Toward a National Dementia Strategy

October 2016   Comments

Cross-party support for a private member’s bill may lead to national standards and a coordinated approach

The Canadian Press/Sean KilpatrickConservative MP Rob Nicholson (right) and Liberal MP Rob Oliphant are interviewed about Bill C-233.

Last winter, Conservative MP Rob Nicholson reached across the House of Commons floor to ask Liberal colleague Rob Oliphant to support his private member’s bill calling for a national dementia strategy.

It was a rare display of cooperation in a House often divided by ideology and political posturing. But the seasoned veteran knew his bill would not pass without the support of the Liberal majority.

“These issues aren’t simple, and they aren’t easy,” says Nicholson, who served for 10 years as a cabinet minister in Stephen Harper’s government. “You do what you can do to do the right thing.”

After reading Nicholson’s bill, Oliphant quickly agreed to support it. He had already made a commitment to the Alzheimer Society of Canada to bring forward a private member’s bill of his own. He thought working with Nicholson could help expedite his plan.

That gesture is expected to pay off. Both MPs are confident that Bill C-233, introduced in the House on Feb. 25, will become law by 2017.

The proposed act will compel the health minister to bring together federal, provincial and territorial representatives and others — including health-care professionals, researchers and patients — to work together in developing a national strategy that will address all aspects of Alzheimer’s disease and other forms of dementia. The bill also calls for a national conference and the establishment of an advisory committee. Within two years of the bill becoming law, the health minister would be required to prepare a report to Parliament setting out recommendations, priorities and national objectives on Alzheimer’s and other forms of dementia, then report to Parliament annually on progress.

A personal crusade
Oliphant says the bill is timely. “I don’t meet anyone now who is not touched by Alzheimer’s and other dementias,” he says. “If it’s not directly in their family, it’s certainly only one step removed. We have to wake up the bureaucracy.”

Both MPs speak from personal experience. Oliphant worked for 25 years as a United Church minister in Toronto, and his church successfully raised money to help build housing for Alzheimer’s and dementia patients in the community. Nicholson watched his father die of Alzheimer’s disease more than 20 years ago.

“I’ve learned that anything you can do to raise public awareness about these issues is very important,” says Nicholson, who knew nothing about the disease until his father was diagnosed. “If you stay at home, if you don’t talk about these issues, you won’t get solutions and you won’t get the kind of publicity that is so important on a national level.”

Senate committee support
The bill is also being supported by members of the Senate standing committee on social affairs, science and technology, which, coincidentally, wrapped up a study on Alzheimer’s disease and other dementias in June. Since early 2016, the committee has heard from a wide range of stakeholders. It is expected to table its report in the fall.

On March 24, CNA director of Policy, Advocacy and Strategy Carolyn Pullen testified before the committee, which also heard from the Canadian Gerontological Nursing Association, the Canadian Medical Association and the Alzheimer Society of Canada among other expert witnesses.

CNA strongly supports the Alzheimer Society’s call for a national dementia strategy and is also advocating for a shift from hospital-based care to community-based care, Pullen said in her statement.

According to Senator Art Eggleton, who serves as deputy chair of the Senate committee, Bill C-233 addresses many of the concerns expressed by the expert witnesses.

“We looked at the bill and we thought, this is what everybody is coming to tell us at the committee, that they wanted a national dementia strategy,” Eggleton says. “I think Mr. Nicholson has done well with this bill.”

Earlier effort
This is not the first time an MP has put forth a private member’s bill calling for action on Alzheimer’s disease and other dementias. In 2011, Claude Gravelle, an NDP MP at the time, tabled a similar bill, but it was defeated in the House of Commons by just one vote.

Nicholson did not support that bill, saying it was “too prescriptive,” and questioned its call for financial commitments that would have made it difficult to pass.

“I felt if we massaged it a bit, and if we were careful with respect to provincial jurisdiction, we’d have a better bet to get it passed.”

Nicholson told the House that the bill he was putting forward would establish a national strategy that would improve the lives of those living with the disease along with those of their family and friends. It would do so in a way that would ensure the autonomy of the provinces and territories.

“This strategy would encourage greater investment in all areas and have the objective of improving the present circumstances of people with Alzheimer’s and other dementias by decreasing the burden on Canadian society,” he said.

Legal commitment
Oliphant says the Nicholson bill is important because it would legally commit the federal government to action on Alzheimer’s and other dementias for the first time.

“What the strategy does is puts some definite timelines around the minister reporting back and an annual conference that will keep people committed to the topic. It lifts it out of the bureaucracy, and it puts it into the public sphere. It raises it up a notch and that just draws more attention to the issue,” Oliphant says.

“In the long run, at the very lowest level, it starts to demand an integrated continuum of care. Of course, much of that is at the provincial level, but as we enter negotiations around a new health accord, I wanted to get this in so that it could be part of the health accord — so the provinces would be engaged in this as well.”

The bill has been referred to the House of Commons standing committee on health, which may decide to make amendments to it before it is sent back to the House.

Pullen encourages individual nurses to raise awareness of the importance of a national dementia strategy and garner support for the bill by writing to MPs and members of provincial/territorial legislatures.

By the numbers

  • An estimated 564,000 Canadians are living with dementia. By 2031, that number is projected to increase to 937,000.
  • About 1.1 million Canadians are affected directly or indirectly by dementia.
  • The estimated annual combined health-care system and out-of-pocket caregiver costs are $10.4 billion. By 2031, they are projected to increase to $16.6 billion.
  • 25,000 new cases of dementia are diagnosed annually.
  • In 2011, family caregivers provided 19.2 million unpaid hours of care. By 2031, this number is projected to double.
  • 47.5 million people worldwide are living with dementia. By 2030, this number will increase to an estimated 75.6 million; by 2050, to an estimated 135.5 million.

Sources: Alzheimer Society of Canada, World Health Organization

Rose Simpson

Rose Simpson is a freelance journalist in Ottawa.

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