Roman Habtu and Andrija Popovic
Human Resources and Social Development
Roman Habtu is senior policy analyst and Andrija Popovic is analyst with the Social Policy Research Group at Human Resources and Social Development.1
Caregiving for seniors has historically been a responsibility shared by family members and later, institutions. However, demographic and social trends may have diminished the capability of families to provide care to the elderly. Canadian families are now smaller and women, the traditional providers of care, are mostly in paid work.2 Meanwhile, an aging population and increased life expectancy suggest that seniors with a disability will represent a growing segment of the population.3 This has the potential of increasing the demands on family caregivers at a time when they have less capacity to do so. Compounding these trends has been the shift of caregiving responsibilities from institutions to the family (Ward-Griffin and Marshall, 2003; Wiles, 2003).4 These factors suggest that caregiving demands on the family have increased, leaving some Canadians struggling to balance their caregiving and work responsibilities. Hence, the priority accorded to families and caregivers in the 2004 Speech from the Throne: The “Government recognizes the vital role of Canadians who care for aged or infirm relatives or those with severe disabilities.”
Statistics Canada’s 2002 General Social Survey (GSS) provides the most recent information about caregivers 45 years of age and over. According to the GSS, informal caregivers 45 years of age and over provided over 40 percent of elder care.5 While caregivers span all age groups, international and Canadian studies show this is an age group that is most likely to provide elder care. An International Labour Organization study, for example, showed that informal caregiving pressures fall mostly on the population 40 years of age and over (Hoskins, 1996). The 1996 GSS also showed that a slight majority of caregivers for seniors in Canada were at least 45 years of age with an average of 46 years for women and 44 for men (Keating et al., 1999).
The paper uses data from the 2002 GSS to explore issues surrounding caregiving for working Canadians. The first section discusses the characteristics of Canadian informal caregivers in paid work, followed by an analysis of the employment, economic, and social consequences they experienced. The next section addresses what caregivers reported they needed to balance their work-life demands with elder care, followed by a discussion of the particular case of working caregivers with children under 18 at home (i.e., the sandwich generation). Finally, the paper concludes with highlights of the research results and the policy issues the findings raise.
Characteristics of Informal Caregivers
Over 1.7 million or more than one in five Canadians aged 45 to 64 years provided informal care to seniors with a long-term health problem or physical limitation. Of these, 1.2 million were in paid work. Most were in their prime working years (45 to 54), married, and lived in urban areas. One in five had one or more children under 18 living at home (Table 1).
Caregivers who are not in paid work tended to be older with more than three in five approaching the “traditional” retirement years (55 to 64).
Characteristics of Informal Caregivers
|IN PAID WORK||NOT IN PAID WORK|
|Notes: * Does not always add up to 100 due to some non-responses.
n.a.: Not applicable.
|All caregivers aged 45-64||(’000)||(’000)|
|High school or less||28.2||38.1|
|Presence of children|
|With youngest child under 18||25.2||13.8|
|Without children under 18||74.8||86.4|
|Less than $40,000||14.1||36.6|
|$40,000 to $60,000||19.6||20.9|
|$60,000 to $80,000||17.3||9.5|
|$80,000 and over||36.7||14.2|
Source: Statistics Canada, 2002 General Social Survey.
While most caregivers not in paid work were also married, proportionately fewer had a child under 18 living at home, suggesting that simultaneously managing the demands of elder care and child care fell more on those in paid work.
Men (23.5%) and women (23.9%) are almost equally likely to provide care. While men comprised a little more than half of working caregivers (54.3%), women constituted a majority of those outside paid work (62.1%), which suggests that, for some in this age group, men continue to be the family breadwinners. Most informal caregivers not in paid work were also married and marriage may provide the needed finances to assist caregivers outside paid work. However, this issue requires further exploration.
Informal Caregivers in Paid Work Have Relatively High Household Income
Among informal caregivers in paid work, one in seven had a family income that was less than $40,000 while more than one in three had at least $80,000 per year. By contrast, more than one third of caregivers not in paid word had a family income of less than $40,00 per year compared to only one in seven who had at least $80,000. The large income disparity between the two groups may be attributed to differences in labour market status. Other factors, such as the hours of work of informal caregivers in paid work, their educational attainment and their spouses' labour market activity, appear to also contribute to these differences.
