The term elder care describes the unpaid help provided by family members, friends, and/or neighbors to frail or disabled elders, including aging parents, grandparents, spouses, other relatives, or friends. Elder care involves care at the person’s home or in a care facility that may be nearby or miles away. Many informal caregivers to elders have jobs and careers and thus find themselves juggling their work and caregiving. The most common types of assistance provided by working caregivers include helping an elder with instrumental activities of daily living, such as transportation, shopping, making care-related decisions, managing money, housekeeping, and chores.
Some of the work-family issues faced by working caregivers of elders are similar to those of working parents, including the difficulties posed when the elder is sick and other care arrangements must be made or when the elder must be taken to the doctor, dentist, or other appointments that generally must be scheduled during the workday. Often, caregivers of elders must also meet the needs of more than one household, because most do not live with the elders. Also, care must sometimes be coordinated among multiple caregivers of the elder (e.g., several adult children). Moreover, elder care differs from child care emotionally, in that the elder generally will become more, not less, dependent over time. Finally, the power and authority dynamics differ when an adult child is caring for an aging parent or other elder versus when a parent is caring for a dependent child.
Providing elder care can yield a sense of great satisfaction and pride and enhance caregivers’ skill sets and sense of competence. At the same time, it can have deleterious effects on caregivers’ work performance and careers and also their personal and financial well-being, such as when one must quit work or reduce the number of hours worked, resulting in costs to employers and employees alike.
Prevalence of Elder Care
Estimates of the proportion of employees in the U.S. workforce who have informal elder care responsibilities range from 10 percent to 25 percent, and the numbers are increasing. Most working care-givers, especially those who are married, are providing care to more than one aging parent, stepparent, parent-in-law, or other elder. Moreover, later child-bearing has meant that more than a third of working caregivers of elders are also caring for dependent children. These caregivers have been called the “sandwiched generation.”
Factors Contributing To Employer Involvement
Employers have developed workplace supports to help employees manage their elder-care duties and reduce work-family conflict, due to growing awareness of the increased numbers of workers providing elder care, management’s personal experience with elder care, and research findings concerning the possible negative effects of caregiving on employees, their work performance, and worker retention and recruitment. For example, many working caregivers of elders have been found to experience an increase in time lost from work, including missing days, arriving late or leaving early, and being interrupted during the day by caregiving responsibilities, such as making or receiving telephone calls concerning the elders in their care. Some take unpaid leaves of absence to provide care. Some caregivers experience a decline in their performance or effectiveness at work. Some quit their jobs to provide elder care, or they take early retirement. Others refuse promotions, travel, or training, thus forgoing career advancement opportunities and decreased lifetime earnings. A greater risk of depression among working caregivers of elders also has been found, as have greater stress and fatigue and more health problems.
Types of Employer Support
Three basic types of support have been offered by U.S. employers in an attempt to reduce working caregivers’ work-family conflicts and maximize employees’ abilities to provide informal help to elders while continuing to perform optimally at work: policies, benefits, and direct services or programs. Key care-giver needs that have been addressed through these mechanisms include time to deal with family issues, emotional support, and tangible assistance.
Specifically, policies that maximize flexibility in the scheduling of work hours, the place of work, the number of hours worked, and the ability to take time off from work when needed, including leaves of absence, have been implemented by employers. For employers with 50 or more employees, offering such leave is mandated by the federal Family and Medical Leave Act (FMLA) of 1993, which allows an employee to take up to 12 weeks of leave, with the guarantee of being able to return to his or her same or similar job at the same pay and benefits. This leave, however, is unpaid, except where state law stipulates otherwise (e.g., California). Supervisor support for work-family issues, reinforced through management sensitivity training, is another policy that contributes to perceived flexibility in the workplace and reduces work-family conflict.
In addition to paid time off to deal with family-related needs, other benefits that can be useful to employees with dependent-care needs include full or partial payment for health and long-term care insurance, legal expenses, and dependent-care services. Offering a cafeteria, or flexible, benefits plan allows maximum flexibility and can address employee needs across the life span. In such plans, the employer pays a major portion of the costs of the benefits by establishing a “flexible benefit allowance” of a certain dollar amount, and employees choose the benefits that best meet their needs. Flexible spending accounts, such as dependent care assistance plans (DCAPs), are a benefit of particular use to employees with dependents. DCAPs may or may not involve direct employer contributions but are available only when set up by employers for their employees. Another form of assistance is the Dependent Care Tax Credit, which is a federal, and also sometimes a state, tax credit for employment-related dependent care expenses. Employers have no direct role in providing these credits, but they can publicize their availability. Finally, because long-term care is not covered by health insurance plans or by Medicare, some employers have begun offering long-term care insurance at reduced, group rates, generally with no employer subsidy.
Direct services are the last general type of support offered, typically only by large employers, to aid employees with dependent care responsibilities. Some employers establish a library of educational materials, distribute newsletters, and/or provide seminars concerning caregiving, health conditions, and where to turn for help. Some make computers available so that employees can access information electronically through company intranets or the Internet, and some offer caregiving fairs, where local service providers set up tables or booths so that employees may obtain information at one time in one place.
Although there is a wide range of public, nonprofit, and for-profit services in the community, the service system is fragmented and difficult to negotiate. Therefore, some employers offer information and assistance or referral services, and some offer assessment and case management to assess the elder’s needs, determine eligibility and payment options, and then package together the needed services. Psychological counseling and support groups are offered by some employers to help employees deal emotionally with their elder-care responsibilities. Other direct services include take-home dinners from the company’s cafeteria, employee convenience centers that handle grocery shopping, laundry, dry cleaning, shoe repair, and so on or provide door-to-door transportation in employee-driven vans. The benefit consists of the time and travel costs saved; employees pay for the actual services. A few U.S. companies provide services for elder care recipients themselves, such as day-care facilities, or offer subsidies, vouchers, or discounts for such services provided in the community. Sometimes services are offered through an employer’s employee assistance program; other times, they are provided by a separate contractor (with both venues representing career opportunities for those trained in gerontology).
Finally, some employers have determined that the best way to help their employees is to contribute funds, either solely or jointly with other employers, to expand the supply and improve the quality of elder (and child) care services in the local community.
- Child care practices
- Employee assistance programs
- Family and Medical Leave Act (FMLA)
- Family-responsive workplace practices
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