The Strategic and Compassionate Employer: How Compassionate Care Leave Policies can Improve Employee Retention and Engagement PRESENTATION TO THE HRPA 2015 CONFERENCE SHARON BAXTER, EXECUTIVE DIRECTOR, CANADIAN HOSPICE PALLIATIVE CARE ASSOCIATION KATHRYN BUTLER MALETTE, CHRL FORMER CHIEF HUMAN RESOURCES OFFICER, THE HOUSE OF COMMONS OF CANADA (RETIRED) JANUARY 21, 2015 2 Did You Know? 260,000 Canadians die each year. CHPCA estimates that each death in Canada affects the immediate well-being of an average of five other people, or more than 1.25 million Canadians each year When asked, most people have indicated that they would prefer to die at home or stay at home as long as possible and in the presence of loved ones 75% 85% of care is provided by informal caregivers (Dr. Neena Chappel, Canada research chair in social gerontology) 3 1
1.7 million Canadians, two-thirds of whom are active members of the workforce, provide care and support to family members who are ill Few employers have instituted measures to protect employees jobs when they must take a leave of absence to care for a loved one Many caregivers use vacation time or unpaid sick leave to look after their family members. This can result in employees feeling slighted by and disconnected from their workplace. 4 There are only four kinds of people in this world: those who have been caregivers; those who currently are caregivers; those who will be caregivers and those who will need caregivers. - Rosalyn Carter, former US First Lady 5 Who is a caregiver? A caregiver is an individual who provides ongoing care and assistance, with or without pay, for family members and friends in need of support due to physical, cognitive, or mental health conditions. Family is defined as anyone someone believes to be family including family of origin and family of choice. The family caregiver often has no formal training. 6 2
Compassionate Care Benefit - ESA In 2004, the Government of Canada instituted the Compassionate Care Benefit through the Employment Insurance Program at Human Resources and Skills Development Canada: 6 weeks of paid leave over an 8 week period for someone who is caring for a terminally ill child, parent or spouse At the same time, most provinces introduced legislation protecting a person s employment status while taking leave to care for same. 7 What are Compassionate Care Benefits? The Government of Canada defines these benefits as: EI benefits paid to people who have to be away from work temporarily to provide care or support to a family member who is gravely ill and who has a significant risk of death within 26 weeks. A maximum of 6 weeks of compassionate care leave may be paid to eligible people 8 What is Care and Support? Care or support of a family member means providing psychological or emotional support; or arranging for care by a third party; or directly providing or participating in the care. End of life care can occur in acute care hospitals, long term care facilities, complex continuing care, residential hospices, home care and occasionally in shelters 9 3
Around 35 % of Canadians will need specialist or tertiary hospice palliative care programs and services to accommodate their acute needs. These persons, families and caregivers will often find themselves in hospitals or residential hospices 65% of Canadians do not need this level of care and continue to be cared for in primary care with their family physicians often at home or in long term care facilities Trends in Public Policy Over time there has been a shift from institutional care to community care without the resources required to support effective community care The trend to privatize health care and shift more responsibilities and costs from the system to individuals The trend to shorter hospital stays The pressure on families and informal caregivers to care for dying persons at home Transitions between settings of care are often difficult and not well coordinated. 11 Trends in Public Policy (cont d) Cutbacks and restructuring in home care services, which have reduced the amount of home care available (nursing care and practical care) Restrictive criteria for some programs, such as services available only to people dying of cancer, or workplace policies that allow employees time off to care for a child but not a parent 12 4
Trends in Public Policy (cont d) Lack of development of the psychosocial area in hospice palliative care (i.e. hospice palliative care programs faced with budget pressures typically cut social workers). Lack of policies that focus specifically on the needs of informal caregivers 13 HRPA Surveys Its Members In 2014, HRPA conducted a survey of its members to capture the attitudes and policies of organizations regarding compassionate care 692 members responded 82% of large organizations (5000+ employees) offer compassionate care leave 46% of small companies (50-199 employees) offer this leave Unionized workplaces are more likely to have formal compassionate care leave policies 14 56% of employers responding to the survey who did not have a policy in place indicated that they would be developing a policy in future. Demographics and the arrival of new Canadians in the workplace have an impact on this type of policy as employees may have to travel long distances and take more time off to care for loved ones. 15 5
Why Implement a Compassionate Care Leave Policy? Workforce is aging and boomers have the responsibility to care for elderly parents who are ill Employees may need continued time off to care for a critically ill family member Stress and mental health issues are prevalent in any workplace Employees involved in caring for a critically ill or fragile elderly parent may need accommodation to carry out these responsibilities 16 Employers want employees to know that they support them in difficult times 49% of employers said having a policy makes it easier for an employee to return to work and to reintegrate into the work team 56% said having a compassionate careleave policy increases employee engagement and retention Some employers would support a top-up to the ESA compassionate care leave provisions 17 61% of HR Professionals found that compassionate care leave policies increased employee engagement These policies reduce the need for further leaves of absence for stress and mental health issues 81% of employers allowed employees on leave to remain connected to their workplace, if they wished to do so With a policy, there is a clear increase in employee engagement, trust in the employer, desire to remain with the company and continued productivity. 18 6