First, a large majority of men and women caregivers in paid work were employed full time. Proportionately, more of those in paid work have at least some post-secondary education (71.7%) although the proportion of those not in paid work with the same level of education is also quite high (61.3%). Finally, although a majority of caregivers (in paid work and not in paid work) were married, those in paid work were in dual-earner families. Almost seven in ten men (68.3%) in paid work reported that their spouse was also in paid work while an even higher proportion (82.2%) of working women indicated that their spouse was working (Table 2). A majority of the spouses also worked full time and a large proportion had at least some post-secondary education (data not shown). These factors taken together may help explain the relatively high family income of working caregivers in dual-earner families. It is important to note, however, that while family income is an important indicator of well-being, the influence of factors, such as family size and region of residence, is important and needs to be explored further.
Caregivers in Paid Work and Spouse's Activity
|Activity of Spouse/Partner||Men||Women|
|Not paid work||173||31.7||72||17.8|
Source: Statistics Canada, 2002 General Social Survey.
Who Provides the Most Informal Care?
As noted above, a majority of men and women caregivers work full time, which suggests that balancing time between work and caregiving may be an issue. Among working caregivers, women spent proportionately longer hours giving care than men. While women provided an average of 26 hours of care per month, men provided only 15 hours of care likely due to gender differences in caregiving duties.6 The evidence suggests that women spent more hours providing personal care and other activities inside the home, such as meal preparation and household chores, which most likely occur on a regular basis (18 hours on inside activities versus 5.3 hours for men). Men were more likely to help with activities outside the house, such as home maintenance, yard work, and transportation, which may occur less frequently (Figure 1).
Employment and Economic Consequences of Caregiving
Caregiving is a responsibility that is embedded in our social fabric, and most Canadians value the enrichment derived from giving care. According to the 2002 General Social Survey, the vast majority of men and women felt that, in giving care, they were simply giving back what they had received (Cranswick, 2003). With proportionately more Canadians working longer hours than in the past, caregivers in paid work increasingly have to balance the demands of caregiving with the demands of the workplace.7
The juggling act of balancing elder care and work has an impact on hours of work as well as earnings for working caregivers. Moreover, close to two in five caregivers in paid work claimed to have incurred extra expenses related to caregiving (Table 3). More than one in five caregivers changed their work patterns to meet their caregiving responsibilities, and more than one in six reduced their hours of work.
While men and women are equally likely to provide care, women bore the brunt of these adjustments. Women were more likely than men to change their work patterns, to adjust to caregiving demands (27.0% versus 14.9%) and reduce their hours of work (20.2% versus 12.8%). More women also reported a reduction in income (10.6% versus 7.4%) perhaps due to the longer hours of informal care that women provide. These findings are consistent with research that shows that women providing personal care incur higher costs in terms of added expenses, short-term job costs, and long-term career costs (Gottlieb et al., 1994). These adjustments may also be indicative of the child-care pressures women experience in the family (see sandwich generation).
Average Time Spent on Various Caregiving Duties
Source: Statistics Canada, 2002 General Social Survey.
Social and Personal Consequences of Caregiving
In addition to the financial pressure and adjustments to work, the social and personal well-being of caregivers can also be negatively affected. For example, more than three in ten working caregivers stated that they altered their social activities to provide care. Close to one in four changed their holiday plans, and there were sleep and health consequences for at least one in ten Canadian caregivers. These results illustrate that a significant proportion of working Canadians face difficulties maintaining a balance between the demands in their personal life and providing care for the elderly.
Proportionately more women also experienced social and personal consequences. Women were more likely to have changed their social activities (33.0% versus 27.8% for men) as well as their holiday plans (28.3% versus 19.9%). When asked about health, close to one in five working women reported that their sleep and health were affected by caregiving. Fewer men reported that their sleep (10.2%) or health (6.1%) was affected on account of caregiving. The disproportionate effect on women is likely linked to the type of care, which they provide, and the relatively longer hours spent in caregiving compared to men. This is also linked to socially assigned gender roles. Men generally assist in tasks, such as home maintenance and financial management, while women take the direct, hands-on personal care, which is likely to cause more strain (Brody, 2004).
Consequences Related to Caregiving
|All Caregivers in Paid Work (’000)|
|Notes: *Use with caution due to small sample size.
