women of an (un)certain age a2.pdf · plus the caregiving factor in middle and later life...

October, 2005October, 2005 11

Women of an Women of an (Un)certain Age(Un)certain Age

Imagining Public Policy to Meet Imagining Public Policy to Meet Women’s Economic Security Women’s Economic Security

Needs Needs


Roundtable PresentersRoundtable Presenters

Lillian Zimmerman, Gerontology Research Lillian Zimmerman, Gerontology Research Centre, Simon Fraser UniversityCentre, Simon Fraser UniversityCharmaine Spencer, Gerontology Research Charmaine Spencer, Gerontology Research Centre, Simon Fraser UniversityCentre, Simon Fraser UniversityElsie Dean, Women Elders in Action Elsie Dean, Women Elders in Action (WE*ACT)(WE*ACT)


“Old age means something quite different —and more troubling — for women than for men”

…The World Bank (1994)


Part 1 Part 1 Why Such an Uncertain Why Such an Uncertain

Future?Future?

Lillian ZimmermanLillian Zimmerman


Background and ContextBackground and Context

45.6% of unattached older Canadian 45.6% of unattached older Canadian women live at or below the poverty line women live at or below the poverty line ((vsvs 32.8% of unattached older men).32.8% of unattached older men).An International Plight:An International Plight: 2002 United 2002 United Nations study on the “Economic Status of Nations study on the “Economic Status of Older Women” finds that in the 56 Older Women” finds that in the 56 countries they studied older women were countries they studied older women were consistently amongst the poorest age consistently amongst the poorest age group. group.


Who is Poor?Who is Poor?

Close behind female headed single parent Close behind female headed single parent households, poverty commonly occurs in households, poverty commonly occurs in divorced, separated, and widowed older divorced, separated, and widowed older female populations. female populations. Widowhood is a woman’s issue. Widowhood is a woman’s issue. –– Given average longevity and the fact that Given average longevity and the fact that

more women are living to be 85+, widowed more women are living to be 85+, widowed women suffer a large drop in income and women suffer a large drop in income and living standards. living standards.


Poverty in Widowhood is Common.Poverty in Widowhood is Common.

Senior widows outnumber Senior widows outnumber senior widowers 4 to 1. senior widowers 4 to 1. Widowers remarry at 5 times Widowers remarry at 5 times the rate for women. the rate for women. The incomes of widowed The incomes of widowed women decline 9.8% over the women decline 9.8% over the years compared to married years compared to married women (or 6 X greater than women (or 6 X greater than their married counterparts)their married counterparts)Poverty rates and family status Poverty rates and family status are closely connected.are closely connected.


Which Women Fare Better Which Women Fare Better Financially in Later Life?Financially in Later Life?

““Ever single” women fare the best; married are Ever single” women fare the best; married are second.second.Divorced or separated (including commonDivorced or separated (including common--law) law) are the poorest among unattached older are the poorest among unattached older Canadian women (poorest of the poor)Canadian women (poorest of the poor)Security in widowhood is variableSecurity in widowhood is variable–– some widows have built assets with their late some widows have built assets with their late

spouses, many others may not be able. Poverty in spouses, many others may not be able. Poverty in widowhood commonplace.widowhood commonplace.


Factors Behind Older Women’s Factors Behind Older Women’s Current Economic InsecurityCurrent Economic Insecurity

Social Expectations and Social StructureSocial Expectations and Social StructureFewer women were in the paid workforce Fewer women were in the paid workforce from 1950s to 1980s. from 1950s to 1980s. Expected to “interrupt their work” for child Expected to “interrupt their work” for child rearing and other family responsibilities.rearing and other family responsibilities.Worked in female traditional occupation Worked in female traditional occupation and earned much less. and earned much less.


As a Result…As a Result…

Late life incomes of older Canadian Late life incomes of older Canadian women are an economic map of their life women are an economic map of their life course … (where they have been and course … (where they have been and where they will go) where they will go)


The Future of Women The Future of Women Baby BoomersBaby Boomers

Boomers were born 1947 to 1964.Boomers were born 1947 to 1964.9 million adults in Canada are “boomers”; 9 million adults in Canada are “boomers”; 22ndnd largest (US is 1largest (US is 1stst); of which 4.5 million ); of which 4.5 million women.women.Not a homogeneous group.Not a homogeneous group.


