May is National Caregiver Month in Canada and with the spotlight on caregiving, a perfect storm is brewing. Caregivers glue together our fragmented health care and social care services. They provide the majority of care as well. Did you know that more health care occurs in the home than elsewhere? The demand for care is growing as our population rapidly ages and fewer caregivers are available, with smaller families often living at a distance.

At some point in our lives, most of us will either be caregivers or receive care from a family member or friend. The reality is that caregiving, while rewarding, can also have a profound impact on a person’s health, well-being, and financial security. Often, a family member or attorney for personal care becomes the de facto care manager, juggling multiple responsibilities and tasks. This personal impact underscores the urgent need for a comprehensive caregiving strategy.

In 2022, the US Department of Health and Human Services released its First National Strategy to Support Family Caregivers. At the time of its release, it was noted that family caregiver support was an urgent public health issue exacerbated by the effects of the COVID-19 pandemic. This comprehensive strategy includes an action plan outlining specific goals and actions at the national, state, and local government levels AND the private sector. This effort is intended to improve services and supports for family caregivers including workplace security. [1]

Despite our similarities with the US, Canada has no national caregiving strategy. However, this week, the federal government remarked on the need to start talking about it. Canadian organizations, including Canada’s International Federation for Integrated Care (IFIC), are advocating for a national strategy.[2]

Canada has prioritized facility-based funding—developing more long-term care beds rather than focusing on care in the community…. Canada’s 75 and older population is expected to double over the next 20 years, and most Canadians want to age in place. This will increase demands for family caregivers, home care, and integrated primary and community services. We do not have ten years to make the changes that the system needs. Next year, the first baby boomers turn 75. If we persist with the status quo, the operating costs of continuing care will double by 2032. Innovative solutions are imperative in tackling this looming care crisis head-on.

The Canadian Centre for Caregiving Excellence is a relatively new organization that just completed the first national caregiving survey in Canada and released its report, Caring in Canada. Here are key findings with their suggested policy implications:

• Caregiving takes a toll on the caregivers’ wellbeing. The policy implication is providing more accessible mental health supports and better-defined pathways into supports such as the health care system.
• Caregivers are working an extra shift (up to 30 hours per week). The policy implication is caregiving-friendly workplace policies and employment protections.
• Caregivers are getting older and require additional support. The policy implication is making home care services more accessible with increased funding for home and community care, and better integrated systems of care.
• Caregiving creates financial stress, and more than half surveyed were not familiar with tax credits related to care. The policy implication is that financial supports are the most important policy solution – across all supports domains – for meeting their needs. Action to look at direct compensation for caregivers, and improved awareness and broader eligibility for tax credits and benefits.
• The care provider system is broken with two thirds of caregivers not being able to find high quality, reliable care. Care providers noted requirements such as higher pay, flexible scheduling, reasonable working hours and paid sick leave. The policy implication is that care providers urgently need increased compensation as well as supports at work.
• Caregiving experience varies across different identities and communities. The policy implication is including the perspective of diverse caregivers in program development and planning.

As advisors and planners, we need to recognize a perfect storm is headed our way. Family caregivers are the most extensive care workforce in the country, but this workforce is under increasing stress. The demand for care is growing, and with a rapidly aging population, the care needs of the elderly are becoming more complex. At the same time, there are fewer available family caregivers, and it’s difficult to hire good quality paid care providers.

Clients who are family members and attorneys for personal care are often ill-prepared for a caregiving role. They are usually surprised that the caregiving role may last for 10 or 15 years, with increasing hours required over time, and finding good and reliable paid caregivers is difficult. From a planning perspective, we all need to consider what happens if you cannot care for yourself and you need care. Who will it be, what are your wishes, what will it cost, and what is your written plan? The perfect storm is brewing.

[1] https://acl.gov/CaregiverStrategy

[2] IFIC Canada Virtual Community Care Valuing Family Caregivers and their Caregiving Family Caregivers are Vital Resources in Integ on Vimeo