Caregiver Program Reduces Absenteeism in Clackamas County

As an employer, Clackamas County has been hard at work assessing factors that contribute to the health and productivity of county employees. In one initiative, county departments collaborate to provide tailored programs that support employees who are caregivers for aging relatives. Employees and retirees appreciate the program’s services and educational materials and report that these services and materials have helped improve their caregiving abilities. An important additional benefit is that the program has helped reduce work absences.

Assessing Employee Absences

In early 2006, the Clackamas County Department of Employee Services noted that a number of key individuals among its 2,100 employees were choosing early retirement or reducing their work schedules to care for aging parents. Losing seasoned and valued employees prompted Employee Services to review data from exit interviews, use of the county’s employee assistance program (EAP), and leaves of absence related to the Family and Medical Leave Act (FMLA) and other leave types.

Finding data about caregiving absences through these sources proved difficult, however, because caregiving was not a tracked category in these sources. So, to gain insight into the employee population, the county examined US Equal Employment Opportunity Commission (EEOC) reports. These reports indicated that the median age of county employees was 45 years. The percentage of female employees exceeded 60% in many county departments and was as high as 80% in a few departments.

By comparing the EEOC data with studies by the National Alliance for Caregiving/AARP (2004) and MetLife (2006), the county found that a significant percentage of their employee population mirrored the typical caregiver profile. While men and women of all ages and races serve as caregivers, a National Alliance for Caregiving/AARP study (2004) found that the typical caregiver is “. . . a 46 year old woman who has at least some college experience and provides more than 20 hours of care each week to her mother.”

Additional data from a wellness assessment completed by 35% of county employees indicated more than 5% were caring for an aging parent or spouse with Alzheimer’s disease and were missing an average of six days of work per year at an estimated cost of $90,000.

The wellness assessment was limited to caregiving for relatives with Alzheimer’s disease and did not query employees’ caregiving for elders with other illnesses. By using the typical caregiver profile, however, the percentage of caregiving employees could be estimated at 25% to 30%. This estimate together with data from the wellness assessment indicated that the potential costs of absenteeism due to caregiving could be as much as $500,000 annually. In addition, the cost of healthcare for caregivers is typically higher than for non-caregivers, because caregivers frequently experience stress and depression from lack of self-care, limited awareness of resources, and feelings of isolation, according to the National Alliance for Caregiving/AARP (2004).

Carolyn J. Williams, the benefits manager for the county’s Department of Employee Services, was concerned that valued employees were choosing to leave employment or reducing their work schedules because they were struggling to balance work and caregiving. “We decided to take action to see how we could support our employee caregivers,” Williams said.

Collaboration Yields Innovative and Tailored Services

The county’s Department of Employee Services, Risk & Benefits Division’s Wellness Program was uniquely positioned to address caregiver issues because it had direct access to staff of the county Social Services Division’s Agency on Aging, who were located in the county office campus. Debra Metz, Wellness Coordinator for the Department of Employee Services, and Mary Ann Hard, Human Services Coordinator in the Agency on Aging, worked together to identify caregiver issues, gaps in existing EAP services, additional services that could be offered, and how best to offer these services onsite at the county campus.

Through this collaboration, an interagency agreement was crafted for the DHS-SSD Agency on Aging Program to provide enhanced onsite caregiving services. The agreement makes a range of services available to employees and retirees, including six sessions of personal advocacy, individualized information and referral services, a monthly support group, and a six-week education program entitled Powerful Tools for Caregivers, developed by Legacy Health Care System of Portland, Oregon. All services and materials are available at no cost to employees.

Additional educational opportunities were developed to address a variety of subjects. Titles of these programs included Introduction & Overview of the Aging Process; Mental Health Issues, Dementia, & Depression; Working with Dementia Behaviors; Navigating Community Resources; and Financial Planning for Older Adults. The employee lending library added new resources, including Hardships into Hope — The Reward of Caregiving, Daily Comforts for Caregivers, Caregiver Wellness, and Quick Tips for Caregiving. According to Metz, the new resources help explain some of the health issues employees’ loved ones are facing, provide suggestions for how to cope, and encourage caregivers to take care of their own health needs as well. The county helps employees find affordable respite care to allow caregivers to replenish and reenergize, a vital part of a caregivers’ responsibilities.

The enhanced caregiver services rolled out in November 2006 during National Caregivers Month. In conjunction with the roll-out, the county held its first Elder Caregiving Symposium, entitled Caring for Those Who Cared for You. The event included several exhibits that provided information on local resources. The keynote speaker was Oregon’s Senior Law Project Volunteer of the Year, Timothy McNeil. Mr. McNeil discussed elder rights, guardianship, legal concerns, and estate planning. Ms. Hard presented Powerful Tools for Caregiving and provided an overview of the program’s educational opportunities, new support group, and other enhanced services. Ms. Metz created brochures, posters, flyers, and payroll envelope stuffers to announce the symposium and outline the new services. She posted e-brochures on the county’s internet and intranet web pages and distributed brochures via e-mail and postal service to all employees and retirees.

Program Outcomes

The Department of Employee Services has been updating internal reporting procedures for exit interviews and use of the EAP, FMLA, and other types of leave to include caregiving absences for improved tracking. Caregiving program evaluations are anonymous, but questions are reviewed and updated to provide more quantifiable absence data before and after an employee accesses caregiving services.

Employees’ adoption of the enhanced caregiving services was slow in the first year, but by mid 2008, when access to onsite resources increased, there was a 50% increase in participation. Employees’ evaluations of the program indicated that receiving information about community resources for caregiving was helpful. They self-reported fewer absences and improved ability to handle challenging situations and to make difficult caregiving decisions.

The two county departments that initiated the program have continued to meet and assess the program’s performance in meeting employees’ needs. Frequent e-mails are sent to employees who could use additional support. Planning meetings are held throughout the year to discuss internal policies and to review evaluations.

Employees’ positive reception and their feedback on the caregiver program prompted the county to expand the interagency agreement in 2008 to provide services for caregivers of adults and children with special needs.

Debra Metz is the Wellness/EAP Coordinator at Clackamas County’s Employee Services.

About the City of Colorado Springs

Clackamas County, Oregon, located in the Portland metropolitan area, is well known as a tourist destination and a haven for outdoor sports enthusiasts, who are drawn to its inviting geographical features, including mountains, forests, and rivers. Since the county’s establishment in 1843, its principal activities have been agriculture, lumbering, manufacturing, and commerce.

Many businesses flourish in Clackamas County, including industry-leading metals, machinery, healthcare, high tech, logistics, forestry, food and beverage processing, renewable energy, nursery/agriculture, tourism, and software development organizations.

Nancy Spangler, PhD, OTR/L is a consultant to the Partnership for Workplace Mental Health and the American Psychiatric Association Foundation.

Last Updated: January 2010