Due to the possibility of multiple responses, the percentages do not add up to 100.
|Employment and Economic Consequences|
|Reduced hours of work||16.2||12.8||20.2||17.3||13.7|
|Changed work patterns||20.4||14.9||27.0||21.3||18.7|
|Reduction in income||8.9||7.4||10.6||9.2||*8.1|
|Social and Personal Consequences (percent)|
|Holiday plans changed||23.7||19.9||28.3||24.2||22.3|
Source: Statistics Canada, 2002 General Social Survey.
Despite these social and personal consequences, both men and women caregivers reported that caregiving strengthens relationships between the generations (61% of men and women caregivers) and enables them to give back what life has given them (60% of men and women). In fact, 20.6 percent of men and 22.2 percent of women felt they should be doing more. This suggests that caregivers in paid work accept their responsibilities, despite the consequences.
Prime-Age Workers Face Slightly Greater Economic and Social Consequences
The results of the 2002 GSS show that both prime-age caregivers (45 to 54 years) and those approaching the traditional retirement years (55 to 64 years) report that caregiving has affected them financially or in their personal lives. Slightly more prime-age workers reported that they incurred extra expenses due to caregiving. Those in the prime-age group were also more likely to report incurring a loss of income, reducing their hours of work and changing their work patterns. In terms of social and personal consequences, prime-age workers were also more inclined to adjust their social activities and holiday plans, and experience sleep and health effects due to their caregiving responsibilities.
Caregiving and Retirement Decisions
The 2002 GSS asked all respondents (45 years of age and over) their reasons for retirement. One question asked if providing care to a family member was a reason for retirement. In response to this question, 10 percent of those 45 years of age and over reported that they retired to care for a family member. More than twice as many of the respondents were women (14.3% versus 6.0% of men).8 These results should, however, be interpreted with caution. Retirement may not be a one-time event as people could retire from employment into self-employment or from one occupation into another. The GSS results also show that six percent of men and women caregivers would have continued to work at the time of their first retirement if they could have found suitable caregiving arrangements. The results suggest a need for further research to explore the consequences of work interruptions or earlier retirement due to elder care responsibilities.9
Research on age and earnings profiles has shown that men’s earnings peak when they reach their 40s (Saint-Pierre, 1996).10 Being at the peak of their earnings potential, caregiving responsibilities may compromise both the earnings and contributions to retirement savings of prime-age caregivers. However, the extent to which caregiving influences the supply of labour or reduces life-time earnings is a subject for future research (see caregiving and retirement).
Informal Caregivers Value Occasional Relief from Their Responsibilities
Relief in terms of time appears to be a high priority for caregivers in paid work. More than half of women and more than two in five men reported that occasional relief or sharing of responsibilities would help them meet their informal care responsibilities (Figure 2).11 In addition, close to half of women and more than three in ten men would like flexible work arrangements, further underscoring their need for flexibility to manage work and life responsibilities.
Next to time pressures, information was identified as important by working Canadian caregivers. Information on the nature of long-term illnesses or disabilities of the care receiver was cited by more than two in five men and more than one in three women. Slightly more than one in three men and more than two in five women reported that financial compensation would help. This suggests that earnings may not stretch enough to cover the extra costs incurred by some informal caregivers in paid work.12
It appears that while some caregivers value financial compensation, more are inclined to seek occasional relief and flexible work/study practices to alleviate their caregiving pressures. It is also important to note that in all the categories, more women than men reported requiring assistance in providing care. This underscores a need to explore further the gender dimension of caregiving in future research. This will help identify optimal policies to help Canadians balance their work and life responsibilities.
What would Help in Continuing to Provide Caregiving Duties
Source: Statistics Canada, 2002, General Social Survey.
The findings suggest that providing care imposes financial and time pressures for working caregivers. Financial pressures weigh more on the sandwich generation than caregivers with no children under 18 at home, likely due to their added responsibility of caring for children. Consequently, proportionately more in the sandwich generation would like financial compensation.
For working informal caregivers as a whole, occasional relief, flexible work arrangements, and information comprise the top three areas of assistance they reported would help. This implies that relief or respite from caregiving, flexible workplace policies, and information that is accessible would go a long way to addressing the needs of family and friends who provide elder care while in paid work.
