Carbon pricing is a conservative policy that works

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Carbon pricing is a conservative policy that works

Catherine McKenna

Canadians know that extreme weather caused by climate change — devastating wildfires, storms, floods — is already costing us billions of dollars. Canadians can also see we are now in a global race with the United States, Europe and China to attract investment in clean energy that creates growth and good jobs.

So you would think that serious politicians would at last agree that carbon pollution can’t be free — that it should be priced with predictable increases to encourage people and businesses to choose cleaner, less expensive energy solutions that also create good jobs and grow our economy.

You would be wrong.

But then life is full of ironies. Using pricing to change behaviour is a strategy drawn from any conservative playbook. By setting a price, a market can work its magic and people can make the best choices for their businesses and families.

This is the logic at the heart of Canada’s approach to meeting its climate commitments and driving carbon pollution out of our economy and environment.

But because I’m not a conservative and know that markets often hurt people who can least afford it, I made sure that the federal approach to carbon pricing had a special protection built-in: it’s revenue neutral. This means that the money raised by putting a price on carbon is transparently rebated in the form of a quarterly Climate Action Incentive rebate made directly to Canadians’ bank accounts.

This can seem complicated but it’s not. Yes, the price of fossil fuels will rise, but most Canadian families are better off with rebates and the choice really is theirs: use the money to offset rising energy prices or use it, alongside other government incentives, to save more money long term by switching to less costly forms of heating and transportation.

This isn’t something I expect our political opponents to advertise, but it doesn’t stop it from being true. Nor does it change the fact that Canada’s carbon pricing system follows the same approach successfully pioneered by conservative politicians.

Think Prime Minister Brian Mulroney and acid rain or Premier Gordon Campbell who created Canada’s first carbon pricing system in British Columbia. Quebec Premier Jean Charest made common cause with the all-American Republican governor Arnold Schwarzenegger to set up a carbon market that, despite opposition in Quebec and California, propels both economies forward.

So on one hand we have today’s Conservatives who refuse to take lessons from their own. On the other, let’s remember that while we are in a fossil fuel climate crisis, the oil and gas industry is playing a double game. They are generating massive profits that they return to their shareholders while charging consumers exorbitant prices. At the same time, they are demanding huge public subsidies to clean up the pollution they cause, while walking away from their already modest climate commitments.

This, incidentally, is why an oil and gas windfall tax is long overdue. It would address the climate crisis and improve affordability by helping families transition to lower cost, clean energy. According to the Parliamentary Budget Office, if the same windfall tax currently paid by Canadian banks and insurance companies was paid by the largest Canadian oil and gas companies, proceeds would reach $4.2 billion in just five years.

Let’s not lose focus. The problem here isn’t carbon pricing. It’s our reliance on outmoded carbon intensive technologies, including home heating systems. As Clean Energy Canada has made clear, “fossil fuel inflation is the culprit for skyrocketing heating oil prices.”  The sooner heating systems relying on oil and gas are switched out — everywhere — for cold-climate heat pumps, the better for consumers and for the planet.

A windfall tax can help Canadians get it done.

Though we might not always like it, the bottom line is governments exist to do hard things and fighting climate change is about as hard as it gets. Voluntary action and goodwill aren’t enough. Neither is magical thinking or the willful ignorance of scientific fact — or, in this case, basic economics. 

Not only do today’s Conservative politicians want to eliminate the most effective and efficient policy that actually works, the reality is that behind their rhetoric it is clear they have no credible plan to tackle climate change.

Canada is a country that can do hard things. We don’t shrink from a fight or shirk our responsibilities. Climate change is the fight of all our lives. We have to hold the line on across-the-board carbon pricing and keep moving forward. Pierre Poilievre and the federal Conservatives have no credible plan — only to pass on the biggest environmental and economic debt ever to our kids and grandkids.

Catherine McKenna is the former Minister of Environment and Climate Change.  In 2017, she introduced Canada’s national carbon pricing system. This system was subsequently upheld by the Supreme Court of Canada in 2021, which deemed greenhouse gas a matter of national concern. In 2022, as Chair of the United Nations High-Level Expert Group on Net Zero, she issued a global report on bringing greater integrity to net zero commitments by business, financial institutions, cities and regions.

