Why Companies Should Care for Their Caregivers: A Call to Action

Why Companies Should Care for Their Caregivers: A Call to Action

By Lisa Rill, PhD

DECK: “Leadership isn’t about being in charge, it’s about taking care of those in your charge.”  – Simon Sinek 

The ability to successfully integrate work, family commitments, and personal life is important for the well-being of all employees. The Organization for Economic Cooperation and Development (OECD, n.d.) reports that, out of 41 countries listed in the work-life balance index, the United States is ranked number 29. A large part of this equation includes caregiving responsibilities. As a country, we have failed to take the rising burden of unpaid care seriously, and because of that countless employees are suffering. We can do better! 

The purpose of this article is to help you recognize the challenges many workers face with regards to caregiving, to learn the difference between the types of aging benefits employees need to be productive workers, and to understand why investing in workplace well-being is a critical pathway to cultivating a sustainable workforce for your company. 

A Bird’s Eye View of Our Aging Population and the Long-Term Care Labor Force

Sociologists have a term called structuration: the two-way process by which we shape our social world through our individual actions, and we are, in turn, reshaped by society. This section will help put some of our societal influences into perspective and reveal the big picture. Therefore, before you can understand the “why” part of this article, you first need to identify the “what,” which is “what is happening in the world around us?” In 2019, we witnessed an international demographic shift never seen before in human history: adults aged 65 and over outnumbered children for the first time (National Institute on Aging et al., 2007). This phenomenon is known as global aging. The United States will witness a similar fate in 2030.

The United States is currently going through two influential societal changes: The growth of the 65+ age group and a decline in the long-term care (LTC) labor force. Medical advances have helped to extend our lives longer than ever before (well past the standard retirement age). At the same time, the LTC workforce is declining. This has been going on long before COVID. Just to give you an idea, in pre-COVID times, for the LTC workforce to keep pace with the increase in the aging population, it needed to grow (at a minimum) 2% each year; however, it was only expected to increase by 0.3% (Rill, 2012). COVID only exacerbated that slow pace. A recent report from PHI (2021) estimates that LTC employers will need to fill 7.4 million job openings in direct care from 2019 to 2029.  

The growth of the aging population combined with a shortage of formal (paid) caregivers in the labor force means that working family members are having to step in and provide care for their aging loved ones. For some, these changes have created something called “the sandwich generation”: adults who are caring for an aging parent along with raising a young child (or supporting a grown child). But the shift is not only affecting working-age adults; it also impacts younger age groups and older workers who have delayed retirement. As a result, both employees and employers are suffering.

Why Should Employers Care?

While employers in various industries are expressing difficulty in finding experienced workers, many of the skilled and productive workers they do have are struggling every day to integrate work and caregiving responsibilities. Employers often do not recognize just how many of their employees are caregivers or how prevalent caregiving responsibilities are for them. This is because only around half of employers track data on their employees who are caregivers, even less (26%) gather information on their employees’ needs related to care responsibilities, and only 24% were aware that these responsibilities influenced employees’ performance (Fuller & Raman, 2019).  

The reality is the impact of caregiving goes beyond the individual and is prevalent in corporate America. No industry, profession, company, or level of seniority is exempt (Nobel et. al., 2017). In the current workforce, roughly 61% of employees are caring for an aging loved one outside of work (AARP & NAC, 2020). They work, on average, an additional 20+ hours/week on caregiving responsibilities (AARP & NAC, 2020; Cariloop, 2018). Four out of 10 are part of the sandwich generation (Fuller & Raman, 2019).  

These employees are increasingly challenged to balance providing informal (unpaid) caregiving for loved ones and continuing to work. This imbalance can take a toll on an employee’s job performance, which in turn affects business operations and the company’s bottom line. There are two types of hidden costs associated with caregiving (Fuller & Raman, 2019): 

Turnover:

• Frequency of turnover 
• Lost institutional knowledge when a senior level or highly-skilled employee leaves 
• Temporary hiring and overtime 

Productivity Loss:

• Absenteeism 
• Presenteeism 
• Unexpected events 
• Replacement 

U.S. businesses that fail to address these matters pay the price: They lose between $17.1 billion and $33.6 billion annually on lost productivity (not including turnover), depending on the level of caregiving involved (Cariloop, 2018). Specifically, 69% of employees reported that they had to rearrange their work schedule, decrease their hours, or take an unpaid leave to care for a loved one (AARP & NAC, 2020). Over half arrive to work late, leave early, or take time off due to their caregiving responsibilities (AARP & NAC, 2020; Cariloop, 2018). 

