The Working Caregiver Crisis: A Whitepaper for Employers who have Employees that Double as Caregivers

The Working Caregiver Crisis: A Whitepaper for Employers who have Employees that Double as Caregivers

The Caregiver Crisis 1 Introduction As the U.S. population continues to age, many families are assuming the role of a caregiver for another family member, relative, or friend. Caregiving often requires as much work as a full-time job, creating a huge impact on the caregiver if they are also employed full-time. Current demographic and healthcare trends make the issue of caregiving even more prevalent. The Baby Boomer generation is reaching prime caregiving age, and many of them will soon become caregiving recipients. Debilitating and/or age-related diseases such as Alzheimer s, arthritis, and diabetes are occurring with increasing frequency. Women, who traditionally have taken the role of caregiver for their children and older relatives, are now more active in the work place and cannot provide full-time care. More men are now taking on caregiving roles. This whitepaper addresses many of the effects that caregiving can have on not only employees who are caregivers, but their employers as well. 2 In the Workplace An estimated 1 in 6 full-time and part-time U.S. workers act as a caregiver for an elderly or disabled family member, relative, or friend. On top of the traditional 40 hour work week, working caregivers are virtually adding another part-time job to their schedule. Fox Business annual survey found that about 1/3 of family caregivers are spending more than 30 hours per week on caregiving tasks shopping for personal care items (81%), attending medical appointments (79%), administering medications (63%), and other caregiving activities. The time it takes to be a working caregiver also tends to have a negative effect on the economy as a whole. The Gallup-Healthways Well-Being survey suggests that caregiver absenteeism costs the economy roughly $25.2 billion in lost productivity per year. The number $25.2 billion derives from a simple equation: (average number of work days missed per working caregiver) x ( $200 lost in productivity per day of absence). 2

2 In the Workplace (cont.) Met Life Mature Market Group, National Alliance for Caregiving, and the University of Pittsburgh also estimate that between $17.1 to $33 billion is lost annually due to working caregiver responsibilities. Their number range also takes into account the costs associated with employees switching from full-time to part-time, replacing employees, and other work day adjustments due to caregiver absenteeism. However, this research done by MetLife (funded partially by AARP) fails to account for any recipient of caregiving that was 50 years or younger. About 1/3 of adults under the age of 50 have a chronic illness or significant disability, meaning they likely have some sort of caregiver that was not accounted for. Many of these numbers could be reduced, however, if companies begin to implement policies that allow working caregivers to have flexible schedules and work from home to make up for time and productivity lost at the office. The chart to the right comes from the National Caregivers Library and shows the cost of employee vs. employer due to caregiver absenteeism. As much of a financial impact that caregiving can have on employers and their business, only 56% of caregivers report that their work supervisor is aware of their caregiving responsibilities. Caregivers report missing an estimated 6.6 workdays a year; including all the working caregivers in the U.S., this adds up to over 126 million missed workdays annually. The trend of working caregivers is not slowing down either. The number of caregivers, and specifically working caregivers, will continue to increase as the U.S. population ages (Baby Boomers in particular). The U.S. Census Bureau predicts that the population over age 65 will grow from 34.6 million in 1999 to over 82 million by 2050. 3

