We all know that Australia is facing an acute care crisis. It’s in the headlines almost daily. As an expert in longevity, health, and care, and with the ample lived experience of caring remotely for a mother who lived to 109, I am acutely aware of what millions of ageing Australians now face.
The care crisis affects multiple generations – caring and cared for – and it is a daily worry for many more than the estimated three million unpaid Australian family carers.
I have been researching and writing the about the eldercare crisis for years. I have compiled the essential need-to-know about working while caring for business, government and employees in a book launching this week, National Carers Week, in New South Wales Parliament by Robyn Preston MP: “The Cost of Not Caring: Working while caring in the era of longevity.”
A summary of how we got here: longer lives (longevity); increasing care needs during the 8-12 years of diminishing “healthspan” compared with lifespan; smaller families meaning fewer adult children to share the care work; and of course the high proportion of women in the workforce (63 per cent) today compared with fifty years ago (38 per cent) according to official government data. The traditional ‘safety net’ – stay at home women – is no longer reliable.
We’ve run out of paid care workers and neither governments nor households have enough money to subsidise or pay out of pocket for what our frail older people need. The cost of even basic support workers is $55-70 an hour and up to $200 or more per hour on weekends and public holidays for workers who administer medication or dress wounds. That’s if you can find a qualified worker. The recent report from the Committee for Economic Development of Australia (CEDA) predicts the entire care sector faces a shortfall of 400,000 workers by 2050 to meet growth in demand. Prof Kathy Eager estimates Australia needs an additional 108,000 full-time equivalent workers just to bring rural and remote aged care provision up to equivalent population/care worker ratios.
The ”care economy” is wickedly complex. Hardly a “system,” Australia’s aged care economy comprises and requires coordination among hospitals, general practitioners, specialists, nurses, home care, rehabilitation, and, of course, nursing homes (residential aged care), only a small proportion of which can care for people with dementia. There is no universal means of communication among all these essential parts, let alone a coherent framework focussed squarely on the needs of the older person and their family. It is no surprise that at various places along their ageing journey older people fall through the cracks. It is not their fault or the fault of their families that so many are literally wasting away in hospital beds.
Most of the recent commentary has focussed on the dollar cost of aged care. Professor Eager refers to complex needs packages causing older Australians to pay $30,000 or more per year in fees. The Productivity Commission concluded that primary carers, overwhelmingly women, lose an average of $392,500 in lifetime earnings and $175,000 in superannuation by retirement age. There are other equally significant unquantified costs. Unpaid carers are consistently reporting lower wellbeing, higher financial stress, and poorer health outcomes than the general population, turning to government-funded services to support themselves.
Families, already the ‘safety net’ providing $78 billion in support and care per year, will inevitably continue to fill the gaps. But at what further cost? Our research revealed that women and men (2/3 of caregivers) who are working while caring leave the workforce when they can no longer juggle work and caregiver responsibilities. They are overwhelmed by the administration required to obtain and managing support for ageing parents; they are not entitled to the same unpaid leave with guarantee of their job commonly offered to new parents; they feel stigmatised as carers and point to discrimination in work opportunities and promotions; and they don’t get formal and informal support and services from their employers – support commonly offered for other life events.
What is largely unseen, unacknowledged and unquantified is that government and employers bear a heavy financial cost for not caring. According to a project of the Harvard Business School most organisations do not look or measure the cost. The Australian Government has overlooked productivity losses when unpaid family carers drop out of the workforce or reduce their hours. Or turn to government-funded health care and other resources when their own mental and physical health suffers from trying to keep it all together.
Yet there is reliable evidence for immediate measures that have no or minimum cost, proven to reduce the financial drain on employers and the economy that can support employees. These adjustments have financial benefits that are a win-win-win: they go straight to businesses’ bottom line, alleviate the strain on employees who are working while caring, and reduce the end costs to government. They are practical and proven – they just need to be implemented. One of the unintended outcomes of COVID-19 is that the workplace of today can survive and thrive with innovation in work practises. Desperation is the mother of innovation.
Demography dictates that the Cost of Not Caring is huge, growing, and will be with us for two decades or more. Governments can no longer rely on the sacrifice and guilt of family members as the unpaid safety net of Australia’s care economy.
Working families and their ageing parents feel abandoned by government and unsupported by employers. They are staggering under the physical mental, and financial loads. The profile of Australian society and its workforce has changed irrevocably. We are no longer in the 1960’s, and our support for people working while caring for ageing parents – and more – needs to adapt.
Feature image: Abby Bloom.