Veterans Affairs Committee on Feb. 7th, 2008

[Dr. Maggie Gibson]

I probably don't know the political systems well enough to really speak to that, but I can give you an example.

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

Go ahead.

[Dr. Maggie Gibson]

The Public Health Agency of Canada is doing stellar work around increasing the profile of seniors in emergency preparedness, both nationally and internationally. I am involved with some of that, and it is being driven very much by seeing the need. It is very dedicated to having people move forward, getting things on the agenda of the agency, and creating enthusiasm for the work within the professional and practitioner community so that people like me, who don't work for the government or the Public Health Agency, are quite engaged in participating in the projects and initiatives they're putting forward.

It's a personal example of where seniors' issues are being very well dealt with in the emergency preparedness field in Canada because of the leadership being shown by the Public Health Agency.

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

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you, Mr. Stoffer.

Now we'll go to Mr. Shipley with the Conservative Party for seven minutes.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Thank you, Mr. Chairman, and thank you, Ms. Gibson, for coming in.

I'm glad I had a chance to meet you earlier. My riding runs just north of London, so we're not very far away. I'm very familiar with the hospital system, and not so much with Parkwood Hospital, but I certainly have been there. It is an amazing facility for what it does for our seniors and our veterans.

We've talked to a number of witnesses from all areas. Clara Fitzgerald and Dr. Mark Speechley were here. Is there a connection between the National Initiative for the Care of the Elderly and the Canadian Centre for Activity and Aging?

[Dr. Maggie Gibson]

They are also from London. I'm pretty sure Clara is also a member, as I am, of the NICE network. I am not sure about Mark, but I wouldn't be surprised if he were also a member.

The way to think of the NICE network is that it's a grant-funded infrastructure that really brings together a whole variety of people who work for other organizations. Many of us who work in gerontology find ourselves members of NICE, the Canadian Coalition for Seniors Mental Health, and the Canadian Association on Gerontology. We sort of cross-reference all of these different organizations. The Centre for Activity and Aging is at the University of Western Ontario. I know that some of them are also members of NICE.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Okay. I was trying to get the connection, because I don't think it was mentioned to us during their presentation.

[Dr. Maggie Gibson]

It may not have been.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

I know we have a lot overlapping initiatives out there.

On what you are doing, we and all witnesses have said that anything we can do to keep our seniors, our veterans.... There's always this correlation between the general-public senior and the veteran senior. What are the correlations, and how has what has happened to our veterans affected them compared to the general-public senior? Obviously we have post-traumatic stress in our society, but how does that differ in veterans compared to the general public? We've had a lot of discussions about that.

I'm wondering if you can help us. The operational stress injury clinic is part of the Parkwood Hospital. Can you tell me how that is going? We've had discussions around operational stress injury. What can we do to help with that?

[Dr. Maggie Gibson]

Unfortunately, I'm not going to be able to answer that question to your satisfaction, because I actually work in the geriatric component, the long-term-care component, at Parkwood Hospital in the veterans care program. I don't work in the operational stress injury program. Certainly there would be people well able to describe that program in detail to you. My focus is geriatrics.

But in terms of your question about how veterans are different, one of the things in long-term care that I think is particularly important is that the long-term-care veterans population is mostly male, and the long-term-care population from the community is predominantly female.

That's going to change for a couple of reasons, partly because the demographics in the mortality rates are changing—men are living longer—and partly because family structures are changing. The given scenario where you have the younger spouse who cares for the older man who is then able to live out his whole life at home is going to change as well, because the family structure is changing.

What we have in the veterans care population is a real opportunity to understand what the needs of aging men are that then can be extrapolated to what the needs of aging men in the community are going to be over the next few decades when the numbers start to balance out and we will have more equal numbers of men and women surviving to older ages.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Can you help a little bit with what you mean by “the needs”?

[Dr. Maggie Gibson]

For older men who have dementia, who move into long-term-care facilities, or who want to stay at home, how do we best support their function, their quality of life, and their interests, as opposed to what are the best ways to meet the needs, wishes, quality of life, and all the rest of it, of older women? And there are gender differences.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Yes. I think most of us know that.

I want to follow up on something that I know my colleague Peter brought up too. It has to do with professional care, just to expand a little bit on that.

One of the things that is always a concern is where do we get the professional care? That was one of the questions.

In every town in Ontario—and I suspect it's pretty much the same across the country—when we're looking for doctors, or we're looking for specialists in some areas but always doctors, each town is struggling to meet the medical needs they find within their community. When we have the same issues in our long-term-care facilities, how do we supply those facilities in terms of the professional needs we have?

Do you have any recommendations on how we can share, how we can work with the communities, work with the general public, on being able to get the care that is needed?

