I'm sorry, but my French isn't up to par. Since you don't have much time and I speak slowly in French, I'll speak in English.

Guide dog schools and the availability of guide dogs in an innovative school like MIRA are available to veterans at an advanced age. There is no cost, but one of the issues is that many guide dog schools in the rest of Canada feel that after a certain age it's not appropriate to have a guide dog. So there is some educating there, about a senior who is perhaps not very active having access to a guide dog should they choose to have one.

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

How much time do I have left, Mr. Chairman?

[The Chair, Conservative, Rob Anders]

You have two minutes left.

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

Just enough.

I feel like I almost need to apologize for my ignorance, this afternoon. I never even considered whether there were services for blind veterans. I'm a little tongue-tied. In your presentation, you mentioned that there are about 30 blind veterans among your clientele. Are we talking about a category of people who are wounded to a lesser degree when they come back from war or from the theatre of operations? What sort of a distinction can you make between a normal war wound, and the type of wound which causes blindness?

[Catherine Moore]

We don't distinguish. People come to CNIB because they are experiencing vision loss to the extent that it is interfering with their life. For us, there is not a worry about eligibility, because people sort themselves out. Nobody wants to be blind. Nobody wants to admit that they're blind. For us, when they arrive or if we have a referral, it is because they have already had a significant vision loss. So for us, there is no category.

We have a range of services and the person expresses to us the problems they are experiencing. It may be that they're socially isolated. They may express that they would like to read again, and in that case we would provide an audio library service, for example.

For us, there is a worry about being able to meet the demand, but there is no worry about someone coming with not enough vision loss to be eligible. We work with whoever identifies themselves as having a vision loss.

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

Thank you, madam.