Families shoulder costs of Canada's failing care economy

A growing number of Canadians are finding it nearly impossible to hold down full-time jobs while caring for children and aging parents simultaneously. The country’s care economy is failing to support them, leaving families to absorb the financial and emotional costs alone. It is a situation that threatens to push many workers out of the labor force entirely, mostly.

In 2022, StatCan found that 20 per cent of adults provided unpaid care to older adults with disabilities. Nearly a third did the same for children. This unpaid work creates significant financial strain, forcing people to use up vacation and sick time while their own health needs are pushed aside.

“It’s absolute survival mode,” says Claire Webster, founder of McGill’s Dementia Education Program. A mother of three, Webster describes being “constantly” pulled in many directions as she tried to balance work with caregiving duties. She recalls that her children were watching her unravel as her own mother’s dementia progressed.

The Economic Toll on Workers

Many caregivers have reduced their work hours or sidelined career ambitions to support aging family members. Trying to balance full-time work with care demands often leads to leaves of absence and lost income. “It bleeds into their work,” says Dr. Ivy Bourgeault, Canada research chair in Gender, Diversity and the Professions at the University of Ottawa.

Many spend upwards of 30 hours a week caring for elders or children. The value of this unpaid labour is estimated at $97 billion annually. This massive contribution goes largely unrecognized in official economic metrics, yet it supports the entire health system.

If current trends persist without significant intervention, the labor market participation rate will likely decline as more women exit the workforce to manage these responsibilities. The economy cannot sustain this level of hidden subsidy indefinitely, suggesting that policy shifts are not just social necessities but economic imperatives.

A Strained Home Care System

Families often turn to paid homecare workers to fill the gaps, but pervasive shortages have a “cascading effect.” This leaves families to shoulder the heavy physical and emotional load. Personal support workers (PSWs) form the backbone of care for elders, but low wages and poor job quality lead to high turnover.

Among health workers in Canada, these workers are “at the bottom” in terms of status and pay. This structural issue makes it difficult to retain staff. Armine Yalnizyan, Economist and Atkinson Fellow on the Future of Workers, says, “By not caring for the caregivers…you are shooting yourself in the foot.” She argues that mismanagement of the supply of these workers shifts more of the burden onto working families.

Canada has leaned heavily on temporary foreign workers to address shortages. The federal government recently paused all new applications through the Home Care Worker Immigration pathway. Alicia Massie, economist at Simon Fraser University, noted that many home health workers will be forced to leave the country as their visas expire.

Women bear the highest load when it comes to caregiving, paid or unpaid. More than half of women in Canada care for a dependent elder or child, and many do both. As care demands intensify, these “sandwich moms” are often forced to exit the workforce entirely.

Over the coming decades, a tripling of the number of people above age 85 is expected. This will accelerate “health care spending and the need to deal with dementia and frail elderly,” says Dr. Michael Wolfson, former research chair in Population Health Modeling at the University of Ottawa. The Alzheimer’s Society of Canada projects the dementia population will double by 2050, reaching 1.7 million people.

Gaps in Infrastructure

Provincial investment in long-term care infrastructure has not kept pace with demographics. Wait times for publicly-subsidized beds extend for months or years. “We have nothing in between living alone and long-term care,” says geriatrician and home care researcher Dr. Amina Jabbar.

Amid a housing shortage, aging in-place is becoming a luxury affordable only to the wealthy. Yalnizyan says the chronic shortage of care workers is a growing constraint on Canada’s economy, a dynamic that will continue to accelerate.