2012 “Aging in America” Conference

by Kevin K. Johnson, CSA

I’m just back from having attended my third ”Aging in America” conference. This is an annual conference of thought leaders in the areas of aging, caregiving, and innovative practices and solutions. This year’s conference was held in Washington, D.C. and attended by approximately 3000 professionals and thought leaders in the field of aging.

U.S. Congress

When in Washington, I always try to schedule meetings in advance with the Ohio (my home state) congressional representatives. This trip, the congressional representatives were in meetings on the hill so I met with their senior aides or fellows. Included was Senator Sherrod Brown’s Legislative Fellow, Karon Phillips, Ph.D. (master’s degree in Public Health). I also spoke with an aide to Congresswoman Marsha Fudge. Neither Senator Portman or his aides were available to speak with any of the conference participates from Ohio during the time we had available. Two senior care and senior services discussion topics were:

• The Older Americans Act (OAA) Reauthorization, and
• The Community Living Assistance Supports and Services (CLASS) Act

From Wikipedia, The stated purpose of the OAA is to ensure equal opportunity to the fair and free enjoyment of: adequate income in retirement; the best possible physical and mental health services without regard to economic status; suitable housing; restorative and long-term care; opportunity for employment; retirement in health, honor, and dignity; civic, cultural, educational and recreational participation and contribution; efficient community services; immediate benefit from proven research knowledge; freedom, independence, and the exercise of self-determination; and protection against abuse neglect and exploitation.

The CLASS Act would have created a voluntary and public long-term insurance option for employees. In my work, I see this as a major problem that every employee is learning about as they access the care options of their elder loved ones. They then begin to understand that they to, need some sort of long-term insurance coverage for their well-being in their later years. Long-term care insurance is more often that not, left out of discussions with Certified Financial Planners, or tremendously undervalued by employees. However, this lack of planning is extremely back-end loaded for our economy. The costs to all taxpayers due to public services having to provide far costlier non-medical care for retirees is quite a burden that every tax payer shares.

A great many seniors in our country will be severely impacted if OAA is cut much further, or worse yet, totally eliminated. Often referred to as our ”Greatest Generation” of Americans, this cohort deserves better as they progress through their later years. Additionally, costs will actually increase if some of these services are stopped. The health of seniors will result in a significant increase in hospital visits and nursing home stays. For example OAA includes nutrition programs including congregate and home delivered “Meals on Wheels”; a stable for many of our seniors.

I was fortunate enough to participate in a policy session and listen to comments on these issues from Senator Sanders (VT), Senator Whitehouse (RI), Senator Kohl (WI), and Senator Blumenthal (CT).

The conference content is always rich. This year included an entire track on my central area of focus; the significant lost revenue that businesses experience resulting from lost productivity due to their employers needing to tend to parental caregiving. (Reference my prior blog postings for quantification).

Education and networking with renown professionals in the field of aging, and the opportunity to speak with and hear from our Congressional representatives once again proved to be an extremely valuable use of my time. I’ll be including some of the content in future posts and giving the companies I work with more information on how valuable and profitable it is for them to support their employees that are caregivers.

Aging Parents’ Care — Remote Patient Monitoring

by Kevin K. Johnson, CSA

The National Institute on Aging estimates around 7 million Americans are long-distance caregivers. Aside from economic factors that often drive people far from their hometowns, shifting demographics in the country could exacerbate the issue: Over the next four decades, the share of people 65 and older is expected to rapidly expand while the number of people under 20 will roughly hold steady. That means there will be a far smaller share of people between 20 and 64, the age group that most often is faced with caregiving. That means an increasing burden on the employee that is tasked with the care of an elderly loved one. Long-distance caregiving also has a regional or even cross-town implication in which case, the 7 million figure explodes. We want to know that our loved ones are managing without having to make a personal visit or trust a voice over the phone.

Remote Patient Monitoring (RPM) refers to a wide variety of technologies designed to manage and monitor a range of health conditions. Point-of-care (e.g., home) monitoring devices, such as weight scales, glucometers, and blood pressure monitors, may standalone to collect and report health data, or they may become part of a fully integrated health data collection, analysis, and reporting system that communicates to multiple nodes of the health system, and provides alerts when health conditions decline.

Think of RPM as a 5-step process:      Collect → Transmit → Evaluate → Notify → Intervene

Technologies that support RPM are particularly useful for the elderly, chronically ill, and people who have trouble accessing traditional sites of care and for caregivers to be assured that their loved ones are well. RPM technologies provide essential support for the coordination of care, behavior change (of providers as well as patients), and evidence-based decision support for patients. There are features of remote patient monitoring that can be used by patients, providers, and caregivers. An ideal remote patient monitoring solution takes into account the needs of all three.

As the workforce is increasingly impacted by eldercare issues , without being intrusive, I believe that RPM technologies will begin to play a greater role in helping us to provide the oversight we need that assure our loved ones are fine. I’ll be providing detailed information on specific RPM solutions in future blog postings. I’ll be illuminating practical solutions that can be leveraged in each of the 5 specific process areas that comprise Remote Patient Monitoring.

