Caring for Working Caregivers

While sometimes overlooked in discussions about workplace mental health, gaining a thorough understanding of the demographics of workers and caretakers affected by mental health issues is imperative to preparing for many workforce trends that can impact your business. This is the first time in American history, for example, that we have seen four different generations working side-by-side in the workplace (Hammill, 2005). Moreover, the number of workers who are also caregivers is growing. A recent study jointly sponsored by the National Alliance for Caregiving (NAC), ReACT, and the Alzheimer’s Immunotherapy Program (AIP)—Best Practices in Workplace Eldercare (Workplace Eldercare Study) (2012)—focused specifically on this aspect of the changing demographics of the United States, namely caregiving and its implications for the workplace.

While caregiving is necessary or required by a range of populations such as injured veterans, children with special needs, and individuals with chronic medical needs, 72% of caregivers currently assist someone 50 years of age or older (National Alliance for Caregiving & AARP, 2009). The Workplace Eldercare Study identifies current trends and innovations in workplace policies, as well as practices that support employees with eldercare responsibilities. Much of the learning gained from this study can be applied to the broader range of caregiving needs. Here, we share the study findings, connecting insights with other complementary views of workplace mental health.

The Challenge and Connection to Mental Health

Millions of Americans provide care for family members at home who are aging or chronically ill, and this population is expected to grow as the number of older Americans is likely to double by the year 2030, according to the U.S. Department of Health and Human Services (2010). A typical profile of the caregiver population shows that 57% have worked and managed caregiving responsibilities at the same time. More than six in ten of these working caregivers (66%) report their caregiving responsibilities as having affected their work (see Figure 1).

The Workplace Eldercare Study also notes that working caregivers reported absenteeism, stress, and distraction at work. These realities have both indirect and direct costs for employers, increasing turnover costs substantially when left unaddressed. MetLife and NAC composed The Caregiving Cost Study: Productivity Losses to U.S. Business (2006) to look at the cost of caregiving in terms of lost productivity, replacing employees, absenteeism, crisis in care, workday interruptions, supervisory time, unpaid leave, and reducing hours from full-time to part-time

Findings from the American Psychological Association’s report Stress in America™: Our Health at Risk (2012) show us that caregivers report higher levels of stress, poorer health, and a greater tendency to engage in unhealthy behaviors to alleviate their stress, compared with the general public. Alternatively, the survey also reported that caregivers who feel adequately supported have, on average, significantly lower levels of stress than those who do not (American Psychological Association, 2012). “The caregiver group seems to do much better when they are plugged in to some sort of a support system,” said Dr. Katherine Nordal, executive director for professional practice at the American Psychological Association. Dr. Nordal pointed out that caregivers demonstrate less isolation, less loneliness, better coping strategies, less depression, less irritability, and less risk of chronic disease when they have the support of family and friends and are connected to a variety of community based support systems.

The Good News: Best Practices

By implementing any of the best practice models recommended through the Workplace Eldercare Study, your organization can become, or facilitate, the supportive network that your caretaker employees need. The best practices from this study were collected from 17 participating employers, representing the fields of professional and nonprofit associations, financial industry, healthcare providers, higher education, insurance, manufacturing, media, pharmaceutical, and information technology. This useful study also speaks for a wide range in workforce sizes and types.

The Workplace Eldercare Study participants were:

• Aetna
• American Psychological Association
• Caring.com
• CBS Corporation
• Duke University
• Emblem Health
• Emory University
• Fannie Mae
• Gundersen Lutheran Health System
• Intel
• Johnson & Johnson
• Johns Hopkins University
• Kimberly-Clark
• MWV (MeadWestvaco)
• Suncoast Hospice
• UnitedHealth Group
• U. S. Chamber of Commerce

Participant companies were found through their membership or affiliation with ReACT, which works to highlight employers who have already identified the need for assistance with caregiver employee needs.

The following summarizes the Workplace Eldercare Study best practice findings:

