Canada's Compassionate Care Benefit: Is it An Adequate Public Health Response to Addressing the Issue of Caregiver Burden in End-of-Life Care?

Background: An increasingly significant public health issue in Canada, and elsewhere throughout the developedworld, pertains to the provision of adequate palliative/end-of-life (P/EOL) care. Informal caregivers who take on the responsibility of providing P/EOL care often experience negative physical, mental, emotional, social and economicconsequences. In this article, we specifically examine how Canada’s Compassionate Care Benefit (CCB) - acontributory benefits social program aimed at informal P/EOL caregivers - operates as a public health response insustaining informal caregivers providing P/EOL care, and whether or not it adequately addresses known aspects ofcaregiver burden that are addressed within the population health promotion (PHP) model.Methods: As part of a national evaluation of Canada’s Compassionate Care Benefit, 57 telephone interviews wereconducted with Canadian informal P/EOL caregivers in 5 different provinces, pertaining to the strengths andweaknesses of the CCB and the general caregiving experience. Interview data was coded with Nvivo software andemerging themes were identified by the research team, with such findings published elsewhere. The purpose ofthe present analysis was identified after comparing the findings to the literature specific to caregiver burden andpublic health, after which data was analyzed using the PHP model as a guiding framework.Results: Informal caregivers spoke to several of the determinants of health outlined in the PHP model that areimplicated in their burden experience: gender, income and social status, working conditions, health and socialservices, social support network, and personal health practises and coping strategies. They recognized the need forimproving the CCB to better address these determinants.Conclusions: This study, from the perspective of family caregivers, demonstrates that the CCB is not living up toits full potential in sustaining informal P/EOL caregivers. Effort is required to transform the CCB so that it may fulfillthe potential it holds for serving as one public health response to caregiver burden that forms part of a healthypublic policy that addresses the determinants of this burden.