Elder Care at Work

​​Many employers are making a business case for helping employees with sudden, short-term elder care needs.

Last year Cyndi Lee, a senior customer management and technology representative at Freddie Mac, a major mortgage reseller based in McLean, Va., got a call that made her feel like she’d been in “a train wreck.” Her husband’s grandfather had lost his home in Texas.

“He came and lived with us for a few months,” Lee continues, but during that time he needed more care than she and her husband felt able to provide. Both work full time and have two young children.

Lee then realized that her employer could help.

Freddie Mac has a backup elder care benefit that Lee used to provide a bridge to a more permanent care arrangement for her husband’s grandfather. Through Bright Horizons, a Watertown, Mass., company known for providing worksite child care, Freddie Mac offers employees up to 20 days of backup elder care per year at a charge of $15 a day to the employee.

The grandfather, 83 and manifesting early signs of Alzheimer’s disease, received nearly three weeks of in-home nursing care before new living arrangements were made for him.

“He was receiving good care,” Lee says. “And I didn’t have to go through all the red tape to get this benefit.” Having access to backup elder care reduced stress, enabled her to avoid missing work and saved an estimated $3,000 in care during the time she used the benefit, she reports.

A Clear and Growing Need

More workers will see sudden needs for backup elder care as the country’s population ages and its employment demographics change.

More than 44 million Americans provide care for adults, generally family members, and more than half of all caregivers are employed, according to the National Alliance for Caregiving (NAC), a Bethesda, Md.-based nonprofit coalition of national organizations focusing on issues of family caregiving.

Similarly, a 2007 report from the AARP Public Policy Institute titled Economic value of Family Caregiving found that about 19 percent of U.S. workers are informal caregivers.

In addition, many individuals have caregiving responsibilities for both children and elders. They’re members of the “sandwich generation”—those who may have waited until later in life to start families and now deal with having school-age children at home just as their elder parents’ care issues crop up, often in other parts of the country.

Andrea Moselle, senior manager of work/life at AstraZeneca, a London-based pharmaceutical company with U.S. headquarters in Wilmington, Del., notes that those signing up for the company’s elder care benefits are not just older employees. “While it does trend toward people who are in their late 40s and up,” she says, “we have people in their 30s who are using it. People often don’t live near their parents.”

Health crises among the elderly often require immediate attention, a change in housing and a plan for managing the person’s day. It’s often difficult to reach doctors and services while at work, adding to the stress and making it difficult to focus on—or to remain at—work.

Some details on elder care’s impact on employees can be found in a 2004 NAC and AARP study, Caregiving in the U.S., which is cited in Economic value of Family Caregiving. The Caregiving in the U.S. study, according to an AARP spokeswoman, “is based on a national survey of 6,139 adults, from which 1,247 family caregivers were identified. Among those caregivers, 935 were employed while caregiving. The data reported below are for those with the most intense levels of caregiving responsibilities, a subgroup of the 935.”

The data showed that:

• 92 percent reported major changes in their working patterns.
• 83 percent said they arrive late, leave early or take time off during the day.
• 41 percent reported taking a leave of absence.
• 37 percent reported going from full time to part time to adjust for their responsibilities.

U.S. businesses lose an estimated $34 billion annually because of employees’ need to care for loved ones age 50 and older, according to a 2006 report, MetLife Caregiving Cost Study: Productivity Losses to U.S. Business, from the MetLife Mature Market Institute and the NAC.

Employers’ Responses

Elder care benefits can help curtail productivity losses, keep employees’ careers on track, and even bolster loyalty and retention. Such benefits can include support groups and resources in an employee assistance program (EAP), custom web sites, referrals, and nursing services specializing in geriatric care. Costs for employees generally are minimal, though there is typically a limit on the number of days an employee can use services such as in-home care or receive time off for elder care.

Some programs accord benefits beyond the employee’s parents to others such as grandparents, domestic partners, a spouse’s parents, and even relatives such as aunts and uncles.

In most instances, the employer decides the types of elder care services its employees might need and contracts with third parties to provide those services at negotiated discounts.

A Productivity Solution

For Children’s Memorial Hospital in Chicago, establishing an elder care benefit was a good business decision. The hospital offers employees 20 days of backup care annually for each elderly dependent. “We can make a business case for it—we need our employees to be here, particularly since these are mainly nursing and child care employees who are responsible for direct patient care,” says Sharon Murphy, manager of employee work/life benefits.

The hospital’s backup care program has 152 registered elder care recipients—employees’ adult family members who may need backup care. They range in age from 54 to 98. During a recent 12-month period, 38 employees used 139 days of care for family members or dependents, Murphy says, and two used the maximum 20 days.