• Paid Time Off and Flexibility in Scheduling: The ability to shift working hours, with notice from the employee, often is sufficient to meet most caregiver needs. When more time is required, there are a range of means for additional paid/unpaid time off to address caregiving needs, dependent on the size of the organization.
• Geriatric Care Manager Service and Consultations: Providing access to independent and trained care managers allows employees to ask questions as they create a care plan. Having care managers who are independent consultants reduces employees’ perceptions of conflict of interest on the part of the care manager or employer.
• Planning for the Workplace Program: Taking the time to plan will make an important contribution to the success of your program. The planning process should include stakeholders such as trained professionals in geriatrics, elder law, work-life professionals, representative(s) from a peer institution who has managed a similar program, and recipients of the services. Having clear goals such as increase employee engagement, reduce absenteeism rates, increase retention rates, and reduce the healthcare costs of employee caregivers, along with the use of recurring surveys to measure success and/or need for adjustments will help keep you on focus and keep the program relevant.
• Offering Employees Benefits Based upon Core Business Elements: Although many of the programs noted in the study are focused on services directly to the elderly patients or caregivers, including other employees in the offerings, for example a webcast on blood pressure management or yoga sessions, allows for crossover benefit to other employees.
• Evidence-Based Programming: Highlight and use tools and materials that apply the most up-to-date research in order to enhance service outcomes. There are many organizations, such as the National Alliance for Caregiving (NAC) and ReACT that provide these tools at no cost.
• Volunteer Programs: When funds are particularly tight, employee-organized volunteer groups have provided grassroots efforts to build a supportive community and share ideas. These networks are often important in reducing the sense of isolation, even when other more formal benefits are available.
• The Corporate Culture: Modeling of support by the leaders of the organization, whether the C-suite or managers and supervisors, is crucial for employees to make use of the services developed for their benefit.

Looking Ahead to the Future

Utilization of services is an overarching need that was noted in the Workplace Eldercare Study that could impact your potential programming. High utilization increases corporate goals of increased recruitment and retention, and reduction of workplace accommodations and adverse outcomes, such as staff leaving the workplace altogether as a consequence of caregiving.

The study indicated that a good strategy for achieving high utilization includes the following components:

• An understanding of your workforce and their needs;
• A program or policy that is available to all employees and not just one category of employee;
• Training of supervisors and managers about eldercare;
• Education for employees about the caregiving process and ways in which the program can support their goal of continuing to be a family caregiver and a productive worker; and
• Programs to help employees plan ahead for their caregiving responsibilities.

Communication and Trust

When it comes to the success of any caregiver support programs instituted in the workplace, the development of communication and trust is crucial. Cross-cultural communication gaps are in play here, between both employers and employees as well as generational preferences and sensibilities related to age. An added twist, age not only impacts the study’s caregiving recipients, but also affects the way people communicate with one another and how much trust exists between them. For instance, Generation X, who currently are or are about to become caregivers to the elderly, are typically skeptical of authority figures in the workplace (Hammill, 2005). These differences in perspective impact a person’s comfort level and underlying trust, which in turn impacts help-seeking behavior at their place of work.

In a workplace characterized by fear and lack of communication, the productivity costs are especially detrimental to both employees and employers, due to the tendency of both parties address caregiving issues only when they reach a crisis level. To create the supportive workforce environment your organization needs, consider initiating open dialogue about what is needed. Potential consequences from both the employee and employer perspective allows for earlier intervention and planning—in turn mitigating risk for all involved.

Remember: As you start to discuss needs and strategies, keep generational differences in trust and communication preferences in mind.

Continual Review of Generational Impact

While much is said and written about the aging of the Baby Boomer generation, the need for employee caregiving of the elderly will not cease in the future. The Workplace Eldercare Study notes that the increase in the number of older elders (age 85 years and older) is compounded by fewer employees taking retirement by the expected age of 65 years. An aging workforce, as well as its caregivers, will likely have different views and expectations from earlier generations. The imminent need for caregiving support should influence employers to make this issue a priority for the future.

Remember: Schedule periodic reviews and/or surveys of your workforce in order to keep workplace leadership informed about the changing dynamics of your workforce and ensure the relevance, adaptability, and success of your program.

Conclusions for the Future

The best practices and considerations for the future outlined here provide a number of building blocks for bettering your organization's response to employee needs. Gail Hunt, the President and CEO of the National Alliance for Caregiving, also notes that, whether you are an employer, human resources professional, employee assistance professional, or employee, the use of the Eldercare Locator is highly advantageous. A public service of the U. S. Administration on Aging, the Eldercare Locator provides a connection to a range of services for older adults and their families. You can also access the Eldercare Locator by calling 1-800-677-1116.

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Resources

• Best Practices in Workplace Eldercare by The National Alliance for Caregiving (NAC)
• ReACT is dedicated to addressing the challenges faced by employees who are caregivers for elderly persons and to reducing the impact on the companies that employ caregivers.
• The Alzheimer’s Immunotherapy Program, of Janssen and Pfizer Inc., focuses on research and products to reduce the burden of neurodegenerative conditions.
• The Rosalynn Carter Institute for Caregiving provides caregiving agencies and organizations with the latest knowledge and practices relating to evidence-based caregiving.

Last Updated: December 2016