1. Work and Elder Care: Effects on Health, Well-Being, and Work Margaret B. Neal, Ph.D. Portland State University Institute on Aging School of Community Health Occupational Health Psychology seminar: "Work-Family Stress: Implications for Safety and Health“ November 7, 2008

2. Presentation Outline  The context – the aging of America: a few key trends  The stresses/challenges of caregiving for an aging parent  The rewards/opportunities/benefits of caregiving  Effective coping strategies for adult child caregivers of aging parents  What can be done, where to turn for help: some resources some resources

3. Trends Affecting the Care of Elders  Increasing number, proportion of older adults  Greatest increases among the “oldest old”  Advanced age, disability  more need for care (paid/formal and unpaid/informal)  Heavy reliance on informal care by family and friends

4. Trends (continued)  Women, the traditional family caregivers, increasingly are engaged in the paid labor force  Among family caregivers who are employed, almost as many men as women provide care to aging parents  Growing numbers of people are caring for/helping out elderly family members and friends.  Estimates vary depending on definition (any elder vs. parent; any help at all vs. particular type or specific amount of help or time spent helping; study methods): 10 - 25% of employees  Some caregivers of elders have multiple caregiving roles (for aging parents and children – the “sandwiched generation”)  Changes in family structure  more aged parents

10. For older adults needing care, 80% is provided informally by family members or friends For older adults needing care, 80% is provided informally by family members or friends Only 5% of adults aged 65+ are residing in nursing homes at any one point in time Only 5% of adults aged 65+ are residing in nursing homes at any one point in time Alzheimer’s Disease and other forms of dementia, while associated with advancing age, are not experienced by all older adults: 12% of those 75-79, 54% of those 80-89, 84% of those 90+ Alzheimer’s Disease and other forms of dementia, while associated with advancing age, are not experienced by all older adults: 12% of those 75-79, 54% of those 80-89, 84% of those 90+

11. Who here is caring for an aging - parent - grandparent - other relative - friend or neighbor?

12. Prevalence – How Common is Combining Caregiving and Work?  AARP’s Caregiving in the U.S. study (2004) found 59% of caregivers worked  Based on workplace surveys, 13% of the workforce is involved in elder care (Wagner, 1999), with 25% - 35% involved in caregiving at some point during the past year (Bond et al., 2003)

13. What are the stresses, or challenges, of care?

14. The Challenges of Care Ample research on negative outcomes of caregiving: Caregiver burden/stress (objective and subjective) Depression Other negative effects on well-being (e.g., poor physical health, poor overall role performance, marital strife) Negative effects on work – absenteeism, lateness, leaving work early, telephone interruptions, poor work performance, lack of advancement, quitting job entirely These affect employee AND employer

15. Nuancing Factors Care at a distance (e.g., 1+ hour’s travel time) Care at a distance (e.g., 1+ hour’s travel time) Other caregiving roles (e.g., for children) Other caregiving roles (e.g., for children) Support available from others (e.g., spouse, siblings) Support available from others (e.g., spouse, siblings) Mastery (skills in caregiving, time caregiving) Mastery (skills in caregiving, time caregiving) Role involvement and meaning Role involvement and meaning Role quality (rewards over stresses) Role quality (rewards over stresses)