Welcome to the 132nd meeting of the Standing Committee on the Status of Women. This meeting is in public.
Today, we'll continue with our study on the challenges faced by senior women, with a focus on factors contributing to their poverty and vulnerability.
We are pleased to welcome in the first hour, from the Hearing Health Alliance, Jean Holden, Advisory Board Member, and Valerie Spino, Advisory Board Member. Then from Pembina Active Living (55+), we have Robert Roehle, President, and Alanna Jones, Executive Director.
I'll now turn the floor over to the Hearing Health Alliance for an opening statement.
Thank you very much, Pam.
My name is Jean Holden, and my colleague here is Valerie Spino. We represent the Hearing Health Alliance of Canada. We are representing a number of groups. We are representing consumers, hearing health care professionals, the hearing industry and foundations across Canada. On behalf of the Hearing Health Alliance of Canada, we thank the committee for inviting us to share our perspective about the important and often overlooked issue of hearing health.
In our meetings with some members of the House of Commons and Senate, some related personal experiences of how a mother or a grandmother cut off regular communication with family and friends, because of unmanaged hearing loss. This is like most people with hearing loss, who delay seven to 10 years before addressing their hearing challenges. Stigma, access to health care and the lack of understanding of the impact of unmanaged hearing loss in the public and the health care system contribute to this delay.
Hearing loss is one of the most prevalent chronic conditions affecting senior Canadians. Today, 78% of Canada's 4.8 million seniors have measurable hearing loss. By 2031, Statistics Canada projects that 5.1 million women will be seniors, so we can predict that almost four million senior women could have measurable hearing loss. This will have serious implications for the health of, and the health care services provided to, senior women.
Despite evidence-based research and statistics that show that hearing loss is widespread, with a serious impact on the health of Canadians, at a significant cost to government programs, hearing health remains a low public and health policy priority.
Women often experience gradual hearing loss as they enter their senior years. It's common for them to slowly withdraw from their social activities with family, friends and community, because it becomes embarrassing and stressful, and takes a lot of energy to cope in situations where they cannot participate and engage as before.
It is no surprise that unmanaged hearing loss is strongly linked to depression, anxiety and loss of self-esteem. Those who are socially isolated often reduce their exercise levels, contributing to other health conditions, such as high blood pressure, heart disease and diabetes. Research also strongly links unmanaged hearing loss in seniors with the onset of cognitive decline earlier, by two to seven years.
Most people are unaware that unmanaged hearing loss is significantly linked to the increase in risk of falls. The risk increases with the severity of hearing loss. Falls are the leading cause of injury-related hospitalizations among seniors. The most common injury is hip fracture, which occurs more often in women. It is very difficult for a senior woman to recover from a hip fracture. Many are admitted to costly long-term care facilities, and between 20% and 40% of seniors with a hip fracture die within one year.
For those with hearing loss, there is also a risk of reduced safety and security, with the inability to detect alarms, traffic and other audible threats in their daily living activities. It is clear that good communication is needed among doctors, other health care providers and patients, in order for patients to benefit from access to health care. Poor communication can cause mistakes in diagnoses—some of them are very serious—and mistakes made by patients when they fail to understand instructions from the health care provider.
I'm going to ask Val to continue. She will be speaking in French for our French-language members and then she will summarize our recommendations in English at the end.
The impact on health and costs resulting from unmanaged hearing loss have been well documented. Unmanaged hearing loss is too often linked to more hospital stays, higher rates of readmission and higher incidence of costly medical errors. This is the case for acute care admissions. We also know that isolation, depression, cognitive decline and falls are some of the top reasons for admission to long-term care facilities.
Canada is unprepared for the challenges of hearing loss. Culturally, hearing loss is often written off as a normal part of aging and carries a stigma.
Screening for hearing loss is often not a part of an annual physical exam. Health care providers across the system are often unaware of the signs of hearing loss, the impact of unmanaged hearing loss and the importance of addressing the issue.
All this adds up to serious problems for senior women, and especially for women who have low incomes or who live in first nations communities. Most of the time, access to hearing health services isn't covered by the health care system, and these services aren't sufficiently available in northern, first nations and rural regions.
