1. The Quiet Problem at Work Business and Community Solutions for Employee Caregivers

2. Introduction Question: What has two legs, exists in almost all work environments, can be a male or female, exempt or nonexempt, a CEO or a line worker? Answer: Employee Caregiver An employee caregiver is someone who works full or part time, and also takes care of an older or disabled loved one. One quarter of all U.S. households are involved in caregiving. The majority, or 64% are employed. Perhaps you are a caregiver or supervising a caregiver. The employee working next to you could very well be a caregiver. Employee caregivers often experience conflicts between work, home, and caregiving responsibilities creating a challenging juggling act. This powerpoint examines this quiet, but growing issue so employers and employees can jointly explore ways to create more caregiver friendly work environments, and increase productivity.

3. Caregiving is a Family Affair Source: US General Accounting Office (GAO/HEHS 95-26, "Long-Term Care: Diverse, Growing Population Includes Millions of Americans of All Ages") 1994 80% of all care provided to older people in our country is provided by family members.

4. The Value of Care BILLIONS OF DOLLARS Source: Expenditure data from HCFA, Office of the Actuary, Levit K. et all, Health Affairs 2002;21. The value of the services family caregivers provide for "free" is estimated to be $257 billion a year.

5. Changing Demographics The number of Americans of age 65 is expected to increase from 34 million in 1995 to 62 million by 2025. More people over 65 than in their teens and people over 85 than under 5 (Lamm & Lamm 2002) 12 million elders will require care by 2020 (Brubaker and Brubaker)

6. The Changing Family Smaller families Blended and nontraditional families More women working outside the home Geographically dispersed Fastest segment of the population are 85+ year olds Sandwich generation evolving into the Club Sandwich Generation where baby boomers take care of their children, their parents, and their parent’s parents

7. Workforce Changes In 2000, 13% of the workforce was 55+ By 2015, 20% of the workforce will be 55+. Highest growth rate in U.S. workforce will be between ages 55-64. By 2010, workers between the ages of 35 and 44 will shrink by 10.2%. Source: Bureau of Labor Statistics

8. Who is the Family Caregiver? More than one-quarter of US households Base case –A 46-year-old Baby Boomer woman who: Works full-time Cares for 77-year-old mother who has chronic illness Lives nearby Does average of 18 hours/week caregiving Average annual income: $35,000 (1996) Source: AARP and NAC (1997), Family Caregiving in the US

9. Men are the Invisible Caregivers As likely as women to be primary caregivers Less likely to provide personal care Less likely to discuss caregiving with supervisors and co-workers Unaware of company eldercare programs Source: Sons at Work: Balancing Employment and Eldercare, Met Life Mature Market, June 2003

10. Why is it a Quiet Problem at Work? Employee caregivers do not self identify (caregiver is a foreign term) Caregiving is an emotionally laden, very personal experience Denial Agism Workers feel it is not a legitimate work life concern Stigma Fear of job loss, demotion, or not receiving a promotion Impact of recession Fear of retribution All these factors keep employee caregivers in the “closet”. The irony is that it’s a crowded closet and becoming more crowded by the day.

11. Elder Care - An Important Business Issue 70% of employers report increases in caregiving-related staffing problems in the past 10 years 40% say they have no plan in place to assist caregivers Source: Families and Work Institute (1998). The 1998 Business and Worklife Study. and Human Resource Institute (2000). Measuring the Impact of Caregiving Responsibilities in the Labor Force: Employer Perspective.

12. Estimate of annual cost to US employers in terms of lost productivity: - Counting caregivers who work full-time, live near the care recipient, and perform personal care tasks: $11.4 billion/year - Counting all caregivers including part-time workers and long- distance caregivers: $29 billion/year Source: NAC and MetLife Mature Market Group (1997), The MetLife Study of Employer Costs for Working Caregivers Cost to Employers

13. Costs to the Employee Caregiver Estimate of cost to the caregivers over the caregiving and work career (MetLife Juggling Act study): - Negative impact on Social Security: $25,494 - Pension lost: $67,202 - Wages lost: $566,443 Total wealth lost: $659,139 Source: NAC and Brandeis (1999), The MetLife Juggling Act Study

14. Nearly nine in ten caregivers say that their caregiving activities have affected their stress level and eight-in-ten say it has affected their personal life. % SOMEWHAT/A GREAT DEAL CAREGIVING ACTIVITIES HAVE AFFECTED Source: Genesis Eldercare - National Association for Female Executives 1999 Eldercare Survey Summary, May and June 1999. (Compiled by Lake, Snell, Perry & Associates)

