Janet Fast | 1 janvier 2016
Rebecca’s days used to start well before sunrise. Every working day, she would wake up at 3 a.m. to make sure her chronically ill husband’s care needs would be met throughout the day — a busy job in itself, one that was well under way by the time her paid job began at 6 a.m. Her shifts were long: she worked until 7 p.m., or sometimes even later, all the time monitoring her husband at home. Then the full cycle would start again the next day — until she burned out.
Rebecca is just one of more than 8 million Canadians who demonstrate that they care about family and friends by caring for them when their health fails. More than 13 million of us will do so during our lifetimes. Indeed the vast majority of care Canadians receive comes from family and friends. And thanks to population aging, rising rates of disability, profound changes in Canadian families and escalating pressures on the health and continuing care sector, the odds of becoming a caregiver are high and will likely grow in the years ahead.
Of course we have always cared for one another. It’s what families, friends and neighbours do. It’s what I did during my parents’ last years, and it’s what almost everyone I know has been, is, or expects to be doing. The difference now is that the demand for care is threatening to outstrip families’ capacity to continue meeting the demand. Families are smaller, more geographically separated and, thanks to higher rates of divorce and remarriage, relationships are more ambiguous.
Most of us are employed full time. Caregivers now comprise a third of the Canadian workforce. And it’s taking a toll. Caregiving carries with it risks of injury and poor health, social exclusion, and economic hardship for the caregiver. Caregiving costs spill over onto employers: care-related turnover, absenteeism and “presenteeism” affect their bottom line. And caregiver burnout means that both caregivers and the persons they’re caring for may draw more heavily on health and continuing care services.
I was lucky. I had a job that paid well, had good benefits, and, with the exception of having to be in the classroom at specific times, gave me enough control and flexibility that I could fit my caregiving responsibilities around my job for the most part. I also was lucky that my father was a veteran and, in those days, Veterans Affairs Canada did well by veterans in need. That said, since my parents lived a province away, a monthly caregiving visit averaged at least $700 in out-of-pocket commuting costs. Others are much less fortunate though.
We can no longer afford to treat family care as essentially free labour, undertaken by and within families as a private matter with no relevance for the rest of society. Family members and friends provide 10 times as many hours of care as paid caregivers do. By my last calculation, that care work is worth more than $66 billion. Society can’t afford to ignore threats to sustainability of this vast care sector.
Opposition to public support for family care is driven by fear that families will abandon their natural obligations and contribute further to what some contend is the modern day “downfall of the family.” But the evidence simply doesn’t support this fear. In fact public supports rarely displace family care, rather they complement it, even extending families’ caring capacity and reducing the risk of institutionalization of the person in need of care.
A recent study published by the Institute for Research and Public Policy outlines four pillars for a comprehensive caregiver policy strategy: we need to recognize the value of family caregivers’ work and their right to “have a life”; ensure that there are adequate, accessible and affordable services for care receivers and caregivers; organize workplaces and labour policy so that caregivers can keep earning a living alongside their care work as long as possible; and when caregiving still results in financial hardship for some, we need to be ready with anti-poverty measures.
Caregivers and care work is an essential component of family, community and our national well-being. As our population ages, disability rates continue to increase and our health and continuing care sectors continue to face growing pressures, it will be essential that we understand, recognize and support caregivers and their work.
Janet Fast is a professor in the Department of Human Ecology at the University of Alberta. She is the author of Caregiving for Older Adults with Disabilities: Present Costs, Future Challenges, published by the Institute for Research on Public Policy.