Supporting Employee Caregivers

​In 2016, Deloitte expanded its paid-leave policies to include time off for workers to care for family members with serious health conditions. One employee used the caregiver leave after her father died and she noticed her mother's mental health was declining.

The employee "took advantage of the caregiver family leave to pack up her mother's life and move her into an appropriate living environment," says Melanie Langsett, leader of rewards, recognition and well-being at Deloitte U.S. "It prevented her from feeling like she had to quit."

The consulting and tax advisory firm, which is headquartered in New York City and has more than 120,000 employees, provides 40 days of paid time off (PTO) annually. It offers an additional 16 weeks—or roughly four months—of paid leave per year to care for a spouse, domestic partner, parent, adult child or sibling with a serious health condition.

"As we looked at our workforce demographics, we had professionals who are caring for both children and parents at the same time," Langsett says of the company's decision to offer paid leave to caregivers.

Deloitte's caregiver benefit is unusual: 79 percent of caregivers do not have access to caregiver support benefits at their workplaces, according to the results of the Homethrive 2021 Employee Caregiver Survey.

A lack of awareness on the part of employers may be part of the problem. Nearly 40 percent of caregivers in the survey said their workplace supervisors are not aware of their caregiving responsibilities outside of work.

Yet caregiving is common. Nearly 1 in 5 workers in the U.S. is also a caregiver for an ill, elderly or special-needs adult, according to Caregiving in the U.S., a 2020 AARP report.

Most employees remain silent about their caregiving responsibilities because they fear being viewed as less than fully committed to work and, as a result, losing their jobs or missing out on promotions. They often become distracted at work and mentally, physically and financially overtaxed. Many eventually resign because the strain becomes too great.

"It's a significant reason why people leave the workforce—they're being pulled in too many directions," says Dave Jacobs, co-founder and co-CEO of Homethrive, a caregiving support service company headquartered in Northbrook, Ill. "Faced with making a choice between career and family, most choose family."

Some employers recognize the extraordinary pressure these employees are under and are choosing to assist them in order to encourage them to stay on. To be sure, altruism plays a role in these efforts, but the Great Resignation has also driven many employers to take a range of steps to retain their most valued workers.

Significant Demands

Caregiving is more than a full-time job. "Someone else's life literally depends on you, and everything else comes second," says Kathleen, who has been her elderly father's primary caregiver for more than five years. (She requested that her last name be withheld.) "You cannot commit to complete something on a tight deadline because your time is not your own."

Moreover, caregiving is not usually a one-time event. Rather, it involves a long-term commitment lasting an average of 4.5 years, according to the AARP report. Health emergencies and lesser crises upend schedules and busy lives.

On average, caregivers spend nearly 24 hours a week providing care, the AARP report states. This care can include activities such as housecleaning and driving to medical appointments, as well as assistance with bathing and getting dressed.

Christina Irving, client services director at the nonprofit organization Family Caregiver Alliance in San Francisco, understands the difficult situation many employees face. "Caregivers are more likely to need to take time off, come in late, leave early, and take calls or check in on someone at home in the middle of the day," she says. "Caregivers are either turned down for promotions or feel unable to apply for promotions because they have to juggle other responsibilities at home."

Employees in certain demographics are more likely to have caregiving responsibilities. The median age of caregivers of adults is 51, according to the AARP report, and 61 percent of caregivers are female.

"Caregiving programs are an important component in keeping women in the workforce, since caregiving responsibility still falls predominantly on women," notes Jennifer Benz, senior vice president and communications leader at Segal Benz, an employee benefits and communications firm in San Francisco. "Companies that are interested in retaining women will make this more of a priority."

The Weight of Caregiving

To identify benefits options that would best help employees caring for loved ones, company leaders need to understand the challenges those workers face. Caregiving stress can lead to:

Mental strain. The toll caregiving takes on an individual's mental health often stems from the feeling of being trapped: 53 percent of caregivers believe they don't have a choice, according to the AARP report. Nearly 4 in 10 say caregiving has been emotionally stressful.

The mental strain can be significant. Caregivers may experience guilt, anger, anxiety, cognitive overload and reduced concentration, says Carrie Theisen, vice president of total rewards at Fannie Mae, which is based in Washington, D.C., and has 7,700 employees.