3 Employee Health Impact Caregiving not only causes a negative impact in the workplace for employees, but can have a negative impact on their health as well. A case study done by Daniel W.L. Lai on the Effect of Financial Costs of Caregiving and Burden of Family Caregivers of Older Adults listed the top major health problems that the sample of caregivers were dealing with due to their caregiving responsibilities. 1. Problems with joints, the back, and arthritis (74.4%) 2. Physical mobility problems (63.2%) 3. High blood pressure (46.6%) 4. Eye problems (37.6%) 5. Hearing problems (36.85) 6. Heart disease (33.2%) In order to avoid such health problems, caregivers must remember the most important kind of care self-care. Caregiver s self-care suffers because they lack time and energy to prepare healthy meals or to exercise. In a national survey, about 6 in 10 caregivers reported that their eating (63%) and exercising (58%) habits are worse now than before they started caring for someone. Participating in regular doctor visits and healthy habits can positively affect a caregiver physically and allow them to continue their caregiving responsibilities without as many negative side effects. Employers should encourage their employees to see a doctor annually, if not more. The healthier an employee, the more productive and beneficial to a company they can be. Caregivers not only deal with physical health problems, however. Many suffer mental health problems as well. An estimated 40% to 70% of family caregivers have clinically significant symptoms of depression, while about ¼ to half of these caregivers meet the diagnostic criteria for major depression. Caregiving can also result in feeling a loss of self-identity, lower levels of self-esteem, constant worry, or feelings of uncertainty. Caregivers tend to have less self-acceptance and feel like they do not have control of their lives outside of their caregiving responsibilities. Chronic stress is also often associated with working caregivers and can have a severe impact. Many caregivers who experience chronic stress are at a greater risk for cognitive decline including short-term memory loss, shorter attention span, and a lower Verbal IQ. According to Drs. Janice-Kiecolt and Roland Glaser, stress caused by caring for a family member with dementia can impact the person s immune system for up to three years after their caregiving responsibilities end. A weakened immune system can then put them at a greater risk for developing a chronic illness. The more health problems employees begin to have, the higher a company s health insurance rates can get. Implementing changes, such as a flexible schedule, or allowing an employee to work from home can help to reduce stress and diminish their risk of becoming physically or mentally ill. For a company to continue to have healthy and happy employees they must learn to adapt the ways in which they handle a working caregiver s schedule. 4

4 Job Impact 6 out of 10 (61%) caregivers experience at least one change in their employment due to their caregiving responsibilities. Some of these changes include cutting back hours, taking a leave of absence, and receiving a warning about attendance/performance. An estimated 49% of working caregivers arrive to work late/leave early/take time off, 15% take a leave of absence, 14% reduce their hours/take a demotion, 7% receive a warning about performance/attendance, 5% turn down a promotion, 4% choose to retire early, 3% lose job benefits, and 5% give up working entirely. These changes can have negative effects on both an employee s personal finances and the company s finances. The Gallup-Healthways Well-Being survey results indicate that about 24% of caregivers feel that caring for a disabled or elderly family member, relative, or friend has had an impact on their performance at work. Compared to co-workers who are not caregivers, family caregivers had to take more time off work, were interrupted regularly during the day regarding family matters, had more work day absences, took more time off without pay, and ultimately worked fewer hours than desired. Less than 1/3 of employers offer paid family leave, causing employees to choose between making money to support their own family, or taking care of another family member/friend. Because of this, caregivers often suffer a loss in wages, health insurance and other job benefits, retirement/other savings, investments, and Social Security benefits. The decrease in these things can have serious consequences for the caregiver, as they are limiting the ability to financially support themselves. Some of a company s best and most dedicated employees could also be working caregivers, and because of this it is important to provide them with the proper benefits so they do not seek out employement somewhere else. Family emergencies arise for anyone, but more often for working caregivers. Allowing an employee who is also a caregiver to make up lost time in the office at home is crucial, as it allows them to work their committed number of hours and keep the full-time benefits the company provides. 5