According to a study by AARP and NAC (2020), employees with caregiving responsibilities who recently left their position most commonly did so because of the following reasons:

• To have more time to care for their loved one.
• The inability to find trustworthy and qualified paid help (this connects back to the LTC labor force shortage).
• The inability to meet work responsibilities. 
• The job did not allow flexible work hours or paid time off. 
• The cost of paid help was unaffordable. 

In general, employees often make the decision to quit because they do not get the right kind of support they need from their employers (AARP, 2020). In fact, 75% of workers who retired early from work because of family caregiving reported that they would have stayed on the job if they had access to better support (AARP & The Economist Intelligence Unit, 2021).

How to Keep Productive and Reliable Employees?

The failure to understand the issues discussed in the previous section is a key factor in the misalignment between the care benefits companies currently provide and what employees need. A study by Fuller and Raman (2019) found that there is a misalignment between three things: 1) what employers think their employees want, 2) what the companies currently provide, and 3) what employees want/need.

For example, in their survey, they asked employees what caregiving benefits were the most valuable for staying on the job. Their top response was “referral services for caregivers”: 78% of employees said that benefit was “very important” to their decision to stay with their company. However, only 38% of employers considered caregiver referral services as an effective benefit for retaining employees. And only 29% of employers offered that benefit. 

When employers were asked what the most effective benefit was for retaining employees, they responded with “subsidies for eldercare services.” Around 70% of employers described the benefit as “very effective,” yet fewer than 10% of employers offered the benefit. 

Results from the survey also found, of employers who offered some type of caregiving resources, 71% of workers were unaware of the offerings, and only 34% had taken advantage of them. Why? Maybe they were not offering the right kind of benefits. 

The extent of these misalignments suggest that employers are inadequately informed about the needs and preferences of their workforce. By not offering benefits that employees want, companies are likely to lose their valuable assets.

As a business owner, you know there is a price of losing talented, trained employees. But how much is it costing your company? It is time for employers to calculate the cost of care for their company. Without accounting for costs like reduced productivity and increased turnover, employers cannot know the true return on investment (ROI) that can be generated from providing care benefits to their employees.

What Is the ROI for Providing Care Benefits?

Productive and reliable workers are invaluable assets to a company. Providing care benefits that retain and improve the productivity of current employees will help to maintain stability in operations and be beneficial to the company’s overall performance. Specifically, these efforts create a high ROI for the employer by decreasing the substantial costs incurred when replacing a worker due to turnover and lost productivity. How much ROI you ask? 

The company Wellthy provides personalized care support services for employees. They conducted an internal study with Stanford University PhD researchers to examine the value of investing in caregiving support solutions (Wellthy, 2023). The results showed that companies who offered Wellthy to their employees averaged a 366% ROI, directly attributed to increased retention rates and decreased absenteeism.

Ianacare, another care coordination platform, conducted a study documenting the outcomes of a pilot program to understand the effectiveness of their comprehensive caregiver support services (Holding Company, 2022). The results showed an 83% increase in productivity (defined as an increase of taking zero days off due to care) and a 30% decrease in feeling overwhelmed, stressed, and burdened. A full 96% of employees felt supported by their employer.

ReACT and AARP (2016) analyzed published evidence of ROI with a focus on flextime and telework. Here are a couple examples of their findings. 

• For every dollar invested in flextime, businesses could expect a return of between $1.70 (assuming average annual salary of $50,000) and $4.34 (assuming average annual salary of $100,000). Roughly half of the ROI is explained by lower absenteeism, 30% by increased retention, and 20% by better recruitment.
• For every dollar invested in telecommuting, businesses could expect a return of between $2.46 (assuming average annual salary of $50,000) and $4.45 (assuming average annual salary of $100,000).

As you can see, care benefits that support employees can help companies with their bottom line by enhancing productivity, along with enabling employees to keep up with their caregiving responsibilities and improve well-being.

Types of Care Benefits

There are many ways you can support your caregiver employees. The different types of care benefits can be classified into two categories: accommodative and appropriative benefits (Fuller & Raman, 2019). 

Accommodative benefits provide adjustable work environments and do not require additional expenditures for the employer. Examples include:

• Flexible work hours: Family leave & flex time off. This can be especially useful during stressful times of transition from hospital to rehab, or to another living situation.
• Working from home/agile working/telecommuting: For those employees who do not have to be onsite to do their work. 
• Voluntary reduced time or part-time work.
• Job sharing: Two part-time employees jointly do a full-time job.

