Old age itself is a women’s issue. The preponderance of women among the elderly is visible to the naked eye in any nursing home. And Statscan recently published a study of widows over 65 who, they report, outnumber widowers five to one.

When it comes to caregiving, whether paid or unpaid, the preponderance of women is even more striking. Approximately 90% of paid caregivers are women, even though the need for men in this field is painfully evident. And among family caregivers (who provide 80-90% of all elder care) wives, sisters, daughters and daughters-in-law probably make up three quarters of the total.

Caring is "Women’s Work"

As an activity, caring is difficult to define or measure, but it is always recognizable, both in its presence and in its absence, What is equally recognizable is that caring is devalued in our society. The most obvious example is the invisibility and absence of recognition or compensation for family caregivers. This devaluation of caring derives from the still entrenched attitude that caring is "women’s work" — necessary but of no economic value.

Low Wages for Paid Caregivers

The devaluation of women’s caring carries over from the family situation to the situation of paid caregivers. Whether in day care centres for children or in community care (mainly for seniors) low wages are the norm. In community care, we are already on the verge of a crisis in human resources — because both personal support/homemakers and nurses are paid less and have less job security than they can have in institutions, like nursing homes and hospitals, for which they are fully qualified.

Home Care Replacing Hospital Care

Another way in which caring is being devalued is in the funding and operation of Ontario’s Community Care Access Centres (CCACs). To meet their fixed budgand the heavy needs of patients sent home too soon from hospitals, they have had to reduce the amount of supportive care they can provide to the frail elderly. The Ministry of Health may boast that their funding is adequate, because CCACs are now coming in under budget, but the Ministry is also now acknowledging how much supportive care has been eliminated to meet budgetary requirements.

Are More Nursing Homes the Answer?

The reduction of personal support homemaking hours leaves many seniors at risk — unless they have available family help or can afford to buy additional care. If they have neither family support nor money, they may have to consider giving up living in their own homes. To many this is the bitterest choice they face.

Nursing home placement is supposed to be available through the CCACs. But waiting lists are long, unless you can afford preferred accommodation, or are willing, or forced, to accept the least desirable facility. Increasingly, persons in this situation are seeking retirement homes, which may appear less impersonal and less threatening to their identity.

Retirement Homes Remain Unregulated

Some retirement homes are luxurious and provide attractive living arrangements, meals and programming. But for seniors whose means are so limited that they cannot pay for extra home care, expensive retirement homes are not an option. They have to seek the cheapest accommodation available, which may be nothing better than a vile boarding house. There are no standards or licensing requirements for these operations. The City of Toronto has been working hard to improve this situation, but what is needed are provincial standards that can be enforced everywhere.

Taking CARE out of Home Care

The reduction in personal support/homemaking hours means that home care workers have to confine themselves to completing only the most essential chores. The pressures of such sick post-hospital patients are leading to the devaluing of the care component in both nursing and personal support. Nurses on pay-per-visit and personal support workers on casual status are both being pushed towards performing tasks and getting out quickly. Paying attention to the person receiving service, caring, in other words, is a frill that is considered extravagant.

Care Watch Toronto held a Strategic Planning meeting on Friday, Jan. 14th, 2000. Twenty-five people attended the session to plan for the future.

WE CELEBRATED OUR ACCOMPLISHMENTS:

WE CONSIDERED OUR FUTURE:

Four priority areas were identified:

1. Formalizing the organization’s structure

2. Continuing/increasing systemic advocacy

3. Strong support for the Education/Outreach Commit tee’s efforts to reach as many people as possible

4. Finding the funds for staff support .

Individual advocacy was also discussed, but it was decided to give priority to systemic advocacy.

A) Organizational structure

It was generally agreed that more formalized structures were needed, as well as better internal and external communication. Discussed were:

B) Systemic Advocacy

Areas of immediate and ongoing concern focused on:

SO, WHAT TO DO?

Resources are limited, and it is impossible to do everything that needs to be done or that we would like to do, nonetheless we have set the following initiatives in motion:

CARE WATCH INITIATIVES

AND WE STILL NEED TO ADDRESS:

ANY SUGGESTIONS FROM READERS

WILL BE APPRECIATED!!!

