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Elder Care Drain

Employers Offer Help as Demand Rises

A private company tweaking its benefits package is rarely the sort of event that makes national headlines. But in September 2016, the global consulting firm Deloitte received a lot of ink for its decision to provide 16 weeks of paid family leave for its employees — time off not just for the birth of a child but for an aging parent or other adult.

The change was perceived in many quarters as a new carrot dangled in front of potential employees in a competitive market for talent. Indeed, a Fortune headline on the move declared it part of a “paid leave arms race.” But Carolyn O’Boyle, chief operating officer for talent at Deloitte, said the decision was driven mainly by what it was hearing from within the company.

“A lot of it was focused on [questions of] ‘What are the needs of our people?’ and ‘How is the workforce changing?,’ as opposed to a competitive response,” she said. “It was really about our people and the future of work and how we might get out in front of the needs that our people might have.”

Those needs have become increasingly substantial when it comes to elder care. According to WorldatWork’s “2018 Inventory of Total Rewards Programs and Practices,” employer use of elder-care resources and referral services increased from 62% to 67% from 2017 to 2018. More than half (58%) of U.S. working adults are caring for a parent or in-law, according to a 2018 study by the insurance company Unum. And AARP estimates that the ratio of family caregivers to those over 80 will shrink from 7:1 to 3:1 by 2050.

Yet, if there truly is an “arms race” when it comes to elder-care benefits, proliferation is slow. The U.S. Bureau of Labor Statistics reports that in 2016, only 14% of U.S. workers received some form of paid family leave, and such leave is more often restricted to the birth of a child. In 2002, California became the first state to enact paid family leave legislation, but only five states and the District of Columbia have passed similar laws in the years since. Federal action on the matter beyond the current Family and Medical Leave Act (FMLA) is unlikely for the foreseeable future. That leaves most employers and employees to close the gaps when it comes to elder care.

Still, experts agree, support for elder-care benefits in the workplace is increasing — and is increasingly demanded by employees. And though a holistic solution may not be in the immediate offing, employers are embracing a mix of support services that, together with a culture that is more open to discussing elder care, can help employers and employees alike face near-term challenges.

Productivity Impact

Conversations and research around elder care and employees often turn on questions of productivity. The Unum study notes that 22% of adult caregivers reported decreased productivity resulting from caregiving responsibilities, and more than half (52%) reported being absent from or late to work because of those responsibilities. A 2015 study from the AARP Public Policy Institute and National Alliance for Caregiving reported that 15% of caregiving workers took a leave of absence to handle those responsibilities, and that 14% have reduced their hours or taken a less demanding job.

The loss of productivity and drain on talent that comes with elder-care stress has prompted employers to explore expanded paid family leave programs. Since 2016, Deloitte has been joined by Allianz Life,, Pfizer, and other firms that have introduced or expanded paid-leave plans, and many more are providing information, referral services and access to backup care providers.

The loss of productivity & drain on talent that comes with elder-care stress has prompted employers to explore expanded paid family leave programs.

Anecdotally, the paid-leave expansion has made a difference. Since launching its program in 2016, O’Boyle says, more than 5,000 of Deloitte’s approximately 286,000 employees have taken advantage of the program, and she adds that the program has been important for retention. “We have heard from people explicitly saying, ‘If this program didn’t exist, I would have quit because I wouldn’t have been able to manage those things’,” she said.

Despite increasing support for elder-care benefits, the available options are patchwork across the country and across industries.

Michelle Jackson, assistant vice president of sales acceleration at Unum, says employers have been looking at elder-care programs as a way to establish “parity or equity for their workforces,” especially for older employees who have less of a need for a parental leave policy. “Think about it from an employer’s perspective,” she said. “If you’ve got a middle-aged or older workforce and you give a benefit to just the younger workers, you’re excluding a whole part of your workforce.”

Ellen Bravo, CEO of Family Values at Work, a nonprofit that advocates for broader family-leave legislation, puts it more bluntly. Comprehensive elder-care plans are “the best way to avoid the kind of divisiveness that some people experience where there’s resentment against parents of new children, because people say, ‘Well, you get to do X and then I had to fill in.’”

And the divide among workers is no longer as simple as saying that young employees care for children and older employees care for parents. One-fourth of employees caring for both children and adults are Millennials, according to a study by the caregiving firm Bright Horizons. To that end, comprehensive family-leave plans may make more sense not just in terms of productivity, but recruitment and retention. A 2016 Ernst and Young study of employers showed that 80% of those with family-leave programs reported higher morale, and 70% reported higher productivity.

A Patchwork of Solutions

Still, despite increasing support for elder-care benefits, the available options are patchwork across the country and across industries.