One of our goals at the Hearing Health Alliance of Canada is to have more women pay attention to their hearing health. There's a role for federal, provincial and territorial governments to collaborate with various communities of interest to adopt policies and actions to promote hearing health.
First, we all need to do much more to increase public awareness to prevent hearing loss, to identify and manage hearing loss and to destigmatize hearing loss.
Second, there is an urgent need to integrate hearing loss assessment, diagnosis, prevention and treatment into existing health programs and to facilitate collaboration among front-line health care providers to promote hearing health as part of overall health.
Third, governments must address existing models of government funding and tax benefits to provide equitable access to hearing health care and assistive devices.
There is no doubt that making hearing health a high public policy priority will provide immediate and long-term benefits in the form of significant savings to our health care system and increase the quality of life for our seniors, especially women.
We thank you for your attention and consideration.
Thank you, Madam Chair.
I would like to begin by thanking this committee for inviting us, Pembina Active Living, to appear before you.
My name is Bob Roehle, and I'm the President of Pembina Active Living. Beside me is Alanna Jones. She's our long-term Executive Director.
As a senior and someone married to one, I don't need to be convinced of the importance of the issues and challenges faced by older people, particularly older women, issues like access to transportation, health services and medication, home care services, affordable housing, justice, widowhood and loneliness. These are all quality of life issues that should, in my opinion, be a right of Canadian citizenship. However, let me say up front that our experience and comments will focus more on the issue of social inclusion and connectedness.
My approach this morning will be to give you an overview of Pembina Active Living, who we are and what we do. Ms. Jones, who is the long-term, hands-on person in the organization, is prepared to elaborate in more detail.
Pembina Active Living came into being in 2009 as a result of a few community-minded seniors in south Winnipeg getting together to discuss needs of their peer group, folks like themselves who had retired and were living in their own homes, condos and apartments. They realized, from their own experience, that much of their social network and connectedness related to their careers and children, and these had come to an end, hence the need for an organization to bring these lost souls together with folks of their own generation and station in life.
Out of these discussions, Pembina Active Living was born. It has a simple mandate, to enhance the quality of older adults living in south Winnipeg. In 2013, PAL achieved charitable status from the Canada Revenue Agency, thus allowing it to issue charitable tax receipts to donors. As a word of explanation, Pembina Active Living is essentially a community club or a community centre for seniors.
With annual funding from the Winnipeg Regional Health Authority of approximately $40,000, plus membership fees of $20 per person and an ongoing fundraising campaign, PAL is able to retain the services of a part-time executive director and administrative assistant. This allows PAL to operate two and a half days per week out of less than adequate space in a local church. This is supplemented by renting space as necessary in local community centres. PAL's membership varies somewhat from year to year and within the year depending on the activities being offered. PAL's current membership is around 450 people. It has been as high as 500.
Without the assistance of over 100 volunteers contributing in excess of 6,000 hours of their time, PAL's $100,000 annual budget could not be stretched to do the things we currently do or offer the services we offer to seniors.
PAL is celebrating its 10th anniversary this year. While we are pleased with our accomplishments to date, we have much more to do. Besides the critical need for more operating funds, our other immediate challenges are as follows.
We need space. PAL needs a permanent home of its own, a dedicated office and storage space and a five-day per week drop-in centre with a canteen to serve coffee and perhaps a light meal at noon.
We need diversity. We must find better and more creative ways to reach out to our indigenous community, to new Canadians and to the rainbow community. A recently awarded and much appreciated New Horizons grant from the federal government of $25,500 should go a long way to helping us reach out to these other groups.
On social cohesion or connectedness, PAL must strive to become more holistic as a seniors centre, not just a place to take one-off inexpensive exercise programs.
Allow me to end my formal comments with a quote from an editorial in a recent issue of Maclean's magazine. It is referring to a study done by people at Brigham Young University, a psychologist by the name of Julianne Holt-Lunstad. It says:
“Current evidence indicates that heightened risk for mortality from a lack of social relationships is greater than that from obesity,” Holt-Lunstad’s study concluded.... Being lonely is comparable to smoking 15 cigarettes a day.... It’s also worse for your health than the...risks arising from alcohol consumption, physical inactivity or air pollution—all of which get much more official attention than loneliness.