The hospital’s backup care is provided through Bright Horizons, and its adult care management services are provided through LifeWorks, a resource and referral product offered by the Ceridian Corp., an HR outsourcing company based in Minneapolis. All 4,200 employees, including full-time, part-time and contingent workers, may receive both free benefits.

By calling LifeWorks, an employee can arrange for an in-person assessment of an older relative’s environment, functional capability, and options for services or for a change in residence. The employee can also arrange for check-in services by telephone or in person to keep an eye on a relative’s condition and care. Services are available nationwide and are provided by professional managers of geriatric care.

Teresa T. Philipp, an orthopedic surgery nurse at Children’s Memorial, says the benefit was a boon when the health of her parents, then in northern Wisconsin, declined. After her mother’s death in 2004, backup care provided some housekeeping for her father, and Philipp was able to secure in-home care for him through the program. He died last year.

Philipp says it’s critical for employees to be made aware of elder care benefits early so timely and seamless care can be provided. She adds, “My siblings were astonished at the level of care that could be provided through this benefit. People think of it as a death and dying benefit, but it’s really for the living.”

Array of Options

Companies’ menus of elder care benefits range widely. AstraZeneca offers employees LifeSolutions, a resource and referral service provided through OptumHealth Behavioral Solutions of Golden Valley, Minn. Employees can gain access to a professional consultant, resource referrals, booklets, audiotapes, tip sheets and additional information on an interactive LifeSolutions web site.

AstraZeneca also works with Optum­Health to offer an integrated suite of elder care services provided in person or via the phone by a nationwide network of nurse practitioners specializing in geriatrics. Employees get six free hours annually and can purchase additional services, which include an assessment of an elderly relative’s medical, social and functional needs—usually done in the home—and recommendations for support and care. The professional who does the assessment does not provide care but develops a plan that takes into account affordability, family support, and whether the elderly person could and would carry out the plan.

All programs are free, but if employees want to continue with elder care beyond the six hours allotted each year, they pay out of pocket, Moselle says.

AstraZeneca also has a 400-member Eldercare Employee Network, featuring monthly programs on various topics. Through the company’s Just In Time Care program, employees are eligible for up to 10 days per year of backup child care or elder care subsidized at up to 90 percent of cost.

At George Mason University in Fairfax, Va., an elder care services coordinator is available for faculty and staff members. Patrice Winter, a physical therapist hired in a collaboration between human resources and the College of Health and Human Services, helps employees identify elder care needs and provides information about housing, transportation and legal matters.

For example, Winter found a way for a department head’s mother, living in the Midwest, to have her laundry done by members of a local church after she could no longer navigate the stairs to her basement. The faculty member used the information that Winter obtained and “was able to work and to not worry” about the problem, Winter says.

The university also has a monthly support group and offers seminars with topics including caregiving from a distance, communication strategies, and financial and legal considerations for long-term care.

Comprehensive Programs

Freddie Mac’s program offers a backup, in-home elder care benefit for its more than 5,300 employees as well as their spouses, domestic partners and partners’ direct relatives, plus parents, grandparents and other adult dependents, says Anne Kaiser, benefits administration manager.

Freddie Mac’s contract with Bright Horizons provides employees access to a national network of elder care specialists for in-home, backup nonmedical care such as meal preparation, bathing, grooming and companion services. Medical care professionals are also available, with fees based on the type of service, Kaiser says.

The Sandwich Generation, a Freddie Mac network group that meets regularly to discuss elder care, lobbied for the elder care benefit, Kaiser says.

Freddie Mac also offers LifeWorks and an on-site EAP counselor to support employees with elder care issues.

Since its inception in 2006, Freddie Mac’s backup in-home elder care benefit has been used approximately 200 times, Kaiser says.

The company reviews utilization data annually, including potential work hours saved, and translates the data into a return on investment. “We also look at how many employees are using the maximum 20 days a year and the types of services they are requesting” to determine whether the benefit needs to change, she says.

The author is a freelance writer based in the New York City area.

Web Extras

• Online sidebar: A Provider’s Perspective on Backup Elder Care
• SHRM article: Respecting the Elders (HR Magazine)
• SHRM article: Help With Elder Care (HR Magazine)
• SHRM article: How To Care for Elder Care Givers (SHRM Online Compensation & Benefits Focus Area)
• SHRM video: Kathryn Fisk, CHRO of Baptist Hospital South Florida, discusses how and why her organization instituted a backup dependent care program and flexible scheduling
• Web site: The MetLife Mature Market Institute
• Web site: Boston College Center for Work & Family