"The stress of caring for an adult dependent or elderly parent takes a huge toll," says Deloitte's Langsett. "We've hired three Ph.D.s on staff that specialize in psychology to offer counseling and advice on the best course of action to address mental health needs."

Physical strain. Twenty-one percent of caregivers rate their own health as fair or poor, the AARP report found, and 23 percent say their health has worsened as a result of engaging in caregiving.

"These responsibilities can take a physical toll on caregivers, including exhaustion and caregiver injuries," Theisen says. Back strains, for example, are common among caregivers who help lift people between their bed and their wheelchair.

"Caregivers may also neglect their own mental and physical health, which can lead to depression, drug and alcohol misuse, and deferment of their own health care needs," she adds.

Financial strain. The cost of providing in-home care is high. "It's challenging for many people to afford that care, even while working full time," Irving says. "And for those who can afford it, they still may find it hard to arrange consistent care or manage care when someone calls out at the last minute.

"Traditional caregivers are workers in their 50s who may end up taking early retirement because they can't juggle it all. That can have an immediate financial impact or a longer-term impact on their retirement."

About 1 in 5 caregivers report feeling a high degree of financial strain as a result of providing care, the AARP report states. Nearly half have experienced a financial impact such as being unable to save, taking on more debt or spending down savings.

Flexible Schedules and Paid Time Off

The rise of flexible, remote work during the COVID-19 pandemic has helped many caregivers balance the needs of work and home in new ways. But the return to in-person work has caused consternation for these individuals. Allowing an employee to continue to work remotely, either at their own home or at their elderly parent's home, can make a huge difference.

"The thing we hear most from caregivers is they need flexible schedules," Irving says. "They need to take time off in the middle of the day and then work longer later in the day. Working remotely during the pandemic has allowed caregivers more flexibility, but working remotely isn't possible in every field. Some caregivers face a lot more stress when they have to go into the office."

At Deloitte, Langsett says, "we've been enhancing our approach to hybrid work to give our professionals maximum flexibility of where they do their work."

Sometimes, flexibility is not enough, and an employee will need to take an extended break from work to provide or arrange care. Paid time off can help relieve the employee's burden and may take the form of regular PTO, which employees can use for any reason, or specific caregiver leave.

Microsoft, for instance, offers four weeks of paid caregiver leave every year. "All you have to do is demonstrate you're caring for an immediate family member who has a serious health condition," explains Fred Thiele, vice president of global benefits and mobility for the company. "We got a great response and rolled it out in 110-plus countries. While employee benefits break down along country lines, caregiver leave was a benefit we could offer because it was additive, not statutory."

Company policies on paid leave for caregivers vary widely regarding the length of time off that's available and who qualifies as "family" when it comes to care; children, parents, spouses, grandparents and special-needs adults are among those who may be included.

Irving encourages employers to define "family" broadly. "In many cultures, people may be caring for grandparents, siblings, aunts and uncles who may not fall under some of the regulations as to who is defined as 'family,' " she says. "LGBTQ caregivers might be caring for a partner, close friend or nonrelative. Make inclusive definitions."

Services That Support

Caregiver support benefits typically fall into three categories: backup care assistance, online resources and expert consultations.

When the nurse who's scheduled to care for an employee's father doesn't show, the employee will call in sick to provide emergency care. Backup care assistance allows employees to call an agency and arrange for paid, substitute in-home or facility-based care. Fannie Mae provides backup care assistance for its employees' adult dependents. In the U.S., Microsoft offers 150 backup care hours through Bright Horizons, a child care and elder care provider.

"If you need elder care because you have a business engagement, you can avail of those hours," Thiele says. (The company increased the number of hours to 250 during the height of the pandemic before reducing it to 150 for 2022.)

Targeted materials are available online 24/7 and save employees time spent culling through hundreds of Internet search results looking for relevant resources. The benefit is especially helpful to employees caring for loved ones from a distance. In those situations, "it's incredibly difficult to find the needed local resources," says Homethrive's Jacobs. Online resources can include lists of local skilled nursing facilities, videos on how to change bedsheets without moving a patient and places to buy products, such as mechanized chairs, that support aging.

Consultations with experts by phone, via videoconference or in person can help address specific situations.

"We provide navigation, coaching and resources for employees who have aging loved ones at home," Jacobs says. "We help them understand what is to come, take care of themselves and support their parents to live at home for as long as they can."