Boomers and RetirementBoomers and RetirementA profound structural change A profound structural change --boomers will retire between 2011 boomers will retire between 2011 and 2029.and 2029.Leading edge of boomers is now Leading edge of boomers is now 59 years old; some are already 59 years old; some are already retired. retired.


Boomers and RetirementBoomers and Retirement

The Big Question “Will boomer women The Big Question “Will boomer women retire into a golden sunset?” retire into a golden sunset?” Perceived Positive Economic Factors Perceived Positive Economic Factors Portending a Positive Future:Portending a Positive Future: More More boomer womenboomer women-- are likely to be in the are likely to be in the paid labour force; have fewer children and paid labour force; have fewer children and have them later; interrupt work less; have them later; interrupt work less; better educated better educated compared to earlier compared to earlier generationsgenerations..


Why the Sunset may not be so Why the Sunset may not be so Golden…Golden…

A 2000 study finds that only 20% of U.S. A 2000 study finds that only 20% of U.S. women would be secure in their later years women would be secure in their later years (Dailey).(Dailey).No similar Canadian studies done; but a No similar Canadian studies done; but a building body of related research to suggest building body of related research to suggest economic insecurityeconomic insecurity is likely for them.is likely for them.–– Increased living costs, less job security, less Increased living costs, less job security, less

ability to save. Blamed for “not planning”.ability to save. Blamed for “not planning”.


Factors Affecting Women’s Current Factors Affecting Women’s Current and Future Insecurityand Future Insecurity

Shift from industrial society to an Shift from industrial society to an information and service society.information and service society.Major growth in nonMajor growth in non--standard standard work work –– casual, contract etc. casual, contract etc. –– not stable jobs, few benefits & lower not stable jobs, few benefits & lower

paying.paying.

Women over represented in these Women over represented in these McJobsMcJobs –– 40% of women vs. 27% 40% of women vs. 27% of men.of men.


Plus the Caregiving FactorPlus the Caregiving Factorin Middle and Later Lifein Middle and Later Life

Caregiving as unpaid and unrecognized Caregiving as unpaid and unrecognized work that contributes to the country’s work that contributes to the country’s economy. Allows economy to function.economy. Allows economy to function.Valuable but not valued.Valuable but not valued.–– The average annual value of caregiving The average annual value of caregiving

estimated rangesestimated ranges–– $13,000 to $17,000 for women and $13,000 to $17,000 for women and –– $8,000 to $10,000 for men. $8,000 to $10,000 for men. –– Annual total $133 billion to $218 billion.Annual total $133 billion to $218 billion.


Caregiving Factor (cont’d) Caregiving Factor (cont’d) in Middle and Later Lifein Middle and Later Life

Increasing need for elder care (older Increasing need for elder care (older spouse or aging parents). spouse or aging parents). This will happen just at the time when This will happen just at the time when women in the paid workforce need to be women in the paid workforce need to be saving for their own retirement.saving for their own retirement.


Private Workplace PensionsPrivate Workplace Pensions

Portion of women with workplace pensions has Portion of women with workplace pensions has increased (men’s has decreased). increased (men’s has decreased). 46.4% of women are now covered by workplace 46.4% of women are now covered by workplace pensions. pensions. However, this means that about However, this means that about 54% 54% are not coveredare not covered. . –– Many service jobs are small businesses where there Many service jobs are small businesses where there

are not enough employees to warrant employer, are not enough employees to warrant employer, workplace pensions.workplace pensions.

Existence of a workplace pension and adequacy Existence of a workplace pension and adequacy of that pension are not the same.of that pension are not the same.


Canada’s Public PensionCanada’s Public Pension

Comprised of C/QPP, the OAS, the GIS Comprised of C/QPP, the OAS, the GIS and the Allowance. and the Allowance. Canada’s public pension system has been Canada’s public pension system has been described as ‘womandescribed as ‘woman--friendly’.friendly’.


Canada’s Public PensionCanada’s Public Pension

Helped significantly to Helped significantly to bring down poverty rates bring down poverty rates for older women and for older women and men.men.