It’s time to transform the culture of charitable giving

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It’s time to transform the culture of charitable giving

Lisa Wolverton

QUOI Media

We are entering a new era of charitable giving – and it’s long overdue. 

Many major philanthropic donors of Canadian and global charities are turning away from traditional ways of giving, such as funding large charities that serve marginalized groups from afar or restricting how funds can be spent.  It’s an attempt to give communities more direct control over their own futures. This trend is part of a larger movement to “decolonize” philanthropy that has been publicly embraced by Canadian donors like The McConnell Foundation and Inspirit Foundation, among others. 

And it’s not just private philanthropists who are making such moves. The Canadian government recently awarded $200 million to the Fund for Black Communities to administer the Black-led Philanthropic Endowment Fund, dedicated to supporting Black-led, Black-focused and Black-serving non-profit organizations.

It’s time more donors put funds directly into the hands of local leaders, giving them crucial decision-making power. This means leaving behind some restrictions and requirements while       enabling community leaders to manage and distribute funds as they see fit.

This kind of bold step requires donors to believe that for money to be truly impactful, it must be accompanied by trust and autonomy — a belief that has the potential to change lives and transform our culture of giving.

This new age of philanthropic giving is not just about how we give but who we give funding to. 

Some donors are making large gifts to groups that have historically had very little autonomy over resources. We’re witnessing large foundations like The McConnell Foundation transferring unprecedented amounts of capital to Indigenous-led foundations, for example. Others are investing in collaborative funds like the Freedom Fund, Equality Fund Canada or Co-Impact, which address issues like gender injustice or human trafficking through funding grassroots groups.

This movement has great potential.

Donors are going beyond solely talking about “shifting power” to actively creating new giving structures, processes and expectations in order to build trust and reduce the power imbalance that is so inherent in philanthropy. They are reconsidering their roles in working towards tangible social change and building markedly different relationships with those they fund: mutually enriching partnerships built on trust, honesty and shared decision-making.

This is not just the right thing to do from a theoretical perspective. Throughout history, attempts to solve societal problems in a dictatorial fashion, without directly involving affected communities, have proven ineffective, unsustainable and even harmful. We know that philanthropy — and really, any attempt at social change — works best when we understand that people with lived experience of a problem are best-placed to design and implement solutions.

Often, what they need most are resources, both financial and otherwise, the support of power holders and the freedom and space to try.

Sometimes just small shifts in donor mindsets and behaviour make a big difference.

At The Philanthropy Workshop, we encourage our donor members to consider the practices and principles that are critical to trust-based funding. We help them to explore questions like: who are you trying to help, what do you bring to the table and who should sit beside you to make decisions about where your money goes? How can you make sure you are funding organizations that are authentically rooted in lived experience? How can you end a funding relationship while minimizing harm to a community?

We also need to document the lessons learned so that other donors can replicate what works.

The Freedom Fund provides a positive model.  Building on a decade of partnering with more than 100 community-led organizations to address modern slavery, the Freedom Fund has launched an essential online resource to encourage other funders to fund frontline groups. From sharing key principles and challenges in frontline grant making, to offering a wide range of case studies, templates and tools, Funding Frontline Impact contains the type of transparent, nuts-and-bolts guidance many donors and charities could learn from. 

One thing is certain: philanthropy cannot continue as it always has.

From governments to foundations to individuals, we all have the ability to ensure that our money is giving communities the power to define their own futures and to encourage others to do the same. We have much further to go, but we’ll know we’re there when this type of giving is the norm, not just something we hear about in big, flashy announcements.

Lisa Wolverton is President of The Philanthropy Workshop Canada.

Healthy aging strategies can help Canada cope with its growing senior population

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Healthy aging strategies can help Canada cope with its growing senior population

John Muscedere

Canada is growing. In June, our population reached 40 million — but we are not only getting bigger, we are getting older.

There are now over 7.3 million Canadians who are 65 years or older and that number is climbing as the Baby Boomers age. By 2051, seniors are expected to make up 25 per cent of the population, with the number of seniors over 85 years tripling to 2.5 million.

This rapidly expanding demographic will have a profound effect on our society. While many younger seniors remain healthy and active in their communities, working and volunteering, a significant proportion of older seniors have complex health-related issues and many require the supports of long-term care settings. 