4 Job Impact (cont.) Many caregivers today belong to what is known as the sandwich generation. They are not only caregivers for their elderly parents/family members, but are responsible for their own children who are often younger and need equal attention. This causes even more of a strain on the caregiver and the relationship they have with their job. Many caregivers do not want to give up their day jobs, but often feel as if they have no choice other than to help their elderly or disabled family member or friend. Employers must continue to be flexible and empathtic towards working caregivers, or their company may suffer as well. The amount of money it takes to hire new employees, train them, and provide benefits may be more money than what is being lost due to employee absenteeism. The end of this guide will go into more detail about how to reduce employee absenteeism and increase employee productivity, either from working at home or in the office. 5 Financial Impact Disregarding the loss of company revenue due to caregiver absenteeism, caregivers suffer large financial blows as well. Caregivers often cut back on retirement savings, eating out, vacations, and other leisure activities. 10 million caregivers over the age of 50 who care for their parent(s) lose an estimated $3 trillion in wages, pensions, retirement funds, and benefits over the course of caring for their loved one. The total costs are higher for women, who lose an estimated $324,000 due to caregiving, compared to men who lose an estimated $283,716. Women tend to lose more wages because they are more often forced to leave the workforce early because of caregiving responsibilities, both as mothers and daughters. The stress caused by financial strain can also cause many of the mental and physical side effects listed earlier. Seeking out the help of a financial advisor can not only help a caregiver deal with expenses today, but help them plan the funds needed for their own care in the future. According to the Disability and American Families 2000 Census, the median incomes of caregiving families are 15% lower than non-caregiving families. Once again this can be linked back to the decrease in hours at their day jobs in order to make time for their caregiving responsibilities. An AARP study, Family Caregiving and Out-of-Pocket Costs: 2016 Report, estimates that family caregivers spend an average of $6,954 on out-of-pocket expenses related to caregiving, or nearly 20% of their annual income. This number tends to be higher if you are taking care of a loved one long-distance, or if they are living in with you. For families who are near or below the poverty line, caregiving can take nearly two months of their annual salary. One could argue that caregiving can take as much out of you physically and mentally, as it does financially. For those families who can afford to hire nurses and other professionals to aid them in the care of their loved one do not face as many of the negative effects as those who cannot afford to do so. 6

5 Financial Impact (cont.) Caregivers are also more likely to lack adequate health insurance coverage due to their decreased hours at work that prohibit them from reaching full-time employee benefits. However, the cost of caregiving is not typically covered by insurance anyway. Out-of-pocket expenses for older adults who are not eligible for Medicaid and do not have any long-term care insurance have to be covered by the family or person that is caring for them. Transportation, non-prescription medications, medical supplies, equipment, and homemaking supplies are all examples of things that would most likely not be covered through insurance and something that would have to be paid with savings/personal income. Although many of these out of pocket expenses may seem relatively small, they add up fast over time, especially if the caretaking is full-time. 6 Policies and Practices that Support Working Caregivers Flexible Workplaces The idea of a flexible workplace includes not defining where work occurs, when work takes place, and an option to adjust your work schedule to accommodate for both work commitments and caregiving responsibilities. Flexible work places not only benefit employees, but employers as well. A study done by the Council of Economic Advisors in 2010 suggests that implementing a flexible work policy can reduce turnover rate and absenteeism and improve productivity among employees. Employers should also have an open door policy, so employees who double as caregivers can be as open as possible about their dual roles and responsibilities. Medical and Family Leave Whether paid or unpaid, it is important for employers to acknowledge that emergencies and situations will arise when their employees may have to leave work. The federal Family and Medical Leave Act allows eligible employees to take unpaid, job-protected leave for specified family and medical reasons, with a continuation of the health insurance terms received by the employer as if the employee had not taken the leave. The act allows employees to take up to 12 weeks of unpaid leave during a 12 month work period, and return to their job with the same pay, benefits, and work environment. According to the National Compensation Survey, only 12% of private-sector workers have access to paid leave from their employers. Many companies do, however, provide paid time off (PTO), which is usually used for vacation or sick days but can be used in place of paid family leave. The form of leave benefits varies across different employers, but mostly all federal, state, and local government workers are entitled to some form of paid leave.. 7

6 Policies and Practices that Support Working Caregivers (cont.) Avoiding Job Discrimination Some employees who are also caregivers are a target of workplace discrimination because of their caregiving responsibilities. Family responsibility discrimination (FRD), also known as caregiver discrimination, is employment discrimination against someone based on his or her family caregiving responsibilities and the assumption that workers with family obligations are not dependable or less productive than their peers. Regardless of their previous work performance or references, FRD is seen when caregivers are rejected for hire, not considered for or denied a promotion, demoted, harassed, terminated, or subject to a schedule change that ultimately leads them to quitting. As an employer, it is important to address common stereotypes and misconceptions about caregivers with other employees that might result in FRD or unlawful conduct, including : Assuming a working caregiver s responsibilities will interfere with their ability to excel in a fast-paced work environment. Assuming those employees who take advantage of flexible work schedules are not as committed to their jobs. Assuming that male employees in particular should not have a part in caregiving roles. If hiring, focus on the applicants qualifications for the position, rather than asking questions dealing with the applicant s or employee s children, plans to start a family, pregnancy, or other caregiving related issues during interviews or performance reviews. Staying completely unbiased towards all employees or applicants is key when learning to avoid discrimination in the workplace. 8

