Spare 28 hours a week?What is Home Care?

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Almost three million Canadians take care of a loved one in their home and 83% of Canadians favour a publically funded home care program. Do you have 28 spare hours in your week? Can you squeeze some time in between doing paid work, running a household, looking after your children, other family commitments, and working in your community?

You probably answered no. Or maybe you are the one in five Canadian women aged 30-64 who spends an average of 28 hours a week caring for someone chronically ill or disabled. This is on top of the time you spend looking after your children, cleaning, organizing, driving, planning and preparing meals!

Many women enjoy caring for others, but even though they do, it is still a lot of work.

Women's Work

Even though the amount of male caregivers is growing, caregiving is still considered mainly women's work. Caregivers paid and unpaid are mostly women, and research tells us that when a family member needs care, a spouse will be the number one choice to fill that role, followed by a daughter, or daughter-in-law.

An Aging Population

Back in 1960, of Canadian women over 50, 16% had a surviving parent. This number is expected to change to 60% in 2010. The result is also that family caregivers are getting older as their parents live longer. Seniors are increasingly taking care of seniors.

The majority of these seniors, on both sides, are women. Women live longer than men, and the projection is that 60% of those over the age of 75 will be women in 2006. A recent survey found more women than men thought they would require home care services in the coming years. Women expect that they may be required to provide home care to their aging partner or relatives, and that their male partners may be unable to assume the caregiver role.

A large number of women in need of care are not covered by health insurance, because their paid work is frequently part-time, or contract work without benefits. Their lower lifetime earnings result in the inability to afford purchasing insurance benefits and home care services. So, again, they rely upon the women in their lives to become caregivers.

Costs of Caregiving

The costs of providing care are often not counted. But there is some data available, and a Canadian profile is beginning to emerge.

Two thirds of unpaid Canadian caregivers work outside the home. Twenty percent of these caregivers report health impacts, and 40% incur personal expenses.

These costs to caregivers also affect employers in the form of absence from work, high employee turnover rates, and emotional and physical strains that affect the caregiver's performance on the job.

Caregivers are not always only looking after one person. Caregivers juggling employment and other family work including childcare, typically are in their later and middle years. This places these women in double jeopardy-losing access to wages, lifetime earnings, and long term financial security.

Employees that care for loved ones can suffer career and financial losses, lowered opportunities to advance at work, loss of benefits and pensions.

There are also family costs including out-of-pocket expenses for hiring respite caregivers, mental and physical fatigue, social isolation and family stress and breakdown.

Who Cares for the Caregiver?

Too many caregivers find that their physical and emotional health is compromised because of the stress and strains involved in trying to improve or maintain the quality of life of their care receiver.

This leads to caregivers' number one affliction: Guilt - "the thought that no matter how much you are doing, you could or should be doing more," according to Gail Bruhm.

"Part of staying healthy involves recognizing your own limitations and being extremely assertive in seeking assistance from family, friends, and formal services," said Bruhm, Project Manager for The Caregivers Research Project funded by the Maritime Centre of Excellence in Women's Health, in a recent workshop with unpaid family caregivers in Nova Scotia.

These caregivers indicated that they need to remind themselves that their own health has to receive high priority.

Caring for Caregivers

As Home Care policies and practices evolve, governments must recognize caregivers as a vital component of the Health System and provide families with the supports and resources they require to maintain their lives and their role as caregivers.

Financial assistance must be made available to encourage and maintain appropriate care of the family and the home environment. This is a cost-effective system, but one that does not come without cost. Training, respite (a break), financial benefits such as tax-breaks, subsidies or pension contributions, could be ways to reduce the costs to individual unpaid caregivers.

Caregivers need choices. Many family caregivers need immediate improvements to the system. Many more will need it very soon.

What's needed?

From Gail Bruhm's experience with her project's workshops in rural Nova Scotia, caregivers will tell us what they need, and what they need now.

They will tell us how home care and caregiving affects women and men differently. Is anyone asking this question, and more important, is anyone listening?

  • Home care services enable Canadians who are incapacitated to live at home, without preventing, delaying, or substituting for long term care or acute care. (MCEWH)
  • Home care reflects individual needs and recognizes that people's needs differ.
  • Home care is a link to citizenship. It is an essential service for many individuals to maintain optimal inclusion in the community of their choice.

(Government/Community Working Group on Home Support Services, Province of Newfoundland and Labrador)

Lesley Poirier is the Research Coordinator at the Maritime Centre of Excellence for Women's Health. This article is based on the findings of a discussion paper, "Home Care and Policy: Bringing Gender into Focus" (online at: http://www.medicine.dal.ca/mcewh), and notes from, "Caregiving is not usually by choice" a presentation by Gail Bruhm.

Our resource section has more information on Caregiving.