Large gender gap Large gender gap remains in average remains in average monthly CPP benefit monthly CPP benefit –– Early structural inequalities Early structural inequalities

in workplace have long in workplace have long lasting economic effectslasting economic effects 0

10

20

30

40

50

60

70

80

Women

19802001


CPP & GenderCPP & Gender

–– Average monthly C/QPP benefit (Aug. 2005) received by men Average monthly C/QPP benefit (Aug. 2005) received by men was $585.09, and women $341.72. (Women receiving 57.8%)was $585.09, and women $341.72. (Women receiving 57.8%)

–– For new retired persons, aged 60 and over average C/QPP For new retired persons, aged 60 and over average C/QPP payment was $535.89 for men & $350.89 for women.payment was $535.89 for men & $350.89 for women.

0

100

200

300

400

500

600

CPP$AVMonth

WomenMen

0200400600

RecentRetirees

WomenMen


A common erroneous impression A common erroneous impression the public is given…the public is given…


Part 2 Part 2 Law and Government PolicyLaw and Government Policy

Uncertainty in the Face of Employment and AssistanceUncertainty in the Face of Employment and Assistance

Charmaine Spencer, LL.M.Charmaine Spencer, LL.M.


Human Rights in BCHuman Rights in BC

Patchwork approach to discrimination Patchwork approach to discrimination affecting older women.affecting older women.Age discrimination often intersects Age discrimination often intersects with sexism, racism. Multiple with sexism, racism. Multiple bariersbariersin middle and later life.in middle and later life.Protection from “age” discrimination Protection from “age” discrimination in employment in BC only covers 19 in employment in BC only covers 19 to 64.to 64.Multiple changes to human rights Multiple changes to human rights process eroded rights of older womenprocess eroded rights of older women


Human Rights in BCHuman Rights in BC

In the key area of providing services, In the key area of providing services, facilities and accommodation ordinarily facilities and accommodation ordinarily available to the public, available to the public, AGE IS NOTAGE IS NOT a a protected category in BC Human Rights protected category in BC Human Rights CodeCode. Makes it ”legal” to discriminate in . Makes it ”legal” to discriminate in these areas at any age.these areas at any age.


Erosion of Human RightsErosion of Human Rights

Elimination of the BC HR Commission Elimination of the BC HR Commission –– responsible for public education, settling cases;responsible for public education, settling cases;

Use of "self help" approach for bringing human Use of "self help" approach for bringing human rights complaints to the BC Human Rights rights complaints to the BC Human Rights Tribunal; and Tribunal; and Little or no public education (people less likely Little or no public education (people less likely to know their rights and employers less likely to to know their rights and employers less likely to know their responsibilities).know their responsibilities).


Age Discrimination in Age Discrimination in EmploymentEmployment

Canada needs to survey age discrimination in Canada needs to survey age discrimination in the workplace (OECD)the workplace (OECD)Mandatory retirement is only one aspect of Mandatory retirement is only one aspect of age discrimination in the workplaceage discrimination in the workplace–– Tip of the icebergTip of the iceberg

Older workers as the retractable employee Older workers as the retractable employee (the Slinky Effect)? Used only when economy (the Slinky Effect)? Used only when economy wants her?wants her?


Ability to Maintain Gainful EmploymentAbility to Maintain Gainful Employment

Ageism in the labour forceAgeism in the labour force–– starts in the 40s and starts in the 40s and 50s, expectation of winding down50s, expectation of winding downSkill sets are not necessarily transferable Skill sets are not necessarily transferable The failure to trainThe failure to train–– The age disadvantageThe age disadvantage-- upgrading/ new skills is well upgrading/ new skills is well

not supported by public or private sector employersnot supported by public or private sector employersIndustry atrophyIndustry atrophy

–– Failure to train the older worker and yet blame as Failure to train the older worker and yet blame as “out of date”“out of date”

–– Failure to educate in a manner suitable for the older Failure to educate in a manner suitable for the older adultadult


Stereotypes are commonplaceStereotypes are commonplace““A younger employee tends A younger employee tends to be more enthusiasticto be more enthusiastic--and cheaper"and cheaper""The older employee on the "The older employee on the other hand is usually valued other hand is usually valued for experience and for experience and professionalismprofessionalism---- but but there's a dark side. there's a dark side. CompaniesCompanies…… become become concerned about lack of concerned about lack of flexibility or negative flexibility or negative thinking from older staff.thinking from older staff.““


Ageism in the Labour Force: Ageism in the Labour Force: Common EuphemismsCommon Euphemisms

RetiringRetiring“Weeding out the dead weight”“Weeding out the dead weight”

Not HiringNot HiringOverqualified/ too much experience Overqualified/ too much experience (euphemism for too old)(euphemism for too old)Opening position for youngOpening position for youngShould have career potential Should have career potential


And the “expert” advice to older And the “expert” advice to older workers?workers?

