Interview with Meghan Joy: Philanthropy and Seniors’ Care

Par Adam Saifer , Directeur du PhiLab Québec
02 novembre 2020

Meghan Joy

 

Meghan Joy is an Assistant Professor in the Department of Political Science at Concordia University. Her research interests include the politics of population aging, theories and practice of progressive politics and policy in cities, and the socio-political role of the nonprofit sector. These topics are combined in Meghan’s research, which examines the development and implementation of the Age-friendly City program in Canadian cities. 

 

Interview with Meghan Joy: Philanthropy and Seniors’ Issues

Interview by Adam Saifer

September 2020

Adam Saifer (AS)Can you tell me a bit about yourself and your research around seniors’ issues? 

Meghan Joy (MJ): I’m an Assistant Professor of Political Science at Concordia. I teach classes on urban politics and policy. I also do research on aging in place and I take an urban lens and focus to that. I’m particularly interested in the kinds of infrastructures, services, and supports that need to be available in place to meet the diverse needs of senior citizens. I’m also interested in how those services are being provided, by whom, and how they’re being governed by local governments, by NGOs, and by other levels of government. And the extent to which senior citizens in all their diversity are informing services and policies too. Also, I am interested in identifying where there are gaps in services and supports. I’m also a member of a Quebec government-funded research team called Équipe VIES (Vieillissements, exclusions sociales et solidarités). It’s an inter-university research team that does interdisciplinary research around social exclusion and inclusion and aging. And then I’m also on the governing board of engAGE, which is Concordia’s research center on aging, and we have some very innovative interdisciplinary research projects on aging in the city on the go. 

AS: What kinds of organizations and programs currently exist to support senior citizens? 

MJ: That’s a big question. We can think about the big income support and healthcare programs being provided by the federal and provincial governments. And then at the municipal level, we can think about the library, the community programs, and the recreation programs. There’s also some social housing and, actually, long-term care and home care that’s provided by some municipalities in Canada. Paratransit programs, accessible infrastructure, that kind of thing is also municipal. And a lot of that municipal work is part of the Age-friendly City program that I study. So that’s the government piece. And then the government also funds a whole bunch of NGOs [non-governmental organizations]. And all levels of government are providing this funding. So there’s a complex and diverse array of programs that exist in the community sector. And what I found in my research in Toronto, and I think this is the case here in Montreal too, is it’s really the NGO sector that is providing a lot of the frontline supports and services for senior citizens, particularly for those that are most vulnerable. I’m thinking, for example, about different kinds of housing supports, perhaps for seniors that have experienced abuse, or for ethno-cultural groups. Some of these NGOs are providing different kinds of transit to senior citizens because paratransit is being underinvested in and it’s not adequate. You’ve also got home care being provided by NGOs. We tend to think of home care as a government service, but a lot of the delivery is happening by a whole bunch of NGOs This includes everything from light day keeping and friendly visits all the way to more medicalized care provided in the home. Then there’s all kinds of NGOs that provide community services, like art programs, meals on wheels and communal dining,  community gardens, different kinds of intergenerational programs.Then there’s a lot of advocacy organizations that operate to inform policy at the local level, at the provincial level, the federal level, and also actually at the international level.  

AS: You mentioned that many seniors’ services and programs are governmentfunded yet provided by NGOs. Has this always been the case in Canada? 

MJ: There has been a push among provincial governments to focus away from investing in longterm care and towards home care. Whether that’s actually being accomplished and whether enough money is actually going to both home care and long-term care, is a question. And I think we’ve really seen in the pandemic that public investment is not adequate. And regulation is not adequate. But there has been this push towards home care and this notion of aging in place and care in community. So we have seen NGOs proliferating in this policy area, contracting with government to deliver home care. But what I found in my research is that their work is becoming more and more medicalized. And more and more, I suppose, in some ways, controlled by government because of these more medicalized contracts. There’s also a lot of mergers that are happening in the home care delivery sector as it becomes treated more and more like a core essential service. At one time we thought about NGOs as filling gaps, but what I’m increasingly finding in this policy area, is that a lot of the core supports and services are being provided by these organizations. 

AS: We’re living through quite a unique time right now with COVID-19. What impact has the pandemic had on senior citizens and the programs that support them?  

