Informal caregiving for seniors
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As Canadians age, informal caregiving becomes increasingly important to the well-being of seniors. According to the 2008/2009 Canadian Community Health Survey (CCHS)–Healthy Aging, an estimated 3.8 million Canadians who were aged 45 or older (35%) were providing informal care to a senior with a short- or long-term health condition. Informal caregivers—family and friends who provide unpaid assistance with tasks such as transportation and personal care—help seniors remain in their homes, thereby reducing demands on the health care system.1 Moreover, remaining in one's home is usually the preference of seniors themselves.2,3
Caring for someone with a health condition or limitation, particularly cognitive impairments such as Alzheimer's disease and dementia, can cause physical and emotional problems and create financial and social burdens for the caregiver.2,4-7 This may be especially true for caregivers who, themselves, are seniors.8 On the other hand, providing care can give individuals pleasure and pride, enhance their self-worth, and help them to build relationships with the care recipient.9
Based on data from the 2008/2009 CCHS–Healthy Aging, this study compares the characteristics of caregivers with those of their contemporaries who are not caregivers (see The data). In addition, the characteristics of the care that caregivers provide are outlined, as are the positive and negative aspects of caregiving.
In 2008/2009, women made up just over half (57%) of people aged 45 or older who were providing care to a senior (Table 1). Almost three-quarters (73%) of these caregivers were aged 45 to 64, although a quarter were seniors themselves; in fact, 10% of them were aged 75 or older. Even so, the age profile of caregivers was younger, compared with non-caregivers (who included care recipients), 18% of whom were 75 or older.
Table 1 Percentage distribution of selected characteristics of caregivers and non-caregivers, household population aged 45 or older, Canada excluding territories, 2008/2009
Perhaps reflecting their younger age profile, caregivers were more likely than non-caregivers to be married or in a common-law relationship (78% versus 71%). They were also more likely to have a higher household income and to be postsecondary graduates. Among those aged 45 to 74, caregivers were less likely than non-caregivers to have been employed in the past year.
Self-perceived health has been shown to be a reliable measure of general health status.11 Higher percentages of caregivers than non-caregivers reported very good or excellent physical and mental health. Nonetheless, it is possible that some degree of self-selection is operating. That is, healthier people may be more capable of being caregivers, and so, more likely to undertake the task. In multivariate analyses that controlled for sex, age, household income and educational attainment, associations between high self-perceived physical and mental health and being a caregiver were no longer significant (data not shown).
Around three-quarters of caregivers reported that the person whom they assisted was at least 75 years old; one-third were caring for a senior aged 85 or older (Table 2).
Table 2 Percentage distribution of characteristics of care recipient and care provided, household population aged 45 or older, Canada excluding territories, 2008/2009
Parents and parents-in-law made up more than half (56%) of those receiving informal care. Another 19% of caregivers reported assisting a friend or neighbour, and 11% were caring for a spouse.
Relatively few care recipients (14%) actually lived with the caregiver. A substantial majority (70%) of these care recipients were living in another private household, and 12% were in a health care institution.
Transportation was the most common form of care provided, reported by 39% of caregivers. About 20% were assisting with household activities, and around 15%, with personal care.
Although 57% of caregivers described their provision of care as "regular," this was a daily commitment for only 21% of them; 36% provided regular care once a week, once a month, or less than once a month. About a third of caregivers had been providing care for at least five years; almost as many reported that they had been doing so for less than a year.
The literature suggests that those who care for someone with severe cognitive impairment are at elevated risk of experiencing caregiver stress or burden,5,7 but because the CCHS did not ask about the care recipients' specific health condition, this issue could not be addressed in the current study.
Challenges and rewards
Although a relatively small percentage of informal caregivers reported that caregiving had caused or worsened a health problem (8%), more than half (56%) of them encountered difficulties and challenges (Table 3). When they were asked about the most negative aspect of caregiving, 17% reported that it was emotionally demanding; 12% said that because of caregiving, they did not have enough time for themselves or family; 10% said it created stress; and 7% reported fatigue.
Table 3 Percentage distribution of negative and positive aspects of caregiving, household population aged 45 or older, Canada excluding territories, 2008/2009
At the same time, almost all (95%) informal caregivers reported positive aspects: 30% said that the most positive aspect of caregiving was personal satisfaction; 26% enjoyed providing assistance; and 19% stated that it made them feel closer to the care recipient.
In 2008/2009, about one-third of Canadians aged 45 or older were providing care to a senior with a short- or long-term health condition or limitation. Among the negative aspects of caregiving that they reported were that it was emotionally demanding and that it meant they did not have enough time for themselves or their family. On the other hand, substantial numbers reported that they derived personal satisfaction from caregiving and enjoyed providing assistance.
The authors thank Heather Gilmour, Guy Gellatly, and members of the focus content team in the Health Statistics Division at Statistics Canada for their comments and feedback on the paper.
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