Policy development requires identifying those in the population who are at risk of compromising their income or well-being due to caregiving. Recent research based on the 2002 GSS has shown who among caregivers in paid work is likely to be at risk (HCIC, 2005). Caregivers who provide personal care, care for more than one senior who is an immediate family member, and live with the care receiver are likely to change their work patterns or reduce their work hours. The research results are true for men and women although women face greater risks as they are more likely to provide personal care, a risk factor for making work adjustments. The adjustments caregivers make will likely reduce their earnings and therefore current and pension income. These short-and long-term effects help identify potential groups among caregivers in paid work who are at risk. It will also be important to look at caregivers (in and not in paid work) in the working age population who may risk reducing their current and future income as a result of the need to provide care.
There are limitations to developing appropriate and comprehensive policies for the working age population on the basis of available information. For example, the consequences of caregiving on the working age population cannot be established with the available data, which only cover elder-care providers aged 45 years and over. With delayed childbearing and longer life expectancy, caregivers younger than 45 will likely be saddled with the responsibility of simultaneously caring for seniors and young children. Younger caregivers will also replace aging baby boomers in the labour force suggesting that more of them will be earning and caring. Information encompassing caregivers in the working age population will therefore be essential for appropriate and comprehensive policy. The needs for assistance reported by caregivers 45 years of age and over, meanwhile, provide initial areas for policy development.
Today in Canada, family and friends provide more care for seniors with long-term health problems or physical limitations than paid employees or organizations. Moreover, a majority of these caregivers are in paid work and about one in four also have children under 18 at home, the sandwich generation.
The Sandwich Generation in Paid Work
The term “sandwich generation” refers to persons with elder care and child care responsibilities. According to the 2002 GSS, the sandwich generation, defined here as Canadians 45 to 64 years of age, who provided informal elder care and had children (less than 18 years of age) at home, constituted a little more than one in four informal caregivers in paid work. More than half of the sandwich generation were men. Although these differences may seem odd at first, they are explained by the fact that women tend to have children earlier in life than men. When women reach 45 years of age, there is a greater chance that their children are already young adults and have left home.
Respondents were asked questions about the employment, economic and social consequences of caregiving.13 The most frequently cited consequence experienced by sandwich generation Canadians in paid work was incurring extra expenses. Nearly two in five of these caregivers reported that they have incurred extra expenses as a result of caregiving. About 20 percent reported a change in work patterns, but only 17 percent reported a reduction in work hours, and 13 percent reported a reduction in income. Although extra expenses were a concern for the sandwich generation, a majority did not incur a reduction in income. This suggests that some Canadian families are able to make workable financial arrangements within the family to prevent their income from being compromised. For example, informal caregivers may arrange for a spouse to continue working so the family income is not affected greatly. This is highly plausible since more than 90 percent of sandwich generation caregivers are married or common-law partners. However, more research is required to establish this link.
When asked what would help ease caregiving obligations, slightly more than half of sandwich generation Canadians in paid work mentioned that occasional relief from their responsibilities would help. This compared to slightly less than half of all working caregivers (48.6%). This is understandable given their multiple responsibilities of caring for children, providing elder care and balancing this with the demands of paid work. Nearly two in five reported that information on caregiving and longterm illness would assist in their caregiving responsibilities while almost one in four indicated that counselling would help. When looking at all caregivers, the proportions identifying the need for information as well as counselling are about the same. Proportionately more in the sandwich generation (46.1%) reported that flexible work or study arrangements would help ease their caregiving responsibilities compared to all caregivers (40.7%). More sandwich generation Canadians also reported the need for financial compensation as compared to all caregivers (37% versus 35.3%). This suggests that sandwich generation Canadians are somewhat more burdened than all caregivers and have a greater need for both time and financial relief.
According to the 2002 GSS, informal caregivers in paid work, including those in the sandwich generation, incurred financial, social, and health consequences due to caregiving. The findings indicate that many individuals experienced employment, economic, and social pressures due to informal care. Proportionately more caregivers reported that time pressures as opposed to financial pressures were a concern. In fact, when asked what would help in their caregiving duties, caregivers reported that occasional relief from their responsibilities would be most helpful. For sandwich generation Canadians, however, both time and financial relief were more important.
