For more than a year now, Manitobans, like all Canadians, have been learning how the COVID-19 pandemic has devastated those who live and work in the seniors’ care sector.
In public conversations, many have tried to ascertain just how this all came about in the first place. Scholars from the Royal Society of Canada pointed to the fundamental problem of "long-standing deficiencies" in the sector. Inherent structural deficiencies that were exacerbated by the pandemic have exposed the lack of political will to act, and ageism might very well be an underlying factor.
We also contend, however, that gender is key to understanding how and why the situation in seniors' care came to be and has persisted for decades in this country.
To date, deficiencies in systems and continuums of publicly funded care persist. As the National Institute on Aging reports, Canada’s expenditures on publicly funded home and long-term care (1.2 per cent of GDP) places us well below the Organization for Economic Co-operation and Development (OECD) average of 1.7 per cent.
Part of the explanation for societal under-investment in seniors' care, as identified by scholars and seniors advocates alike, is pervasive ageism — attitudes devaluing old age and older adults. In this sense, ageism (as well as an ableism that devalues those living with physical or cognitive impairment) is institutionalized within our public systems of care.
Notably, public conversations about seniors' care rarely raise the issue of gender. Yet as researchers have demonstrated for decades, there tend to be persistent assumptions that care for older adults — as with children — should be a private family responsibility and, based on traditional gender-role assumptions, women are best suited to provide this care.
Feminist scholars have been pointing this out for decades, but rarely do their messages gain traction in the general public awareness or debate. For instance, a recent series in the Edmonton Journal, although commendable for drawing attention to the impacts of COVID-19 on family caregivers, does not mention gender.
Yet women (still), on the whole, spend more hours providing more intensive, less discretionary types of unpaid help for older adults than do male family members, and tend to experience greater stressors and subjective burden due to these care responsibilities. Many women are also lifelong caregivers for multiple family members over time. Research shows that the disproportionate burden of caregiving work has negative effects on the health and financial status of women.
It is striking, therefore, that elder care is rarely identified as a feminist issue. Instead, policy-makers falsely assume that publicly funded care for older adults would somehow displace family responsibility, despite gerontological research challenging this assumption. We thus propose that institutionalized sexism is a key component behind the under-funding of home and long-term care for older adults in Canada.
This is compounded, as others have noted, by the fact women (especially racialized women) are more likely to be paid providers of public services, with more than 90 per cent of long-term care employees in Canada being women. And women are more likely than men to experience needs for publicly funded care, such as long-term care or home care, as they tend to live longer, with higher rates of chronic conditions and/or disabilities, and single, widowed and divorced women are more likely to face financial challenges to hiring care outside of the public system.
In Manitoba, even though older adults represent a significant portion of the voting population, this has not resulted in increased political will to invest in seniors' care. Instead, under the current provincial government, we have seen a continuation of frozen operational funding for personal care homes, refusal to increase staffing ratios or even legislate current staffing ratio guidelines, no additional supports for home-care recipients (instead, pandemic-related cuts to service), a refusal to enact legislation to create a Manitoba Seniors Advocate, and an overall de-prioritization of issues directly impacting older adults.
This includes the 2017 axing of the Manitoba Council on Aging and Caregiver Advisory Council. The attempt to placate older adults with a $200 cheque in response to COVID-19 in 2020 did nothing to correct embedded systemic inequities that adversely affect the lives of older adults.
Is this institutionalized ageism at work? Or is it institutionalized sexism? The answer, quite likely, is both.
Laura Funk is an associate professor in the department of sociology and criminology at the University of Manitoba. Brianne Goertzen is the provincial director of the non-partisan Manitoba Health Coalition and a Canadian Centre for Policy Alternatives — Manitoba research associate and steering committee member.