Overview

Abstract (English)

Providing alternatives to hospital and institutional care for the nation’s expanding older population is one of the greatest social policy challenges Canadian governments are facing. Current long-term care policies assume that families (mostly adult children) are available to provide the care needed by their dependent elderly members, and that they have an obligation to do so. But in the next 30 years, the number of elderly Canadians needing assistance is expected to double, and considering that there will be a much smaller cadre of adult children, this will inevitably increase the need for more costly formal care. This IRPP study is an overview of caregiving in Canada today, including the costs incurred by caregivers and the type and extent of public support they receive. Author Janice Keefe presents projections of future care needs and examines potential improvements in policy for income security programs, labour market regulation and human resource management in health and home care. Informal caregivers are family members, friends or neighbours, most frequently women, who provide unpaid care to a person who needs support due to a disability, illness or other difficulty, sometimes for extended periods. They bear substantial costs – economic, social, physical or psychological. For instance, they are likely to incur out-of-pocket expenses and significant lifetime income losses, and they commonly experience stress, social isolation and guilt. Such personal costs can negatively impact the caregivers’ economic security, health and well-being. Canadian governments must re-examine existing public services and programs to ensure that they meet the care needs of the elderly, and to address the adverse consequences of unpaid caregiving. More specifically, informal caregivers should receive financial compensation, together with in-kind support such as home help, education and referral services. At present, the status of caregivers vis-à-vis existing public policy and programs is ambiguous. More public support for caregivers would not only demonstrate greater recognition of caregiving, it would also reduce the need for formal care, delay institutionalization and relieve the cost pressure on the long-term care and health care systems. Given the anticipated shortages of health care workers in Canada, competition for health care resources is expected to be fierce in the coming years. To recruit and retain home support workers in all sectors, whether in voluntary, for-profit or public organizations, working conditions must be enhanced. Key in this regard are compensation levels, education, training and clear quality assurance accountability structures.

Abstract (French)

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