As Parents Age, Children And Their Employers Feel The Burden
By Kathryn Dill
March 31, 2014
About a year after his father died from pulmonary fibrosis, Richard Cabrera’s mother’s mental capacity began to decline noticeably. She was in the early stages of Alzheimer’s disease, and for the next five years Cabrera, now 49, would become her full-time caretaker.
“Because I work from home it was convenient for me to look after my mom,” said Cabrera, who of his five siblings is the only person who works from home and isn’t married. “But it affected my work. It affected my social life. I could no longer go out, I couldn’t do anything.”
Cabrera is just like millions of other Americans who provide care for an aging parent or parent-in-law while working full-time. A 2011 AARP report stated that 49% of the American workforce expected to be caring for an aging adult “within the next five years.” But even as the number of affected employees continues to grow, creating a raft of new workplace issues and measurable lost productivity for employers, company-sanctioned solutions to the problem have remained elusive.
“ Eighty-percent of long-term care is provided by family caregivers. That translates to $450 billion of care ,” said Jody Gastfriend, VP of Senior Care Services at Care.com. “Employers are waking up to the reality that this is something that’s impacting productivity and engagement, and they’re looking for solutions.”
“Family caregiver”—defined by Gastfriend as “providing any kind of ongoing support and care to family members who have some level of dependency”—is a term that has been in use since the 1990s. Gastfriend says the majority of those doing the caregiving are members of the so-called “sandwich generation:” those responsible for both aging parents and their own children.
But the impact of this growing phenomenon, though tangible, can be difficult to measure precisely. Prior studies have presented a range of estimated figures in terms such as an employee’s lost wages and an employer’s lost productivity. An oft-cited 2011 MetLife MET +1.04% report references studies that estimate the impact on caregivers’ lost wages and pension benefits at anywhere from $303,260 to $659,139 throughout retirement. An AARP report estimates the price tag on lost productivity at $33.6 billion.
Family caregivers are also less likely to seek preventative care for themselves, a choice that could manifest in additional time away from work and expense down the road.
“This population tends to report higher work-family conflict, higher stress, and an increase in depressive symptoms—which is particularly true when you compare elder care versus childcare,” says Dr. Marcie Pitt-Catsouphes, Director of the Sloan Center on Aging & Work at Boston College.
The comparison to workplace policies on childcare is one that arises frequently in discussions about caregiving, though many agree that the conversation has advanced only to where perspectives on working professionals and childcare were about twenty-five years ago.
Both the stigma associated with employees who must sometimes leave work to deal with a family crisis and employers’ confusion about how to confront the issue are recalled less-than-fondly by professionals who’ve shouldered the burdens of both child and elder care in the span of one career.
But the not-insignificant challenges of raising a healthy child while working can still be more predictable than elder care. Milestones such as the birth of a child and when a child will begin attending school full-time can be pinned to a general timeline. Conversely, a parent’s decline can unfold over a decade or more of periodic crises and increasing levels of necessary care and medical attention, making it difficult to make use of even the benefits currently in place, such as the Family and Medical Leave Act (FMLA).
Further challenges arise when the timelines of child rearing and parent decline occur simultaneously, making crafting a useful benefit that both aids employees and protects employers a dizzying prospect.
“Some companies are really flexible with FMLA,” says Gastfriend. “Some people take it around a terminal illness, but it’s not structured in a way that reflects the nature of caregiving.”
But even at companies where resources for caregivers are available, most people do not participate. Part of the problem, says Drew Holzapfel, is that a significant percentage–nearly a third–of employees facilitating elder care do not self-identify as “caregivers.” Holzapfel is the convener of Respecting a Caregiver’s Time (ReACT), a coalition of employers focused on addressing the issues of employee caregivers.
He says that even as employer awareness of the need for edler care benefits has risen, employee utilization has remained nearly flat.
“Many [employees surveyed] would say, ‘No, I’m a son. No, I’m a spouse. No, I’m an engineer or a lawyer,’” says Drew. “They see it as a personal responsibility rather than an obligation. That’s how they see their role within the family. They’re seeking ‘caregiver’ as a profession.’”
Gastfriend agrees. “You call it, ‘Taking your mom to the doctor.’ You think of it as isolated tasks. ‘Of course I’m helping my mom.’”
So what do employee caregivers want, and how can employers lessen their burden while maintaining an engaged office environment? “Flexibility” and “access to resources”—what Gastfriend calls a “roadmap”—are the answers that arise most often.
“It’s not just ‘Sally can take the afternoon off to help her mom,’” says Gastfriend. “It’s having some organizational mindset around having flexibility so people can be caregivers and employees at the same time.”
Pitt-Catsouphes cites examples of work weeks that are both flexible and structured—usually four ten-hour days replacing the usual five eight-hour days—so that medical appointments can be scheduled for the fifth day, or employees can travel to be with an aging parent who lives far away.
And caregiver benefits might not always mean time away from the office. Many want their company to help them navigate the dizzying administrative network associated with elder and health care.
“When we asked 3,500 employee caregivers what they wanted most, they wanted access to legal and financial assistance,” says Holzapfel, citing examples ranging from assistance setting up power of attorney to financial planning help to pay for elder care. “It’s not just the Pfizers and CVSs of the world that can address this. There’s a lot employers can do that has no cost or very little additional cost.”
From the employee’s perspective, how you approach your supervisor about your responsibilities outside of work can significantly impact the professional outcome.
Pitt-Catsouphes says it’s important that flexibility be viewed as a resource rather than a break—and that employees demonstrate to managers that they’re approaching it as a way to maintain strong professional performance even while dealing with a family crisis.
“Employees need to reassure their supervisor, but also confirm to themselves, ‘Doing a good job matters to me,” says Pitt-Catsouphes. “To start the conversation with, ‘Here’s the work ahead of me, and here’s how I think I can get it done in a spectacular fashion’—that’s important.”
A study of innovative benefit practices by the Sloan Center on Aging & Work at Boston College looked at employers who were implementing benefits for caregivers, including American Express AXP +0.78%, CBS CBS +2.25%, and Duke University.
After a staff survey found that elder care was an issue for a significant number of employees, the CBS Corporation took several steps to lessen the burden, implementing a combination of benefits and resources. Company employees and relatives can now receive services from the Health Advocate program, which provides healthcare system navigation support that an employee can utilize to, for example, better understand a parent’s Medicaid benefits, or find additional senior care resources.
Caregiving support services from other external vendors, as well as health fairs and books and informational materials are also available, some at no cost. An estimated 10% of CBS employees have availed themselves of these resources.
Ultimately, says Holzapfel, what’s required is a cultural shift in the understood work-life responsibilities of full-time professionals—and the necessary research that can help companies decide how to best allocate resources to meet the needs of employees, and understand the return on that investment.
“It was a cultural shift that allowed for two working parents. It wasn’t just about having daycare on sight, it was about having a manager understand the dynamics of the relationship,” says Holzapfel. “ You can walk into any office and see a picture of someone’s kids. You don’t walk into an office and see a picture of an aging parent, or someone who’s receiving care just as intensely as a child would.”
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