The third Monday of February is observed as "Family Day" Day here in British Columbia, a holiday meant to celebrate the importance of family in our lives. But as I reflect on what ‘family’ means in my own world, I can’t help but see how much the structure and responsibilities of family have changed—not just for me, but for millions of people in Canada, the UK, and beyond.
Two weeks ago, we welcomed a new member into our family, a joyful and life-affirming moment. Meanwhile, my two-year-old demands the constant attention and energy that only a toddler can. At the same time, I am navigating the complexities of securing care for my father, who lives with Alzheimer’s, whilst my mother, his primary caregiver, had to fly down from a remote area in Canada for medical care to receive the support she needs. This balancing act—caring for multiple generations simultaneously—has become a defining feature of life for many, including those in what I previously wrote about in a OIPA Blog post entitled ‘Sandwich Generation’ (link). However, beyond these caregiving demands lies a deeper demographic shift reshaping families across the world.
Declining Fertility and an Ageing Population
One of the key reasons populations are ageing—why families increasingly feel the pressures of caring for older adults —is the decline in fertility rates. Globally, over half of the world’s countries now fall below the replacement-level fertility of 2.1, the number needed to sustain a stable population.
Why is this happening? The reasons are multifaceted. Economic pressures, including rising housing costs and childcare expenses, may be deterrents from having more children. Increased access to education and career opportunities—particularly for women—means family planning is often delayed, and ultimately, family sizes shrink. Social and cultural changes may also play a role, with shifting attitudes toward marriage and parenthood.
The Changing Role of Families in Care
The “traditional” model of family—where multiple siblings might share responsibility for ageing parents—is no longer the norm. Instead, smaller family sizes mean fewer hands to help. My own experience, caring for both my ageing parents and my young children, is an increasingly common one. Many people in my position find themselves stretched between responsibilities, often at the cost of their own well-being.
The strain is particularly acute in rural or remote areas, like the one my mother traveled from, where healthcare services, particularly specialized care, are limited. For families in these regions, choices are often stark: either move to urban centers with more comprehensive services or take on the full burden of care themselves. Neither option is easy, and both carry significant emotional and financial costs.
Policy and Societal Responses
Governments and societies are beginning to grapple with these realities, but the responses vary. Countries like France and Sweden have attempted to bolster birth rates through generous parental leave policies and childcare subsidies, though results have been mixed. Japan, facing one of the fastest ageing populations, has invested heavily in care infrastructure and even robotics to support caregiving needs. Canada and the UK, meanwhile, have focused on immigration as one means of counterbalancing population decline, though this brings its own challenges and adjustments.
In Canada, policies addressing declining fertility and ageing populations have focused on expanding immigration targets to sustain workforce numbers and economic growth. Additionally, investments in childcare, such as the Canada-wide Early Learning and Child Care plan, aim to reduce the financial burden on families. In the UK, efforts include increased funding for social care and flexible work arrangements to support caregivers. However, both countries continue to face significant gaps in long-term care provision, making it crucial to develop more comprehensive strategies for supporting families as they navigate these demographic shifts.
On a more personal level, families like mine—and likely yours—are left to navigate these shifts with limited support. The need for policies that better support intergenerational caregiving is clear: flexible work arrangements, improved access to home care services, and financial incentives for caregivers would help ease the burden.
Looking Forward
As I celebrate Family Day, I do so with deep appreciation for my family in all its complexity. But I also recognize that families today are bearing responsibilities that policies and social structures have yet to fully catch up with. The ongoing changes in fertility, ageing, and caregiving are not abstract demographic trends; they are lived experiences, shaping the way we care for our loved ones, structure our lives, and plan for the future.
The way we define and support family is shifting. How well we respond—both as individuals and as societies—will determine not just the well-being of today’s families, but of future generations as well.
About the Author
Theodore D Cosco joined the Oxford Institute of Population Ageing in 2016 as a Research Fellow. Dr. Cosco is a Chartered Psychologist (British Psychological Society) trained in applied social research methods (MSc 2011, Trinity College Dublin) and epidemiology (PhD 2015, University of Cambridge), and Assistant Professor of Mental Health and Aging in the Department of Gerontology, Simon Fraser University. His research interests include resilience, mental health, and the interface between technology and healthy ageing.
Opinions of the blogger is their own and not endorsed by the Institute
Comments Welcome: We welcome your comments on this or any of the Institute's blog posts. Please feel free to email comments to be posted on your behalf to administrator@ageing.ox.ac.uk or use the Disqus facility linked below.
