Care givers being oppressed
What is care giving? Care giving can include assistance with personal care needs, such as bathing, dressing, and eating or other activities necessary for independent living, such as shopping, medication management, and meal preparation. Family caregivers do care giving themselves may arrange, supervise, or pay for formal or paid care to be provided to the care recipient.
Canadian study (Fast and Keating cited in the Canadian Nurse journal staff 2000) reported that non paid caregivers of the elderly are saving Canada’s health care system more than 5 billion dollars annually. “Saskatchewan has more than 80,000 informal caregivers helping chronically/terminally ill, disabled or elderly adults and children at home . Three out of every four caregivers are women and as many as 10% of these are older than 75 years of age” (Sawatzky & Fowler, 2003, p. 277). While homecare services are available to assist in care, the burden of care often falls disproportionately on mothers, wives and daughters, who are unpaid for their services. Physical effort combined with lack of support, medical knowledge and sleep can often place the health of caregivers at risk. “It is estimated that 60% of caregivers have a health crisis after 18 months of care giving” (Sawatzky & Fowler, 2003, p. 277). Physical, emotional, social burdens as well as economic costs have been reported as negative consequences to care giving.
Another aspect that some care givers experiences are the emotional, psychological and physical effects. Care givers are prone to suffer from emotional pain. This affects her psychological aspect to the point of not having enough sleep and self-care. Their physical aspect is jeopardized that eventually may develop to some illnesses. These care givers also experiences pain because of the situation they are in. They also experience isolation from their loved ones. Their relationship with the one whom they give care is at stake and as well as their relationship with other members of the family and /or friends. Some of the care giver copes with having deep faith believing that their loved ones will be cured and that their agony will end soon. I am not really surprised about this fact because based on my own experience working in home care and knowing a lot of my friends and relatives, the woman mostly become the caregiver. This caregiver goes through many process of change as they experience great loss where they need to strategize how to cope with the situation that affects their lives.
I think women suffer from great loss in terms of their personal identity is what hurts the most, like change of relationship and lifestyle. One of the women that I know of had to give up her employment because she wants to make sure that her husband is well taken care of. According to her, she is doing it because of her great love for the husband. However, the time came when they were not financially getting enough money to support the family so the woman decided in going back to work and applied respite home care for her husband. Though there is home care, it is not enough support as the home care attendant only stays four hours a day. The woman has to work eight hours a day, so she ended up working part time. In most cases it is always women who needs to adjust in this kind of situation. It is not only their personal lives that are jeopardized but also their financial lives. Of course it is a decision to provide care but who is going to suffer again at the end? Women? “ A women’s issues perspective that underlies many current care strategies defines care giving as a woman’s problem, rather than a societal problem” ( Hooyman et. al, 2002, p. 13). It is clear that in this sense women are being taken advantage of.
It is demeaning to know that although the government is saving money for care givers, it is women who are again oppressed here. For me working at WRHA and assessing whether or not the client needs Health Care Aide support is important but I need to understand what the caregiver is going through. This is an eye opener for me to assess objectively what is good for both the client and the caregiver.
Reference:
Hooyman, N., Cloette, B., Ray, R., & Richardson, V. (2002). Feminist Gerontology and the life course. Gerontology & Geriatrics Education. 22 (4), 3-26.
Sawatzky, J.E. & Fowler-Kerry S. (2003). Impact of caregiving: listening to the voice of informal caregivers. Journal of Psychiatric and Mental Health Nursing. 10, (277-286)
Mary Anne,
ReplyDeletethank you for your post. This issues really resonates with me as it is something i have seen frequently in my placement and in my personal life. It truly is amazing the sacrifices that caregivers make for their loved ones. I have seen caregivers who visit their loved one three or four times a day to ensure they are taken care of. As well individuals who require 24 hour care are particularly challenging to care for. Caregivers often have respite during the day when they are at work but when they come home they continue to work to take care of their loved one. This impacts their social life, their sense of freedom, opportunity for self care, their health and much more. I agree Home Care is a great resource for caregivers however it still places a great amount of responsibility on caregivers. It is so true that women bear the brunt of this responsibility. It is shocking the amount of money that unpaid caregivers are saving the government with little to no recognition for this contribution.
Additionally i have noticed with caregivers and those being cared that the change in the role has particular impact on their relationship. For example daughters often become caregivers for their older parents and especially as these caregiving responsibilities become more complex the relationship changes from when the parents were seen as caregivers.
I also have found that caregivers experience intense grief when they can no longer care for the increased needs of their loved one. This is also very difficult for caregivers as they can feel as if they have failed or that they did not give enough. This can be so difficult for caregivers even though they have given their best and sacrificed immensely.
I wonder what more we can do as social workers to validate the experience of the caregivers we come in contact with. I would be interested to hear the perspective of caregivers and how they feel they could be better supported not just financially but emotionally as well.
great post!
-meagan
This post raises some very important issues. I think one of the things that interests me most about this is that there seems to be no clear-cut answer from any angle. On the one hand, it would be nice if the government could pay for home care to improve the standard of life for all the unpaid caregivers in the country, however, there are problems with this approach, as well, that make it difficult to suggest that this is the obvious answer.