Seniors in Canada account for almost half of all health care spending.

As they continue to grow in numbers, older Canadians could overwhelm our healthcare and social services budgets unless we change the way we view aging and make the necessary investments in programs, technologies, and research that foster healthy aging or aging in place.

Fortunately, we are starting to see changes. In the wake of the COVID-19 pandemic and its devastating effect on older Canadians, governments and other organizations are becoming increasingly interested in healthy aging. For instance, last fall, Kingston, Ontario became home to the first centre for healthy aging in Canada and this past spring, the federal government held public consultations on how to better support seniors living in their own homes.

What is healthy aging?

It is about creating environments and opportunities that enable people to maintain their functional abilities as they get older. It challenges the mindset that as we age, we inevitably will have more diseases and health conditions, lose mental and physical capacity, and have a reduced quality of life.

While older people are more susceptible to many diseases and illnesses, there are things we can do to reduce this and increase their healthspan, or the time that they are in good health, can live independently on their own, engage in social relationships, and contribute to society.

Healthy aging covers a range of strategies. It includes things like getting regular exercise and doing strength training, eating a healthy diet, keeping vaccinations up to date, limiting medications to only what is necessary, and staying socially connected to others.

There is a lot that governments and other organizations can do to encourage and support these behaviours. Examples include funding community centres so that they can offer senior-focused exercise and nutrition classes, making vaccination more accessible through local community hubs, and offering more opportunities for seniors to engage with others either through community-based programs or online.

Healthy aging is also about finding ways to make it easier for seniors to continue to live at home or in their community. Governments and communities need to ensure that there are more and better home care options, not just to meet healthcare needs, but also to help seniors maintain their homes.

Governments should also consider financial support for unpaid caregivers, more flexible public transportation choices, and investing in a range of housing options that truly meet seniors’ needs.

Technology is also an important tool in healthy aging. During the early months of the COVID-19 pandemic, we saw how vital cell phones and tablets were for families trying to stay connected to their older relatives and how important telemedicine was for seniors to connect with their doctors.

Other technology innovations such as smart or wearable devices, virtual reality, and artificial intelligence, can help seniors set and monitor health goals, track medication use, and participate in physiotherapy and other activities to retain or regain physical function.

Research into the biology of aging and disease is also essential for healthy aging. Health researchers in the field of geroscience are working to understand the genetic, molecular, and cellular biological mechanisms and determinants of aging and the diseases and conditions that are more prevalent as we get older.

Our goal is to find ways to prevent, diagnose, and treat age-related diseases and conditions so that aging does not have to be synonymous with illness and frailty.

Geroscientists are pursing many promising research avenues that could profoundly change how we view and treat aging – but they need policy makers to help put those ideas into widespread action. With research advances and more investments in healthy aging initiatives, older Canadians can live healthier, more independent lives longer, to all of society’s benefit.

John Muscedere is CEO of the Canadian Frailty Network and a Professor in the School of Medicine at Queen’s University.

Rebooting Canada’s broken innovation system

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Rebooting Canada’s broken innovation system

Andrea Nemtin and Tim Draimin

QUOI Media

The most common themes about Canada’s growth-oriented innovation system are that it is unwieldy, expensive and underperforming. The latest WIPO 2023 report notes that Canada’s innovation inputs dramatically exceed its outputs. But these critiques miss the mark.

Innovation is traditionally understood as science and technological advances resulting in the development and commercialization of improved products and services. It thrives on efficiency, competition and market-driven solutions. Think of Silicon Valley’s tech giants, continuously pushing the boundaries of what’s possible with gadgets and software — smartphones, electric vehicles and the Internet, transforming the ways we live and work.

Success is measured in economic growth which can create much needed jobs. Too often however, innovation fails to create prosperity for Canadians or drive social or environmental outcomes. 

Canada’s innovation policy framework needs a new paradigm and a fundamental reboot. 

Increasingly governments are identifying the need to apply innovation to social and environmental challenges through what is known variously as social innovation, inclusive innovation, mission innovation, or most recently, transformation innovation. These terms all mean innovation that tackles societal challenges with creative solutions that aim to improve the well-being of communities, people and the environment.

