With an aging population and more people preferring to remain in their homes for as long as possible, the idea of aging in place in Canada often underlines various initiatives to support this goal. It is a policy direction that is promoted as a means of addressing increased costs of long-term care, and involves several jurisdictions.
While there is a general consensus that aging at home is more desirable than the alternatives, the costs of care for family carers is often not recognized.
Home care has received renewed public attention as aversions to nursing homes rise in the wake of the COVID-19 pandemic. But such attention often neglects the reality that those receiving care at home require people and resources to maintain them and the home.
Managing the home while caring for an elderly relative involves a multitude of activities and constant co-ordination of space and relationships. This work is done by family carers who are usually women and who have few community and government resources to draw on, particularly in rural areas.
Health work
Caregiver benefits, like Nova Scotia’s $400 a month benefit, are key to reducing gender-based inequality.
My interest in researching family carers grew out of the cancellation of a similar program in New Brunswick, the Primary Informal Caregiver Benefit (PICB), which offered just over $100 per month to eligible informal caregivers. The program was introduced in 2018 and cancelled within a year when the provincial government changed from Liberal to Conservative.
My mother was caring for my father who was living with dementia and was able to receive the benefit for a brief period. She experienced the cancellation of PICB as a personal insult and disregard for her work caring for her aging husband at home.
The type of assistance my mother required involved financial support to help maintain her rural property and subsidize transportation. However, the programs that were offered, and are standard forms of home care across Canada, involved help with personal care, meal preparation and “light housework” — gendered forms of work performed by mostly female home care aides.
Yet, the way my mother experienced rural home maintenance while providing care suggested that it was an equally essential form of “health work.”
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The process of “knowing, doing, and negotiating care” in a complex environment involves invisible forms of labour. Activities such as property maintenance and renovation as well as administrative tasks like acquiring medical equipment and filling out insurance forms are essential forms of health work.
To understand the range of work required to maintain a home, I interviewed 13 family caregivers in New Brunswick about the problems they encounter when doing their work. My conversations with family caregivers across the province suggest that the challenges my mother experienced were common; care was complicated by place-based factors and government home care interventions failed to address the reality of rural life.
Their work is not limited to specific tasks but includes the mental and emotional, invisible labour required in navigating the home as a health-care environment and sometimes cumbersome government programs designed, ostensibly, to ease their burden.
Women as social safety net
The combination of unequal gender norms and aging in place provides an example of how women become “a privatized safety net.” Unpaid caregiving is increasing in Canada yet public policy remains gender-blind, meaning the distinct impacts of policies and programs on women are largely invisible.
If policymakers do not consider gender when making caregiving policy, the differential effects on women caregivers are left unexamined and unacknowledged.
As Carleton University social work professor Susan Braedley points out, policymakers have reframed care as a family concern, and promote the “presumption that households and communities should and will actively provide services formerly offered by the state or third-sector organizations.”
Women are less likely to have employee benefits that would support their care activities and are less likely to have the financial resources available to hire others to help with domestic chores.
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Current discussion on the future of long-term care focuses on the need for more staffing in care homes. However, governments are aware that well-paid, unionized, full-time home care roles demand exponentially higher operating budgets.
As public funding for long-term care is limited, the burden of aging in place is therefore disproportionately carried by women caregivers, particularly in rural areas. Keeping those costs inside the home has created new forms of health work for family carers who have few community and government resources to draw on.
A fuller accounting of rural family care provides an opportunity to ensure policy decisions reflect identities and values, key aspects of healthy rural aging and essential to the project of women’s equality in society.
Mary Rita Holland, Nancy’s Chair in Women’s Studies, Mount Saint Vincent University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
