The Caregiver’s Dilemma

AARP Bulletin

The working caregiver and his/her clueless boss

Even though Roxanne Aune’s boss is aware that her 59-year-old husband has early onset Alzheimer’s, he’ll never know how much it impacts her work. “I feel I can’t say I’m a caregiver because a red flag will go up and my boss will think, ‘Oh, there’s something wrong with her husband again,’ ” says Aune, 57, of Minneapolis. “I can’t afford to be absent, or start over again, so I don’t discuss this part of my life.”

Roxanne Aune has had difficulties at work since her husband has needed assistance. — Photo by Jose Mandojana

Aune, an auditor at a health insurance company, believes she has suffered professionally since her husband’s diagnosis last year. “I feel I get overlooked for projects,” she says.

For many employees, Aune’s dilemma about work vs. elder care is becoming business as usual. The angst will only grow, for many reasons: Parents are living longer. Employees are working longer. More women have paid jobs, and more men are pitching in with caregiving. Smaller families mean fewer siblings to help with Mom and Dad. Federal and state budgets are slashing funds for caregiving. Families are less interested in expensive institutional care, and hospital stays are getting shorter.

The silver tsunami effect

Then there are the numbers: The sheer magnitude of boomers and others who will need help in the future guarantees an elder care tsunami. According to a June 2011 report by MetLife Mature Market Institute, the percentage of age 50-plus adult children taking care of parents has tripled since 1994. The Families and Work Institute reports that 42 percent of U.S. workers in the last five years have had elder care responsibilities and 49 percent expect to care for an older family member or friend in the next five years. And a newly released AARP study reveals that at any given time in 2009, 42.1 million U.S. family caregivers were caring for an adult with limitations, with 61.6 million providing care at some time during the year. The estimated value of their unpaid contributions was nearly $450 billion in 2009, $75 billion more than in 2007.

Many employees are in that elder care-giving boat, yet workers with work-family conflicts are often reluctant to raise the issue with superiors. They fear they’ll be viewed as not committed enough, or receive bad year-end reviews. They may also think that discussing their personal life is unprofessional or sense resentment from colleagues and the boss, who may have to pick up the slack during their absences.

Deborah Smith, 55, a federal employee in North Carolina, is the 24/7 long-distance caregiver to her friend Donna, who lives in Florida and has dementia and no family. Smith visits Donna every four to six weeks but avoids discussing her at work because “I fear not being promoted or selected for training that could enhance my career,” she says. “I fear I may be on the chopping block if I appear too distracted.”

Even when workers explain their situation, younger or parentless superiors and coworkers may not “get” it. “Instead of saying to themselves, ‘I admire this person because he has the guts to take off work as a way of coping with the situation,’ coworkers and managers think, ‘How dare they leave, why don’t they just hire someone else?’ ” says Sarah Bullard Steck, a Washington, D.C., social worker in private practice and former director of an employee assistance program that addressed elder care issues.

Challenges all around

What makes elder care unusually challenging is its unpredictability. You might ask about taking off every Tuesday at 3 p.m. for your child’s soccer, but you have no heads-up about when your mother is going to fall and break a hip. Experts believe there may be a bit of ageism lurking, too.

“As a society, we don’t always respect and honor older adults needing care as much as we should,” says Melissa Brown of Boston College’s Sloan Center on Aging & Work. “Maybe we are afraid to look at our own aging.”

“Many businesses don’t consider elder care an issue and call me only when there’s a crisis,” says Linda Ziac, president of the Caregiver Resource Center, which offers corporate seminars on elder care issues. “Companies need to acknowledge the workforce is aging and has aging parents, and what not addressing their struggles costs them.”

Caregiving costs

It’s a hefty tab for both sides. A caregiving employee may feel forced to turn down a job promotion or relocation, radically reduce work hours, or quit altogether. Companies spend more on recruiting, hiring and training, lose productivity and experienced employees, and have higher health care costs for stressed-out workers, according to a 2006 MetLife and National Alliance for Caregiving study. U.S. businesses lose an estimated $33.6 billion a year in productivity with employees who are caregivers full time, at an average of $2,110 per person.

Preliminary research from the Sloan Center on Aging & Work shows that people caring for older adults report more stress and depression than employees who aren’t caregivers or who care for kids. The new AARP report says that 40 to 70 percent of family caregivers of older adults have clinical symptoms of depression; one-quarter to one-half meet major depression criteria.

“What people need is flexibility and support, even if they don’t need help immediately,” says Eliza Pavalko, an Indiana University sociology professor and expert on aging and the workplace. She and colleagues found that when companies have a family caregiving policy, employees tend to stay longer, even if they don’t use the benefits, than at companies that don’t.

A few decades ago, the man was typically the full-time worker and the woman handled the house, kids, parents and in-laws. “We have this ideal of the perfect worker who doesn’t have any distractions from work. This doesn’t fit the reality of our lives,” says Pavalko.

Mary Blair-Loy, a University of California-San Diego sociologist and author of Competing Devotions: Career and Family Among Women Executives, agrees. “In many organizations, work is viewed as a demanding single-minded allegiance,” she says. “Many organizations have an unspoken culture that devalues and stigmatizes workers that don’t seem to conform to this norm.”

That’s what Kathleen Toomey says her former boss did. While Toomey was working as an office manager for a Boston financial company, both of her parents were diagnosed with dementia. Her brother was taking care of them, but then he had a stroke, followed by Lou Gehrig’s disease.

One Friday morning at the office, she learned her father had died. She told her boss she wanted to go. His response: “Is all the work completed? Well, have a nice weekend, I’ll see you on Monday!” Her boss would tell her that “my concentration was not with the company and he would always use that as an excuse for not giving me a raise,” recalls Toomey, 53.

Now an administrative assistant, Toomey says her current boss couldn’t be more supportive. “If I have to be at the nursing home or take my mother somewhere, there’s no problem,” says Toomey. “If you have a family emergency, you shouldn’t have to worry, ‘Will I have my job tomorrow?’ “

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Award-winning writer specializing in aging and baby boomers for national and custom magazines, the web, companies, and organizations.

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Check out my latest work for AARP, inspiring people age 50+ for TIME, and my MetLife report on purpose in later life.

Recipient of two fellowships on aging from the New York Times Foundation and the MetLife Foundation.

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