"Keep up appearances of good health "make sure if you "Keep up appearances of good health "make sure if you are older you never talk about personal health issues at are older you never talk about personal health issues at work.work.””

““DonDon’’t wear dated clothing. It translates into dated t wear dated clothing. It translates into dated thinking, implying you are behind the times".thinking, implying you are behind the times".

"Older employees should clock in half the number of sick "Older employees should clock in half the number of sick days a company allows, if any". days a company allows, if any".

Source: Vancouver Sun, October, 2005, Business SectionSource: Vancouver Sun, October, 2005, Business Section


Health Cost and LabourHealth Cost and Labour

Need to recognize the cost of privatizing Need to recognize the cost of privatizing or offloading health care costs.or offloading health care costs.–– Shifting costs to individuals or employers Shifting costs to individuals or employers

“supplementary insurance” (Blue Cross).“supplementary insurance” (Blue Cross).

In the U.S., one of the primary reasons for In the U.S., one of the primary reasons for “getting rid of” older workers, is the high “getting rid of” older workers, is the high health costs that the employer bears for health costs that the employer bears for private insurance.private insurance.


Challenges in (Challenges in (Re)gainingRe)gaining EmploymentEmployment

Experience, but less formal education than younger Experience, but less formal education than younger adults on average adults on average The shift from "work experience“ qualifications to The shift from "work experience“ qualifications to paper qualifications (e.g. the college degree) in many paper qualifications (e.g. the college degree) in many sectorssectorsLess ability as a couple or with a home to simply "pull Less ability as a couple or with a home to simply "pull up roots and move" up roots and move" –– Important for community stabilityImportant for community stability

Fewer reFewer re--training opportunities available for older training opportunities available for older workers.workers.


Provincial Policy Changes Provincial Policy Changes Middle Aged ~ Older WomenMiddle Aged ~ Older Women

Social AssistanceSocial AssistanceLoss of the “age differential” for social Loss of the “age differential” for social assistance assistance –– ignores significant challenges in gaining employment ignores significant challenges in gaining employment

among displaced older workersamong displaced older workers–– “equal in poverty”“equal in poverty”Forced application for early CPPForced application for early CPP–– Permanently reduced benefitsPermanently reduced benefits

Liens on house if on social assistance > 6 Liens on house if on social assistance > 6 months.months.–– older adults more likely to be home ownersolder adults more likely to be home owners


Changes to Employment Standards Act Changes to Employment Standards Act (2002)(2002)

Changes led to reduced legal protections for workers: especially affect women (Fuller & Stephens). Minimum shift length was reduced from 4 to 2 hours.Introduction of the $6/hour “training wage” – Youth focus, but “training wage” also easily applies to

first timers, especially after mid/late life divorce– Recent research indicates very little if any “training”

occurs (McBride, et al.). Just cheap labour.


Other Employment Standard Other Employment Standard Changes in 2002…Changes in 2002…

The introduction of “voluntary averaging agreements”– allows employers to avoid

paying overtime, provided hours in the overall period average 40 hours per week or less.

Weakening of monitoring and enforcement of the regulations


Imagining Policy: Needed DirectionsImagining Policy: Needed Directions

1.1. Policy Development GenerallyPolicy Development Generally(a) Gender policy analysis across the lifespan(a) Gender policy analysis across the lifespan

–– The need for an “age impact lens” within gender The need for an “age impact lens” within gender analysisanalysis-- short term and longer term short term and longer term

(b) Integrated and multifaceted approach to (b) Integrated and multifaceted approach to government policy government policy –– Financial security in later life is not just income Financial security in later life is not just income

that people receive, it is what is people must pay that people receive, it is what is people must pay outout-- housing, medications, home support, health housing, medications, home support, health care, energy, taxes.care, energy, taxes.