Humans are social creatures, and avoiding the necessity of social contact can be devastating to our physical and mental health. I believe that applies equally to both young and old in our society. That's really where PAL is operating. It's trying to increase social inclusion among the older adults of south Winnipeg.
Thank you to the committee for this opportunity.
I would like to acknowledge the federal government's commitment to seniors through its minister of seniors position, the national seniors strategy and the new horizons for seniors program.
As you know, senior centres are an important part of our communities. Through the promotion of healthy active aging, community involvement and social inclusion, senior centres provide valuable resources and opportunities to older adults all across Canada. Research on senior centres demonstrates that participation is associated with social, mental and physical benefits; and that by fostering the exchange of social support, senior centres protect older adults against the negative impacts associated with social isolation, making senior centres invaluable resources in the communities in which they operate. Given that older Canadians are now the fastest-growing segment of our population, with their numbers expected to double over the next two decades, the importance of our senior centres to the well-being of this demographic cannot be overstated.
Pembina Active Living (55+) is an non-profit, senior-serving organization in south Winnipeg. Our catchment area of Fort Garry comprises 11 communities, 77 square kilometres, and is home to 18,775 adults over the age of 55, or over 25% of the total population of our area.
PAL recognizes the diverse needs and challenges of older adults and is committed to the development of programming and opportunities that will enhance their lives. The well-being of older adults is one of our core values and we believe that active living and social inclusion can enhance physical and mental wellness. Research at the Canadian Centre for Activity and Aging found that fit people are half as likely to become dependent in later life. Health Canada's physical activity tips for older adults recommend two and a half hours of moderate to vigorous aerobic activity each week.
We address that at PAL through some of our weekly programs. We have 20 plus programs running through the communities, including older adult resistance and weight training, yogalates, line dance, seniors' yoga, zumba for seniors, cycling, bowling, a garden club and a lunch group. We have a movie group, a writing program that has published nine books, computer workshops, pickleball, three free annual community events, and a wellness, leisure and special interests speaker series that is free to all the community.
All this is great for those who can afford our programs, but for the many low-income older adults in our community, many of our programs and activities are out of reach financially. In addition, transportation to and from senior centres was the most common barrier to participation for older adults. These are two issues that, with our limited resources, we simply cannot address.
PAL has accomplished a lot in its 10 years with very few resources, and we have a lot to be proud of. At the same time, there is so much that we cannot do and many we cannot reach because we simply do not have the resources. We are at the limit of what we can do with a skeleton staff and a volunteer base who are already putting in approximately 500 hours a month.
In order to reach out to the thousands of older adults in our community, many facing social isolation and loneliness, we need support. We need stable annual operating funds, without which we will not be able to fulfill our mission. We believe that senior centres are perfectly poised in the community to address the various issues faced by older adults. The most impactful thing we believe the federal government can do is support senior centres through direct funding.
I just want to add that we did not specifically name women as the subject of our presentation, but our membership is 70% women.
All of these issues are directly impacting the senior women in our communities.
Thank you very much.
I'll answer, since my day-to-day work involves bringing older people out of isolation and helping them return to their social lives. I'm an audioprosthetist. I spend my days answering these questions.
Yes, there's a range of hearing aid technology. A hearing aid is a computer. Take the example of two computers in an electronics store that look exactly the same. If you launch software such as Word while simultaneously surfing the Internet on one computer, it will be difficult to use, whereas you can launch all the software at the same time on the other computer, and it will work well.
A hearing aid contains a computer. A more sophisticated computer will manage sound better. It will certainly lead to a better understanding of speech and better audibility. The software in hearing aids can emphasize “s” and “f” sounds and contain a noise reducer. A range of technology exists.
It's often said that the best and most high-end hearing aids are the closest thing to normal hearing. All the available research and technology is used to manufacture high-end hearing aids. Basically, the latest technology is used to design a machine that most closely matches the human ear.