MJ: It’s a huge and devastating issue as it relates to the pre-existing policy failures in the realm of long-term care that have resulted in the premature death of seniors living in those facilities. These policy failures have also placed the care workers in those facilities at extreme risk. So this is something that we need to think about, and that governments are thinking about right now in terms of regulation, labour issues, and public investment. We also have seniors that are aging in place. We think about this notion of aging in place as aging in the community, and then aging in institutions as aging in longterm care. I think that’s a false and problematic binary, because longterm care is in communities. I think that we need to really think about how to integrate long-term care into communities and think about intergenerational spaces. We also need to think about how senior citizens that are aging in place in the community are also more at risk of dying from COVID-19. And this makes them particularly vulnerable as they engage in their everyday lives.

Getting groceries, and going out and about becomes much more risky. That creates more risk for social isolation for those senior citizens as well. And particularly those that are the most vulnerable. They don’t maybe have friends and neighbors to drop in with supports, or money to get things delivered. And I think the other thing that’s happening here is that a lot of NGOs that are providing support have been very much affected by the pandemicMany of these community supports and services have had to shut down during the pandemic. Others have run out of funding, or their funding has become more precarious, especially if they were reliant on fundraising that’s dried up, and volunteering that’s become more limited. There’s a lot of precarity in the sector. At the same time, there are those organizations that have been able to move some of their activities online. I think there’s innovations there. However, we also need to recognize that not all seniors have access to internet and access to technology. So we need to take that intersectional perspective, in terms of class, in terms of ability, in terms of geography and where folks are.  

AS: Do you see a role for philanthropic foundations In supporting senior citizens both during COVID-19 and beyond? 

MJ: I think it’s an interesting question. I just want to preface it, first and foremost, by saying I think the focus does need to be on public investment in a lot of these core programs. And those big core programs that I was talking about earlier around income support, certainly around healthcarea lot of those municipal programs and services need to be invested in publicly. But I think it’s an interesting time to think about the role of philanthropy in extending rather than replacing the state. I would want to see a more active state, not an austerity state.

Right now, and post-pandemic, there’s a policy window for more progressive politics. And so the question to ponder is what is or what could be the role of philanthropy within that. I think what we might see, and what I hope to see, among states is a real emphasis on these big-ticket programs: investing in long term care, publicly investing in home care, investing in housing. Within this, there needs to be that push to ensure that these large policy areas are tailored to community needs and are human-centered. Maybe bring artspace programming or intergenerational programming into long termcare and into forms of supportive housing. I am worried that some of the community programming that’s provided by municipalities—who are also very precariously funded and at-risk now—some of those programs like great programs in libraries might be at risk. I do think there might be a role for philanthropy in supporting those programs and helping to push for those programs. And working with community organizations to develop and think about innovative programming in preexisting long-term care, housing, community, and municipal facilities. 

Just one example: the Luc Maurice Foundation has supported some of our researchers at engAGE to do an Art Hive project that includes seniors living with developmental disabilities. This is allowing researchers to explore how these programs are accessible to certain folks, and what some of the gaps and challenges are. And it also is leading to these bigger questions around the role of a university as a community space. There are these huge public facilities that aren’t open sometimes on the weekend and that have not always prioritized accessibility in their design. Maybe philanthropists can help to support innovative uses of public space, such as age-friendly universities. Philanthropists could also take a look at the kinds of innovative programs that were happening pre-COVID that have now shifted online and ask how they can support that, in terms of partnering with researchers and supporting researchers to study these sorts of programs to improve access and scale them up. 

I’m also thinking about the way that philanthropy could support researchers and organizations to develop policy-relevant toolkits and reports and advocate to governments to scale up really great local programs, online or otherwise. So I think it’s an interesting time for philanthropy to think about what their role might be in expanding a more community-oriented activist state and partnering in many ways with organizations, researchers, local levels of government and provincial governments to build that 

AS: Why should foundations and philanthropists pay more attention to seniors’ issues? 

MJ: I think we should all pay more attention to seniors issues. Our population is aging, and it’s going to continue aging. So this is going to continue to be a really important issue. And a really important issue for governments, too, to really think about. I’m just thinking about senior citizens that I’ve talked to over the last couple of months, who have said,

“there is no way I’m ending up in a long-term care facility.” Or “we have got to do something about these facilities—we’ve all got to work together to do something about this.” 

My sense is there’s going to be even more of a push around aging in place, especially in the realm of housing and different kinds of co-housing and different housing models. There could be some interesting opportunities for philanthropy to partner with organizations of researchers to do research around that. It will be interesting for philanthropists, too, that have different pockets of project funding for different groups in society: maybe it’s time to think about how to bring those groups together and think about some different types of intergenerational projects.  

AS: Thank you for taking the time to share your insights with us Meghan Joy.