While accommodative benefits are useful, they do not necessarily solve the caregiving challenges that employees face or guarantee that they will be able to “figure things out” on their own. That is where appropriative benefits come into play.

Appropriative benefits provide support and care services and can require a direct expenditure by the employer (but, not always. There are inexpensive and free resources out there, you just need to know where to look). Examples include:

• Counseling services.
• Caregiver provider referral services: Employee Assistance Programs provide navigation resources to help employees find in-home care, pay for care, determine which legal documents are needed, and more. 
• Seminars/classes/educational panels on aging topics with local experts to connect employees to resources. They tend to be inexpensive and provide bite-sized and digestible information on the topics that employees are interested in or need information on for a specific situation. 
• Caregiving support groups/networks. Some large companies offer an Employee Resource Group (or Affinity group) for employees caring for an older adult. Employees experiencing similar caregiving challenges may meet regularly to share resources and support. 
• Subsidy for care services/products. For example, match the cost of care (for a month, six months, or a year—not all caregiving responsibilities are forever) for things like transportation services, grocery delivery, home care (subsidized back-up), LTC insurance, respite services, or personal emergency response systems. 
• On-site or near-site care services: Adult day care.

Unfortunately, there is no one-size-fits-all solution. Businesses come in all sizes, with different levels of resources, and a diverse workforce. Therefore, the challenge is more than just providing any care benefits; they must be the right type of care benefits. Simply providing benefit programs selected from a list without the input from your employees will not be enough. By understanding the type of care benefits your employees want, you can make sensible investments to increase employee productivity and loyalty. Once you have made that decision, the next step is making sure your employees know what’s available to them.

Tips for Building a Company That Cares for its Caregivers

Caregivers make up the backbone of our economy, yet our workplaces are not built to support the care we need at each stage of life. I hope by now it is clear that for companies that offer care benefits, the advantage goes beyond improving employee engagement. Providing care benefits allows employees to do their best work, creates a high ROI for the employer, and has the potential to be an important source of competitive advantage for attracting talented workers.

Here are some tips (Fuller & Raman, 2019; Nobel et al., 2017).

• Create a culture of awareness. Provide education and training for all staff (especially managers) on the challenges caregivers face with regards to the impact on the job and in their personal life. This can help dispel incorrect assumptions and stereotypes about caregiving employees.
• Provide a safe space for an open dialogue where employees of all levels can share their caregiving experiences. Hearing other people’s stories can help decrease stigma and normalize these conversations. Why is it that most people in the workplace are comfortable saying they are leaving early to take their child to a dentist appointment, but less comfortable saying they are leaving early to take their mom to the doctor?
• Conduct a care census. Learn what percentage of your employees are caregivers and how many are part of the sandwich generation. Surveys can be anonymous.
• Conduct a benefits survey asking employees about their view of the current benefit offerings, and what additional benefits/resources would be most valuable to them to better manage their lives and become healthier and more productive workers.
• Review what you offer and compare current care benefits with the requests of your employees and what other companies are offering. Based on survey results and interviews with employees, you can evaluate and decide what programs to implement.
• Make sure all employees are aware of the benefits you offer. There is no advantage to either the company or the employees if the benefits are not utilized. Develop lunch-and-learn programs to educate employees about caregiving and what your company is doing to support them. 
• Provide hands-on assistance with the implementation of any new interactive resources or tools. Many companies simply offer a list of resources with links to their websites and consider that to be a sufficient care benefit. Example: Here is a list of all the caregiving service providers in the area. However, caregivers often operate under enormous stress and time constraints. The seemingly simple act of searching for services from your resource list (or learning to use a new tool, such as wearable tech) may prove to be an overwhelming barrier for a caregiver who is working full-time and providing an additional 20+ hours a week in caregiving responsibilities (Northeast Business Group on Health, 2018). To help, set aside time at staff meetings or provide tutorials to introduce employees to new benefits.
• Monitor the utilization rates of each benefit.
• Assess the impact of the benefits from the perspective of the employee and on the finances associated with reduced turnover and improved productivity.

Offering a variety of care benefits sends a message to employees that the employer is invested in them and in their well-being.

Leading in a Time of Change

Committing to a strategy that provides the right kind of care benefits and designing the policies required to execute it might take some extra time and resources up front. But overall, it should not be too costly. The goal is not to simply spend extra money and offer more benefits, but to customize the benefits that will support your employees. By incorporating community resources and taking advantage of favorable programs, leaders can create a cultural shift that celebrates and supports the lives of its employees more effectively. These efforts, in turn, help create a productive and sustainable workforce for their company.