…… Needed DirectionsNeeded Directions

2. BC Human Rights Policy2. BC Human Rights PolicyA human rights framework that recognizes A human rights framework that recognizes age (age 19 plus) as a protected categories in age (age 19 plus) as a protected categories in employment as well as in services, facilities employment as well as in services, facilities and accommodation ordinarily available the and accommodation ordinarily available the public public Gender, age and race analysis of “neutral” Gender, age and race analysis of “neutral” concepts such as bona fide occupational concepts such as bona fide occupational requirement. requirement.


…… Needed DirectionsNeeded Directions

33. Employment. EmploymentA framework for achieving more gender and A framework for achieving more gender and age equality in workplace, while recognizing age equality in workplace, while recognizing relevant differencesrelevant differences. . “Building equality" may include programs that:“Building equality" may include programs that:–– Provide appropriate training and retraining Provide appropriate training and retraining

throughout work lifespan.throughout work lifespan.–– Address ageism and sexism in the workplace Address ageism and sexism in the workplace

(employers, employees, and unions).(employers, employees, and unions).–– Provide age discrimination protection. Redress Provide age discrimination protection. Redress

inequality.inequality.


……Needed DirectionsNeeded Directions

4. Labour and economic security frameworks that 4. Labour and economic security frameworks that recognize the different life paths of women, recognize the different life paths of women, including their caregiving roles. including their caregiving roles.

5. An authentic voice for seniors now…5. An authentic voice for seniors now…–– E.g., representatives on the Premier's Council on E.g., representatives on the Premier's Council on

Aging and Seniors Issues and on other influential Aging and Seniors Issues and on other influential groups who are able to raise and speak groups who are able to raise and speak knowledgeably about employment and economic knowledgeably about employment and economic security issues. security issues.


Part 3Part 3WE*ACTWE*ACT

Elsie DeanElsie Dean


WE*ACTWE*ACTIs an organization of older women concerned Is an organization of older women concerned about social and economic issues affecting older about social and economic issues affecting older women.women.–– Developed in 2000 in response to Developed in 2000 in response to

recommendations from the BC Seniors’ Summit recommendations from the BC Seniors’ Summit the year beforethe year before

–– Is supported by grant from Status of Women Is supported by grant from Status of Women Canada.Canada.

Focusses on advocacy, increasing awareness.Focusses on advocacy, increasing awareness.Prepared Prepared Pensions in Canada: Policy Reform Pensions in Canada: Policy Reform Because Women Matter. >30 recommendations.Because Women Matter. >30 recommendations.


Select Recommendations from Select Recommendations from WE*ACTWE*ACT

Pensions in Canada: Policy Reform Because Pensions in Canada: Policy Reform Because Women MatterWomen Matter


1. Increase the Guaranteed Income 1. Increase the Guaranteed Income Supplement (GIS)Supplement (GIS)

Federally paid to low income seniors who Federally paid to low income seniors who receive receive –– Eligible if income is < $$1,126 per month Eligible if income is < $$1,126 per month

(single); <1,468 per month (couples)(single); <1,468 per month (couples)

Only paid to those receiving Old Age Only paid to those receiving Old Age Security (OAS)Security (OAS)Well below the low income cut off, LICO Well below the low income cut off, LICO


2. Make OAS/ GIS universal2. Make OAS/ GIS universal

Currently residency Currently residency requirements limit amount requirements limit amount paid to immigrants coming paid to immigrants coming to Canada after age 65to Canada after age 65Inequities: Inequities: –– only some immigrants from only some immigrants from

favored countries statusfavored countries status–– violate international and violate international and

Canadian commitment to Canadian commitment to human rights human rights


3. 3. AnalyseAnalyse the impact of C/QPP the impact of C/QPP Joint & LastJoint & Last Survivor RatesSurvivor Rates

CPP or QPP is reduced by 40% upon a CPP or QPP is reduced by 40% upon a spouse’s death spouse’s death –– Joint and Last Survivor Benefit Joint and Last Survivor Benefit rates are rates are

currently set at 60%currently set at 60%Does 60% rate cover the real costs of Does 60% rate cover the real costs of maintaining living standards of the maintaining living standards of the survivor?survivor?Is 60% a proper differential between Is 60% a proper differential between singles and couples?singles and couples?