RECENT HAPPENINGS

At the Care Watch Toronto PhoneLine we continue to hear from callers about the quality of community-based care. Despite the fact that senior officials at the Ministry of Health have told us that CCACs are running surpluses, our callers report inadequate hours, uneven quality of care, and a lack of useful respite care. It is clear that care dollars are continuing to be spent on acute "out of hospital" cases while the frail elderly, the chronically ill and disabled go without much needed services.

While stories of those who call the PhoneLine are very important in painting a picture of community-based care, we are extending our reach into the community, particularly to those people for whom English is not a first language. We have prepared a short survey, which we are distributing in English, Portuguese, Tamil, Chinese and Vietnamese. In this way we hope to hear from care recipients and informal caregivers, as well as those who may have been denied care altogether, who feel more comfortable reporting their experiences in their first language. The survey also gives voice to those people who, for whatever reason, are reluctant to tell their stories on the telephone.

We are enclosing a copy of the survey in this issue of Who Cares? and ask that readers for whom the questions are applicable complete and send it to us at the PhoneLine office (address below). If you are in touch with individuals or groups who may have home care stories to tell, please feel free to copy and distribute the survey. Or if you would like copies of the survey in any of the other languages mentioned above, please contact Tammy Smith at (416) 441-3500. Completed surveys may be sent directly to:

Care Watch PhoneLine
875 Don Mills Road, Unit 7,
Don Mills, ON, M3C 1V9

Please call the PhoneLine at (416) 441-3500, or e-mail us at

THE CARING GAME is a unique, copyrighted and registered board game developed by Care Watch Toronto. Six people receiving in-home care are the game’s characters, which the participants role-play as they make their way around the board, using a die. With a trained facilitator, the participants are assisted to stay in character to experience the concerns, feelings, hopes and life occurrences of in-home care recipients.

Over the past year we have taken The Caring Game to various facilities to share with interested groups including:

• Boards and staff of some CCACs

• Four Villages Community Health Centre seniors

• Support workers from Unionville Home and Community Health Centre, West Toronto Support Services, and York Regional Community Home Assistance to Seniors (CHATS)

• Palliative care volunteers from the Victorian Order of Nurses, Toronto, Bayview Community Hospice and Scarborough Hospice

We have been impressed and pleased with the excellent response from these various groups. More than 85% of the participants rate The Caring Game as very good to excellent. Written comments have included:

"I have learned a lot at this workshop"

"Wonderful way to learn about people’s life experiences"

"Very well thought up and very down to earth"

"Genuine situations and characters"

"The entire presentation was very effective"

We appreciate the positive feedback and suggestions. If you require more information, or wish to book an appointment to play The Caring Game, please call :

Care Watch Toronto at (416) 590-0455

SPEAKERS’ CORNER

Our speakers discuss the problems facing the public health care sector and urges the listeners to join Care Watch Toronto to advocate for changes to the system. They also discuss what community health care services are presently available, as well as how to access them and whether there is a charge; we have found that many seniors, and others, do not know how to get help when they need it, or even what kind of help is available to them. This is an information gap that needs to be rectified.

We are looking for more volunteer speakers, and would be delighted to hear from anyone interested in joining our committee. We provide information packages and practice sessions for new speakers. For more information, to volunteer, or if you know of or belong to a group that might be interested in having one or our speakers come to a meeting, please call:

(416) 590-0455

CARE WATCH TORONTO NOTES

VOLUNTEERS NEEDED!

Education/Outreach Committee is looking for anyone who would like to help with educational programs, ethno-racial access projects or the Speakers’ Corner;

The Caring Came would like volunteers to help with making agency contacts for playing the Game;

The PhoneLine needs helpers to answer the telephone as well as to work on administrative tasks;

The Executive Committee is looking for volunteers to help with fundraising, policy development, and various organizational and constitutional endeavours.

If you are interested, please call (416) 590-0455

If you would like to remain up-to-date on CWT activities, or if you would like to know what the government is doing about in-home services, do come to our General Meetings and find out. They are usually held on the 2nd Friday of every month, from 9:45 am to 12 noon, at:

Toronto District Health Council
4141 Yonge Street,
 Suite #200
Toronto, Ontario

To verify the meeting date, call (416) 590-0455, and we will be pleased to return your call with the information.

ALL ARE WELCOME!

Care Watch Toronto at (416) 590-0455

"Who Cares?" is edited by: Madeline Grant: