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Monday, August 15, 2011

The Hidden Cost of Working Caregivers

Blog posting written by Stephen P. Rudolph MHCA, FACHE, CSA, NHA

If you are caring for an aging relative and holding down a job at the same time, you are not alone.

The U.S. Department of Labor estimates that 30 percent of the workforce is caring for an aging parent or relative. These working caregivers are paying a heavy price as they struggle to balance their personal and work responsibilities.

Each year, it’s estimated 10,000 baby boomers will turn 65. DOL statistics show that 85 percent of people 65 and over will require some form of caregiving assistance within their lifetime.

Eldercare is an evolving challenge for employees and organizations alike. For most employees, it's not a question of if they will receive a call about mom being diagnosed with Alzheimer's or dad breaking a hip. It's really a question of when the call will come.

MetLife has conducted studies on the impact of family caregiving on work, and the most recent looked at the cost to employers of absenteeism, workplace disruptions and reduced work status of working family caregivers. The study, “Working Caregivers and Employer Health Care Costs,” found that American business loses between $17.1 and $33.6 billion per year.

The MetLife study shows that once caregiving has started, 62 percent of caregivers say they make some sort of workplace accommodation, such as going in late, leaving early, taking a leave of absence or dropping back to part-time.

Three percent chose early retirement and 6 percent gave up work entirely to care for an impaired or frail older relative. Thus, the relationship of caregiving and work may operate in both directions: Being employed reduces the likelihood of being a caregiver and being a caregiver reduces the likelihood of being employed.

MetLife also studied how much caregiving affects the health of caregivers for the elderly and the costs to employers. It asked questions about the health care cost differential for working caregivers and what policies employers can put in place to promote healthier lifestyles and lower health care costs for caregivers.

The findings indicate that caregiving employers cost health care plans 8 percent more, potentially costing U.S. employers an extra estimated $13.4 billion per year. Those are conservative estimates, since the employees in the study are caring for the elderly and didn’t include those caring for a spouse or a younger family member.

A greater number of employees of all ages will assume the role of family caregiver with an increasingly older population. The results demonstrate a clear impact of eldercare burdens on the health issues facing employees ages 18 to 39, as much as those ages 50 and older.

One reason is employed caregivers find it more difficult than non-caregivers to take care of their own health or participate in preventive health screenings. For example, women caregivers were less likely to report annual mammograms than non-caregivers. Employed caregivers of all ages and gender defer preventive health screenings, as well.

Increased medical care costs associated with caregiving are consistent across job type and age, and partly consistent across gender. Caregiving is associated with the greatest increase in medical care costs among male, blue-collar, and younger employees.

The results of the study indicate that caregiving for an older relative is an important factor in the health, medical care expense, and productivity of employees across all age groups, and therefore in the health costs for employers.

As a result, the MetLife study claimed, employers can serve their employees as well as those of their corporation by anticipating and responding to the challenges of eldercare for their employees. In combination, eldercare benefits and wellness programs can provide not only the needed support to working caregivers, but also a vehicle to directly reduce employee health care costs, with resulting bottom-line benefits to the employer.

MetLife researchers have determined that caregivers providing 14 hours or fewer of care per week (considered a low level) can do that with little impact on their ability to stay on the job. However, providing 20 hours or more per week often results in major work adjustments, such as cutting back on hours or stopping work altogether, as well as the decline in annual income that goes with that work adjustment.

Since most businesses not only pay at least some employee health insurance, but support preventive health programs for employees, they have a clear interest in addressing risk factors for acute and chronic disease associated with caregiving for older relatives.

One way is having an Employee Assistance Plan (EAP) that offers referral to a caregiving agency. The agency would provide the care to the elder family member for the employed caregiver so they may function more effectively at work. Sometimes the employer contributes to the cost of the service or agency and sometimes it does not.

Clearly elder caregiving is an additional cost to the company, the worker, and the health care system in general. And the percentage of family caregivers in the workplace will only rise over time.

All employers need to recognize that supporting working caregivers can improve their health and productivity, not just in their personal lives but in their corporate lives as well.

This is not unique to any one state, ethnic group culture or geographic region. It covers all businesses, large or small, public and private. We need to recognize the growing demands of caregiving, especially in the workplace.

Most employers and employees either do not recognize the needs, underestimate the demands or deny the growing negative impact of family caregiving.

As employers, employees, managers, workers, and citizens, we need to stand up and respond in an efficient and effective way so the employees who are also caregivers may continue to serve their loved ones.

Stephen P. Rudolph has a Masters Degree in Health Care Administration and is the owner of Comfort Keeper of South Central Wisconsin, a leading non-medical, in-home service offering care on an hourly, daily, weekly or live in basis. Comfort Keepers provides personal cares and other non-medical services for aging adults, people with disabilities and others needing assistance to allow them to continue living safely and in the privacy of their own, Comfort Keepers is a member of the Better Business Bureau of Wisconsin (A+ rating), the National Private Duty Association (NPDA)and is Home Care Pulse Certified. . Rudolph is Board Certified in Health Care Management, a Fellow in the American College of Health Care Executives (FACHE), is a Certified Senior Advisor (CSA) and a member of the Society of Certified Senior Advisors. He lives in Verona, WI.

Study findings
Employees providing eldercare services were more likely to report fair or poor health in general. Among female employees ages 50 and older, 17 percent of caregivers reported fair or poor health, compared with 9 percent of non-caregivers.

Employees providing eldercare were significantly more likely to report depression, diabetes, hypertension, or pulmonary disease, regardless of age, gender and work type.

Female employees with eldercare responsibilities reported more stress at home than non-caregivers in every age group.

Employees with eldercare responsibilities were more likely to report missed days of work, particularly those ages 18 to 39.

Excess employee medical care costs associated with eldercare were highest among younger employees, males and blue-collar workers.

Younger caregivers (ages 18 to 39) demonstrated significantly higher rates of cholesterol, hypertension, chronic obstructive pulmonary disease (COPD), depression, kidney disease, and heart disease in comparison to non-caregivers of the same age.