Compared to men, women caregivers experienced greater employment, economic, health, and social consequences. Slightly more prime-age workers also experienced greater consequences associated with caregiving compared to older workers approaching the traditional retirement years. With a majority of informal caregivers in paid work, work-life balance is an issue of concern for many. Caregivers in paid work met their caregiving responsibilities, in some cases, by reducing the time spent in paid work and consequently incurring social, economic, and health costs. Despite this, caregivers reported that giving care strengthens relationships and enables them to give back what life has given them.
Data Sources and Definitions
Statistics Canada’s Cycle 16 of the 2002 GSS focused on aging and social support. The GSS collected information from nearly 25,000 adults aged 45 years and over who live outside of institutions in the 10 provinces of Canada. Unless otherwise specified, all findings in the paper are from the GSS.
The GSS focused on the themes of social support to seniors and retirement. Respondents were asked questions about help provided and received, with a focus on care received by the senior population, as well as questions related to transitions to retirement.
Care receiver refers to seniors 65 years of age and over who received care for a long-term health problem or physical limitation from both formal and informal sources, in the previous 12 months.
Caregiver refers to Canadians aged 45 years and over who provided care to one or more seniors with a long-term health problem or physical limitation, in the previous 12 months.
Informal caregiver refers to family and friends providing unpaid care to seniors with a long-term health problem or physical limitation.
The sandwich generation is defined as Canadians aged 45 to 64 years who have children under 18 years of age living at home, and provide care to one or more seniors with a long-term health problem or physical limitation.
Caregiving is a policy priority in Canada. To this end, social policies will need to consider the appropriate balance of supports to assist caregivers in paid work balance their work and life responsibilities. There are data limitations due to the coverage of caregivers 45 years and over only. The findings, nonetheless, provide pertinent information for policy development. Policies to assist caregivers will need to recognize the contribution of caregivers to the social fabric in the family, community, and society at large, and enable caregivers to contribute to the economy and society.
- This paper represents the views of the authors and does not necessarily reflect the views of Social Development Canada. Acknowledgments: We would like to thank Statistics Canada for making data from the 2002 General Social Survey available.
- More than two in three working age women were employed in 2003 (Statistics Canada, 2004).
- The need for care rises with age. By following cohorts of seniors from 1994 to 2000, Martel et al. (2003) found that of those living independently and aged 80 and over in 1994, only one in five were living independently in 2000.
- Informal care from family and friends was the most common form of care pro vided for seniors receiving care, according to the 2002 General Social Survey.
- Formal care (i.e., care provided by paid employees or organizations) constituted only 26 percent of elder care according to the same survey. For a detailed review of caregiving for seniors, see Cranswick (2003); Stobert and Cranswick (2004).
- Caregiving tasks are often divided into two categories: activities that help maintain a household (e.g., finances, housekeeping, transportation, and yard care) and personal care, which includes assistance with the activities of daily living (e.g., bathing, dressing, or grooming) (Cranswick, 1997; Conner, 2000).
- The proportion of Canadian adults working longer hours (41 hours or more per week) increased between 1976 and 2003 (Statistics Canada, 2004a). While men work more hours on average than women, the proportion of women working these longer hours increased from nine percent in 1976 to 13 percent in 2003.
- This is corroborated by recent research which indicates that caregiving has the effect of delaying men’s retirement without a consistent influence for women except in spousal caregiving which precipitates it (Kazi, 2005).
- A US study of caregivers 45 years of age and over documented the employment, earnings, and pension losses experienced by caregivers (National Alliance, 1999). Recent research also suggests that the shift in the burden of caregiving to the family, particularly women, will likely affect their economic well-being in later life, potentially pushing them toward dependence on public supports (Wakabayashi and Donato, 2005).
- The research focused on men as women’s earnings profiles have only recently started resembling that of men.
- Policy designed to meet the time demands of caregivers is in the early stages. A recent policy tool is the compassionate care leave, which came into effect in January 2004. Eligible workers can receive Employment Insurance benefits for a period of up to six weeks to provide care for a family member who has been medically certified to be at risk of dying within six months (HRSDC, 2004). The initial results indicate a low take-up rate suggesting that the provision of an appropriate balance of supports to address the needs of caregivers still remains.
- In the literature, out-of-pocket expenses cited by caregivers include food, transportation, medications, assistance with rent, or expenses for home care professionals (National Alliance, 1999).
- Only responses on the employment and financial consequences could be reported due to a small sample size.
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