The Quiet Problem at Work

1
The Quiet Problem at Work

• Business and Community Solutions for Employee
  Caregivers

2
Caregiving is a Family Affair
80 of all care provided to older people in our
country is provided by family members.
Source US General Accounting Office (GAO/HEHS
95-26, "Long-Term Care Diverse, Growing
Population Includes Millions of Americans of All
Ages") 1994
3
The Value of Care
The value of the services family caregivers
provide for "free" is estimated to be 257
billion a year.
BILLIONS OF DOLLARS
Source Expenditure data from HCFA, Office of the
Actuary, Levit K. et all, Health Affairs
200221.
4
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
ALL COSTS TO EMPLOYERS
Source NAC and MetLife Mature Market Group
(1997), The MetLife Study of Employer Costs for
Working Caregivers
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Caregiving and Work

• 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
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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)

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Elder Care - An Important Business Issue

• 42 of workers will provide some form of elder
  care by 2002
• 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.
8
Percent of Population by Age
Age Distribution of Population in 2000 (percent)
1996-2000
1981-1995
1966-1980
Before 1945
1946-1965
Source Census 2000, U.S. Census Bureau
9
Shrinking Ratios of Caregivers
The pool of family caregivers is dwindling. In
1990 there were 11 potential caregivers for each
person needing care. In 2050 that ratio will
be 4 to 1.
Source Chronic Care in America, Journal of the
American Medical Association, Dec. 15, 1999,
Volume 218, no. 23
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Growth Caregiver Households
Millions
Source Family Caregiving in the U.S. 1997
11
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
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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
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Women are the Primary Caregivers but that is
Changing

• Women are the primary recipients and providers of
  long term care.
• In fact, women comprise more than 73 of family
  caregivers for chronically ill elders.
• However, a more current study shows that men now
  make up 44 of the caregiver population.

Source Family Caregiver in the U. S.
1997 Source National Family Caregiver
Association, Random Sample Surveys of 1000
adults funded by CareThere.com, Summer 2000
14
ATT Caregivers by Current, Future, and Gender
Source ATT Survey of Elder Caregivers in the
Workplace - 1999
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Caregivers by Age
65 of all caregivers are aged 35-64
Source AARP and NAC (1997), Family Caregiving in
the US
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ATT Survey Distance Between Caregiver and Elder
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Working Caregivers

• Over 60 of caregivers are working full or
  part-time. More than 40 also care for children
  under 18.
• 47 of caregivers are employed and 71 are
  employed full-time.
• Caregivers dedicate on average 18 hours per week
  to provide care for older persons and even more
  when the person has multiple disabilities.

Source National Family Caregivers Association,
2000
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Caregiving-Related Adjustments at Work
Went in late, left early, time off during work
49 Took leave of absence 11 Dropped to
part-time, less demanding job 7 Lost job
benefits 4 Turned down promotion
3 Chose early retirement
4 Gave up work entirely 6
Source AARP and NAC (1997), Family Caregiving in
the US
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Elder Caregiving - Impact on Employees
Elder caregiving impacts an employees ability to
work and to advance their career (AARP, 2001) -
11 of caregivers took a leave of absence - 7
reduced their work hours - 3 turned down a
promotion - 10 took early retirement or quit
their jobs - 39 lost time at work (Galinsky)
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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)
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What do employed caregivers want from the
community?NCOA SurveyEmployee Caregiver Needs

• One phone number to call to get started looking
  for resources
• A way of finding information on caregiver rights,
  elder rights, caregiving services and their costs
• Consolidated resources/one-stop shopping
• Affordable services
• Easier, more user-friendly billing for services
• Service providers that translate industry terms
  into common language
• Service providers that operate with working
  caregiver hours in mind

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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)
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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)

• 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)

Source Last Acts (1999). Research Findings from
Studies with Companies and Caregivers.
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How to Deliver Services Employer Perspectives

• 56 of employers believe a combination of
  in-house and outsourced is best for caregiver
  programs
• 46 of employers do or would be willing to spend
  11 or more per employee on caregiver programs
• 54 do or would be willing to spend 10 or less
• 63 of employers would prefer flexibility in
  determining how costs are shared

Source Human Resource Institute (2000).
Measuring the Impact Caregiving Responsibilities
in the Labor Force Employer Perspective
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2002 Benefits SurveyFamily-Friendly Benefits
Table
Note Percentages may not total 100 percent due
to rounding. Source 2002 SHRM Benefits Survey
26
2002 Benefits SurveyFamily-Friendly Benefits
Table
Source 2002 SHRM Benefits Survey
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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

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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.

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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

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Questions

• What constitutes a caregiver friendly work
  environment now and in the future?
• What support does your organization provide or
  could provide?
• 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?

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Forum Sponsors

• The National Council on the Aging (NCOA)
• ATT Family Care Development Fund

Local Sponsors

• Alexandria Office on Aging and Adult Services
• Arlington Agency on Aging
• Fairfax Area Agency on Aging
• Loudoun Agency on Aging
• Prince William Area Agency on Aging
• Alzheimer's Association
• American Red Cross, National Headquarters
• Center for Medicare and Medicaid Services (CMS)
• Greenspring Village, an Erickson Retirement
  Community
• Senior Services of Alexandria
• Society for Human Resource Management (SHRM)
• SOLACE
• Virginia Department on Aging

Thanks to the ATT Family Care Development Fund
for its support of this event. The Fund is a
joint project of ATT the Communications Workers
of America and the International Brotherhood of
Electrical Workers.
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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)