Veterans Affairs Committee on March 4th, 2008

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

Is it because of the cost that we are not paying attention to it?

[Gloria Gutman]

Some of it is just a matter of attitude, not recognizing the potential size of the market, and the belief, again....

You know, I spoke earlier about people not understanding, seniors included, the possibilities of rehabilitation or habilitation. Similarly, there are opportunities for technology because of the fact that you have a potentially huge market worldwide--not just in Canada--of people who are living outside of major centres. Instead of making another iPod for the kids, they should be thinking about how we make that iPod work for an older population, some of whom are not quite so techno-savvy.

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

Thank you, Madam.

[The Chair, Conservative, Rob Anders]

Merci.

Now we'll go over to Mr. Stoffer, from the New Democratic Party, for five minutes.

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

Thank you, Mr. Chairman.

Thank you, Madam, for your presentation.

We have the Canadian Medical Association in town today doing their lobbying efforts. One of the things they did with MPs was check our pulse, our blood pressure, our glucose, and all that, and I found out today that as a 52-year-old, I have the body of a 51-year-old. Amazing. It's simply amazing.

My question for you is about dealing, generally, with a generation that doesn't like to ask for help. How do we get them around the asking and actually say, you know, you can do this?

Second, of course, in terms of veterans and their past experiences, is that some of them may be suffering not from dementia or Alzheimer's but from psychological nightmares or concerns of that nature. It concerns not just them but their caregivers as well. What advice do you give to the committee in order to assist them in dealing not only with their own human frailties but with their psychological frailties as well?

[Gloria Gutman]

One of the things that has been found to work in a variety of contexts is having peers give the lessons. So it's one veteran talking to another, one older person talking to another, and using our older people as resources. At any point in time you will have about 5% of seniors who are sufficiently disabled that they require institutional care. Another 10% are living at home with major restrictions on what they can do. That leaves 85% who are able to do most of what they want to do most of the time and who have things they can offer other people.

If you read the reports on volunteers, you know that per capita, those seniors who volunteer give more hours than many of the younger people. Many seniors do volunteer, but I think we have an untapped resource in terms of using peer groups and peer leadership to deal with some of the problems of aging.

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

In my own riding and across the country there are people who are functionally illiterate. They don't understand prescriptions. They don't understand what a doctor writes up. In some cases, inadvertently, not on purpose, the person who is speaking to them speaks above their heads at a level they just tune out. They don't want to feel stupid. They just basically say they didn't hear a word that person said, because they didn't understand.

What advice would you give practitioners and professionals, not to dumb down the message, but to make the message as straightforward as possible so that they clearly understand what's available?

[Gloria Gutman]

That again is something that needs to be in the generic training. We need to get into the very basic medical curriculum that you should understand who your patients are.

We also need to use some of the other health professionals. Medication is a huge issue, but there are many pharmacists in various communities, and there have been demonstration projects showing that the pharmacists are able to answer the front-line questions. They take the time. They're willing to answer the questions. So we need to take greater advantage of the allied health professions and not just rely on the physician. To many older people the doctor is the last word, but still, they will listen to another professional.

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

The last question for you is the cultural aspect. As you know, the face of Canada is changing. In about 20 or 30 years, many of our seniors will be of Asian descent, Middle Eastern descent, African descent, and first nations people, of course. That is changing, and obviously there will have to be a change in the approach of some of the practitioners because of cultural differences. Do you see them preparing for that?

[Gloria Gutman]

Certainly if you take a determinants-of-health approach, then you have to recognize culture is a very big issue. Culture and gender are the two cross-cutting variables within the World Health Organization's active-aging model. In virtually every situation you need to take those two into consideration.

In our own document produced by Health Canada, the document that has to do with policy directions, it says very clearly as well that we need to look at and take a determinants-of-health approach. The face of the country is changing, and presumably the face of the health care professions is also going to change, so that's a positive note.

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

Thank you.

[The Chair, Conservative, Rob Anders]

Thank you very much.

Now over to the Conservative Party of Canada and Mrs. Hinton for seven minutes.

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

Good afternoon, Mrs. Gutman, and thank you very much for coming today.

