Year: 2019
Type: dissertation
Abstract: Population aging and concomitant growth in the number of older Canadians experiencing multiple chronic health and social needs has sparked inquiry respecting the support of informal caregivers—the family, friends and neighbours who provide the bulk of the everyday personal, instrumental and emotional help required by persons with chronic needs to maintain well-being and independence. The central argument proposed in this thesis is that, although there have been advances in caregiver support policies in Ontario, for the most part, progress in this area has been uneven, halting, and at the policy margins. Chapter 2 (Study 1) identifies policy instrument use, programmatic interventions, and the comprehensiveness of supports targeting caregivers among five OECD Member States: Canada, Japan, Germany, the United Kingdom, and the United States. Policies for informal caregivers of seniors in Ontario are also examined from 1981 to 2016. Results demonstrated despite a similar policy context, heterogeneity exists among interventions and policy instruments across the OECD. Additionally, as early as the mid-1980s a large and growing body of evidence documented the difficulties of Ontario’s caregivers, and yet, their situation remains only minimally addressed by policymakers. Chapter 3 (Study 2), examines the Caregiver Framework for Seniors Project (CFSP) using quantitative analysis. Results demonstrated that the mix, cost, and volume of supports selected in care plans signaled that program resources were deployed to cross-subsidize and offset rising care burden amidst constricted home and community care budgets. Chapter 4 (Study 3), examines the dynamics of policy change and/or stasis in Ontario. As neo-institutional theory would predict, change is heavily influenced by political and historical factors, including: (1) powerful interests and the structure of health system design on resource allocation, (2) economic and demand side factors, and (3) institutional factors that limit scale and spread. Chapter 5 reviews key findings, strengths and limitations. Recommendations for future research are also presented in this concluding chapter. The findings of this thesis confirm that progress across Canada has been halting. With few exceptions, including the Ontario case, even promising initiatives such as the CFSP have not scaled or spread.
Source: TSpace (University of Toronto)
Author: Natalie Warrick
Language: English
Subfield: Life-span and Life-course Studies
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W3154914216