The increasing strain on Manitoba’s health-care system and paid care workers during COVID-19 is palpable. But we cannot forget the critical role that family caregivers also play in this relentless pandemic. Unpaid caregivers assist family members and friends of any age requiring physical, emotional, or practical help due to chronic, physical, mental and/or cognitive conditions.
They are essential, yet remain largely invisible. There is a dire need for Manitoba’s government to significantly bolster support for family caregivers — and the time is now.
In 2011, Manitoba legislated the Caregiver Recognition Act, highlighted as an ideal exemplar nationally and internationally. The act recognizes family/friend carers’ significant contributions and promotes the importance of "timely, responsive, appropriate and accessible" supports for caregivers’ personal needs and well-being.
The act is admirable in theory, yet little has been done to put it into action. Caregivers in this province have been forging along with little support for too long, but the pandemic has amplified challenges and needs that can no longer be ignored. Increased strains stem in part from extended pauses in public-health and social services, such as home care, and fear of leaving loved ones in congregate care settings due to concerns about care quality and the rampant spread of COVID- 19.
University of Alberta researchers released findings from a survey of family care during COVID-19 in that province, presenting "two solitudes" — carers of persons in congregate care facilities are often unable to visit or provide care in those settings; carers of persons in the community have significantly increased the amount of time they spend providing care.
Both groups report increased distress, anxiety and loneliness. A Quebec caregiver organization also found that carers reported being "exhausted and impoverished" by the pandemic. Twenty-two per cent could not return to work because other care options were unavailable, and 31 per cent did not return for fear of transmitting COVID-19 to the care recipient.
The situation in Manitoba is no doubt similar. Even prior to COVID-19, there was evidence (such as the Virgo Report in 2018) that the lack of services available to caregivers was distressing, a situation that has now been exacerbated by this pandemic. Both Alberta and British Columbia have increased funding for caregiver supports because of COVID-19. Where is Manitoba’s commitment to its family caregivers?
Every two years, the minister of health, seniors and active living is required to report on progress in recognizing and supporting family caregivers. The last publicly released report was in 2015. Five years have passed for the province to be able to demonstrate significant progress and concrete actions to address the principles of the Caregiver Recognition Act.
So what can the Manitoba government do?
1. Release and publicize an updated, comprehensive Caregiver Recognition Act report, detailing current supports for the varied needs of diverse caregivers. An addendum to highlight COVID-19-specific supports for caregivers is pertinent.
2. Re-establish the provincial Caregiver Advisory Council, which was disbanded in 2017, to provide the minister with information, advice and recommendations about developing meaningful caregiver supports.
3. Conduct a non-partisan review of existing knowledge to inform policy leadership and identify priorities for caregiver support. This could include financial and employment-related supports, counselling and information, access to congregate care facilities, and safely reinstating home care and other services as needed.
4. Identify and address gaps in potential leave benefits. Last spring, Manitoba legislated temporary job protection for family caregivers taking unpaid leave from employment during the pandemic. This is not a long-term solution. More promising is a federal employment leave benefit for people in similar circumstances (for example, those for whom "regular care services" are unavailable), but eligibility requires clarification.
Care is not a private issue for individuals and families. It is a complex public-health concern and a social justice issue — it is about the right to provide care, but without risking one’s own health; the right to control the amount and type of one’s involvement in unpaid care, and to mitigate the impact on one’s life.
Prior to the pandemic, research had documented profound, long-term impacts of unpaid care work, especially for women, who tend to shoulder more care with greater risk of negative outcomes. These effects will likely be intensified during the pandemic.
The COVID-19 pandemic is propelling caregiver issues, and the need for evidence-informed political leadership, accountability and action, into the spotlight. We can no longer afford for caregivers to remain invisible. Immediate investments in caregiver well-being is not only prudent; it is critical.
Laura Funk is an associate professor of sociology and Jamie Penner is an assistant professor of nursing at the University of Manitoba. Dianne Booth is a caregiver advocate and community member.