Social innovation seeks to address issues like poverty, healthcare access, climate change, education inequality and affordable housing. It works to address the root causes of complex challenges with a portfolio of solutions that together create systemic change. Social innovation fosters positive social and environmental outcomes that drive local economic growth.  

While both traditional innovation and social innovation aim to drive progress and change, understanding the nuances between the two forms is crucial, as it not only helps us appreciate their roles in society but also sheds light on the imperative for prioritizing social innovation. 

So, what do we need to do to make social innovation a reality?

In an era of poly-crisis, social innovation offers Canada the potential for transformation, but it will require policy shifts to get us there. The recent publication from the Brookfield Institutes, Canada’s Moonshot, Solving Grand Challenges Through Transformational Innovation categorically states: “Canada’s innovation policy framework does not sufficiently align innovation with solving the most pressing social, economic, and environmental problems that Canada and the world face today.”  

The report identifies five basic principles for designing enabling policy for transformative innovations or “moonshots.”  We would do well to heed them:

            •           Select “grand challenges” that have clear, bold, measurable and time-limited goals that are sector-, discipline-, and technology-agnostic and that align with top government priorities.

            •           Seek a lean, agile and independent governance structure.

            •           Coordinate end-to-end support using a wide range of policy instruments to help scale the most promising ideas and help them reach their intended markets.

            •           Create meaningful engagement with willing stakeholders, including existing innovation ecosystem actors, leading industry and research experts, communities and the wider public. 

            •           Use a portfolio approach to managing risk, a high tolerance for failure, and an evaluation framework focused on learning and adaptation.

The resulting policies should address needs that are unmet and of little interest to public or private investment due to their complexity or because there’s no profit to be made.  The policies also create the environment for collaboration between different actors — from academia, industry, government, communities or civil society (NGOs or non-profit organizations).  

Mariana Mazzucato recently published, Inclusive and Sustainable British Columbia: A Mission-oriented Approach to a Renewed Economy that identifies a complementary approach to the development of enabling an innovative policy framework based on four questions:

            •           Overall Objectives: Do the overall aims of innovation policy involve more than economic growth?

            •           Direction of innovation: Whose needs are being met?

            •           Participation in innovation: Who participates in innovation?

            •           Governance of innovation: Who sets priorities and how are the outcomes of innovation managed?

Bringing these questions to bear on Canada’s innovation policy would be highly disruptive — and necessary.

Between the legacy of a still-smoldering pandemic, the dramatically rising costs of climate change and the deteriorating indicators of social well-being (mental health, housing, income inequality, etc.), innovation goals must now be directly aligned with the social and environmental needs of Canadians. 

By prioritizing social innovation, we can create a more equitable and sustainable future for all.

Andrea Nemtin is currently the CEO of Social Innovation Canada. Tim Draimin is Senior Fellow at Community Foundations of Canada and board member of Social Innovation Canada, Trico Charitable Foundation and Green Economy Canada.

It’s time for oil and gas to get real on net zero

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It’s time for oil and gas to get real on net zero

Catherine McKenna

This summer scorched the Earth, breaking heat records globally and setting off wildfires that choked North American cities. And Suncor chief executive officer Rich Kruger? He chose this moment to announce that his company will double down on oil sands production and sideline its renewables strategy.

Regrettably, Suncor is not a rogue producer. Recently, Shell and BP announced plans to slow-walk clean energy and pump more fossil fuels – the main cause of the climate crisis. They chose to spend the vast majority of their record profits on shareholder dividends and executive compensation while investing a small fraction in the clean energy transition. Incredibly, at the same time, oil sands companies demand that Canadian taxpayers spend even more to subsidize their carbon capture projects. This contravenes the basic principle that polluters should pay for the damage they cause.

These announcements are shameful, but at least we know what we’re dealing with. After years of pious corporate announcements and feel-good advertising, it’s magical thinking to believe the oil and gas sector has anything but its own profits at heart. Especially after ExxonMobil – where Mr. Kruger was a 40-year veteran – spent decades hiding, denying and downplaying the climate risks posed by fossil fuels. This is why it’s time to do what a majority of Canadians – including in Alberta – believe is necessary and put a hard cap on emissions from Canada’s oil and gas industry.

