Families shoulder the costs in Canada’s failing care economy

Growing numbers of Canadians struggle to care for children and aging parents while also holding down full-time jobs.

A majority of unpaid caregivers have reduced their work hours or sidelined their career ambitions to support aging family members. Trying to balance full-time work with care demands often leads to leaves of absence, lost income, and burnout.

In 2022, StatCan found 20 per cent of adults provided unpaid care to older adults with disabilities, and nearly a third did the same for children.

Unpaid care work is a major source of financial strain for households, forcing people to use up vacation and sick time while pushing their own needs aside. “It’s absolute survival mode,” says Claire Webster, founder of McGill’s Dementia Education Program.

A mother of three, Webster describes being “constantly” pulled in many directions as she tried to balance work with caregiving. “My children were watching me unravel,” she says, as her own mother’s dementia progressed.

“It bleeds into their work” says Dr. Ivy Bourgeault, Canada research chair in Gender, Diversity and the Professions at the University of Ottawa.

Many spend upwards of 30 hours a week caring for elders or children. The value of this unpaid labour is estimated at $97 billion annually.

Many caregivers turn to paid homecare workers to fill gaps. But pervasive care worker shortages have a “cascading effect” as families step in to shoulder the heavy physical and emotional load, says Bourgeault. 

Personal support workers (PSWs) form the backbone of care for elders and family caregivers, but low wages and poor job quality lead to high turnover in this essential workforce.

Among health workers in Canada, these workers are “at the bottom” says Bourgeault.

Armine Yalnizyan, Economist and Atkinson Fellow on the Future of Workers, says, “By not caring for the caregivers…you are shooting yourself in the foot.”

Canada has leaned heavily on temporary foreign workers (TFWs) to address home care worker shortages. The federal government recently paused all new TFW applications through the Home Care Worker Immigration pathway.

Alicia Massie, economist at Simon Fraser University, told the Globe that many home health workers will be forced to leave the country as their visas expire, leaving families to find new arrangements.

Yalnizyan says mismanagement of the supply of these workers shifts more of the burden of care onto working families.

When it comes to building the elder care workforce, “we should be doing a better job,” says Bourgeault.

Women bear the highest load when it comes to caregiving, paid or unpaid. More than half of women in Canada care for a dependent elder or child, and many do both. As care demands intensify, these “sandwich moms” are often forced to exit the workforce.

Over the coming decades, a tripling of the number of people above age 85 will accelerate “health care spending and the need to deal with dementia and frail elderly,” says Dr. Michael Wolfson, former research chair in Population Health Modeling at the University of Ottawa.  

Canada’s dementia population is projected to double by 2050, reaching 1.7 million people, according to the Alzheimer’s Society of Canada.

“The more the disease progresses, the more care that’s required,” says Webster, forcing families to place their aging family members in long-term care.

Provincial investment in long-term care infrastructure has not kept pace with changing demographics and rising demand. Wait times for publicly-subsidized beds and assisted living units extend for months, or in some cases, years.

“We have nothing in between living alone and long-term care,” says geriatrician and home care researcher Dr. Amina Jabbar. 

Amid the country’s historic housing shortage, with the number of unhoused elderly on the rise, the choice to “age in-place” at home is quickly becoming a luxury afforded only to the financially well-off.

Yalnizyan says the chronic shortage of care workers is a growing constraint on Canada’s economy. This dynamic, she says, “will continue to accelerate.”