Fannie Mae was an early adopter of caregiver benefits. In 1999, the organization partnered with Iona Senior Services to expand its offerings. "While we already had a referral service, we wanted to expand that to provide a dedicated, in-house elder care consultant who is a licensed clinical social worker and who provides comprehensive support for employees free of charge," Theisen explains.

Fannie Mae's elder care program includes confidential caregiver consultations, educational materials and crisis counseling. "Employees routinely provide positive feedback on the program," Theisen says. "The services have significantly reduced stress levels, saved caregiving time and effort, and helped achieve better quality of life for both employees and the older adults in their lives."

Microsoft offers two benefits to parents of children with special needs, Thiele says. The first is Rethink, a program that includes teleconsultations with people who hold doctoral or medical degrees to address specific educational, social or behavioral challenges. The other benefit is 672 hours of respite care in the home to give primary caregivers mental health breaks.                                                                              

Most organizations don't have the budgets that large companies such as Deloitte and Microsoft have to offer targeted support programs to employees with caregiving responsibilities. However, experts say smaller employers can still support employees who are experiencing challenges related to being caregivers. Examples include the following: Verbalize the value of caregiving. Sometimes, the most important thing an HR professional or manager can do is validate the employee's caregiving challenges and provide a listening ear. "Create a culture that is supportive and welcoming to caregivers," says Christina Irving, client services director at the Family Caregiver Alliance. "Talk about the value of caregiving. Even if caregiving benefits exist, many caregivers don't feel comfortable sharing that they're caregiving. They worry sharing will have a negative impact on their career or employment." Be flexible with work hours and locations. Flexibility is among the most important benefits to workers with caregiving responsibilities. If an employee can't work from home, consider part-time arrangements, job sharing or project-based work. Explore relevant employee assistance program (EAP) benefits. Employees may know that their company's EAP can provide resources in the event of a caregiving crisis, but they are often unaware of how the program might help with general caregiving needs. "An EAP might provide elder care resources which can be helpful, such as counseling help for caregivers coping with the emotional strain," Irving says. Discover what benefits are already available and market them in a way that highlights how they can be used to support employees with caregiving responsibilities. Research and share lists of free local and national community caregiving resources. Providing some "legwork" research about community resources for an employee who is experiencing a caregiving crisis can be a blessing. For instance, ComForCare.com offers monthly, 30-minute virtual workshops that are free to employees and that feature experts who share caregiving tips, such as how to reduce falls and fall-related injuries for people with neurological disorders. Initiate employee caregiver support groups. A support group for employees with caregiving responsibilities, especially if it offers the option to meet via videoconference as well as in person, provides a safe environment for employees to share their challenges of balancing work and caregiving—and it costs the employer little to nothing. For instance, Fannie Mae "facilitates forums for employees to connect with each other to discuss the rewards and challenges of caring for others via an online internal resource group and quarterly safe-space discussions," says Carrie Theisen, the company's vice president of total rewards. —K.T.

Messaging

The pandemic and Great Resignation have brought the topic of caregiving, along with its resulting challenges, to the forefront as companies focus on supporting—and retaining—workers.

"Elder care is a benefit we recently adopted," says Sirmara Campbell, CHRO at LaSalle Network, a staffing and recruiting firm with 260 employees headquartered in Chicago. "Without the proper help, it's inevitable employees will feel more stressed when all caregiving responsibilities fall on their shoulders, which leads them to being distracted and not as productive in their jobs. It's important employers figure out ways to support employees, not only to ensure they're productive but to retain them in today's extremely tight labor market."

For these benefits to be useful, companies need to advertise them to job candidates and current employees. "It's important to educate managers and leaders about these programs and who has access to them," Benz says.

"Leaders need to talk about the challenges to destigmatize caregiving," Jacobs advises. "Make employees aware of the benefits you offer. Target the employees who are more likely to need to opt in to things. Many employees aren't even aware of what is already available to them. That's a missed opportunity."

Theisen advises employers to survey employees to see what they need, enhance programs and policies where possible, and find creative ways to communicate what benefits are already in place. "And importantly," she adds, "lead from a place of empathy, understanding and flexibility as employees navigate life challenges."

Kathryn Tyler is a freelance writer and former HR generalist and trainer in Wixom, Mich.

Explore Further

SHRM provide information and resources to help business leaders support their organizations' employees who are caregivers.