We need to get serious about net zero and not let bad actors make the Paris agreement goal of limiting global warming to 1.5 degrees – and averting the worst effects of climate change – meaningless.

We must reduce global emissions in half by 2030 if we are to achieve net zero by 2050. That requires far more ambitious efforts to reduce emissions now while scaling up clean-energy investments. Bogus plans to reach net zero at the 11th hour exacerbate the climate crisis and amount to nothing more than greenwashing.

Last year, at COP27, the United Nations released a report, Integrity Matters, produced by its High-Level Expert Group, which I chaired. The report establishes clear criteria for net-zero commitments: Any company or region setting net-zero targets cannot continue to build or invest in new fossil fuel supply. Companies cannot defer real emissions reductions by buying carbon credits. Nor can they privately lobby against climate action while claiming to be climate champions. Progress on net-zero commitments must be publicly reported and independently verified. These are tangible, specific standards that combined can move the world in the right direction.

But one year later, while other industries have started to step up, many oil and gas producers are making things worse while hiding behind trade associations such as the Pathways Alliance – a consortium that includes Suncor – and which is currently being investigated by Canada’s Competition Bureau for misleading advertising.

How bad is it? A 2021 report found that several Pathways member companies – Suncor, Cenovus, Canadian Natural Resources – have no plans to stop approving new extraction projects or exploration. Investigative reporting found that the Pathways Alliance lobbied to delay and weaken the proposed federal cap on oil and gas emissions.

On top of this, a report released last week found that Canada is poised to be the world’s second largest developer of new oil and gas extraction to 2050. The associated emissions generated would be equivalent to opening 117 new coal-fired power plants. This is wrong and wrongheaded for both the climate and for the economy.

UN Secretary-General António Guterres said it best: “Investing in new fossil fuels infrastructure is moral and economic madness. Such investments will soon be stranded assets – a blot on the landscape and a blight on investment portfolios. But it doesn’t have to be this way.”

Indeed, Canada’s oil and gas sector could be part of the solution to the climate crisis instead of a significant contributor. They could be leaders not laggards by making Canada a clean energy powerhouse that creates good jobs for workers and helps Canada win in the trillion-dollar clean economy.

Instead, Suncor and fronts like the Pathways Alliance remind us why talk is cheap. Canadians aren’t fools. They can see through the spin. But time is running out. Absolute emissions from oil and gas are rising. Real action – and a hard cap on oil and gas emissions – is needed now.

Catherine McKenna is a former federal minister of environment and climate change. Ms. McKenna is CEO of Climate and Nature Solutions and chair of the United Nations Secretary-General’s expert group on net-zero emissions. She participated in the UN Climate Ambition Summit in New York on Wednesday.

Is the Bank of Canada sufficiently transparent on monetary policy?

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Is the Bank of Canada sufficiently transparent on monetary policy?

Senator Diane Bellemare

QUOI Media

Canadians and the financial markets are often nervous on the day the Governor of the Bank of Canada announces the key interest rate. Not surprising, given the financial consequences for people’s wallets and the impact of this decision on the economy.

Do we really know how this decision is made?

Technically, the Governor of the Bank of Canada determines the key interest rate eight times a year in the context of monetary policy. He is supported by his Governing Council, made up of Deputy Governors whom he has chosen and who work for the Bank. In recent months, an external non-executive Deputy Governor has joined the committee.

But the Governor and his team could get it wrong, and the Bank Act is of no assistance.

The Bank Act was adopted in 1935 while the General Theory on Employment, Interest and Money of Lord Keynes was published in 1936. The Act was amended through time and revised in 1985. The preamble to the Bank’s Act was never changed and presents a list of objectives, of equal importance, with the intent, as the Act summarizes, “to promote the economic and financial welfare of Canada.” But the specific mandates for the Bank and for monetary policy have never been incorporated in the Act.

The Act gives the Governor full powers to act as he sees fit, without any transparency requirements.  It’s time we updated the Bank Act to reflect contemporary economic realities.

Since 1991, there is a monetary policy framework specified through a five-year agreement prepared by the Bank in agreement with the government through the Minister of Finance. This framework determines an inflation rate target without specifying the timeframe for achieving it. For the last thirty years, and renewed in December 2021, the agreement has targeted a two per cent year-on-year increase in the overall consumer price index (CPI).

