Veterans Affairs Committee on March 4th, 2008

[Roger Valley, Liberal, Kenora, ON]

I know we've heard of some involvement. Maybe we'll ask the researchers to let us know what studies Veterans Affairs has been involved in.

That's all I have. Thank you.

[The Chair, Conservative, Rob Anders]

Mr. Sweet.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Thank you, Mr. Chair.

Thank you for coming today and giving us some really good information.

I wanted to go back and clarify a couple of things you mentioned. You mentioned about iatrogenic illnesses and the fact that these are from physician interventions. Did I hear you right that most of the complications are iatrogenic, that most occur after they're hospitalized?

[Gloria Gutman]

A high proportion of the deconditioning that occurs happens because of iatrogenic problems, yes. A Harvard malpractice study showed that the number of mistakes made were disproportional in the older population.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Is there a high level of awareness of this in the medical community, and is it being addressed? We have an aging population. If most of the complications occur from physician intervention, then we're going to create numerous problems. Are there actions on the go right now?

[Gloria Gutman]

Some of it is a matter of figuring that older people don't warrant the concern they'd give to others. Some of it comes from not paying enough attention to the fact that you can rehabilitate these older individuals. They're not necessarily a writeoff just because they hit a particular age. Yes, I think we need to draw more attention to those kinds of things.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

That's good, because all of us are careening towards that kind of age, and at some point we'll all hit it. The Canadian Medical Association ought to be interested in this issue. I know McMaster University does a lot of educating in the riding that I represent.

Do you think there's a new push on to keep doctors aware that this needs to be a high priority for them?

[Gloria Gutman]

I don't think there's as much emphasis as there needs to be. The geriatrition side, or certainly the Canadian Geriatrics Society, will make the point as loudly as they can. But I don't know that the Canadian Medical Association as a full association is reading the demographics as they should.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

We've had previous witnesses talk about cities designed to be age-friendly. Do you think that municipalities are really applying age-friendly principles to future design? Do you have any data on this?

[Gloria Gutman]

Well, it's interesting. This is one project that has captured quite a lot of fancy. The key question is whether they will, in fact, act on it. We've spent the last three years engaged in this age-friendly cities project and getting the design guidelines; what we don't know is the follow-through, because the research has not taken place. The development of the project only went to phase one, which was to get the guidelines in place; we need now to make sure they are implemented.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

You talked about deconditioning. Do seniors decondition much faster than their counterparts who are 20 to 30 years younger?

[Gloria Gutman]

Yes, they do decondition faster. One interesting article asked what astronauts, seniors, and people with AIDS have in common. The answer is that all three groups tend to spend time immobilized, and it's that immobilization that.... If you have them in space, where they're not able to exercise and to use their muscles in the normal way, even the young, healthy astronauts start to decondition very fast. There have been several studies in which volunteers spent several days in bed; the deconditioning does happen, but it is faster for the older population.

[David Sweet, Conservative, Ancaster—Dundas—Flamborough—Westdale, ON]

Thank you very much.

Thank you, Mr. Chair.

[The Chair, Conservative, Rob Anders]

Thank you. That was fascinating.

Now, because of rotation issues and various things, it's going to be Mr. Cannan up for five minutes for the Conservative Party.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Thank you, Mr. Chair, and thank you, Ms. Gutman.

I've had the opportunity to hear you speak a few times. I'm from Kelowna; I represent Kelowna--Lake Country. I know that a gentleman by the name of Warren Neufeld brought you to the Okanagan many years ago. He was way before many people's understanding of the whole gerontology issue and before the study of aging came into play. I appreciate your hard work in the studies in this area.

There was one specific area you mentioned in dealing with our veterans when they're in the care homes: the training that staff receive. Most or many of the staff are care aides, and it's sometimes a six-month to a one-year program. A post-secondary institution such as SFU or UBC doesn't do that much short-term teaching; it's more the colleges and institutes.

I just wondered what studies you have been able to pass along to the colleges. Have you seen those programs being implemented into the training of the care aides so that they are able to pass that expertise on to the veterans when they're tending to them?

[Gloria Gutman]

Several of the colleges over the years have had programs. Malaspina had a program, and the college in New Westminster; I've forgotten the name of it. They were pioneers in the development of training programs for the care aides. There have been some of those.

At my own university, Simon Fraser, we have a post-baccalaureate diploma that can be done in one year if a person goes full-time, or over five years if they're doing it part-time. We've had a number of individuals who have taken advantage of that to get the extra credential in gerontology, but those are degree programs for people who come in with one degree already.

We also have a very well-subscribed master's program and shortly we'll have an operational PhD program, but largely the training of care aides has been at the community college level. Some of the graduates of our program are people who are training the care aides; we have felt it very important to train the trainers at the university level.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Another area that's very important is occupational therapy. Have you been working with occupational therapists as well?

[Gloria Gutman]

Yes. Graduates with our post-baccalaureate diploma or our master's degree literally go through all of the helping professions, so we have OTs, PTs, nurses, social workers, pharmacists--many of the allied health professions.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

At Simon Fraser University, specifically with the gerontology study, have you had much interaction with the Department of Veterans Affairs?

[Gloria Gutman]

We have not had a lot of involvement with them in the past. It has been more on an individual level. I've been consulted on a few of the projects with Veterans Affairs, but we have not worked specifically with them on the development of their training programs. We could.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Lastly, specifically you mentioned a lot of improvements that are required in some of the care homes where our veterans are staying, and services are provided by the provinces. So have you been working with provinces across the country, or just with the B.C. government?

[Gloria Gutman]

My people have worked primarily with the B.C. government, although some of our people have had contracts with the U.S. It's a contract basis. We're very willing and able to work with other groups, and we do try to make sure that there is some knowledge translation from every project we do.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Great.

Obviously, each province delivers the health care service, according to our Constitution, and can look to the advice that you can provide to each province and territory to ensure that we have the services that our veterans require in those care homes. So thank you very much for your leadership.

[Gloria Gutman]

There are a lot of things that are generic. Yes, we have delivery systems that vary by province, but still, many of those services are generic and apply across the board and are translatable from one province to another.

[Ron Cannan, Conservative, Kelowna—Lake Country, BC]

Thank you very much. Keep up the good work.