Caregiving:Implication for work and retirement

Peter Donahue, MSW, PhDAssociate Professor

Renison University College

May 23, 2013

Caregiving: 1987

Caregiving: 2008

Caregiving: 2010

Caregivers: Who are they?

Caregivers are:

“individuals who provide ongoing care to family members and friends in need due to physical, cognitive, or mental health conditions”

(Canadian Caregiver Coalition, 2001)

Caregivers care for individuals from all age groups, across all stages of life, and across the continuum of care. Their needs, networks, resources, strengths and limitations vary from caregiver to caregiver.

Characteristics of Caregivers

Source: Research on Aging Policies and Practice. (2011). Employment consequences of family/friend caregiving in Canada.

Percentage of Men and Women Providing Basic Parental Care 1994 versus 2008

Source: MetLife Mature Marker Institute. (2011). The MetLife Study of caregiving costs to working caregivers: Double jeopardy for Baby Boomers.

Types of Caregiving

Care can be categorized by:Personal Care (dressing, bathing, eating, toileting, grooming);

Household Work (house cleaning, shopping/errands, preparing meals);

Coordination of Care (transportation, making appointments, visiting);

Support (phone check-in, supervision, emotional support); and

Nursing Care (medication administration, changing dressings)

(Keating et al., 1999).

About one quarter of caregivers report daily assistance with personal care (Health Canada, 2002).

Caregiving & Gender

Caregiving tasks differ by gender:66% of female caregivers aged 45-64 provide assistance inside the home, such as meal preparation and house work as compared to 34% of men.

60% of male caregivers between the ages of 45-64 provide help outside the home, such as yard work and home repair.

Personal care tasks were performed by more female caregivers with 34% of 45-64 female caregivers and 32% of female caregivers over the age of 65 (Cranswick, 2003).

Caregivers who live with the care receiver often provide more care and a wider variety of care tasks than other caregivers who do not live with the care receiver (Keating et al., 1999).

Average Time Spent on Various Caregiving Duties

Source: Roman Habtu & Andrija Popovic. (2006). Informal Caregiving: Balancing work and life responsibilities. Horizons, 8:3

Caregiving: Key Research Findings

There are an estimated 2.85 million Canadians who report they are caring for a family member with long-term health problems (Cranswick, 2003).

Just over one in four (27.8%) employed Canadians have responsibilities for the care of elderly dependents – a percent that is likely to grow as the baby boom population ages (Duxbury, Higins, & Schroeder, 2009).

Almost one in five (16.8%) employed Canadians have responsibility for both childcare and eldercare - i.e. they have dual demands at home and demands at work (Duxbury, Higins, & Schroeder, 2009).

Just over one in 10 Canadians provide care for an elderly dependent who either lives nearby (12.7%) or in another location altogether (9.7%) (Duxbury, Higins, & Schroeder, 2009).

Caregiving: Key Research Findings

Each caregiver is providing help to an average of 1.3 seniors (Stobert and Cranswick, 2004).

The majority of people who receive care are between the ages of 75 and 85 years old (Keating et al., 1999).

Care Receivers are more likely to require care due to a physical disability (61%). Almost 18% require care due to both a physical and mental disability (Cranswick, 2003).

The Costs of Caring

CostsFinancial

Emotional, Psychological

Social

Physical

Work & Retirement

SOCIAL AND DEMOGRAPHIC TRENDS INFLUENCING THE NUMBER OF WORKING CAREGIVERS

the aging of the Canadian population

the aging of the Canadian workforce

an increasing number of women in the workforce

changes in family size and composition

rising health care costs and the informalization of care

Understanding the realities of being a working caregiver

Caregiving isn’t just a “woman’s responsibility”

Over 1/3 of employed women and 1/4 of employed men aged 45 and older provide care to a family member or friend with long term health conditions or physical limitations. (Canadian General Social Survey, 2007 - FACTS, 2011).

It is estimated that 1.4 million Canadians over the age of 45 combine paid work and caregiving (Walker, 2005).

Most people underestimate how much time they will spend as caregivers

Caregiving often spans over a period of several years and it is estimated that over 60% of caregivers have been caring for over three years.

20% of caregivers report caring for more than 10 years (Health Canada, 2002).

Caregivers often find that caregiving affects their health

50% of caregivers report health problems due to caregiving

79% of caregivers reported some emotional difficulties (Health Canada, 2002).

Increased stress, sleep disturbances, and other physical problems were reported by caregivers (Cranswick, 2003).

Caregiving can be especially stressful when a relative lives far away

25% of caregivers report their employment situation has been affected by their caregiving responsibilities (Health Canada, 2002).

Employed female caregivers are more likely to make workplace adjustments than male caregivers

Changing work patterns and reducing hours were more likely reported by employed caregivers than declining a promotion and quitting a job (Walker, 2005).

Many young people are caregivers

A new trend in caregiving is young caregivers, often teenagers or young adults caring for parents with chronic illnesses, such as MS or mental health problems (Keating et al., 1999).

