Caring for the Caregiver

The stress of caregiving is not something employees can leave at the door. Employers need to provide resources and create a culture where caregiving is understood in order to best support their employees.

Ann Walls is a nurse. Today she is a clinical adviser registered nurse with Humana Inc. in an Oak Brook, Illinois-based office, but for the majority of her career she worked in the intensive-care unit at a series of hospitals in the Chicago area. There she did back-breaking work caring for the most seriously ill patients.

Even though she is trained and certified to care for others, nothing really prepared her for caring for her own father.

“It’s just different,” Walls said. “You always do your best for a patient, but at the end of the day, you go home and you leave it behind."

Walls’ father's health has been deteriorating over the past five years. He has been hospitalized for pneumonia and other upper-respiratory conditions on multiple occasions.

Walls is more than qualified to oversee the recovery involved with each of these ailments. It’s her father’s strong will and temperament that makes things difficult.

“I can’t get him to give up driving,” she said. “Every Saturday and Sunday morning, he’s out cruising around looking for garage and estate sales. I want him to be home resting. He wants to be out. And he always wins.”

Situations like that convinced Walls that she needed to spend more time at home. Last year she adjusted her schedule to work from home so she can keep an eye on her father — and make sure he eats his lunch.

"Working from home gives me the flexibility to take him to doctors appointments if something should come up," Walls said. "That way I'm there to listen and make sure he does what the doctor says."

Walls is not alone in her struggle. According to a 2015 Ceridian HCM Inc. study, “Double Duty: The Caregiving Crisis in the Workplace,” 15 percent of the U.S. workforce is currently caring for an elder loved one. Furthermore, 29 percent of those caregivers have reduced or adjusted their weekly hours in order to juggle their caregiving responsibilities.

And it’s taking a toll on their health, too. The same study found that beyond the obvious stress that most caregivers admit to feeling, 45 percent are also experiencing weight problems, while 52 percent report anxiety. And it doesn’t stop there, according to Christine Adoni, vice president of account management at Ceridian LifeWorks, an employee assistance and wellness program that Ceridian offers.

“Many report disappointment, depression and guilt along with anger and trouble eating,” Adoni said. “We have found that when we go out into the community, many people are recognizing the impact that caregiving is having on their own health. There is a need to support the caregiver themselves and help them recognize the importance of taking care of themselves. “

Assistance, Please

One of the biggest hurdles to caregivers getting the support they need is a basic lack of knowledge, Adoni said. Referring back to her company’ study, she said that only 19 percent of U.S. caregivers could name a specific support organization.

“There is a need for education, and that’s really an opportunity for employers to step in and provide very specific training and resources for employees in the workplace,” Adoni said.

Unfortunately, to the detriment of employees and companies, employers are still not providing the resources needed for workers to effectively manage their personal and professional responsibilities.

A 2015 National Behavioral Consortium study found that 37 percent of caregivers have called in sick to care for a loved one, while more than 40 percent of North American caregivers have difficulty getting to work on time. In the U.S. alone, this has led to an estimated $38 billion in lost productivity.

Employee assistance programs provide a cost-effective solution, according to Kathleen Greer, the founder of KGA Inc., an employee assistance, work life and training firm located in Framingham, Massachusetts. Greer has 35 years experience setting up confidential hotlines that link employees to resources necessary to handle a variety of personal issues that ultimately affect their work-life balance.

“The rise of the aging population and the aging workforce has made elder care a growing issue,” Greer said. “EAPs have a lot to offer, but unfortunately they’re not promoted as much as they need to be in the workplace.”

One of the greatest resources EAPs can provide is financial counseling, Adoni said. Many employees seek out EAPs for financial guidance regarding issues such as living wills, estate planning and the need for advanced directives. EAP programs can connect employees with resources in their area to fill these needs and alleviate cursory stressors such as finances.

However, one problem that Greer has found via an internal study and through collaboration with other similar EAPs nationally is that the full eldercare story is often lost. Greer said, “What we learned was that the data wasn’t telling the whole story about all the different ways that people enter our system in the EAP. If someone reached out for legal help, it was getting classified in our system as a legal case. It wasn’t classified as an eldercare issue unless we dug down.”

As a result, the full impact of eldercare related issues on an organization is underreported. Greer added, “Not only were we failing to show our clients how much work we were doing on behalf of their employees; we were not enabling our clients to fully appreciate the toll caregiving was having on its workforce. Data speaks, and as a result of our study we have increased focus on our eldercare solutions and how we track them.”

Today’s EAP programs have been prompted to provide more than just Band-Aid solutions for individual problems related to elder care, Adoni said. The programs themselves have become more comprehensive largely because of the fact that the counselors who run them are beginning to receive more elder care training.

For example, as part of Ceridian’s LifeWorks program, counselors have the opportunity to be trained as caregiver coaches, which means they are specifically trained to recognize signs of caregiving stress, such as the need for financial counseling, and follow up over a series of scheduled calls to get at the root of the issue.

“It’s about providing more than just a one-time consultation,” Adoni said. “It gives us the time that is needed to work through multiple issues that a caregiver might be experiencing and help them identify resources for their parents and themselves.”

Employers Need to Do Their Part

While EAPs are able to provide many of the resources that employee caregivers need, it’s not enough for an employer to shift all the responsibility off-site. Employers must do their part to not only make employees aware of EAP services, but also create a company culture where caregiving is understood and accepted.

Greer recommends that companies with an intranet use that platform to provide data sheets and posters to make employees aware that caregiving is an important issue.

While that is one approach, Adoni found that larger events that bring the issue of caregiving out into the open workspace tend to be more effective. One client brought in a local agency on aging and a private geriatric care manager to give a public forum panel on the topic that was recorded and rebroadcast over the company’s television network.

“It was an opportunity for employees to engage with the issue of caregiving and ask questions and learn from one another’s experiences,” Adoni said. “Most importantly, it created a community of caregivers at thecompany so that they could begin to support each other.”

Marriott International Inc. took a more educational approach, developing an ongoing series of seminars on different caregiver topics so employees remain both engaged and educated on how to deal with the struggles of being a caregiver, Adoni said.

The more specific these courses are, the better, Greer added. Consider offering classes on having difficult conversations, such as not wanting a parent to drive anymore as in Walls’ case. Employees find value in resources used to tackle specific issues instead of discussing the generally overwhelming nature of caregiving.

Outside of education, it is paramount that employers create a formal caregiving policy.

“Flexible work arrangements are very important to caregivers in the workplace,” Adoni said. “A formal caregiving policy will allow employees to take advantage of flexible work arrangements, PTO and define any potential restrictions on time off.”

Making sure that managers understand such policies is also important, Greer added.

According to the Ceridian study, 1 in 5 caregivers said that their direct manager made a negative comment about the negative effect of their caregiving activities on their work performance. Managers need to understand both the burden of caregiving and the policies the company has put in place to ease that burden, Adoni said.

“We need to keep talking about how can we help this group more to feel like they can be in two places at once,” Greer said. “When you have an elderly parent that you’re essentially responsible for, it’s very difficult to balance that with your job, but there are ways to do it if your employer is able to practice flexibility and understanding.”

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