Employers get creative to help with elder care

Flex time, resources among offerings

One segment of your employee population might be stretched thin balancing work and children, but another growing segment of the U.S. work force is also feeling the pull of conflicting obligations: work and caring for elderly parents. For more and more companies, eldercare resources are becoming a commonplace benefit.

For the 16,000 employees of Inova Health System in Northern Virginia, headquartered in Fairfax, eldercare resources are provided through the employee, which means the employer and human resources provide access to services to the employee, not directly to the elderly parent or spouse. "If we have an employee who is concerned with an elderly parent or spouse, we give them an opportunity to talk with an eldercare specialist," according to Joe Roche, executive director of Inova's employee assistance program. Inova employs eldercare specialists who are trained specifically to assist with eldercare issues. "They don't do anything else but eldercare," he explains. This expertise is important to offer, he adds, because many employees who seek help with eldercare issues don't know what their relative needs or what resources are available. "A lot of time, people don't know what the levels of care are — the difference between assisted living and nursing homes, for example," he points out.

Valerie Palazzolo, Work-Life Program manager for the University of Michigan in Ann Arbor, echoes Roche's experience. "One of the major things an employer can do is offer a way for employees to find out what resources are out there," she says. "That's what we do. We're an office that helps people find that out at the outset, hopefully before they are in the position of having to make immediate decisions."

According to the National Association for Caregiving and the MetLife Foundation, employees who are struggling with elderly dependents cost their employees up to $34 billion a year in absenteeism, presenteeism, and the cost of replacement workers. That averages out to $2,110 for each of the estimated 15.9 million full-time workers who also are caregivers. With the average age of Americans rising, that number is expected to increase. By 2020, one of every three American households is expected to be involved in caring for an elderly or disabled relative, up from one in four now, according to a recent survey by MetLife and the National Alliance for Caregiving.1

Employers can lose workers

While the federal Family and Medical Leave Act (FMLA) grants workers at large employers up to 12 weeks of unpaid leave per year, going three months without income is often an untenable situation for families. Smaller companies are exempt from the FMLA; in either case, employers often lose their employees to the demands of caring for their elderly relatives. (See box below for examples of assistance employers can offer.) Subsequently, companies are turning to their benefits menus and employee assistance programs to provide help that keeps the employees' families functioning, their elderly relatives cared for, and the employees at work. These measures can include extended, sometimes subsidized, leaves of absence; inclusion of elderly relatives on employer-provided health insurance; assistance with in-home care; and counseling.

Supporting employees with elderly relatives
Eldercare is now recognized by a growing number of employers. According to the National Alliance for Caregiving, support for employees who have caregiving responsibilities can take a variety of forms:
• "Cafeteria-style" employee benefits allow employees to select supplemental dependent care coverage to reimburse costs for in-home care or adult day care. Benefits also should cover therapeutic counseling for the employee to help cope with the stresses of caregiving.
• Human resource or employee assistance program staff can provide information on helpful Internet sites and local resource centers.
• Larger businesses can organize in-house caregiver support groups or coordinate with local community groups or hospitals so that employees can attend an outside support group.
• One of the most critical benefits for an employee with caregiving responsibilities is time. Flexible work hours, family illness days, and leave time are key. Data from the Bureau of National Affairs (1993) found that flexible scheduling improved job performance,
decreased lateness and employee turnover, and increased job satisfaction.
• Companies with 50 or more employees must comply with the Family and Medical Leave Act (FMLA), which allows for up to 12 weeks of unpaid leave to care for a seriously ill parent, spouse, or child, while protecting job security. Smaller firms can use the FMLA guidelines to tailor their own support plans for individual employees.
• Offer private long-term care insurance coverage for employees, their spouses, and dependents. Information on available insurance packages is available from the Health Insurance Association of America.
• Consider organizing a company "caregiver fair" or a series of lunchtime seminars on issues such as hiring a home care attendant or coping skills for caregivers. Employers can establish a telephone hotline or publish a list of key contacts in their employee newsletter.

Source: National Alliance for Caregiving. Web: www.caregiving.org.

The McGraw-Hill Co., with headquarters in New York City, provides a comprehensive set of benefits to their employees including backup dependent care, matching contributions to dependent care flexible spending accounts, eldercare resources and referrals, eldercare case management, and an emergency personal business policy that allows employees to take up to two paid days off per calendar year for family reasons, according to Marty Martin, vice president of employee benefits. An innovative benefit McGraw-Hill has added allows employees to extend their health care coverage to one adult family member in addition to themselves, such as a parent or grandparent. "Together, these policies and programs help create an environment in which all of our employees can develop to their fullest potential, both professionally and personally," Martin adds.

Inova eldercare specialists emphasize early assessment and intervention as the preferred means of preventing a caregiving situation from turning into a caregiving crisis. When an Inova employee contacts eldercare services, the first thing that occurs is an assessment of what the employee's family needs and what the community has to offer, Roche says.

"Then we go out and search the market and find the facilities that are a fit for them, wherever they are," Roche explains, pointing out that the elderly relative might not be living in the same town or even state that the employee is. "So wherever they are, we provide the employee a list of licensed, bonded facilities that can meet their loved one's needs."

The information package Inova prepares includes details about the facilities, rates, contact information, and how to go about evaluating the level of care they select for their relative. "We also have attorneys available who specialize in elderlaw issues, to help with any estate or planning issues that might arise when they are moving their relative into a different facility and out of the home," Roche says.

Inova tries to alleviate some of the stress and confusion employees might be experiencing by providing "a one-stop shop" for a variety of needs, he adds.

While the focus of the employee's interest, and the eldercare specialist's efforts, is the elderly relative, Inova's work-life program does not ignore the needs of the employee, Roche says. "We can provide resources and emotional support for employees who are caring for a loved one directly," he says. "We can find respite care for them, so that the employee can have a break."

There are plenty of ways Inova tries to help when an elderly relative is still fairly independent but in need of some extra help. Employees have successfully sought eldercare specialists' help in obtaining Meals on Wheels assistance, landscaping and mowing help, housecleaning, and in-home temporary care.

Assisting employees with making sure their relatives are comfortable and safe, wherever that might be, is the biggest help an employer can give a caregiving employee, Palazzolo says. "Having those things, like respite care or housing care or adult day care, in place helps the employee come to work without worrying about the parent home alone," she points out. "And we do everything we can to encourage employees to seek out resources early, and not wait for a crisis." Employees who not only have aging parents, but also aging spouses — or who are aging themselves — are urged to prepare.

"Another piece of it is flexibility in the workplace. If the manager can let them have flexible start and stop times, that might allow them to take a longer lunch break, so they can run home and check on their relative," Palazzolo says.


1. National Alliance for Caregiving. Caregiving in the U.S.: Findings from the National Caregiver Survey (2004). Accessed at www.caregiving.org/data/04finalreport.pdf.


For more information on eldercare resources at work, contact:

  • Joe Roche, Executive Director, Inova Employee Assistance, Fairfax, VA. Phone: (800) 346-0110. E-mail: joe.roche@inova.com.
  • Valerie Palazzolo, Manager, Work/Life Program. Work/Life Resource Center University of Michigan, Ann Arbor, MI.
  • Marty Martin, Vice President, Employee Benefits, The McGraw-Hill Co., New York, NY. Phone: (212) 512-2000.