Thursday, February 23, 2017

Guest Commentary: Caring for Caregivers, a Win-Win Proposition

Family care is crucial to keeping our formal health and continuing care systems afloat.

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By Janet Fast

The vast majority—between 80 and 90 per cent—of all care received by Canadians is provided by family members, friends and neighbours. In fact they provide 10 times as many hours of care as paid caregivers do. By my last calculation, the replacement cost of that care work is more than $66B, equivalent to one third of all health care expenditures in Canada. In short, family care is crucial to keeping our formal health and continuing care systems afloat.

But caregiving has health, social and financial consequences for caregivers. The stress, sleep disturbance and injuries that often come with caregiving threaten caregiver health. Lack of time for family, friends and community engagement leaves many caregivers socially isolated. Caregivers, the majority of whom also are employed full time, are more likely to miss days of work and work fewer hours at their jobs, or leave their jobs entirely, putting them at higher risk of poverty now and in the future.

These consequences not only put caregivers at risk of becoming the sick and poor seniors of tomorrow, they also spill over to other stakeholders. Caregiver burnout means that both caregivers and the persons they’re caring for may draw more heavily on health and continuing care services. Care-related employee turnover, absenteeism and “presenteeism” (distractions at work) affect employers’ bottom line, costing them nearly $12B in 2012 by my calculation. Caregivers who work less, or not at all, also pay less taxes—$641M less annually according to one recent estimate.

Better supporting family caregivers in Canada — where services are tightly rationed and highly variable across jurisdictions, where private costs can be high, and where identifying and accessing even those services that are available is difficult — isn’t just the right thing to do, it’s the smart thing to do. Opposition to public support for family care is driven by fear that families will abandon their natural obligations and contribute further to what some say is the modern day “downfall of the family”.

But public supports rarely displace family care, rather they complement it, even extending families’ caring capacity and delaying care recipients’ transition to residential care. In one Canadian study unpaid family care was shown to reduce reliance on publicly supported paid care, saving Canadian governments an estimated $4.4B. For employed caregivers flexible working options have been shown to increase workplace productivity by as much as 21 per cent and reduced stress-related absence by 26 per cent.

In a recent report I did for the Institute for Research and Public Policy (IRPP) I outline four pillars for a comprehensive caregiver policy strategy:

  1. Recognition of family caregivers’ work and their right to “have a life” during periods when they’re providing care
  2. Adequate, accessible and affordable services for care receivers and caregivers
  3. Workplace organization and labour policies that allow caregivers to maintain their paid jobs — to continue earning an income, contributing to their pensions and continue progressing along their career path
  4. Financial security and predictability measures to support those caregivers who experience periods of low income

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.