ReplyDeleteThe most important thing, of course, is that there are many demands for government funding for social services and it is difficult to know how to set priorities. Undoubtedly, not being able to afford home care (or having financial difficulty in order to do so) is hard on caregivers, however how do we compare these difficulties with the danger of people dying in trauma care at the hospital because emergency rooms cannot be staffed. When we think of people waiting months for diagnostic tests for diseases like cancer, it becomes less clear that unpaid caregivers (who at least are not actually dying) have higher priority. In other blogs we have read about how people with severe mental health issues are freezing to death in the streets without homes. Despite the huge negative effects on the lives of caregivers, at least most of them have a roof over their heads. This is not to say that it is an unimportant issue - nothing could be further from the truth - but trying to decide where this fits in the priority line-up is very difficult.
At the same time, I find it very interesting how the authors of the study worded the line that non-paid caregivers of the elderly "save" the government 5 billion a year. This to me reflects a very Canadian cultural assumption; that the default provider of care should be the government, and that unpaid caregivers somehow reduce this duty of the state. Coming from my own background in a much more family-oriented culture in a less wealthy country, this assumption feels very foreign to me. In Colombia, the normal assumption is that family should look after their own aging members and that the government's proper role in society is far more limited. This is about more than money; by implying that the government has a duty to "buy" care for the elderly, it runs against our cultural norm that membership in a family comes with both pleasures and duties, and that both have to be embraced together. Additionally, it is interesting for me to see how in Canada, the article implies that women are oppressed by being made to take on more of the caregiver roles, while in other cultures, women take great pride in care giving roles and see this somewhat as their "right" more than their "duty".
Of course, being cultural values, it is impossible to say that one is "right" and the other "wrong", but I felt it would be an interesting look at how something which we define in Canada as a problem is somewhat dependent on the cultural assumptions that underlie the situation.
Thank you for sharing this blog post Mary Anne. I really appreciated your thorough research into some of this issues that caregivers face.
ReplyDeleteAs Dianna mentioned in her comment, there are many values intertwined with caregiving. I do agree with you Diana, in that I believe that there is one right answer for everyone. I have found throughout my professional practice that there are some programs available to assist a variety of caregiver needs, but the system is still lacking.
Firstly, it is important to note that home care in Manitoba a free service, based on an individual’s citizenship. Although any Canadian citizen should have access to home care to meet their needs, services can be limited and exclude many immigrants residing in Canada.
In addition to home care, there are also many other day or longer term programs developed to support older adults and their caregivers that are also either paid for by the province, or adjusted to income. Although I do not wish to ignore the fact that services for older adults are limited and that as a result many caregivers are facing a range of issues, but I do wish to raise the fact that there are some programs which are beginning to be developed in Manitoba to meet a variety of caregiver needs.
One particular client situation which came to mind after reading the blog and comments which is related to this issue involved a family who had moved to Canada from Africa about ten years ago. The older woman in this family required a high amount of care, but her daughter was committed to be her caregiver and to keep her living in her home in the community. One option which we found was appropriate was family managed care. This program allows caregivers to oversee and manage their loved one’s home support workers and other related services that home care provides. Although this may not be appropriate for everyone, for this particular family who believed that older adults should be cared for by their relatives, it was quite helpful. This type of program supports people who wish to have a role in their loved one’s care, instead of delegating the responsibility to a professional.
Although there are many more policies and procedures related to family managed care which I have not discussed, my point is that is important to provide options to caregivers, because no two people are the same. Every individual has different beliefs and needs and the future of this type of care should be to support them.
Thanks again ladies,
Alison
Thank you for your blog post. It is surprising to read that so many women, those who are not paid for caregiving, can save more than five billion dollars per year in Canadian health system.
ReplyDeleteAs a woman, I am not pleased to listen to some negative effects of care giving because I assume that these effects may make me stressed a lot and my later life harder. Within my husband’s family, all family members are expecting me to care for my parents-in-law because I am the oldest-daughter-in-law who is traditionally considered as a caregiver.
As Diana mentioned, there may be many urgent situations which must be prioritized to receive support before non-paid caregivers, so it may almost impossible to expect governments to pay informal caregivers. If informal caregiving was paid, the governments would need five billion dollars right now. Where can governments make this amount of funds for caregiving?
On the other hand, even if I understand this situation of the health system, I am doubtful if there are any alternatives for women to exit caregiving without being paid from the government. Could men take over caregiving if women stopped it? In reality, it is very hard to tell whether men willingly share caregiving for their old adults who have illness or dementia with their wives.
Despite this fact, as Alison mentioned, it is good to know that our province provides a free homecare service even though there are some limitations for immigrants. As a person, who was an immigrant, this fact makes me unhappy.By Eunkyeong
Hi Mary Anne,
ReplyDeleteYou presented another in-depth analysis on caregiver issues. I was struck by the example that you shared where a woman had to quit her employment in order to care for her partner. That was a sad but realistic scenario. It is disheartening to reflect that for many people, including a significant number of women (especially those who possess memberships to other marginalized social locations), care-giving is not a matter of choice but a sense of responsibility. And oftentimes this situation creates multiple stressful outcomes for these caregivers. Thanks for sharing.
-Darnel