Unfortunately, not everyone can afford the Ferrari of hearing aids, or the largest and most efficient hearing aid. As a result, there are various forms of hearing aids.
Since I work in the field, I can see the difference between an entry-level hearing aid and a high-end hearing aid. The performance varies according to the quality of the hearing aid. Obviously, it's better to have an entry-level hearing aid than nothing at all. Science has understood for a very long time that it's better to have a hearing aid in each ear than a hearing aid in only one ear. At one time, glasses had only a single lens, but it was quickly understood that we use both eyes to see in three dimensions. It's the same principle for ears.
Yes, there are different qualities. In an ideal, utopian world, everyone would have high-end hearing aids. That would be best. However, unfortunately, that's not the reality. That said, certainly each increase in quality is a small improvement for the patient. We don't disapprove of the fact that there are hearing aids for all budgets because, unfortunately, not everyone can afford high-end hearing aids.
We need to mount some very strong public awareness campaigns. Get it out there everywhere, so that families who support seniors and the seniors themselves understand that hearing loss is a major issue and it should not be considered a terrible thing as you age.
There is a stigma. People associate hearing loss with what happens to you when you're a senior, and they don't want to admit that they're getting older. Some of the people we've interviewed in our awareness-building admit that they themselves have a hearing loss. It impacts their daily activities and ability to continue with their work, and they don't want to admit it to their colleagues. They don't want to address it.
This is an issue. Also, because of the gradual hearing loss, people don't really know that over the years they've changed activities to compensate for their hearing loss. They don't realize that they're challenging people around them and that they're losing out and becoming more and more isolated. It's a gradual process, so there are issues around that.
We need to mount a public campaign.
We also find that in the health care system itself, people in hospitals—doctors, nurses, physiotherapists—don't understand that the patient they're working with doesn't understand a thing they're saying. We've had examples of people who were sent to a specialist to be assessed for dementia, and they didn't have a problem with anything else but their hearing. They corrected the hearing, and gradually those people were able to connect and live healthier lives.
Thank you very much for taking the time today to come and chat with us.
I have some personal experience with this. I have a gentleman in my life by the name of Kit Leitch, who is my father. His grandchildren now affectionately tell him regularly, “Papa, put your ears in”, because for the longest time he did not want to grapple with the issue of hearing loss. As a single grandparent...it's made a world of difference to us, but it's very obvious when he doesn't have them on—shockingly, actually.
That being said, one of the things our family looked at, and was fortunate enough to be able to deal with, was the issue of cost.
I wanted to ask all of you. I'm sure, at the centre, you have also faced this. Many of your participants probably are using hearing aids regularly. It's not just the cost related to the actual device, its also the batteries and maintenance and everything else. What are your recommendations to our committee for how that should be dealt with?
I recognize that there is, “The government should pay for it,” but what is particularly helpful to us—and I think to the committee—is to be specific. For example, we know that insulin pumps in the last five years have been added to the medical devices discount with regard to federal funding. Are there specific aspects of public policy that would be valuable?
Those were excellent presentations, and you're doing fabulous work in the community. I'm very aware of it and the difference that you make in seniors' lives.
I'm very interested in the demographic change that you talked about—not only in Winnipeg but across the country—and the particular challenges that you face. Two big ones are space and, of course, the cost of space and the cost of putting on your program.
I happen to know the St. Norbert Community Centre, where you have some of your programming. Unfortunately, you have to spread yourselves out instead of going to one location, but it's empty during the day; it's not being used. Not only is it a waste of space, it's a waste of investment in what could be health benefits for seniors and others.
Is there a model out there anywhere in Canada that you have researched? I know we have the Good Neighbours facility in East Kildonan, which is what we call an intergenerational facility, seniors by day and young people and families by night. That's one model. I understand they're struggling financially as well because of the whole issue of operating costs. Again, with this aging dynamic that we have in all of our communities across Canada, and community centres basically being vacant during the day, this is not an isolated phenomenon.
Is there some scope for some sort of national program to look at that and for the three levels of government to put their heads together to see how we could use the space and the resources more efficiently to get the kinds of health benefits you mentioned?