Problems Related to Work & Caregiving

The Conference Board of Canada (1999) has drawn up a list of potential problems specifically related to long-term eldercare responsibilities and the workplace:

absenteeism,

tardiness

frequent interruptions from work

lack of availability for overtime and business trips

inability of workers to accept projects or added responsibilities

requests for a reduction of work hours

health problems

stress

poor morale and work attitude

stress-related disorders

depression

tension

sleep disorders

redistribution of work hours

higher frequency of unpaid leave

reduced quality and quantity of work

greater number of accidents

staff turnover

increased costs and decreased productivity

A 1999 Health Canada report estimates that employees juggling work and family demands cost Canadian employers at least $2.7 billion a year in absenteeism, and the health care system approximately $425.8 million for physicians visits ( in Duxbury, Higins, & Schroeder, 2009).

Gender Difference in Employment Consequences

Source: Research on Aging Policies and Practice. (2011). Employment consequences of family/friend caregiving in Canada.

Expenses & CaregivingMore than one third reported extra expenses due to their caregiver responsibilities (Cranswick, 2003).

It is estimated that two-thirds of caregivers are spending more than $100 per month on caregiving (Health Canada, 2002).

Expenses commonly associated with caregiving: payment for care services, prescriptions, adaptive equipment, medication and home modifications; care-related expenses include such things as buying convenience foods, televisions, adjustable beds, transportation services or paying for the delivery of services in order to make caregiving easier, less stressful or because they cannot leave the care receiver alone (Guberman 1999).

This is a conservative estimated annual cost to Canadians of $80 million.

The economic value of caregivers’ unpaid work to the Canadian economy is estimated to be over $5 billion

(Eales et al., 2001).

Percentage of Workers in Fair to Poor Health by Caregiving Status and Gender

Source: MetLife Mature Marker Institute. (2011). The MetLife Study of caregiving costs to working caregivers: Double jeopardy for Baby Boomers.

Consequences Related to Caregiving

Source: Roman Habtu & Andrija Popovic. (2006). Informal Caregiving: Balancing work and life responsibilities. Horizons, 8:3

Caregiving and Retirement Decisions

Selected Reasons for Retirement

Caregiving and Retirement Decisions

The 2002 General Social Survey (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).

The 2002 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.

Source: Roman Habtu & Andrija Popovic. (2006). Informal Caregiving: Balancing work and life responsibilities. Horizons, 8:3

Retiring to Caregive & When the Caregiving Ends

Methods:

In study of 100 involuntary retirees, in-depth interviews were carried out with 17 people who self-identified as retiring to caregive

In a follow-up study five years later, in-depth interviews were carried out with 24 caregivers who self-identified as retiring to caregive and who represented different points along the caregiving, retirement, post- caregiving continuum.

14 of whom were still in the caregiving phase and 10 of whom were in the post caregiving phase (three caregivers who lost their care recipient during the original study and 7 additional newly recruited caregivers for whom the caregiving was over).

Retiring to Caregive & When the Caregiving Ends

Findings:

Conditions Initiating the Transition into Retirement

There were two types of conditions that lead to the caregivers’ initial retirement:

(1) a crisis or a series of crises related to caregiving or; (2) a calculated choice was made to retire permanently to caregive.

Crisis route - the route to retirement taken by those who experienced a crisis was not viewed as retirement at first, but rather, as a temporary measure that gradually evolved into a permanent retirement.

Calculated choice - those who did not experience a caregiving crisis were responding more to job pressures than to caregiving demands, although caregiving was offered as the main reason for their retirement.

Retiring to Caregive & When the Caregiving Ends

Findings:

Costs of Retiring to Caregive

There were a number of “costs” that caregivers indicated they had incurred as a result of retiring to caregive:

Financial

Physical

Psychological/Emotional

Social

There were both differences and similarities between those who felt the decision to retire was a crisis and those who made a calculated choice

Retiring to Caregive & When the Caregiving EndsFindings:

Post Caregiving Financial Outcomes

There were two types of financial outcomes for caregivers when the caregiving ended:

(1) adequate incomes or; (2) minimal incomes.

Adequate incomes - only three of the ten former caregivers in this sample described their post caregiving retirement incomes as adequate. Two of these situations were caregivers who retired to caregive at an advantageous time in their careers and who received adequate pensions as a result. A third caregiver had received a substantial inheritance from her deceased father and therefore could live comfortably on his investment income alone.

Minimal incomes - Most caregivers in this study described the post caregiving period as financially devastating. Having incurred debts and spent savings during the caregiving period these caregivers were left in a state of financial “catch up”

“You’re left with this void and you look at all those bills and know you owe the money, what am I going to do, how can I get back into the workforce when I’m, let’s see, just turned 65, no resources, do I have to rent rooms and get strangers in my place, what do I do, and you’re just sitting there, what, do I do sell this place, where do I go?”

Retiring to Caregive & When the Caregiving Ends

Findings:

Post Caregiving Survival Strategies

There were several post-caregiving survival strategies employed by those in financial crisis:

attempts at work re-entry – only 1 of the 10 previous caregivers was working full-time when the caregiving ended.

Obstacles experienced in looking for work included a mix of factors: obsolete job skills, age discrimination, health problems and feelings of financial and emotional devastation

juggling debts

bartering services

pawning belongings

Retiring to Caregive: When the Caregiving Ends

THANK YOU!

Questions