[Dr. Maggie Gibson]

It's a clearly recognized problem, and actually this does come back nicely to NICE, the organization I'm here representing, because one of their three objectives addresses that issue head-on. One of their objectives is to improve training of existing practitioners, improve geriatric curricula in universities, and interest students in specializing in geriatric care.

They don't have the answers yet either, but it's actually one of the organization's three priorities, to face that issue head-on and start to think about what we are going to do. I don't think anyone has the answers yet.

[Bev Shipley, Conservative, Lambton—Kent—Middlesex, ON]

Well, it all takes so much time.

Speaking of time, thank you, Maggie.

[The Chair, Conservative, Rob Anders]

You're on cue, let me tell you.

Now we'll go back over to the Liberal Party of Canada and Mr. Russell for five minutes.

[Todd Russell, Liberal, Labrador, NL]

Thank you, Mr. Chair.

Good afternoon, Ms. Gibson. We're glad to have you here as well as, certainly, your presentation in raising the whole issue of mental health and its importance in terms of this particular study.

I just have a question. I was struck when Health Canada appeared before us and they listed a couple of statistics. I don't know exactly what they were now—I don't have the paper in front of me—but they said that the vast majority of the elderly in a certain category said they were in good health when they were asked. Then there was another statistic that said, basically, in the same group there was a high percentage with at least four chronic diseases they were managing and a higher percentage dealing with at least one chronic disease, but still when asked how they would view their overall health, they said it was very good.

So I asked them that question, and they said that was a state of mind. I still feel a statement such as “I'm in a good state, even though I have four chronic diseases” is quite interesting. Could you speak to that at all?

My second question would be this. Because we're talking about veterans and we're targeting programs around veterans, we know there are going to be certain similarities between elderly or seniors or the aged and veterans as a subgroup. But if we're talking about veterans specifically and we're talking about programs targeted towards veterans, we know some of them are going to be similar to what you would do for similar types of populations. Is there anything specific that we should be addressing for elderly veterans, which make up the vast majority, so that our resources, time, and efforts are more targeted?

Those would be my two questions.

[Dr. Maggie Gibson]

I think with respect to the second question, it's really more a matter of being able to target veteran populations with programs that are.... It's a contained population, so you can target veterans populations with ideal programs, with model programs that are focused on different issues. We don't know because we aren't targeting the elderly who need assistance with ideal and model programs in general, but we can at least think about targeting the veterans population, which is a defined group, with what we think are really ideal programs. Then when they work and when we figure out what works about them, why they help, and which pieces of how they help are really because it's focused on men or on long-standing relationships between spouses or on something about having that camaraderie of the veterans' identity, we'll be in a good position to learn from those programs and figure out how they could be translated to the broader community.

The literature on Second World War veterans internationally really seems to show that one of the things that has been very protective for veterans in many countries is the camaraderie. It is the fact that their services were acknowledged and continue to be acknowledged through remembrance kinds of activities. That sense of appreciation and of being cared for is actually correlated with good mental health in the face of many aging challenges.

It's really worth looking at the studies that go across the Finnish, Russian, British, and American veteran populations to see where some of those commonalities come out. One of them seems to be that if you have been through a really traumatic event like a war, the remembrance component and the acknowledgement component carried out through your life is a protective factor. That's different from the rank and file community person who may have various traumas occur to them but not in any kind of systematic, organized, acknowledged way.

So there are some advantages to the veterans group that I think we can capitalize on, in terms of developing health care programs for an aging population that will be really quite model programs. I think that's what Veterans Affairs has tried to do in many ways.

I apologize; I have completely forgotten your first question. What was it?

[Todd Russell, Liberal, Labrador, NL]

Just to paraphrase, if you have four chronic diseases and you say your health is in good condition, the explanation is that it's a mindset.

[Dr. Maggie Gibson]

A lot of the research would say that when people answer that question--how's your health?--they actually are using their own age group as a reference. When you ask someone who is 85, how are you doing?, they don't look at you as the 28-year-old interviewer and say, well, not very good compared to you. They think of their own reference group and say, well, I'm not doing too badly compared to my peers. In the scientific world that's the kind of explanation for why you get someone younger who has no chronic diseases thinking, how can you be saying you're healthy? Look, you have two diseases. But really, compared to your peers, you're not doing so badly.

[Todd Russell, Liberal, Labrador, NL]

Does that sort of say that those others have six chronic diseases, or something of that nature?

[Dr. Maggie Gibson]

It could be.

[Todd Russell, Liberal, Labrador, NL]

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you, Mr. Russell.

Now to the Bloc Québécois, Monsieur Asselin.