I'm going to bring everyone back and we'll get started.
Before we get started, both witnesses have provided us with PowerPoint presentations that are in English only. Can we get a show of hands to get unanimous consent to do the PowerPoints in English only?
The Chair: We don't have unanimous consent so we can't use the PowerPoints. We can get them translated and provided to the committee though.
Our next witness is Lori Weeks, from Dalhousie University. She's a professor with the School of Nursing.
Also, we have Tania Dick, who is the Vancouver Island representative in British Columbia for the First Nations Health Council.
I think we'll start with the video conference first, just in case we lose the signal there.
It's over to you, Professor Weeks.
Thank you very much for inviting me to present to you today. I'm sorry that I couldn't be there in person. I'm very pleased that your group is focusing on the needs of older women. There are certainly a lot of issues and not a lot of focus on this group, so I really commend you on this work.
I was asked to talk about issues that contribute to women's poverty and vulnerability, and hopefully you'll have access to my slides at some point.
We have a lot of intersections due to the issues of ageism and sexism. That's really the focus of this, I think, and it's what I'm going to talk about today. In addition to women who are older, there are additional groups of women who face additional vulnerability.
I'm really pleased that you have a person who is going to talk about indigenous issues and aging, so I won't focus very much on that component. That's another issue that can affect vulnerability in later life.
We know that there's a great deal of diversity among older women. We have a lot of older women in Canada who belong to a visible minority group, and that can also have a great impact on their experiences in later life.
One of the main things that I wanted to first focus on is the anti-aging industry. We have a lot of overt discrimination against older women. If you're watching commercials or any kind of media, it doesn't take long to see commercials that really are talking about why older people, women especially, should not look old. I think we really need to look critically at that. We don't have commercials saying why it's bad to be a woman or bad to be a young person, but we have a lot of focus in our society about women not looking old.
I think that's something that we need to change and really talk about in terms of a very overt form of discrimination that needs to be addressed in our society. I wanted to make that point very clear first of all. I teach a course on women and aging, with a lot of wonderful discussion amongst the mostly younger women in my course who are already absorbing these messages about wanting to look young. I think we need to have a lot of social marketing and a lot of campaigns around, “Why is it that we're allowed to discriminate overtly against looking like an older woman in our society?”
I'm sure that you are well aware of the demographics of our aging population, but we don't focus as much on the fact that there are more older women than older men—in my slides, you'll eventually be able to see some of the statistics around that—especially as we get older. Among people who are in their sixties, there's not a lot of difference in terms of the proportion of men and women, but it steadily increases over time. For example, for people who are 100 and over, it's about 90% women at that point. It's a steady increase in the proportion of women.
For any kind of services and supports that are focused especially on our frail older adult population—I'm thinking about things like home care, community-based supports and residential-based long-term care facilities—these issues are disproportionately affecting older women. Any time we have waiting lists and we don't adequately fund these kinds of services, it's really disproportionately affecting older women.
Another important demographic point that I would like to make is that as women get older, they are much less likely to live in a couple relationship than men are. A lot of older men have a spouse. For women, because women live longer and women often have a male partner who is older, it ends up being a situation in later life where there are a lot more women who are not in a partner situation, don't have access to a spousal caregiver and are living alone.
In Canada, we have a very large proportion of our older adult population living alone, but especially our older female population. We know that there can be a lot of challenges related to social isolation. It has a major impact on physical and cognitive health. Any efforts to reduce social isolation amongst our older adult population, especially our population of older women, are very important.
I've been really interested and engaged in research on housing for older adults for many years now. For the last couple of years, I've been focused on housing that supports social engagement. There are some really interesting and innovative forms of housing. One of them is called co-housing. I'm not sure if it's something that many people in the room are familiar with.
There are some examples of co-housing in Canada. They are very rare on the east coast, where I'm from. They are more common in central and western Canada. They are a form of intentional community where people come together and choose to live in a community. The size can range. Often they are somewhere between 10 and 30 units.