The FMLA allows workers to take up to 12 weeks of family leave annually, but it is unpaid. To date, the District of Columbia and five states — California, New Jersey, Rhode Island, New York, and Washington — have paid family leave plans of various lengths and types, supported by payroll taxes. Currently, no broader plan appears to be in the offing — a proposed Family and Medical Insurance Leave Act never came to a vote in Congress, and the sole current White House proposal would provide paid leave only for births and adoptions.

And because many employers say they can’t bear the expense of paid leave, alternative support tools are emerging. Employee-subsidized backup care, for instance, was one of the most popular tools mentioned by employers in a 2017 AARP study. In 2006, the company Bright Horizons expanded from childcare into emergency backup elder-care services; today it has 615 employer clients using elder-care benefits, more than three-fourths of its total client base.

Stephen Kramer, CEO of Bright Horizons, notes that in recent years, its work has been around being “both high touch as well as high-tech,” giving employees the option to coordinate their caregiving options online. But he cautions against having HR departments simply handing employees a site login to plan care.

“Because supporting an aging elder is something that typically is new to an employee, they often need some additional support beyond what self-service can provide,” he said. “We find that once someone may have used the backup elder-care support, they then may go online and find a caregiver that will provide ongoing support... But given the immediacy and urgency with which elder care often comes on, it’s important to have something that is a bit more full-service on the front end.”

Indeed, counseling and support services are the kind of tools that are on the upswing, according to Unum’s Jackson. “What you’re finding is that progressive employers are beginning to expand on elder-care-type benefits, and these can include things like referral services, backup elder care, geriatric counseling, care coordination, assisted living assessments — things that will assist a family member in coordinating the needs and the care of elderly parents or grandparents,” she said. “These types of services offer support for an employee to navigate through what is often a crisis situation and a very complex medical landscape that they’re not familiar with.”

Employers have been looking at elder-care programs as a way to establish parity or equity for their workforces, especially for older employees.

That, too, can take different shapes. Allianz Life hosts quarterly seminars for caregiver employees and a resource hotline; Home Instead Senior Care provides direct caregiver training; Eli Lilly maintains an elder-care support group. Unum’s Jackson says employers should expect their workers to ask for even more. “Two, three years ago, there was a greater focus on parental benefits, paid parental leave, and corporate benefits that would support that,” she said. “Now we’re seeing an evolution that encompasses broader family aspects and that would include caregiving.”

What the Future Might Look Like

Beyond simply adopting such programs, experts say, employers also need to find ways to spotlight and even celebrate them. Elder care can drain workers’ time and energy, and opportunities to show that employers are supportive can destigmatize the challenge and encourage workers to consider the programs.

“A big element [of the paid-leave program] was telling our stories internally,” said Deloitte’s O’Boyle. “It reinforced to our people the full range of situations under which this program might be beneficial. And it demonstrated that there is a culture at Deloitte where people can and should be taking advantage of this. That was some of the feedback that we heard early on. People would say, ‘I wasn’t sure if I should take this. I wasn’t sure if it would be OK. And then I talked to my manager about it and they were enthusiastically supportive and strongly encouraged me to take this and said that I was making a huge mistake if I didn’t.’”

Bravo of Family Values at Work similarly suggests using internal communications to share benefits among staff. “Whatever means a company uses to get the word out — something online, a newsletter, a note [in] people’s paychecks — use that to show you care,” she said. “For example, ‘Frank just came back from helping his mom after she had a heart attack. We’re so glad that Frank was able to use our policy and have that time with his mom and we’re happy to report that rather than having to go to the nursing home or rehab center, she was able to stay in her own home.’

“Those kind of stories send a message: We have this policy, and not only will you not be punished for using it, but we’ll applaud you. We want you to use it.”

Bravo would still prefer to see a comprehensive, federal approach to elder care. So, too, might many companies, if only to avoid the state-by-state patchwork currently in place. (Deloitte’s plan allows workers to receive the full benefit of its plan regardless of the limitations of programs in whatever state they work in.) In the meantime, more states are considering legislation, and more employers are looking for solutions. And the easiest way to do that, Bravo says, is to take the question directly to the employees.

“Do a cultural scan of how things are going,” Bravo said. “Ask questions like, How does your job accommodate or facilitate your family needs outside of work? What are the best things? Are there obstacles? And if so, what are they? Do you feel like your manager knows and cares about those things and communicates that to you? Ask some meaningful questions about whether you’re walking your talk. And if not, what are your suggestions for ways to do it better?”

Mark Athitakis Mark Athitakis is a contributing writer for Workspan magazine.

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