This agreement is tabled in Parliament but is not subject to any parliamentary approval or accountability. The framework, which has no legal force, allows the Governor to raise the base interest rate as long as the overall CPI increases by more than two per cent. This is a simple rule for a problem that is not at all simple.

Indeed, inflation in the 21st Century has become a more complex issue than in previous generations. It is not mainly an excess demand problem. The climate crisis, political uncertainty, reversed globalization, demographic issues, all create supply shocks that will impact inflation. The target of two per cent may no longer be realistic.

Rising interest rates reduce with certainty consumption, investment, growth and employment. But it is not clear that it will reduce prices without creating a recession.

The Bank of Canada should not put aside its main purpose — the prosperity of Canadians — in the name of a risky strategy. Besides, there are alternatives.

Section 91 of the 1867 Constitution gives responsibility to the Canadian Parliament for making laws for the peace, order and good government of Canada in the areas of banking, the issue of paper, interest and legal tender. In short, from a legal standpoint, although the Bank Act gives the Governor and the Bank a great deal of autonomy, the Bank is not above Parliament. It must explain how its policy reduces inflation and at what cost.

Currently, the Governor explains his view in Parliamentary committees and to the media. And recently, the Bank started publishing the summary of the deliberations on the interest rate decision. Four times a year, it publishes a review of the general economic context. This is where the Bank of Canada’s transparency ends.

We do not know the economic and financial costs of the Bank of Canada’s strategy for individuals, businesses and governments. What are the redistributive effects, the effects on investment and productivity? What are the specific indicators on which decisions are based? What are the alternatives?

The Governor of the Bank of Canada has enormous powers compared to other central banks, which have a dual mandate (United States, Australia, New Zealand) that gives equal importance to price stability and full employment or have a monetary policy committee (United States, England, New Zealand) with external members that can propose alternative views.

If supply chains shocks are to become common, shouldn’t Canada’s monetary policy take them into account?  By repeatedly raising interest rates to bring inflation down, aren’t we compromising the future of the country by damaging business start-ups, housing construction and the climate transition, as well as tangible and intangible investment such as human capital?

The time has come to demand greater transparency on the real impact of short- and medium-term monetary policy on the Canadian economy and to amend the Bank Act.

Diane Bellemare is a Quebec Senator and an economist.

COVID-19 unleashed an ongoing crisis of delirium in hospitals

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COVID-19 unleashed an ongoing crisis of delirium in hospitals

Christina Reppas-Rindlisbacher, Nathan M. Stall and Paula A. Rochon

Older adults have borne the brunt of the COVID-19 pandemic. While Canadians aged 60 years and older make up only 20 per cent of the population, they account for 69.5 per cent of all COVID-19 hospitalizations, and most — 91.7 per cent — of all COVID-19 deaths.

One aspect of healthcare during the pandemic that has received considerably less attention is the failure of effective delirium care.

Delirium is a sudden and distressing state of confusion that occurs in up to half of hospitalized older people. It is usually triggered by a change in health, such as an infection or surgery, and is often short-lived but can sometimes cause long-term cognitive impairment leading to an increased risk of dementia.

Fortunately, delirium can be prevented or minimized using simple strategies. Within our own health practices, we have seen the effectiveness of promoting family caregiver presence, encouraging mobility and minimizing disruptions to eating, drinking and sleeping.  

In May of 2020, an opinion piece written by geriatrician Dr. Sharon Inouye in the New York Times, warned of an epidemic within the pandemic that was leaving many hospitalized older patients more vulnerable to delirium by abandoning many simple care approaches.  Unfortunately, she was right.

Our study recently published in JAMA Network Open showed that the fear of a delirium epidemic was realized. We found that during the first two years of the COVID-19 pandemic, older adults admitted to Ontario hospitals experienced more delirium and were discharged home with more sedating medications compared to before the pandemic.

Disruptions to delirium prevention care caused by the pandemic are in part to blame. A shortage of staff and volunteers, visitor restrictions and infection control rules created the perfect storm of less interaction with patients and fewer opportunities to use non-drug approaches for preventing and managing delirium.

