title: Contributions and Challenges of Non-Professional Patient Care: A Key Component of Contemporary Canadian Healthcare.
abstract: The Canadian public is aging. Population levels of excellent, or very good, health are decreasing, and the prevalence of chronic diseases is increasing. Timely access to caring and respectful care from health professionals, with supporting information transfer, are key qualities in patients' sense of centricity and hope for best outcomes. Data from the 2013-2014 Health Care in Canada (HCIC) survey reveal, however, that 38% of such patients do not always, or often, access this support. The lack of timely access may be one underlying driver for non-professional caregivers to contribute to the care, as well as the personal and financial management, of family members or friends with chronic disease. Previous HCIC surveys, in 2005, 2006 and 2007, reported non-professional caregivers' prevalence in the adult public at 21, 23 and 26%, respectively, compared with 19% in the 2013-2014 survey. In all the surveys, a notable feature of non-professional care providers has been their universality of contribution, across age, sex, geography and time. Caregivers pay, however, a price. They have a lower level of self-related health, a higher incidence of chronic illness and net-negative impacts on relationships, career and finances, including use of personal savings (53%) and necessity of quitting their job (12%). Conversely, they infrequently claim available tax (12%) or compassionate care (11%) benefits. Interestingly, non-professional caregivers work in team-care settings with health professionals more frequently (29%) than patients in the general population with chronic illnesses (18%). Nonetheless, their current levels of always, or often, receiving assisting support (46%) and information (53%) from health professionals are lower than the respective results reported by the general public (65% and 68%). In conclusion, non-professional patient care in Canada is a common, longstanding and not-for-profit enterprise. It is more likely driven by altruistic caring or sense of duty that balance, or overwhelm, its associated personal, medical and financial burdens. In the short term, practical opportunities for enhancement include broader recognition of caregivers' contributions, their improved access to professional support and communication and wider use of available governmental financial support. All are likely to enhance both patient-centred care and lessen the practical burdens of caregivers. Things can be better.
authors.affiliation: Principal, Care Net Health Management Consulting Ltd., and Adjunct Professor of Medicine, University of Alberta, Edmonton, AB.
authors.forename: Terrence
authors.initials: T
authors.lastname: Montague
authors.affiliation: PhD candidate and Research Assistant, Faculty of Medicine, McGill University, Montréal, QC.
authors.forename: Amédé
authors.initials: A
authors.lastname: Gogovor
authors.affiliation: Associate Professor, Faculty of Medicine, McGill University, with appointments in the School of Physical and Occupational Therapy, the University Health Center's Division of Clinical Epidemiology, Clinical and Health Informatics and the Centre de recherche interdisciplinaire en réadaptation, Montréal, QC.
authors.forename: Sara
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: Associate, CIHR Institute of Human Development, Child and Youth Health, and knowledge translation consultant to the HCIC project, Toronto, ON.
authors.forename: Emily
authors.initials: E
authors.lastname: Torr
authors.affiliation: President, John Aylen Communications, and Lecturer in Marketing Communications, John Molson School of Business, Concordia University, Montréal, QC.
authors.forename: John
authors.initials: J
authors.lastname: Aylen
authors.affiliation: Senior research consultant and Vice President, Public Affairs, POLLARA Strategic Insights, Toronto, ON.
authors.forename: Lucas
authors.initials: L
authors.lastname: Marshall
authors.affiliation: President, Canadian Caregiver Coalition and Executive Director, Canadian Home Care Association, Mississauga, ON.
authors.forename: Nadine
authors.initials: N
authors.lastname: Henningsen
authors.affiliation: Principal, Strive Health Management Consulting Inc., Halifax, NS.
authors.forename: Joanna
authors.initials: J
authors.lastname: Nemis-White
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D017028:Caregivers / Q000458:organization & administration* / Q000706:statistics & numerical data; D002908:Chronic Disease / Q000628:therapy; D003695:Delivery of Health Care / Q000458:organization & administration; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult