By Rudy Yandrick
HR Magazine, November 2001

In early 1989, Bill Swartz went from working as a senior state government administrator in Harrisburg, Pa., to being a primary caregiver for five elderly relatives. Soon after leaving the Pennsylvania payroll he found himself fully engaged in taking care of his father, who became ill with cancer; his wifes parents, who were injured in an automobile accident; and two aunts who lived in separate towns, each a two-hour drive from his home.

I got a crash course on the exorbitant cost of nursing homes, restrictions on Medicaid benefits and the maze of agencies that may or may not be the right ones for my relatives needs, he recalls. For a while, I was in deep water without a life preserver.

The following year Swartz used his caregiver experience to co-found Senior Management Services, an elder care firm in Camp Hill, Pa. The company contracts with employers to offer advice and services for employees facing the kinds of problems that Swartz encountered. Turns out, my episode was just a little ahead of its time, he says. Many workers now in their 50s are being hit with caregiving for elderly parents after raising their own children, he adds. Many of them need professional advice on complex issues that they had never thought about before.

Caring for an elderly relative is a personal concern but its also a workplace issue, AARP executive William D. Novelli told a forum on elder care last spring in Washington, D.C. Novelli, now chief executive officer of AARP, said that over one-third of U.S. workers are providing elder care, they do it for about eight years and it costs them about $19,000 out-of-pocket over time.

Employers cant avoid responding to the needs of those workers immersed in caregiving responsibilities of many kinds, Novelli said. Its life. Its reality. If employers want to maintain a healthy work environment and the highest degree of productivity, they need to embrace family-friendly policies, which include elder care.

Resources on the Rise

Increasingly, companies are offering employees resources to help them handle their elder care obligations without shortchanging their job responsibilities, taking leave or putting their careers on hold. Elder care referral services are offered by 19 percent of the companies whose HR professionals responded to this years benefits survey by the Society for Human Resource Management (SHRM). The figure is up from 15 percent last year and 13 percent in 1997.

Elder care referrals are offered by 39 percent of companies with 2,501 to 5,000 employees, according to the SHRM survey, and by 31 percent of companies with more than 5,000 employees. Industries in which such services are most prevalent are high technology and utilities (27 percent of the companies in each category), health services (25 percent), business and professional services (22 percent) and retailing and the financial/insurance/real estate sectors (20 percent each).

Companies elder care programs typically offer tangible benefitswork time flexibility, for example, and financial assistanceas well as services such as phone- or Internet-based resource and referral (R&R), face-to-face consulting and educational activities, which may include on-site seminars and health-fair kiosks.

Most programs use R&R as the base and add other services as employees caregiving needs become clearer. Cathy Saka, a work/life specialist for Hewitt Associates, a global HR consulting firm based in Lincolnshire, Ill., says, More employers are looking at other optionslong-term-care insurance, providing services through the employee assistance program (EAP) and beefing up elder care programsto serve the so-called sandwich generation, those caring for both older and younger relatives.

In addition, Saka says, information and self-assessments are being offered through employee web sites, which may link directly to the companys elder care provider.

Companies costs for elder care services, according to Saka, run from about 50 cents per employee per month for basic R&R and web site access to $2 or more for services that are more labor-intensive, such as comprehensive assessments.

An elder care service need not be extensive to be effective, however. Simply providing expert advice or keeping an up-to-date Rolodex of affordable providers of in-home or residential care can reduce legwork for employees and minimize productivity losses for employers. Such services also may help relieve employee stress.

The human toll on caregivers is high and bound to get higher, says Betty J. Kramer, an associate professor of social work at the University of WisconsinMadison. Caregivers have greater levels of depression than those not grappling with such responsibilities, says Kramer. Guilt also surrounds caregiving, especially when our self-expectations are unrealistic and we punish ourselves. Its unrealistic to work 40-50 hours a week while taking care of our children or parents. The more that employers can help to alleviate this burden on employees, the better off their work organizations will be.

How To Make It Work

The ingredients of a successful elder care program include consulting, education and face-to-face contact, says Judy Seitz, benefits and compensation specialist for PHICO, a hospital malpractice insurance company in Mechanicsburg, Pa. We bring in speakers to talk with employees about the legal issues of wills [and] Medicare and Medicaid requirements, she says. From time to time our elder care service provider has an information table on site to provide information and advice. PHICOs periodic lunch and learn sessions on elder care issues draw about 10 percent of the companys 300 headquarters employees.

Elder care initiatives in larger companies sometimes become more sophisticated and service-intensive as they grow. For example, the United Auto Workers (UAW) and Ford Motor Co. Family Consultation and Referral Program began in 1996 as an R&R service and in 1999 added geriatric in-home assessments. The program, available to about 150,000 hourly and salaried workers at Ford and at parts manufacturer Visteon Corp., is one of several initiatives sponsored jointly by the automaker and the autoworkers union and run from the UAW-Ford National Programs Center, in Detroit.​

Greg Mack, who oversees the program for Fords salaried employees, says about 5,000 employees used it in the first half of this year, which is about 50 percent higher than the total for all of 2000.

The geriatric in-home assessment service, according to its sponsors, has been indispensable to the 94 clients who have used it so far. Judy Harden, who oversees the elder care program on behalf of hourly workers in the UAW, says, An elder care professional from the local community does a detailed assessmentusually lasting about two hoursand interviews the elderly person about everything from medicines they take to their physical capabilities. Thats followed by a written report that summarizes the findings, lists areas of concern and presents detailed suggestions and options for the best possible care. The assessment and the report are free to employees.

In the San Francisco area, a consortium of about 50 hotels joined with Local 2 of the Hotel Employees & Restaurant Employees International Union to provide the Child and Elder Care Plan for about 6,000 unionized workers. The program offers R&R and counseling services as well as financial assistance, and it is funded by employer contributions of 18 cents per employee hour worked.

Reimbursements include up to $125 per month for the care of infants up to age 1, as much as $225 per month for child care administered by a licensed caregiver, up to $400 per year for enrichment programs for children under 18such as computer classes, summer camps and an SAT preparation course offered through Princeton Review for college-bound teensand as much as $150 per month for the care of disabled or elder adults.

The adult-care reimbursement can be applied to health care costs not covered by insurance and to expenses for daily-living services recommended by a health care professional. An eligible disabled or elder adult can be a parent, parent-in-law, spouse, grandparent or domestic partner. It was a priority for us that even nontraditional family members be eligible so that the program would have as much flexibility as possible, says Lisa Jaicks, the plans coordinator.

The plan has benefited San Franciscos working-class neighborhoods, according to Netsy Firestein, consultant to the plan and director of the Labor Project for Working Families, in Berkeley, Calif. Weve found that corporate elder care programs most often are for the benefit of higher-skilled, higher-wage workers, says Firestein. So we negotiated across the boardeveryone from room cleaners to waitresses to dishwashers. This year the plan received the Alliance of Work/Life Professionals Excellence Award for helping low-wage employees find affordable dependent care.

Counseling through the plan is provided by the Goldman Institute on Aging, an elder care services firm that uses licensed social workers and emphasizes family involvement in helping restructure an elderly persons life. Elder care service is not just a matter of finding an in-home or residential care provider, says Ann Hinton, director of case management services at Goldman. She maintains that advisers should know a locality inside outwhether theres curb-to-curb transportation for the disabled and elderly, for example, whether any cab companies offer cars with lifts and if the steps leading to homes front doors are typically daunting for older people. This means that service providers need to know the lay of the land, she says. If these challenges are resolved, an older adult may not need to be institutionalized. For this reason, Hinton says, employers should be wary of phone-only programs that know little about a community and its resources.

At Washington, D.C.-based Fannie Mae, the home mortgage company whose elder care program was featured in the May 2000 issue of HR Magazine, program participants now can get not only on-site counseling and R&R services but also a new aidthe ElderKit. It is a binder of materials designed to help the caregiver gather and record information and stay organized.

Caregivers tend to get buried in paperwork about medical, legal, financial and other concerns, especially when they are dealing with governmental assistance programs, says Judy Dale, director of Fannie Maes Health and Work/Life Center. They may have to provide the same information to different agencies over and over. The kit provides a place for keeping all of that personal information together.

Increasingly, elder care services are being offered via the Internet. In fact, many employers web sites provide direct links to service providers. For example, Stanford University employees looking for information on elder care or access to counseling services can simply click an icon for Avenidas Programs, the universitys service provider, and from there they can navigate to the information or service they need.

In addition, independent web sites on caregiving for the elderly are springing up. About.coms Senior Living guide ( provides visitors with daily news updates and links to more than 700 other web sites, arranged by topic. And That Home Site ( offers numerous free chat rooms on family and home-ownership topics, including caregiving.

Know Who You Are

Whether a company needs to offer elder care or other work/life services depends largely on the characteristics of its workforce. The Stride Rite Corp., a marketer of casual shoes based in Lexington, Mass., assessed employees needs and then changed direction. In the mid-1980s, when Stride Rite was in Cambridge, the company implemented an intergenerational program that paired elderly dependents in the communitysome of them the parents of Stride Rite employeeswith young children in the immediate neighborhood. Its aim was to help the elderly stay active and help the children become socialized.

When Stride Rite moved three towns down to suburban Lexington in 1995, says Beverlye Keaton, director of associate relations, the companys demographics shifted to younger workers dealing much more with child care issues. In addition, its Lexington facility had less need than Cambridge did for elder care services. Since then, our primary attention has been on helping associates juggle working and raising their children, being active in the community and helping the company to perform well financially, says Keaton. Thus, because employees at times may be called on to work longer than a 9-to-5 day, the company has an on-site childrens day care center and a concierge service for personal needs such as dry cleaning and photo processing. Stride Rite still offers elder care guidance, however.

Getting Started

The following suggestions can help HR professionals interested in assessing their employees elder care needs:

  • Draw a demographic profile of the workforce to determine aging trends, employees marital status (which could unveil an elder care need if it shows many of the older employees are single), gender (womenwhether employed or notgenerally are the primary caregivers of the very young and the elderly) and health care use by covered individuals under the employee benefits plan.

  • Survey employees on their current and expected future needs for services. For example, ask them if they think their elderly parents will move in with them and if they foresee long-term caregiving needs. Ask any employees who are now caregivers if they have had difficulties that might have been easier to handle with an elder care program. Additional questions can be asked about their parents changing health care needs as well as their legal and financial concerns, and whether theythe employeesfear that someday they may have to forgo career advancement in favor of caregiving.

  • Determine if there is ingrained organizational resistance to accommodating employees who are caregivers for the elderly. Ann Bannes, vice president of community-based services for St. Andrews At-Home Services, which provides elder care services to a consortium of employers in the St. Louis area, says employees should be asked if they are comfortable talking about their elderly caregiving responsibilities with their supervisor. Their responses will tell you a lot about the company, she says. If employees arent sharing information, this may call attention to the need for supervisor sensitivity training in order for the program to improve its odds of success.

  • Consult with your EAP to find out the percentage of its casesand the percentage of incoming calls, including those that never became open casesthat are related to elder care issues. And find out if those percentages have increased in recent years.

Five years ago, employers looked at their demographics and said, Elder care is not an issue of focus for us, says Hal Thompson, president of Seniors Unlimited, an elder care consulting firm in Carmel, Ind. Today, some of those companies are coming back to us on their own because theyre hearing about it from employees or have lost key people.

As employers stake in the elderly increases, HR managers can help their companies by getting an overview of their employees current and future elder care responsibilities and then choosing the right mix of benefits and services to help their workers meet those needs.

Rudy M. Yandrick is a Mechanicsburg, Pa., freelance writer specializing in human resource and employee assistance issues.

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