In Canada, there are a lot of regulatory challenges to these kinds of communities developing, but they are very mutually supportive. People choose to live in community with other people where they own their own unit, which is often some kind of apartment, but they participate in looking after the needs of each other and looking after the needs of the community.
This form of housing can also promote health in many ways. There's also some evidence starting to show that it can increase the amount of time people can live in the community versus using higher levels of care.
Some work we're doing on co-housing in eastern Canada has been really interesting because the only real model that groups have in Canada is to use a condo kind of model in terms of organizing these communities. Not all older women have the financial ability to purchase a home. There's no funding in particular to support these communities. They are not really a form of affordable housing. They are simply at the cost of building housing today.
I would like to think about whether there are any ways to support innovations in housing, especially housing that promotes community, social engagement and connection, but there are a lot of financial and regulatory barriers to these kinds of things.
I will turn now to economic issues. Again, we don't focus enough on this, but there's a very large income gap between older men and older women, for various lifelong reasons, where a lot of older women today have spent a lot of time in very important, but often unpaid, labour.
Many older adults, and especially older women, arrive in later life where they only have access to old age security and the guaranteed income supplement for their income. We have a very large number of low-income older women in Canada.
There are a few challenges with some of the financial programs that we have available. It is good that we live in a country where we do have income support programs for older adults. Of course, this is a wonderful thing, but the maximum monthly payment for old age security today is around $600 a month, and the person needs to be a Canadian citizen or a legal resident for at least 10 years after turning 18. This does preclude some older adults, especially older immigrants to our country, from gaining access even to very basic amounts of money in later life.
The guaranteed income supplement for those who have very low income is almost $900 a month. For many older women that is the amount of money they have to survive on between the old age security and guaranteed income supplement.
I've also read some research showing that some people have challenges in accessing some of these forms of financial support, especially the guaranteed income supplement. I think we need to take a look at whether there is enough education around how to access these kinds of financial support programs in later life.
There's also a new Canada caregiver credit, which is a wonderful thing to have in our country. However, for people who are providing support to a spouse, a partner or another dependent person in their life, such as a child or a parent, again, this is a program that would—
Good morning. Thanks for having me.
First, I'd like to acknowledge the Algonquin nation, whose traditional and unceded territory we are gathered upon today.
I was pretty excited to be invited to come and speak about senior care, because it is a broad issue, across the country, that we really need to deal with. More particularly, I was excited to look at it through the indigenous lens as well.
I am a registered nurse. It's wonderful to see Dr. Weeks, and hear her. Thank you for that.
I represent the First Nations Health Council, an advocacy group in British Columbia. We now fall under the First Nations Health Authority. We took over from Health Canada, which stops at the Alberta-B.C. border, and have created a community-driven, nation-based program. We are in the transformation stage around that.
Senior care is a big issue for us. We find in our communities that the majority of our elders, particularly over 50—we broke it in two different sections—end up leaving the communities, and rely on provincial services and acute care settings for their primary health care—all of their health care demands. In our communities, we only get physicians who fly in every two weeks, or once a month. The acuteness of their issues demands that they be moved to cities or towns where they are closer to access to those services. They no longer fall, per se, under Indian health or the First Nations Health Authority, and have to rely on the provincial health system. What we do federally— big-picture, umbrella-like—really impacts the indigenous community as well, through the provincial programs.
In B.C., in 2013 we assumed all of the programs and services from Health Canada, and the first nations and Inuit health branch, Pacific region. Our vision was to transform the health and well-being of B.C. first nations and aboriginal people by dramatically changing health care for the better. We have the opportunity, through the new organization, to work with surrounding provincial stakeholders. Bringing all of our data together really allows us to see what's working, or not working, and where the gaps are, which is really helpful. For quite while, we've been kind of stand-alone with Health Canada, so that makes a big difference. That relational piece among all of the stakeholders, provincially, is so important for closing those gaps. That has been a really exciting process as well.
Particularly for the analysis for today, we studied access to health care and medications, including data on chronic conditions, using the health system matrix for B.C. first nations senior women, broken out into two age categories: 50 to 64, and over 65. This was done in recognition that first nations communities themselves determine when a member has become an elder. The ages vary across B.C.