Our study results are particularly alarming because we have made so much progress in delirium care over the last 30 years. Initiatives such as Senior Friendly hospitals, acute care of the elderly units and hospital elder life programs have flourished across Canada. In the three years preceding the pandemic, our study shows a clear trend of declining prescriptions of harmful and addictive sleep medicines given to older people after they left the hospital.

COVID-19 disrupted this hard-fought progress. Even two years after the onset of the pandemic, the number of new sedative prescriptions being prescribed out in hospitals has not returned to pre-pandemic levels.

So how do we reverse these dangerous trends?

It is likely that the fall and winter will bring a seasonal wave of viral illness such as influenza, RSV — and COVID-19, among others. Hospital and healthcare systems will soon be faced with decisions about visitor and volunteer policies in the face of viral outbreaks.

We can minimize rates of delirium by:

  1. Implementing policies centered on delivering dignified care, especially to older persons with cognitive impairment who cannot always advocate for themselves.
  • Renewing nationwide hospital efforts to mandate flexible hospital visitation and implement the simple and evidence-based care strategies needed to prevent and manage delirium.
  • Addressing national staffing shortages plaguing healthcare facilities across the country and redoubling our efforts to build and sustain senior-friendly healthcare environments.

Never again should sick patients with delirium be isolated from their family caregivers.

We must return to providing the standard of care for older people that reduces delirium and minimizes sedating drugs. We owe it to our aging population to provide the kind of humanistic care that helps older adults leave hospitals with their independence and cognition intact.

Dr. Reppas-Rindlisbacher is a geriatrician at Sinai Health and University Health Network and a PhD student at Women’s Age Lab at Women’s College Hospital.

Dr. Nathan Stall is a geriatrician and clinician scientist at Sinai Health and Women’s Age Lab at Women’s College Hospital.

Dr. Paula Rochon is a geriatrician and the founding director of Women’s Age Lab at Women’s College Hospital.

Reimagine aging in place

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Reimagine aging in place

Rachel Savage, QUOI Media

Both Canada and the United States are set to reach super-aged status in the coming decade, meaning over 20 per cent of the population will be over the age of 65.

Most will be older women with unique, and often misunderstood health needs. 

Many older adults are aging alone in the community even though we know being connected to family, friends, neighbors and communities are crucial for health and well-being.

Older adults are also at elevated risk for homelessness, something that can be exacerbated by financial disparity and social isolation, and a lack of access to and understanding of support services available.

We need to rethink how older adults age in the community.

Naturally Occurring Retirement Communities (or NORCs) offer a community-based solution to these pressing issues. NORCs are a geographical area, often a high-rise apartment building, that has become home to a concentration of 30 per cent or more older adults.

Offering enhanced supports within NORCs is a low-cost approach to support healthy aging that bridges connections between older adults and their communities and creates a space where external resources can have a bigger impact.

The Women’s Age Lab, along with partners, is embarking upon a six-year research study to support the implementation and evaluation of three enhanced NORC supportive service models across 10 sites in Ontario.

Examples of the interventions include on-site staff with specialized training and recreation coordination, mobile integrated health units to support distinct clinical needs, in-unit support for virtual care, and dedicated spaces for social and health programming.

We hope our initiative will help establish a model for others to follow that will improve the quality of lives of older adults, mostly women, as they age in place.

Rachel Savage, PhD is a Scientist at Women’s Age Lab and Women’s College Research Institute, Women’s College Hospital, an Adjunct Scientist at ICES, and an Assistant Professor at the Institute of Health Policy, Management and Evaluation, University of Toronto.

We need to rethink how we treat older women in healthcare.

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We need to rethink how we treat older women in healthcare.

Paula Rochon, QUOI Media

Older adults need health care and social services that respond to their unique needs. For older women, however, research shows that this is not happening. They are often overlooked by the policy planners, researchers, and care providers whose decisions affect their well-being.

This is despite the fact that older women make up 55 per cent of the population of older adults in the United States and their numbers are expected to grow. In the coming decade, 20 per cent of the population in the U.S. and Canada will be over age 65, and most of them will be women. Older women may have different health and social needs than older men and fewer economic resources.

A new Women’s Age Lab is working to change the way society perceives and treats older women. Believed to be the first of its kind, the centre is using scientific research to address four under-studied areas that older women say are important to their health and well-being.

