A closer look at caregiving

(Article originally published by WFC Resources, September 2006, as an UpDate Column)

This summer, the combined effort of MetLife and the National Alliance for Caregiving produced an outstanding report on the subject of caregiving. It answers questions about how many workers are now responsible for at least some of the care of dependent adults, what the cost is to employers and what they might do about it.

The last study on the subject was done in 1997. It put the average cost per employee who is also a full-time caregiver at $1,143.50 a year. That was then. New research has helped these experts better understand both the issues facing employed caregivers and those facing their employers. The cost estimate, they say, is now $2,220 for each full-time employed caregiver, and that's just the average.

The average age for family caregivers is 47. Most who care for someone over 50 (the majority) are still women, but nearly 40% of caregivers are now men. Nearly 60% of those who care for an older person are working; most work full-time. And about 15% are providing care for someone who lives more than an hour away.

This new study differentiates between caregivers who work at it fewer than ten hours a week, doing things like taking someone to a doctor's appointment or doing housework for them, and those who do it all, bathing, dressing, feeding, toileting, transferring from chair or bed, etc. They introduce a scale from 1-5, with 1 being the lowest caregiving intensity and 5 the highest, responsible for an average of 12 to 87 hours per week.

Their estimate: nearly 3 million men and more than 4 million women are providing intense care while working full-time.

The cost for those with "intense" caregiving responsibilities is about $300 more per person per year and includes the costs associated with absences, turnover and replacement, crises in care, workday interruptions, supervisory time, unpaid leave and reducing hours from full-time to part-time.

Calculating costs
They offer an opportunity to figure out what these caregivers are costing you at www.eldercarecalculator.org - We tried it out, figuring the costs for a fictitious organization. We gave our organization 5,000 employees with an average salary (including benefits) of $40 per hour. We took their suggestion and multiplied our total employees by a very conservative 2% to figure out how many caregivers our company had and got 100 out of the 5,000.

Our yearly cost: $429,700.00. Here's how they figure it.

Employees who quit as a result of caregiving: $96,000.00
Absenteeism Cost: $66,560.00
Partial Absenteeism Cost: $25,520.00
Costs Due to Workday Interruptions: $86,000.00
Costs Due to Crisis in Care: $57,600.00
Costs Due to Supervision: $23,760.00
Costs Due to Unpaid Leave: $51,200.00
Costs Due to Reduction of Hours: $23,060.00

The calculator is quick, but it's definitely based on averages and it's definitely conservative. They use 50% of median salary to figure replacement costs; the accepted figure now is 150% to 200% of salary for exempt and 75% for non-exempt. And if more of your caregivers are women, your costs will go up. Ten percent of male caregivers reported missing an average 12 work days a year but 18% of the women say they missed an average 33 days a year.

What can employers do?
While the figures and the costs are important, what's most important, we believe, is what an employer can do about it. This report suggests the usual – flextime, telecommuting and job sharing, programs to provide respite care, adult day services and caregiver support groups. And every employer can offer links to information and referral services, even if they can't afford to provide that service themselves. A discounted rate on long-term care insurance can also be helpful as more of our employees move closer to 60, and the younger you are when you buy it the cheaper it is.

The report also says managers who are sensitive to family caregivers can make a world of difference, which may mean some training, and a clear message from the top that being sensitive to employees' personal responsibilities is extremely important and pays off in increased engagement, commitment, satisfaction, productivity and reduced turnover.

An Associated Press article a few weeks ago offered some additional information on the subject. About a fourth of all companies provide some basic eldercare benefits, most offering resource and referral. But this reporter has done some homework and found some who go a few steps beyond the basics.

McGraw-Hill lets employees enroll one other adult family member, which can be an elderly relative, on their health-insurance plan at regular family rates.

The Verizon Wireless division allows some employees to take advantage of their emergency in-home care for older adults.

Mellon Financial Corp. offers a free emergency eldercare service. (Says one employee, "I was able to come to work and concentrate on my job and not have the stress of worrying about what was going on with my father.")

By 2020, one in three U.S. households is expected to be involved in caring for elderly or disabled relatives, up from one in four today, the survey said.

Unilever offers its salaried U.S. employees emergency-care services, flexible working arrangements and other benefits to help care for elderly relatives. One employee used the company's free concierge service to arrange repair of an elderly parent's storm-damaged house in another state, a Unilever spokeswoman says.

Alston & Bird LLP, a law firm based in Atlanta, has added a catastrophic leave-sharing program that allows employees to donate vacation time to other employees who may have family members who are sick but have exhausted their own leave. "We recently had an employee whose husband had a stem-cell transplant and employees donated four months of time to her so she could stay home and take care of him when he came home from the hospital," says a spokeswoman.

Tim Gavin of Minneapolis says the emergency eldercare service offered by his employer, KPMG, helped him provide care for his parents in Elkhorn, Wisc., more than five hours away, after his 85-year-old mother underwent triple-bypass heart surgery last year. An aide came to the house to make meals and do housecleaning for his mother and 88-year-old father and provide transportation to medical appointments. After he used up his allotment of 15 employer-provided days, Mr. Gavin says he contracted directly with the provider for continuing care.

The article says companies that contract with these providers for emergency elder care pay an annual fee based on employee utilization. Companies might offer the service to employees for free, or charge a co-payment, typically about $4 an hour. By comparison, private agencies that provide such backup care might charge about $14 an hour in some parts of the country.

Backup adult-care benefits are offered mainly by large companies with more than 500 employees. Some 9% of such companies offer the service, according to a survey by the Society for Human Resource Management released last month. At Children's Hospital and Health System Inc. of Wisconsin, the cost of providing backup services for elder and child care runs about $50,000 a year for the institution's 4,200 employees across 80 work sites.

If you're new to the eldercare issue, a good first step may be to find out how many of your workforce are affected. We know that people aren't as apt to talk about elder issues, not as comfortable as they are with childcare problems. Including a question or two about eldercare ("Are you now responsible, either fully or partially, for the care of a dependent adult? Do you anticipate having that responsibility within the next two years?") will give you a sense of the numbers. Then train managers and supervisors to ask that one-size-fits-all question, "What can we do to make your lives more livable and still get the job done?" and do it.