You've talked about a few things today that I would love to hear a little bit more about, but I have some observations, if you will bear with me. It's obvious to me that you're interested in all aging Canadians, as I believe everyone at this table is, but this committee's mandate is to speak about veterans and their health issues and their aging. It's part of what we're dealing with in this committee. I'll get to a point later where you might be able to speak specifically to veterans.

You mentioned something I found very interesting. You used the phrase “physical design of hospitals”. I think most of us would be guilty of the same problem, that we don't really think about the physical design of a hospital because with any luck at all we stay out of them. If you end up having to go to a hospital, you're usually feeling pretty rotten anyway, and you're now at that age where some difficult things are happening, as you described the acoustics in the bathroom and changing the flooring, etc. Those are all very interesting things to me.

Do you advise provincial governments as well? Are you part and parcel of that? That would be one question, because obviously hospitals are under the mandate of provincial governments. Do you give advice to hospitals?

Secondly, I'm reading that the mission of the B.C. Network for Aging Research is to “increase the overall capacity for aging research and leverage funding by bringing together individuals and organizations with an interest in aging research”. What kinds of groups and organizations do you work with? Do you believe the collaboration of these groups allows the research to be more complete?

If there's more time, I have a couple more questions.

[Gloria Gutman]

To answer your first question, the research I did was commissioned by the Fraser Health Authority. To their credit, they have been looking into the issue of age-friendly physical design of hospitals for some time, and they came to the gerontology centre at the university. I did a review of the literature for them, because they wanted to know if they were missing something, and then designed the study to answer some of the gaps that were identified.

So yes, we certainly are consulted by groups or agencies like the Fraser Health Authority, which deal with a sizable population. We try to transfer the knowledge so the information is available to other people and other jurisdictions.

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

You're a member of the International Association of Gerontology and Geriatrics' executive committee. You're a very impressive lady, by the way, with all the things you're involved in, and I offer you my congratulations for what you do for seniors.

How do you feel the services offered to Canadian veterans compare with those that are offered in other parts of the world? What changes would you implement if you had the authority to do so?

[Gloria Gutman]

Let me answer your previous question first, which was the one about the groups that the B.C. Network for Aging Research brings together. What we try to do is bring together health authorities with academics, the provincial government, and the private sector, as well as with consumers. We find that the seniors need to be involved in the research, both in drawing attention to what questions need to be answered to improve their quality of life, and also in the area of technology or environmental gerontology, where we most definitely want to user-test the products.

The users need to be consulted right from the beginning, through the prototype and through to the next stage, the development of the product, because there are closets full of assisted devices that people have bought. They use them once or twice and they find them too darned difficult, so they sit unused.

In the study we did for Fraser Health we tried out some grab bars that were available from a commercial outfit—they sit on either side of the toilet to enable people to steady themselves so that they can get on and off safely—and found that they were just too difficult to manipulate, except by the tallest and strongest of our sample of people.

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

It defeats the purpose, doesn't it?

[Gloria Gutman]

So you have to try them out.

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

The last question I asked you is how you feel the services offered to Canadian veterans comparate with other services around the world. How do you feel it's going, and what would you recommend as a change if you had the authority to do so?

[Gloria Gutman]

Relatively speaking, I think the services that have been offered have been exemplary. That's why I prefaced my remarks at the beginning by saying that the VIP program, particularly on the home care side, has offered some very good opportunities in support of seniors.

There was a recent article in the Canadian Association of Gerontology's journal, “They Suffered With Us and Should be Compensated: Entitling Caregivers of Canada's Veterans”. I think the gerontological community would agree that the support of those caregivers is an area that could be strengthened and expanded.

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

We've managed to add 24,000 veterans and their caregivers to the program in the last two years. It's something I'm very proud of, but I will give you my assurance that this is not the end and that there will be more.

You are making a contribution to this committee making recommendations in a report, so thank you for your time.

[Gloria Gutman]

Also, as we continue to be involved in peacekeeping or in efforts such as Iraq, we're going to have succeeding generations of veterans, and those groups are each going to be different. The people who are coming back from the countries in which we've been sending troops are techno-savvy, for example; that's a very different cat from the veteran of previous wars.

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

We're not in Iraq, by the way.

[Gloria Gutman]

So you have to keep being dynamic.

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

Canada's not in Iraq; we're in Afghanistan. But you said that you have connections to groups in the United States, so I can certainly understand that little mix-up.