15. Caregiving-Related Adjustments at Work Informal Adjustments (100%) - Late to work - Leave work early - Incoming and outgoing telephone calls - Unexpected days off Formal Adjustments (84%) - Use vacation, sick, and personal days (64%) - Decreased hours (33%) - Leave of absence (22%) - Full to part-time (20%) - Quit job (13%) - Retire early (13%) Source: Met Life Juggling Act Study, 1999

16. Benefits to Creating a Caregiver- Friendly Work Environment Reduced absenteeism Improved morale Reduce hidden costs (i.e. Replacement, training, accidents, health) Attract and retain the best workers Increase productivity and reduce presenteeism and accidents by reducing stress on employees Reduce disruptions in the work schedule Enhance your community image and reputation, which will attract more customers Simplify the ability to locate and use resources Better work-life balance

17. How are Employers Responding? Half of all employers offer some form of elder care assistance, with dependent care spending accounts (38%) and resource/referral programs (33%) the most common Year 2000 - 15% offered an eldercare referral service benefit and increased to 21% in 2002 Year 2000 - 36% offered Long-Term Care insurance and increased to 48% in 2002 Source: Society for Human Resource Managers

18. What do caregivers want from the workplace? Caregivers’ agenda involves more access to flex time, making eldercare benefits the same as child care benefits, pre-tax spending accounts for eldercare, access to services that relieve stress/time consuming tasks and workplace seminars that offer information to build caregiving skills. % HELPFUL IF PROVIDED BY EMPLOYERS Source: Genesis Eldercare - National Association for Female Executives 1999 Eldercare Survey Summary, May and June 1999. (Compiled by Lake, Snell, Perry & Associates)

19. What Employees Would Use Employees would use, if their employer offered it: –a policy allowing flexible use of sick leave, vacation leave, and family leave for end-of-life situations (96%) – referrals for information or advice about counseling or bereavement services (89%) –educational materials about dealing with end-of-life tasks and decisions (84%) Source: Last Acts (1999). Research Findings from Studies with Companies and Caregivers. referrals to professionals for information or advice about medical care (82%) referrals for legal information and advice (82%) confidential individual sessions about facilitating communications among family members and care providers (82%)

20. The needs of working caregivers are similar wherever you go… Community resources do exist to help!

21. Useful Resources Benefits CheckUp www.benefitscheckup.org The Eldercare Locator 800.677.1116 www.eldercare.gov

22. Barriers Caregivers do not self-identify Impact of the recession Stigma/fear of job loss or demotion Aging network can be confusing and intimidating Shortage of affordable homes and community- based services and supportive housing Critical shortgage of reliable, paid caregivers Low participation rates of company sponsored programs; chicken or egg dilemma

23. Future Trends in Caregiver Support More male caregivers More workplace interventions (e.g. case management) More supportive services such as respite, adult day, home healthcare Greater use of Internet More public and private dollars allocated for caregiver support More supportive housing, i.e. assisted living

24. Implications The aging population is growing, particularly those 85+, increasing elder care needs. The workforce is aging, increasing caregivers in the workforce. Generation X and Generation Y are smaller in numbers than baby boomers, reducing the number of caregivers in the future. More and more workers are joining the sandwich and whopper generation (three generations) increasing caregiver obligations.

25. Questions What constitutes a “caregiver friendly” work environment now and in the future? What support does your organization provide or could provide? What is the cost of not responding to employee caregiver needs? How can community services and businesses create strategic partnerships to better support employed caregivers? Who is going to be the future caregiver? Who is going to care for YOU?

26. Employee Caregiver Task Forces The National Council on the Aging (NCOA), with funding from the AT&T Family Care Development Fund, is providing technical assistance to enhance employee caregiver and eldercare services. Forums were held in five communities with the goal of increasing the responsiveness of community services and business practices in meeting the eldercare and caregiving needs of employees in these communities. As a result of these forums, ongoing task forces have been created to identify and implement effective approaches which will assist working caregivers with elder care issues and mitigate the negative effects of caregiving on employees, employers, and the workplace. To learn more, contact Donna Phillips, NCOA, 202-479-6981, donna.phillips@ncoa.org.

27. NCOA thanks the following organizations for the information they provided Society for Human Resource Management National Association of Area Agencies on Aging American Association of Retired Persons (AARP) The National Alliance for Caregivers IBM American Business Collaboration For Quality Dependent Care (ABA) Met Life Mature Market