It frustrated me to read the Hartlin’s story about health care delayed on my Facebook feed and on the CBC. Another incident where our health care system is failing Canadians. Pamela Hartlin slipped on ice and fell. She went to the Emergency Department that afternoon. I felt distraught for her and her family. Not only because she wasn’t seen in a timely manner-an x-ray at 4:00 PM that verified 3 breaks in her shoulder, not that she was sent home 7 hours later at 11:00 PM as she wouldn’t be seen for the necessary surgery that night, not that she was told to fast (no food or liquids in order to be prepared for surgery) in spite of her diabetes-and she was told this for three days in a row, not that she was in pain and nauseated for the three days she was fasting, and not that it took her daughter posting the story on Social Media where the CBC picked up the story. All those things did distress me. However, what caught my attention and made me distraught was when I read that she is her husband’s caregiver. She has been caring for him for 21 years since a blood clot in his brain caused right sided paralysis and he relies on his wife, Pamela, to help him meet his daily needs. Since her fall and the wait for surgery, between them they have only two good arms and are not able to care for themselves. 

I don’t know them, but I know these stories. It sounds like they were able to rely on the help of their daughter. I doubt very much that the ER staff even knew Pamela had a partially paralyzed husband at home who was dependent on her for care. We never ask about the caregiver, or how they are going to manage at home. 

With more than 8 million family caregivers across Canada, they are a significant part of the health care work force, albeit a volunteer work force. What happens when one or more of these 8 million people can’t do their job? Their loved one will still need care. Someone will need to step in. 

Often, when a family caregiver gets sick or injured there is no one else to step in. There is a 35-45% likelihood that the family caregiver who gets sick or injured lives with the one they care for. If there happens to be another family member around, like an adult child or a sibling, they may be working or have other commitments, and while they might be able to make arrangements to help out with advance warning, it is likely that they can’t step in on a moments notice. 

If no other family or friend is available to step in, then one who was cared for by the ill or injured family caregiver, will need care. It will either mean hospitalization, which is inappropriate use of those resources; 24 hour home care, which is rarely available on short notice or for extensive hours unless the family can pay privately; or short term respite, which is nonexistent in most areas of Canada. 

With increased occurrences of family caregiving (Stats Canada intends to release the latest  [2015] numbers in June and current figures are based on 2012 data) we can no longer keep our head in the sand about the impacts of this unpaid, volunteer, and significant part of the health care workforce.

When nurses triage in the Emergency Room, can we not ask about the situation at home??? Adding this question to intake forms is imperative. In most cases, the answer might not bump the family caregiver to the top of the line, but it certainly should be taken under consideration and mechanisms put in place to help the family caregiver problem solve. Food for Thought.