4. 4. Increase eligibility for Increase eligibility for workplace pensions workplace pensions

Work place pensions are considered a Work place pensions are considered a valuable source of income in retirementvaluable source of income in retirementFew women are eligible due to their fewer Few women are eligible due to their fewer hours of paid work time and lower wages hours of paid work time and lower wages

Enable anyone working more than 10 Enable anyone working more than 10 hours weekly to be eligible for onehours weekly to be eligible for one


5. Prevent incomes from falling below the 5. Prevent incomes from falling below the poverty line.poverty line.

6. Make private pension and retirement 6. Make private pension and retirement savings more equitable savings more equitable ---- move from move from deductions for deductions for RPPsRPPs and and RRSPsRRSPs to to creditscredits


A Final ThoughtA Final Thought

Women’s economic uncertainty Women’s economic uncertainty and poverty in later life reflectsand poverty in later life reflectsPolitical choices in areas such as Political choices in areas such as taxation, as well as taxation, as well as Political and philosophical Political and philosophical decisions around the relative decisions around the relative distribution of responsibility distribution of responsibility between individuals and society between individuals and society as a wholeas a whole


Imagine the PossibilitiesImagine the Possibilities

……governments have the economic capacity governments have the economic capacity and social responsibility to improve the and social responsibility to improve the lives of older women and fulfill their lives of older women and fulfill their commitment to women’s equality…they commitment to women’s equality…they can continue to reduce povertycan continue to reduce poverty …they can …they can eliminate iteliminate it


Time for DiscussionTime for DiscussionYour perspective on issues ….


Select ReferencesSelect ReferencesWE*ACT (2005) Pensions in Canada: Policy Reform Because Women Matter , , Vancouver, BCVancouver, BC

Fuller, S. & Stephens, L. Women’s Employment in BC: Effects of Government Downsizing and Employment Policy Changes 2001–2004 (Canadian Centre for Policy Alternatives)

International Longevity Center USA. The Economic Status of Older Women. An International Report.Prepared for the United Nation Second World Assembly on Ageing. www.ilcusa.org/_lib/pdf/econwomen.pdfwww.ilcusa.org/_lib/pdf/econwomen.pdf


Select References (cont’d)Select References (cont’d)

TownsonTownson, Monica (2000) , Monica (2000) Reducing Poverty among older Women: Reducing Poverty among older Women: The Potential of retirement income policies.The Potential of retirement income policies. Ottawa. Status of Ottawa. Status of Women Canada.Women Canada.

Dailey, Nancy. (1998) Dailey, Nancy. (1998) When Baby Boom Women RetireWhen Baby Boom Women Retire. . Westport Westport Connecticut & London. Connecticut & London. PraegerPraeger, p. 4., p. 4.

Statistics Canada, the Daily, Tuesday May 4 2002 and Vanier Statistics Canada, the Daily, Tuesday May 4 2002 and Vanier Institute of the Family. Institute of the Family. Divorce Facts: Causes and Consequences Divorce Facts: Causes and Consequences (2002). (2002). http://http://www.vifamily.ca/library/cft/divorce.htmlwww.vifamily.ca/library/cft/divorce.html

Zimmerman, L. & Spencer. C. Zimmerman, L. & Spencer. C. Bismarck meets the boomersBismarck meets the boomers. . Gerontology Research Centre, Simon Fraser University.Gerontology Research Centre, Simon Fraser University.


Select References (cont’d)Select References (cont’d)Statistics Canada. (1995) System of National accounts Statistics Canada. (1995) System of National accounts and Environment Division Households.and Environment Division Households. Unpaid Work: Unpaid Work: Measurement and valuation.Measurement and valuation. Ministry of Industry.Ministry of Industry.

National Council of Welfare Reports (Autumn, National Council of Welfare Reports (Autumn, 2004)2004) Poverty Profile 2001Poverty Profile 2001. . Ministry of Public Works and Ministry of Public Works and Government Services Canada.Government Services Canada.

YalnizyanYalnizyan, A, , A, Canada’s Commitment to Equality: A Canada’s Commitment to Equality: A Gender Analysis of the Last Ten Federal Budgets (1995Gender Analysis of the Last Ten Federal Budgets (1995--2004)2004) (Prepared for FAFIA)(Prepared for FAFIA)

Shillington, R. (April, 2003) Shillington, R. (April, 2003) New Poverty Traps: Means-Testing and Modest-Income Seniors (Backgrounder in Brief) CD Howe Institute.

women of an (un)certain age a2.pdf · plus the caregiving factor in middle and later life...

Documents