7 How TruSense Can Help TruSense is a smart home monitoring solution designed for seniors that brings assurance to loved ones and helps older adults stay in their homes longer. Using in-home sensors, TruSense is non-intrusive and does not require a wearable or pendant to deliver insights into daily activities. The solution also measures variables that can impact health and safety, such as water leak detection, unsafe temperatures and even vehicle and personal GPS tracking. TruSense also tracks caregiver visits and uses alerts and notifications based on customized user thresholds that can trigger a text or notify our 24/7 emergency response team. TruSense may not be able to solve every problem faced by a working caregiver, but at the very least it can give them back some time and lower their stress levels. Allowing them to monitor their loved one from their personal devices can lead to minimal disruptions at work (e.g. phone calls to check up on loved ones) and result in more productivity and revenue. As a company, this is can be extremely beneficial. Lower stress levels can increase health of employees and potentially reduce the company s insurance rates. TruSense allows working caregivers to continue living their daily lives, while their loved ones can also do the same. If an emergency were to arise, TruSense can be programmed to alert you and also send for help, so as a caregiver, you can have a new sense of peace of mind. With TruSense, you do not need to worry about hidden fees or contracts. For $299 and $39/month, you receive the TruSense starter kit, including activity sensors, an Amazon Echo Dot, a smart outlet, and a hub, along with access to a 24/7 monitoring center and the ability to customize alerts sent to your smartphone, based on activity within the home. There is no installation fee and you are free to cancel at any time. In fact, you can even try the product risk free for 60 days. If it does not suit your needs, you may send it back for a full refund on the purchase price for up to 60 days after your install date. TruSense is not only the smart choice for working caregivers, but its effects can have a positive impact on the workplace as well. 9

