Family Caregiver

Being the primary caregiver for an elderly loved one takes on many titles

A primary caregiver can be a friend, family member, associate, or a trained professional.  They can be paid or unpaid.  They are responsible for assisting with activities of daily living (ADL’s) for someone who cannot perform these tasks on their own.  Duties consist of, but are not limited to:

• Taking care of someone who has a chronic illness or a disease
• Managing medications
• Talking to doctors and nurses on someone’s behalf
• Helping to bath and dressing
• Taking care of household chores
• Preparing meals
• Pay bills
• Transportation

The role of the caregiver is recognized as an important one, both functionally and economically.  With the rise of our aging population (10,000 people turning 65 every day since 2011) we are seeing this role only increasing.  The physical, emotional and financial demands on the family caregiver can be overwhelming.  Some family caregivers find themselves in a category called the “Sandwich Generation”.  This category of people are normally middle-aged (40 to 60), working full time and are having to support both their children and their parents. One in eight people are in this category.  Today, over 15% of all working adults are providing some sort of financial support to both parents and children of all ages.

The stress of being a caregiver

The stress associated with caring for ill family member has resulted in health issues for caregivers.  The Center on Aging found that more than 1 in 10 caregivers say that the role of being a caregiver has caused their own health to decline. According to the Family Caregiver Alliance caregivers:

• Show higher levels of depression
• Suffer from high levels of stress and frustration
• Are in worse health
• Have an increased risk of heart disease
• Have lower levels of self-care
• Pay the ultimate price for providing care—increased mortality

The demands on family caregivers can be overwhelming especially when trying to do this on their own or without some support.  Respite Care provides a temporary break from the challenges faced by the family caregiver.  The caregiver is no good to the person needing assistance when they become ill.  There are more than 61 million people who are caring at home for family members.  Without family caregivers looking after their loved ones in their home, they would require placement in facilities costing lots of money.

Financial challenges caregivers face

It is costing the Sandwich Generation nearly $10,000 and 1,350 hours total on their parents and children per year. Children are more costly, while more time is spent with the aging.  Time is money.  Either way this could be a financial burden on them and their family.  A study of female caregivers found:

• 33% working decreased work hours
• 29% passed up a job promotion, training or assignment
• 22% took a leave of absence
• 20% switched from full-time to part-time employment
• 16% quit their jobs
• 13% retired early

The cost of caregiving also impacts the male family caregiver with respect to lost wages and Social Security benefits but are lower than a female caregiver, which exceeds $300,000.  There are ways to potentially offset these financial burdens and become a paid caregiver.  Creating a personal care agreement between your parents might be useful if you’re getting paid directly from their savings or some other asset.  If you are caring for a parent that is eligible to receive Medicaid, you may be able to get payment for the care you provide under the “Cash and Counseling Program”.  Different states have different names for these programs.  Family Caregivers could be paid directly out of different insurance benefits like Long-term care insurance or from VA benefits that their parents are receiving.

Getting outside help

Where do you go for help when you are taking care of your own family and trying to hold a full time job? Hiring someone to look after your loved one may be hard to come to grips with, but a necessity.  You think you can do it all, but statistics is NOT on your side.  Your first thought is to ask a friend or another family member.  This might work on a temporary basis, but isn’t a permanent fix.  Your loved one might not be willing to have someone that they don’t know well come in to look after them.  Are these people trained?  They might be good for companion care, how about bathing?

You can place an ad and find a caregiver that is professionally trained and hire them.  If you hire someone direct, remember, you are the employer.  You have to do a back ground check, you have to pay them, the state taxes, the federal taxes, unemployment tax and don’t forget that you have to insure them with workers’ compensation. One of the biggest problems you will face by going direct is finding a replacement when the caregiver you hired is sick or needs a day off.  You may have to be the backup and take time off from work.  You can hire a Home Care company and they would provide the caregiver that best suits the need of your loved one.  They provide all the insurance, training, pay their taxes and even finds a comparable replacement when the caregiver calls in sick.

Not all agencies are created equal.  You can find caregivers online.  They look like agencies, but they are just an aggregator of caregivers.  These are 1099 employees (independent contractors). Many will promote that do background checks, but most don’t even provide workers’ compensation.  So if a caregiver should hurt them self while caring for your loved one, you or your loved one (being the employer) will be responsible for their medical costs.  Then there is the brick and mortar agencies.  These can be confusing as well.  Some of these agencies are really “registries” in disguised.  What is the difference between an agency and a registry?  These type of agencies follow the direct hire concept described earlier.