Some of the key trends we found preparing for today include a really increased reliance of first nations females aged 50 and over on accessing primary care in a hospital setting, particularly emergency departments. In 2014-15, first nations females between the ages of 50 and 64 were just over two times more likely than other resident females in B.C. to use the emergency department for basic primary care.
First nations women aged 50 to 64 have decreased access to primary care outside of hospitals. As I mentioned earlier, it depends on how we purchase services, and how isolated and remote the communities are. It's a general trend, across the board, for most communities purchasing those services, and having access to continual, consistent, adequate and safe primary health care for communities, particularly for our elders....
When we analyzed the prescription drug piece, we looked at 56,000 first nations members, through the health benefits program, particularly female clients. Some of the highlights are as follows: first nations women 50 years of age or older are significantly more likely than the general female population in B.C. to have prescriptions for hypertension—
I feel like I don't want to talk about that. Statistics and data show we've been the sickest people in the country for generations. So really that's kind of repeating that message and that story. It's about what we do and how we go about tackling that and changing that through the transformation of those systems that provide those services for us.
One of the biggest things we talked about and that came out of going through the data was mental health and wellness. We could only collect the data through the physicians service lens—their visits, hospitalizations for mental health and substance use. But when we talk a little bit to our nurses.... We have access to some of the nurses in our communities, and this was profound for me. I actually talked to my mom. She was a nurse too. She is 74 now and my dad is 68. So, we're talking about my parents when we talk about this issue. They are the seniors in the community today. They are the first survivors of the residential school. That is really ground zero of the whole mental health trauma-informed piece that we hear about. The approach and the delivery of service have to ensure that we get to those people at a level where they are going to be able to respond to that and live the healthiest life they possibly can. Mainstream systems are not working for our indigenous people with the lack of trauma-informed care. I think this intersection is a really great opportunity for the TRC recommendations that have been rolling out and for the health system to really get on board and jump on that train and work through it and for our seniors. It triggered for me that, as I begin to look at losing my parents as they move through their lifespan, that that really was the first flow-through of residential school survivors, and that's huge.
Some of the recommendations we came up with through the data points highlight, of course, the need for more access to better quality of health services, particularly primary care.
Increased attachment to general practitioners can facilitate better access to tertiary care and other important services for improving health and wellness for first nations senior women. The following provides a summary of recommendations through these shared resources and the stakeholders we talked to in B.C. before arriving here today.
One is to improve home and community care programs to accommodate clients discharged from hospital, many of whom require continuing care at home. My mom is a prime example. She has had bilateral hip replacements and ended up losing the apparatus completely. She is wheelchair-bound and requires a lot of home care. We had to move her out of the village. She is now off reserve and doesn't have access to or does not qualify for Indian health services anymore. She is a little too far from the health authority for provincial services to come in, so she gets limited access to those services. There really has to be a collaboration between the federal and provincial services to actually capture these individuals when they come out of those kinds of acute-care settings. Our labs and X-rays end at three o'clock when the technician leaves and jumps on the ferry and goes away. So we have to put them in an ambulance and drive them two hours and a ferry ride away. Quite often the procedure is done, the test is done, and they are discharged and left at the door. These are 72-year-old people who don't have an escort, don't have a wallet and are in a hospital gown. That type of thing happens on a regular basis in our communities.
Next is to increase population health promotion and programming at individual, community and population levels to reduce rates of chronic conditions among first nations. At the first nations health authority level, we are really tackling that at a community-driven nation base level, but it really has to be reflected in the provincial level as well, and we have to find ways to collaborate on that because the majority of our people are off reserve and outside of those programs.
Improving primary health care access for first nations is absolutely vital. We also have to prioritize mental health and wellness including substance use and needs.
The biggest thing for me is to increase cultural safety and humility within the health system through adequate training, through constant revisiting. It's a culture that I personally have been a big part of and it's like running into a brick wall every day. We have to tackle it together, because it's going to directly impact the health status of indigenous people regardless of whether they live on reserve or off reserve.
I think that's it.