References 1 Work and Eldercare. Work and Eldercare Family Caregiver Alliance, www.caregiver.org/work-and-eldercare. 2 Gallup-Healthways. (2011). Gallup-Healthways Well-Being Index. 3 Dowd, Casey. The Financial Implications of Being a Caregiver. Fox Business, Fox Business, 18 Sept. 2014, www.foxbusiness.com/features/2014/09/18/financial-implications-being-caregiver.html. 4 Gallup-Healthways. (2011). Gallup-Healthways Well-Being Survey: Caregiving Costs U.S. Economy $25.2 Billion in Lost Productivity. 5 MetLife Mature Market Group, National Alliance for Caregiving, and the University of Pittsburgh Institute on Aging. (2010). The MetLife Study of Working Caregivers and Employer Health Costs: Double Jeopardy for Baby Boomers Caring for their Parents. 6 National Caregivers Library. Business, Caregiving, and the Bottom Line. Changes at Home, Changes at Work, June 2009, doi:http://www.caregiverslibrary.org/portals/0/business_caregiving_bottom_linejune2009national.pdf. 7 National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S. 8 Gallup-Healthways. (2011). Gallup-Healthways Well-Being Index. 9 National Caregivers Library. Business, Caregiving, and the Bottom Line. Changes at Home, Changes at Work, June 2009, doi:http://www.caregiverslibrary.org/portals/0/business_caregiving_bottom_linejune2009national.pdf. 10 Lai, Daniel W.L. Effect of Financial Costs of Caregiving and Burden of Family Caregivers of Older Adults. SAGE, Dec. 2012, journals.sagepub.com/doi/pdf/10.1177/2158244012470467. 1 1 Caregiver Health. Caregiver Health Family Caregiver Alliance, Family Caregiver Alliance, www.caregiver.org/caregiver-health#30. 1 2 Zarit, S. (2006). Assessment of Family Caregivers: A Research Perspective. In Family Caregiver Alliance (Eds.), Caregiver Assessment: Voices and Views from the Field. Report from a National Consensus Development Conference (Vol. II) (pp. 12 37). San Francisco: Family Caregiver Alliance. 1 3 Marks, N., Lambert, J.D. & Choi, H. (2002). Transitions to caregiving, gender, and psychological well-being: A prospective U.S. national study. Journal of Marriage and Family, 64, 657 667. 14 Vitaliano, P.P., Echeverria, D., Yi, J., Phillips, P.E.M, Young, H. & Siegler, I.C.. (2005). Psychophysiological mediators of caregiver stress and differential cognitive decline. Psychology and Aging, 20: 402-411. 15 National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S. 16 Addington-Hall et al., 1992; Brienbaum & Clarke-Steffen, 1992; Brooks, 1989; Covinsky, Goldman, & Cook, 1994; Ferris et al., 1991; Grunfeld, 1997; Neal, Chapman, & Ingersoll-Dayton, 1988; Scharlach & Boyd, 1989; Schulz et al., 2003; Stommel, Given, & Given, 1993; Stone, Cafferata, & Sangl, 1987 17 National Alliance for Caregiving and AARP. (2015). Caregiving in the U.S 18 AARP Public Policy Institute. (2008). Valuing the Invaluable: The Economic Value of Family Caregiving. 19 MetLife Mature Market Group, National Alliance for Caregiving, and the University of Pittsburgh Institute on Aging 20 Chuck Rainville, Laura Skufca, Laura Mehegan. Family Caregivers Cost Survey: What They Spend & What They Sacrafice. AARP, 1 Nov. 2016, www.aarp.org/research/topics/care/info-2016/family-caregivers-cost-survey.html?cmp=rdrct-ppi-caregiving-102416. 21 Ho, A., Collins, S., Davis, K. & Doty, M. (2005). A Look at Working-Age Caregivers Roles, Health Concerns, and Need for Support (Issue Brief). New York, NY: The Commonwealth Fund. 22 Schulz, Richard. Economic Impact of Family Caregiving. Families Caring for an Aging America., U.S. National Library of Medicine, 8 Nov. 2016, www.ncbi.nlm.nih.gov/books/nbk396402/. 23 Decima Research, 2002; Hollander, Liu, & Chappell, 2009. 24 Schulz, Richard. Economic Impact of Family Caregiving. Families Caring for an Aging America., U.S. National Library of Medicine, 8 Nov. 2016, www.ncbi.nlm.nih.gov/books/nbk396402/. 25 Employer Best Practices for Workers with Caregiving Responsibilities. Employer Best Practices For Workers With Caregiving Responsibilities, The U.S. Equal Employment Opportunity Commision, 19 Jan. 2011, www.eeoc.gov/policy/docs/caregiver-best-practices.html. 26 Family and Medical Leave Act. Wage and Hour Division (WHD), U.S. Department of Labor, www.dol.gov/whd/fmla/. 27 Schulz, Richard. Economic Impact of Family Caregiving. Families Caring for an Aging America., U.S. National Library of Medicine, 8 Nov. 2016, www.ncbi.nlm.nih.gov/books/nbk396402/. 28 (Bornstein, 2012; Calvert, 2010; Calvert et al., 2014; EEOC, 2007, 2009; Williams et al., 2012) 29 Employer Best Practices for Workers with Caregiving Responsibilities. Employer Best Practices For Workers With Caregiving Responsibilities, The U.S. Equal Employment Opportunity Commision, 19 Jan. 2011, www.eeoc.gov/policy/docs/caregiver-best-practices.html. 10

About TruSense TruSense is a smart home monitoring solution designed for seniors that brings assurance to loved ones and helps older adults stay in their own homes longer. Using in-home sensors, TruSense is non-intrusive and does not require a wearable or pendant to deliver insights into daily activities. The solution also measures variables that can impact health and safety such as home leak detection, temperature and even vehicle and personal GPS tracking. TruSense also tracks caregiver visits and uses alerts and notifications based on customized user thresholds that can trigger a text or notify our 24/7 emergency response team. 5481 Creek Road, Cincinnati, Ohio 45242 1-855-814-6478 www.mytrusense.com 11