How can businesses help caregivers

There are several ways that businesses can help a working employee that is caring for a loved.  Some companies have Employee Assistance Programs (EAP) or an Employee Benefit that provide resources.  These are valuable and are found through the human resource department.  Depending on the size of the company and the benefits they might provide, you might be able to apply for Family and Medical Leave Act (FMLA) leave.  Most employers with 50 or more employees will usually have guidelines about the time that can be taken off from work.  You can ask your HR department if they have a FMLA Checklist.

Not everyone may be eligible for FMLA leave.  To be eligible:

• Employed at company for at least 12 months
• Have worked at least 1,250 hours
• Employer must have at least 50 employees who work within 75 miles of workplace
• Check with your local state as there have been recent laws that expand eligibility

Employees miss work from time to time, the number of absences both planned and unplanned grow considerably when you are caregiving for a loved one.  Talking to your supervisor about your situation may lead to having more flexible hours or even the ability to telecommute.  Some businesses are allowing their employees to donate PTO to a company “Bank”.  When employees need additional time they can receive it from the “Bank” and don’t have to worry about paying it back.

Is there any help available from outside of work

National Family Caregiver Support Program is a special program has been designed to aid caregivers in providing the very best possible home care to an aging loved one. So who is Eligible?  Since 2016 Reauthorization of the Older Americans Act, caregivers are eligible to receive NFCSP services for the following:

• Family members or other informal caregivers age 18 and older that are providing care to people 60 years of age and older
• Adult family members or other informal caregivers age 18 and older providing care to individuals of any age with Alzheimer’s disease and related disorders
• Older relatives (not parents) age 55 and older providing care to children under the age of 18
• Older relatives, including parents, age 55 and older providing care to adults of the ages 18-59 with disabilities

There are other organizations that can help out like Meals on Wheels which could provide a fresh meal to someone.  Local churches may offer a loaner service for Durable Medical Equipment (DME). If your loved one needed a shower stool, walker, or maybe a wheelchair and their insurance didn’t cover the expenses, these organization might have one to loan you.  Every November is National Family Caregivers Month and it highlights the special challenges that family caregivers face.

The impact that caregiver absenteeism is having on businesses

Caregiving has a substantial impact on business. Employee absenteeism hurts every business.  Having to replace employees who had to quit to provide care for an aging loved one, can have serious financial consequences to employers. For instance:

• The cost to businesses to replace employees who quit their jobs because of their caregiving responsibilities has been estimated at over $3 billion.
• Absenteeism among employees that are caregivers due to caregiving responsibilities costs businesses millions of dollars and the numbers keep climbing.
• Extended lunch breaks, leaving work early or arriving late cost businesses because of partial absenteeism. Women caregiving has been estimated at $327 million. Caregiving-related workday interruptions add another $3+ billion to the burden bottom line.

Getting employees back to work quicker and under less stress is key to most businesses.  Providing them the right resources will only help the situation.  The eldercare industry is fragmented and confusing with terms like “home care” and “home healthcare”.  They have a one word difference and their definitions have polar opposites.  One being medical and the other being non-medical, one paid for with Medicare and the other with out of pocket money or Long Term Care Insurance.  With confusion like this, it’s a wonder people aren’t taking more time off.  You can’t make your HR Staff be social workers on top of what they have to do already.

Why elder care services in your employee benefits are necessary

Employees juggling an elderly loved one’s hospital discharges and physical well-being on top of their job obligations are overwhelmed.  Employee assistance programs (EAP) that do include eldercare benefits are usually not as robust as the demand is for them.  The statistics behind why an elder care EAP programs are necessary helps in making effective HR decisions (1):

• 5 million Americans informally care for an elderly loved one
• Average lost income for an informal caregiver is $303,880
• 57% report they have no choice but to perform clinical tasks
• 40% are in high-burden situations (21+ hours per week caregiving)
• 1 in 4 caregivers spend 41+ hours per week caregiving
• Live-in caregivers spend 40.5 hours per week caregiving

We cannot forget about the aging workforce, employees are starting to care for their brothers, sisters, and spouses.  Employee benefits are there to help employees. Companies need to communicate them to their employees.  This can be done through email, newsletters, lunch and learns, webinars, however the company feels will get the word out there.  Employee benefits is all about utilization and how companies can get their employees to be more productive.  It’s sad that more companies offer “Pet Insurance” than Eldercare Employee Benefits. Click here for a free Employee Benefits Guide.