I want to end by saying, we must shift our mindset that caregiving is solely an individual, or family matter, and that any caregiving challenges that occur are due to the family’s failure to prepare for the situation. Rather, there are societal influences at hand that are affecting us as a country, and we can no longer ignore them. My call to action to you is to be proactive in terms of how you envision the future of your workplace to be. Be mindful of how you lead. Create bespoke solutions. Share your best practices. Encourage other companies to create their own caring path. Most importantly, take the time to listen to your employees’ needs and normalize the discussion around aging. 

 

**Side bar notes:

The sandwich generation includes adults who are caring for an aging parent while also raising a young child or supporting a grown child.

 

Working family caregivers are defined as anyone who is employed (either full-time or part-time) while also providing care for an older relative or friend (AARP and The Economist Intelligence Unit, 2021). Working family caregivers may be part of the sandwich generation.

 

Caregiving includes a broad range of duties, such as household, social/communication, health, personal care, medical-related, and paying bills/managing finances (Transamerica Institute, 2017). 

 

Lisa Rill received her PhD in Sociology, specializing in Aging/Health. She has served as a geriatric social worker and as Research Faculty for the Claude Pepper Center on Aging at Florida State University, addressing quality of life in long-term care. Dr. Rill is an editorial board member for CSA Journal and a Certified Eden at Home Associate/Mentor. She is currently Executive Director at Senior Life Source, a nonprofit organization that provides education on aging for all ages. 

 

References

AARP & National Alliance for Caregiving. (2020). Caregiving in the U.S. https://www.aarp.org/content/dam/aarp/ppi/2020/05/full-report-caregiving-in-the-united-states.doi.10.26419-2Fppi.00103.001.pdf

AARP & The Economist Intelligence Unit. (2021). The economic impact of supporting working family caregivers. https://www.aarp.org/content/dam/aarp/research/surveys_statistics/econ/2021/longevity-economy-working-caregivers.doi.10.26419-2Fint.00042.006.pdf

Cariloop, Facebook, & Chicken Soup for the Soul. (2018). Taking care of caregivers: Why corporate America should support employees who give their hearts and souls to those in need [White paper]. https://drive.google.com/file/d/1dJovq5iQfc-p0fwIunowuyqoA6z-BVqu/view 

Fuller, J., & Raman, M. (2019). The caring company: How employers can help employees manage their caregiving responsibilities while reducing costs and increasing productivity. Harvard Business School. https://www.hbs.edu/managing-the-future-of-work/Documents/The_Caring_Company.pdf

National Institute on Aging, National Institutes of Health, & U.S. Department of Health and Human Services. (2007). Why population aging matters: A global perspective. https://www.nia.nih.gov/sites/default/files/2017-06/WPAM.pdf

Nobel, J., Weiss, J., Sherman, C., Wilson-Myers, C., & Pickering, L. (2017). Supporting caregivers in the workplace: A practical guide for employers. Northeast Business Group on Health. https://nebgh.org/wp-content/uploads/2017/11/NEBGH-Caregiving_Practical-Guide-FINAL.pdf

Northeast Business Group on Health. (2018, December). Digital tools and solutions for caregivers: An employer’s guide. https://nebgh.org/wp-content/uploads/2018/12/Digital-CG_121218.pdf

Organization for Economic Cooperation and Development. (n.d.). Work-life balance. Retrieved April 2023, from http://www.oecdbetterlifeindex.org/topics/work-life-balance/ 

PHI. (2021, September 7). Direct care workers in the United States: Key facts. https://www.phinational.org/resource/direct-care-workers-in-the-united-states-key-facts-2/ 

ReACT & AARP. (2016). Determining the return on investment: Supportive policies for employee caregivers. https://respectcaregivers.org/wp-content/uploads/2016/04/AARP-ROI-Report-FINAL-4.1.16.pdf

Rill, L. (2012). Who’s going to take care of me? Our impending LTC labor crisis. A special report for the CSA Journal. CSA Journal, 52. 

The Holding Company. (2022). Employers as payors: A 101 guide to selling care benefits. https://www.investin.care/entrepreneurs-guide-to-the-care-economy/employers-as-payors 

Transamerica Institute. (2017). The many faces of caregivers: A close-up look at caregiving and its impacts. https://www.transamericainstitute.org/docs/default-source/caregivers-research/the-many-faces-of-caregivers-research-report-2017.pdf

Wellthy. (2023). Caregiving benefits: A measurable ROI in an uncertain economy. https://blog.wellthy.com/caregiving-benefits-a-measurable-roi-in-an-uncertain-economy