Conceptualizing the Economic Costs of Care

Transcription

1 Conceptualizing the Economic Costs of Care Donna Lero 2, Norah Keating 1, Sarah Lucas 1, Janet Fast Canada Coming of Age RDC conference, 2011 Edmonton, AB Research on Aging, Policies, & Practice (RAPP) Dept. of Human Ecology, University of Alberta, Edmonton AB Canada T6G 2N1

2 Family/friend care: The issue in context Increasing demand for care and support Families are increasingly complex Health and continuing care policy reform Increased emphasis on labour force attachment 2of 16

3 Implications For Caregivers Economic, health & social consequences For Policymakers Health & continuing care system sustainability; labour force sustainability; social exclusion For Employers Absenteeism, turnover, reduced productivity, expenditures on benefits

4 Caregiving is Assistance provided to a family member or friend, because of their long term health problems With a specified set of tasks: Housekeeping Outdoor maintenance/home repair Meal prep & clean-up Medical & personal care Transportation Bills & banking Care management Monitoring Social support 4of 16

5 Economic Costs to Family / Friend Caregivers Impacts of costs to family / friend caregivers are not well understood Key Questions: What are the major domains / types of economic costs caregivers experience? What factors influence the nature and extent of costs that caregivers incur?? What are the longer-term impacts for caregivers? What key gaps remain in our understanding of economic costs?

6 Methodology Scoping Review, York framework Inclusion Criteria: Family / friend caregivers of adult care recipients Economic costs Search strategy included academic and grey literature available in English since 2000 Retrieval, review, collation & synthesis of results

7 Taxonomy of the Economic Costs of Care to Family / Friend Caregivers Costs to Caregivers Economic Costs Social, Mental & Physical Health Costs Employment Restrictions Out of Pocket Expenses Caregiving Labour

8 Employment Restrictions Economic Costs Employment Restrictions Out of Pocket Expenses Caregiving Labour Labour force exit/ preclusion Restricted work hours; Absences Decreased productivity Career limitations

9 Out of Pocket Economic Costs Employment Restrictions Out of Pocket Expenses Caregiving Labour Residential care/ Housing Community services Supplies Transportation /Travel

10 Caregiving Labour Economic Costs Employment Restrictions Out of Pocket Expenses Caregiving Labour Time spent with care recipient Time spent on behalf of care recipient Time spent getting to care recipient Time spent monitoring care recipient

11 Economic Costs to Caregivers Employment Restrictions Out of Pocket Caregiving Labour Labour force exit Residential care Time spent with Restricted work hours; Absences Community services Time spent on behalf of Decreased productivity Supplies Time spent getting to Career limitations Transportation /Travel Time spent monitoring Reduced/ Foregone income Lost benefits Reduced Pension Extra expenses Reduced savings / Investments Foregone income Health care costs

12 Who incurs higher costs? Under what conditions? Employment - Related Costs Younger adults with long-term, significant caregiving responsibilities Women; especially those who provide more hours of care, more personal care, higher intensity caregiving

13 Who incurs higher costs? Under what conditions? Out of Pocket Expenditures Caregivers who pay for nursing home or assisted living fees or for home care services Caregivers to individuals with high, long-term needs (e.g. cerebral palsy, spinal cord injuries, schizophrenia) Long-distance caregivers; co-resident caregivers Low income caregivers*

14 Who incurs higher costs? Under what conditions? Caregiving Labour Women Caregivers who provide more hours of care, more personal care, higher intensity caregiving as per the care recipient s needs Those who lack access to care services and supports

15 Conceptualizing Employers Costs NK6 Direct Costs Indirect Costs Discretionary Costs Wages paid to absent workers, those on paid leave Overtime pay / replacement workers Additional benefits costs (medical, stress, disability) Recruitment, Selection and Training Additional supervisory time Impacts on co-workers, team productivity Potential lost revenue/ impacts on customers/clients Loss of investments made in training, firmspecific experience Paid leave Top-up of EI benefits Investments in EAP / Caregiver Supports Financial support to employees NOTE: Potential for avoiding or reducing costs; ROI, reputational and recruitment advantage

16 Diapositive 15 NK6 enough time in the presentation to present this part of the taxonomy? It gets little attention compared to the caregivercosts Keating, Norah;

17 Knowledge and Research Gaps Long-term impacts of economic costs for caregivers Impacts on self-employed individuals, those with non-standard/ precarious employment Low income, immigrant, aboriginal populations Shared and non-shared costs among family members Moderating effects of public policies including tax credits, home care, etc. Effects of workplace flexibility and support on employmentrelated costs to caregivers and to employers

18 Contact Donna S. Lero Centre for Families, Work and Well-Being University of Guelph Guelph, ON CANADA N1G Norah Keating Research on Aging, Policies & Practices (RAPP) University of Alberta Edmonton, AB T6G 2N1