One is gendered ageism, which results in older women’s experiences and contributions being devalued.

Another is reimagining aging in place and in congregate care to ensure that the specific needs of older women are addressed whether they are living at home or in a long-term care facility.

A third focus is on researching ways to optimize drug treatments to reduce the incidence of adverse drug effects on older women.

The fourth area is on research to better understand loneliness in older women and develop strategies to foster social connection.

Through collaboration with healthcare providers, community organizations, and international experts, the lab is developing science-based health and social policy solutions to improve the lives of older women around the world.

Dr. Paula Rochon, MD, MPH, FCRPC, is Founding Director of Women’s Age Lab, a geriatrician and senior scientist at Women’s College Hospital and ICES in Toronto. She is a professor in the Department of Medicine at the University of Toronto (UofT) and is the inaugural RTOERO Chair in Geriatric Medicine at UofT.

Building a barrier-free benefit for people with disabilities

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Building a barrier-free benefit for people with disabilities

Leonard Baker and Elizabeth Mulholland

It has been three years since the government first proposed the CDB to much fanfare in its 2020 Speech from the Throne. The good news is that Bill C-22 was supported by every political party in our government.  The bad news is that since the idea was first introduced, people with disabilities have fallen even further behind.

It’s time to get the money flowing.

The federal government must also fulfill its commitment to collaborate with the disability community in the design and delivery of the benefit to make it truly accessible and responsive to their needs. A Benefit without Barriers, a new report by March of Dimes Canada and Prosper Canada, can help.

Developed with people with disabilities and disability organizations, the report sets out principles and recommendations for the design and administration of the new benefit that are rooted in the hard-won experiences of those who have had to navigate Canada’s disability income support programs and are intimately familiar with the challenges these entail.

Their advice is designed to ensure that we turn a page on past mistakes and deliver a CDB that leaves no eligible person with disabilities behind. Their voices must be heard.

The process of applying for benefits is fraught with barriers that cause many applicants to give up in frustration. Even those who are ultimately successful may also pay a steep personal price.

Barriers include lack of awareness and information, as well as long, onerous and costly application processes that are hard to understand and navigate, and undermine the self-respect, dignity and mental health of many applicants. Individuals with disabilities often feel government application processes are largely designed to drive them away, rather than help them access benefits they are entitled to. They and their families and caregivers feel distrusted by their own government.

Applying for disability benefits is also costly, requiring applicants to pay out-of-pocket for assessments by healthcare providers and associated travel if they live in a community without someone who provides this service. Other barriers like lack of government-issued identification, difficulty finding a physician, and housing insecurity, further compound these challenges, leaving people feeling discouraged and defeated.

In addition, most people with disabilities lack access to one-on-one help to complete applications, appeal decisions, and self-advocate – all of which are often needed to successfully access benefits. 

Proving one’s disability can be exhausting and dehumanizing, especially when you have to do it over and over again to access different benefits – or to requalify for them, even when your disability is permanent and irreversible.

The new CDB needs to be better than this if it’s going to meet its goal of eliminating disability poverty. if its going to meet the government’s goal of eliminating disability poverty. It’s time for a humane, empathetic, and respectful benefit experience that, above all, does no harm to the people the CDB is intended to help. 

Success requires that government engage directly with people with disabilities as it designs the benefit and its administration to understand and actively address the risks associated with different options.

Only then can we be sure that the result will be a benefit experience that  fosters respect and dignity and treats people with disabilities as valued members of society.

We can start by automatically deeming anyone receiving provincial/territorial disability income support, CPP-Disability, the Disability Tax Credit or Veterans’ disability benefits to be eligible for the CDB. The government can also ensure that all CDB delivery staff are trained to the highest standard in how to communicate with and support CDB applicants and recipients.

Finally, the federal government can harmonize the CDB with other federal disability programs and work with its provincial and territorial counterparts to protect CDB income from claw backs. Our goal is to reduce poverty – not fill provincial/territorial coffers or simply move money between federal programs.

We can build a disability benefit without barriers and now is the time to do it. People with disabilities in Canada have waited long enough. Let’s get on with the job.

Leonard Baker is President and CEO of March of Dimes Canada.

Elizabeth Mulholland is CEO of Prosper Canada.

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