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We need a national strategy to support unpaid caregivers


The phenomenon is not exactly marginal: according to a recently released government report, one in every three workers in Canada is assisting a chronically disabled person — many of them seniors — with transportation, household maintenance or day-to-day tasks. The 6.1 million employed workers who are providing such care, free of charge, to a family member or friend are more likely to experience interruptions at work and to arrive late or even be absent from work. Many are less available than they would otherwise be to work overtime, travel for work or advance their careers.

Without a doubt, the impacts of informal caregiving commitments do not remain confined to the home: they are felt in the Canadian workplace and reduce productivity. They translate into 2.2 million hours of reduced effort in the workplace every week and cause an estimated $1.3 billion productivity loss annually, says the report.

With the anticipated growing numbers of seniors requiring care, the costs of unpaid caregiving and reduced productivity will likely expand over the next two decades. What should we do about them?

As Canadian employers are increasingly confronted with the reality the work of informal caregiving has on their employees, it only makes sense that they should be the first to recognize and support informal caregiving. Some of them already offer flexible arrangements (e.g., compressed work weeks, work from home, unpaid and even paid leaves) to employees with caregiving commitments. This said, not all employers are equally supportive, if at all, and many Canadian workers with caregiving responsibilities are paying the price: reduced income, career limitations and exit from the labour force.

A year ago, the federal government established the Employer Panel for Caregivers, which consulted with employers to help them find ways to better support their employee caregivers. The consultation was premised on the realistic assumption that unpaid care will remain the main source of long-term care in this country.

The most significant insight it gained is this: while employer support to employee caregivers may foster engagement and greater retention in the workplace, there might not be a business case for many employers to voluntary engage in this. Put another way, moral appeal and compassion for employee caregivers will not translate into a massive, spontaneous movement in the Canadian workplace to address the issue any time soon.

It is becoming increasingly difficult for Canadian policymakers to ignore their own essential role — beyond that of offering limited and sporadic supports — to address the issue.

Confronted with a similar situation, the United Kingdom, Australia and New Zealand have, in recent years, adopted national caregiver strategies. These strategies provide educational and financial supports and connect caregivers to community organizations that can ease their responsibilities. At home, Manitoba and Nova Scotia are leading in many ways, but efforts across the country remain fragmented and inconsistent. Canada can do better.

Needed as part of a national strategy are integrated policy instruments to support caregivers and their employers. First, Canada’s workplace legislation, which is primarily a provincial jurisdiction, needs to ensure minimum standards to protect workers with caregiving commitments. Second, we need a comprehensive set of financial instruments — possibly a combination of private or public programs — to better protect the workers’ incomes and their employers’ productivity losses. Third, more substantial coverage of homecare, nursing care and supportive services, such as adapted transportation or supervised day centers for the disabled, is an essential component that would benefit everyone.

These government and employer contributions are not so much to ask. The costs of supporting caregivers with employee protections and supports are tiny compared to the contributions unpaid caregivers already make. A study estimated that if governments had to pay for caregiving provided free of charge by people 45 and over in this country, it would have cost about $25 billion in 2009.

Some argue that governments should compensate caregivers. I don’t think they should. But governments do need to ensure that while providing unpaid caregiving, workers never incur catastrophic income losses or lose their jobs as a result.

Instead of having a situation where we have some employers who provide workers with coverage and some not, only a coherent national strategy will allow Canadian workers looking after a spouse or relative to better focus on their work, their employers to better focus on their mission and disabled persons to get the care they need.

Nicole Bernier is a research director of the Faces of Aging program at the Institute for Research on Public Policy.

This blog is reprinted with the kind permission of the Evidence Network.

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2 comments

  1. Paul Webster

    http://www.cmaj.ca/content/early/2015/06/15/cmaj.109-5092.full.pdf

    Speaking at the Technology Evaluation in the Elderly Network National Forum 2015 in Toronto dedicated to kick-starting work on a “national strategy for the care of the frail elderly,” Dr. Ken Rockwood, director of geriatric medicine research at Dalhousie University in Halifax, outlined a set of more than 30 frailty indicators across domains including cognition, communication, mood and behaviour, activities of daily living, continence, nutrition, skin condition, falls, vision and a multitude of medical diagnoses such as arthritis….

    For clinicians, Rockwood emphasized, frailty is a concept that requires close consideration of patients’ lives outside the hospital or clinic. That comment drew strong support from Dr. Samir Sinha, director of geriatrics at Mount Sinai Hospital and the University Health Network Hospitals in Toronto.

    For frail patients, Sinha explained, knowledge of underlying problems rooted in social and family histories is often crucial. “We’re more socially frail than ever before; 28% of elderly Canadians are without a loved one or friend who can help get a prescription filled.”

    … Alongside better hospital care, the frail older person needs better community care focused on avoiding the need for acute care, argued Dr. Jayna Holroyd- Leduc, director of the geriatric medicine training program at the University of Calgary Department of Medicine. “More care does not spell better care,” said Holroyd-Leduc during an open discussion. “A growing body of evidence indicates aggressive, invasive care can be injurious. That’s hugely important to consider with the frail.”

  2. Fiona McMurran

    Family caregivers definitely need support to care for their elderly relatives. So do those looking after adult relatives with disabilities, both physical, mental and developmental. As parents caring for an adult autistic daughter, we having a growing concern, not only for her future, but for our own capacity to continue as caregivers as we get older and more infirm.

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