Compassionate Care Benefits Becoming part of a roster of employee benefits A policy provides guidelines to employees and management Workplace trend is to allow employees to take leave whether there is a policy in place or not 75% of respondents would allow an employee to take a leave to care for a family member (paid/unpaid) Many employers examine each request based on the employee s particular needs 19 The employee needs reassurance that his/her job will not be affected by taking time off for caregiving The ESA Ontario provides unpaid leave for compassionate care reasons Employers can increase employee engagement by having a policy in place A compassionate care leave policy addresses these situations. 20 Strategic Talent Acquisition and Employee Retention Acquiring good talent is an art and represents a significant cost to HR and employers As a business partner, HR strategies must include initiatives to increase employee engagement and retention Employee engagement and retention are affected by the employee s responsibility to care for ailing or elderly family members Caregiving for elderly or critically ill family members is a significant issue for the baby boomer generation 21 7
Impact in the Workplace Being a caregiver comes at great personal cost: Caregiving is all-consuming Caregiving is physically and emotionally exhausting Its intensity causes work to be the last thing on the minds of caregivers. And if someone were to think about work, it is usually the source of additional stress A significant number of caregivers providing care for someone over the age of 65, report a loss in social activities, a drop in income and an increase in out-ofpocket costs (Statistics Canada) 22 Impact in the Workplace While most caregivers found caring for a loved one rewarding and meaningful, more than one in four showed signs of distress, anger and depression 70% of family and informal caregivers found caring for a loved one stressful. This stress is compounded by worrying about work related issues 23 Impact in the Workplace According to research done in the United States, informal caregivers who provide 36 or more hours of care per week are more likely than non-caregivers to experience depression and anxiety. For partners, the rate is six times higher; for those caring for a parent, the rate is twice as high(cannuscio et. al., 2002) Caregivers use prescription drugs for depression, anxiety, insomnia two to three times as often as the rest of the population 24 8
How Employees Cope when Caring for an Ill or Dying Person When you took time off work to care for this person did you do any of the following? Source: Phoenix SPI; HRSDC EI Survey 2010 25 Wellness Strategies Employers must develop strategies to support employees health which, in turn, assists them in improving their productivity at work Employers must become more sensitive to the reality that employees may be the sole or participating caregiver to a dying family member Employees who are also informal caregivers may be working in full time positions while they are under the stress of caregiving 26 Wellness Strategies Absences from work for mental health reasons, stress and depression are increasing as employees face unexpected and stressful caregiving responsibilities Costs related to absenteeism include overtime and staff replacement costs An indirect impact of absenteeism is the effect of the absence on the employee s co-workers and work team. 27 9
Step 1: Involve the Employee Work out a plan with the employee that permits time away from work (paid or unpaid or a combination of both) Permit the employee to remain engaged by means of email or teleconference attendance at meetings Ask employee to provide updates as to the status of his/her situation Permit the employee to use vacation leave or sick leave (if necessary) Discuss temporary replacement of the employee if the leave is lengthy 28 Step 2: Employee/Manager Accommodation Determine how to accommodate employees in unionized positions who can often least afford to take unpaid time off Determine how to accommodate a manager or professional employee who must be replaced temporarily if they take extended time off work Some employers provide a blend of EI leave with other leaves of absence Some employers provide such leave on a case-bycase basis 29 Step 3: HR Strategic Plan - Maintain Statistics Review special-case leaves provided to employees and determine the % of successful returns to work and employee retention following the leave Collect and analyze absenteeism statistics Collect data about the % of absenteeism that is related to stress and mental health issues Analyze the use of the company s Employee Assistance Program 30 10
Roles in End of Life Care at Home Demands on caregivers have increased in all settings, particularly for those caring for family members at home and can include: Medical care Psychosocial, social and spiritual care Personal or practical care Loss, grief and bereavement care 31 Roles in End-of-Life Care at Home And let s not forget: Advocacy and care co-ordination Financial support Other responsibilities such as caring for children or another older person in the home (often sandwiched between two different generations) Families should have discussions around their end of life wishes often referred to as advance care planning. This helps to ensure that family and caregivers know the wishes of their loved ones. 32 In Summary Canada s population is aging Caregivers should be supported in the care they willingly provide Caregivers are an invaluable resource Dying is a family affair (great feeling of satisfaction if you can provide care as a caregiver for your loved ones) Employers can support their employees and maintain their business activities by having comprehensive compassionate care leave policies in place. 33 11
In Summary Employment and Social Development Canada (ESDC) is working on caregiver in the workplace issues Contact them at website: www.seniors.gc.ca or by calling 1-800 O-Canada In Summary Kathy is a member of the CHPCA Champion s Council, which comprises leaders in business who want to make a difference. Bill Greenhalgh, CEO of HRPA, is also a member of our Champion s Council We thank them for being Champions You all can be leaders and champions in everything you do consider it! Some places to look for information www.chpca.net www.advancecareplanning.ca http://www.servicecanada.gc.ca (Compassionate care benefits) 12