The Caregiver Crisis in Canada
Have you attended a social event lately with people aged 40 to 60? Often described as the ‘sandwich generation,’ they try to care for older family or friends while working full-time, coping with busy family lives, and raising children. No doubt the conversation will turn to how they feel exhausted, overwhelmed, and frustrated trying to help manage care for elderly parents.
Canada is in a caregiving crisis. Public policies and programs have not kept pace with the predictable demographic shifts as our population ages, and the added impact of the COVID-pandemic demonstrated serious cracks in our social infrastructure. With healthcare and community organizations struggling to deliver services, labour market shortages, and economic challenges, business leaders and governments are realizing that economic recovery is linked to the care economy.
The Canadian Centre for Caregiving Excellence (CCCE) recently released a whitepaper profiling caregiving and the current crisis. Most Canadian caregivers are unpaid family members and friends who care for someone with an illness or disability because they have a relationship with that person. The reality is that if those unpaid caregivers stopped for a few days, this country’s health care and social care systems would grind to a halt.
A Canadian Profile of Unpaid Caregivers (CCCE)
- 1 in 4 (over 8 million) people identify as caregivers, and 1 in 2 will become one in their lifetime.
- Caregivers spend 5.7 billion hours supporting others every year, valued at $97.1B
- Lost economic productivity due to care responsibilities is estimated at $1.3 billion annually.
- Unpaid caregivers provide the equivalent of 2.8 million full-time paid care providers each year.
- 69% of caregivers report deterioration of mental health.
The paid workforce is also in crisis. Even if people can afford to buy caregiver services, the providers are in short supply.
A Canadian Profile of Paid Care Providers (CCCE)
- In 2020, long-term care facilities were short 1 to 2 staff per shift.
- Only 50% of PSWs remain in the sector for more than 5 years.
- Most PSWs and Direct Support Workers (DSWs) are women of colour.
- High demand and a shortage of workers have increased pressures to work unreasonably long hours, cover additional shifts and work short-staffed.
The caregiving crisis has been years in the making, and there will be no quick fixes. Most of us will either need care or be caregivers, or both. Given this situation, every family, estate planner, and advisor working with older adults need to consider how to create a caregiving roadmap.
How to Start the Caregiving Roadmap Discussion
Start with busting some myths. I often hear adult children say that their parent’s declining health or mobility concerns are a one-off situation, and if they could just get through the next 6 weeks or 3 months, they will be fine. In most cases, caring for older parents is a multi-episode and multi-year exercise. A University of Alberta study has confirmed this by identifying five common care trajectories with most involving transitions into and out of multiple care episodes that span years or decades.
Consider other factors such as families having fewer children and therefore fewer hands to share the care. When families are located in other cities or countries, issues with long-distance caregiving can emerge. And blended families may have several older people at varying stages who require assistance. In my own experience, I have been a caregiver and Attorney for Personal Care for my parents since the summer of 2001 – 22 years and still counting.
While participating on a panel discussion, I was asked the following: What are the two most important pieces of wisdom you would share to get the discussion going?
1. Hope is not a plan.
You need to be persistent in talking with your parent or client. Understand their wants, needs, and preferences for different stages of ability. Use scenarios to discuss what type of care they would like or where they would consider living under certain circumstances and why. Document the conclusions so you can reference the discussions if there are questions later.
2. Plan for the risk of diminished capacity.
Even those who proactively think about estate planning often plan for divorce or death but out of fear or denial or perhaps naiveté or discomfort, they do not discuss or plan for diminished capacity. Imagine the business owner or partner in a firm who begins to have diminished capacity. This could be a gradual decline, but how will this be managed, and who takes what responsibility at what stage?
Life happens. All of us will either receive care and/or be caregivers in our lifetime. Amid a caregiver crisis, estate plans need to include a caregiver roadmap. We need to start now to map out how to navigate the complexities of multiple care episodes over several years while juggling other life priorities.
 Canadian Centre for Caregiving Excellence, “Giving Care: An Approach to a Better Care Landscape in Canada”. 2022, https://canadiancaregiving.org/wp-content/uploads/2022/11/CCCE_Giving-Care.pdf.
 Fast, J., Keating, N., Eales, J., Kim, C., & Lee, Y. (2021). Trajectories of family care over the lifecourse: Evidence from Canada. Ageing & Society, 41(5), 1145-1162. doi:10.1017/S0144686X19001806