Essay: We are failing our seniors and our family caregivers

This article was originally published in the Province on October 21st 2011, to visit the Province’s website, please click here

Canada’s population is aging. Canadians are having fewer babies and are living longer. By 2031, a quarter of Canadians will be 65 years or older, double the proportion of seniors today. The proportion of Canada’s oldest seniors, those over 80 years of age, is expected to triple in the next four decades, meaning one in 10 Canadians will be over 80 years of age. Not only are Canadians living longer, they are living longer with multiple chronic health conditions, placing increasing pressure on the health and social care systems, and on Canada’s 1.5 to 2 million family caregivers.

The increasing emphasis on health-care delivery in the home setting and in the community has meant the family caregiver continues to shoulder a greater burden of care. Although the health-care system continues to increase the burden on caregivers, we have failed to recognize that trend from a public policy perspective and to put in place measures to ease the financial, emotional and psychosocial effects on caregivers. We are failing our seniors and our family caregivers.

Family caregivers come from all walks of life and all age groups. Although caregivers can be found across all income strata, generally they have household incomes below the national average. Only 35 per cent of households with caregivers report income over $45,000. An overwhelming 77 per cent of caregivers are women.

Family caregiving can be a rewarding experience for many people. Yet caregiving comes with a price. For some, it can even cause serious harm to their psychological, economic and physical well-being. Caregivers are often forced to miss work or give up their employment entirely to provide care, leading to short-term financial difficulty and potentially longer-term financial instability as they risk decreased benefits under the Canada Pension Plan.

While the health and social care systems save money by keeping people at home and out of acute and community care facilities, caregivers shoulder extra out-of-pocket expenses for costs such as transportation, medication and supplies. Given the financial and emotional toll, it is no wonder that the provision of caregiving often results in compromised mental, emotional, physical, social and financial health.

The alternative to family caregiving, group-care facilities, is in short supply, especially those able to meet the complex needs of patients with dementia or advanced Alzheimer’s disease. Consider the recent case of the Ottawa woman who waited three months for a placement in a care facility for her husband who has Alzheimer’s, only to find out that the facility would not take him as he was too aggressive. She continues to care for him at home.

Or the case of the Winnipeg man suffering from Alzheimer’s who doesn’t recognize his wife so he attacks her, resulting in him being held in remand for a month as there is no place else for him to go. With our aging population and increasing incidence of dementia and Alzheimer’s disease, the public policy initiatives the provinces and federal government are currently pursuing are inadequate to meet the needs of the seniors and their family caregivers.

Yet family caregivers are an important part of the solution in dealing with the tsunami of an aging population and increased demands for care. We must invest the resources necessary to support caregivers, and to alleviate the financial, emotional and physical toll of caregiving. Family caregivers need access to respite services, training, counselling and resources that can provide information and advice any time of the day or night.

The government of Nova Scotia now provides a caregiver allowance of $400 per month to regular caregivers providing more than 20 hours per week of assistance. This program innovates by breaking through a barrier that was once unassailable: family members can receive payment, albeit a small amount, as compensation for their extraordinary efforts. This is the type of fresh thinking which will be required to meet the public policy challenges which face us as a society.

The Honourable Sharon Carstairs, P.C. has been a tireless champion for hospice palliative care in Canada since 1994, as a senator and a federal cabinet minister. A teacher before joining public life, in 1986 Senator Carstairs was elected to the Legislative Assembly in Manitoba. In 1988, she became the first woman to lead the Official Opposition in a Canadian legislative assembly. She remained a provincial Member of the Legislative Assembly until 1994, when she was appointed to the Senate of Canada to represent the province of Manitoba. As a senator, she has been an advocate for women and children and for seniors. From 1997 to 1999, Senator Carstairs served as the first woman to be Deputy Leader of the Government in the Senate. She served as a federal cabinet minister from 2001 to 2003 as Leader of the Government in the Senate and Minister with Special Responsibility for Palliative Care. Senator Carstairs has served as a member and as chair of various senate committees, including two that examined the issues of hospice palliative care, and most recently she served as chair of the Special Senate Committee on Aging. Senator Carstairs has also been an ardent defender of human rights. She has been a member of the Human Rights Committee of the IPU since 2004 and chaired the Committee from 2007 to 2009.

© The Province