Reasons We Work with Employers!

by Kevin K. Johnson, CSA

Reasons we work with employers!

As I’ve noted in prior postings, lost employee productivity is very expensive for employers; over $30 billion per year and growing!

Did you know that more than one in six American workers act as caregivers, according to the Gallup-Healthways Well-Being Index released in July 2011, and 24% of those caregivers say that providing care to an aging family member or relative keeps them from being able to work more. As the sandwich generation (those employees who care for young children as well as their aging parents) grows, employers might want to consider offering special-needs seminars as a benefit. Otherwise, they might be at risk of losing talented employees who simply can no longer manage the dual responsibilities of a full-time job and caregiving.

Anywhere from 18% to 23% of caregivers cut back their hours or leave the workforce to provide care in a given year.

Additionally, 22% of caregivers report being exhausted when they go to bed at night, according to the Center on Aging Society. Caregivers also are less healthy than non-caregivers (see our May 19, 2011 blog post): They are 49% more likely to have been diagnosed with depression, while adult caregivers younger than 30 are 63% more likely to have high blood pressure and 61% are more likely to have recurring neck or back pain.

We enjoy working with employers to provide education that addresses these issues. We greatly appreciate working with our partner company’s to assist them in managing this growing issue.

Annual Care Costs in 2011

written by Kevin K. Johnson, CSA

Recently I hosted discussion sessions with employees at client companies. Two topics have been of particular interest with employees. One topic is ”the cost of caregiving services” for both an elder loved-one.  A second topic has been ”how to plan for the required care” for an elder loved-one and for themselves when necessary. 

I thought I would detail some of the costs that employees are concerned about in this blog posting. The issue of “how to plan for the required care” is a larger issue. I’ll discuss that one in our monthly newsletter.

Some of the employees I spoke with had reached the point where they wanted to compare the costs of various alternatives of care. For example, “can my mother stay in her home” and “how much does that cost?” “If she can’t stay in her home, what are the options and how much do they cost?”

ANNUAL CARE COSTS

Genworth recently published information on median costs for several categories of eldercare services. For reference, I’ve included costs for three states.

	Ohio	California	Florida
Home Health Aide	$41,367	$48,048	$41,184
Adult Day Health Care	$12,969	$20,020	$15,600
Assisted Living Facility*	$39,900	$42,000	$31,950
Nursing Home Care**	$69,350	$77,745	$76,777

* Private, one bedroom               ** Semi-private room 

This information provides a frame of reference for alternative comparison on price only. Determining which alternative is best for a specific situation is a more complex issue that we help employees work through.

Home for the Holiday’s … Gather Critical Information on Your Aging Parents

Written by Kevin K. Johnson, CSA

Many years ago I was recruited out of my home town of Cleveland, Ohio and for the next 18 years I only saw my parents periodically; holidays, mother’s day, father’s day, etc…  When I called my parents from out-of-town, they always said they were “fine”, “wonderful”, “doing well”. After a few years, when I visited them for Thanksgiving and/or Christmas, it became clear to me that they were NOT “fine”, “wonderful”, and “doing well”! I eventually moved back to Cleveland in large part to be available to assist with caregiving requirements for my parents.

At the end of the year I particularly encourage people to take time to gather critical information regarding their aging parents and have it just in case you need it. This information may not be easy to attain. Parents can be very private so you will have to assist them in understanding that all they have to do is gather the relevent information, then keep it in a safe, secure location that either they or you can access in an emergency.

Also, take time to do this for yourself and your family when you get home.

Remember, life happens fast and in unexpected ways!

Here’s a list of some of the typical information your parents will need to have available. This is also good information for you and your immediate family to keep in a safe secure location!

Bank Accounts and Numbers – You may also want to note where hard copy checks are being stored, if applicable.

Birth Certificate – If you can’t find yours, you can order an official copy.

Brokerage Account Numbers, Account Web Sites and Passwords, Broker Contact Info – Most brokerage accounts have online account information that can be easily accessed.

Computer/Web Site Passwords – These are important for your executor to have in order to close down any open online email services, subscriptions, PayPal accounts, online bank accounts and the like.

Family Contacts – Provide the contact information of professionals who have assisted the family and who the executor will likely need to contact.

Health Records – Provide your executor with all personal health records: this information will be important to the future generations of your family. If you have children who are minors, take the responsibility now to organize their personal health records.

Home Alarm Code and Location of Instructions – It could be pretty embarrassing for your executor to trip off your alarm or not know how it works should you not be around.

Insurance Policies – Make sure life and health insurance policies can be located along with any agent or company information.

Military Discharge Papers – These will come into play if military benefits are due to your beneficiaries.

Organ Donor – If you are a donor, without proper documentation, your wishes will not be observed.

Safe Deposit Box Number and Key – Some have one safe deposit box, others have many. Regardless of your situation, make sure you leave clear instructions as to where yours is and how the executor can access it.

Social Security Number and Card – This is important for identification and benefit claims – not just your Social Security number, but those of your beneficiaries, including minor children.

Trust Documents – If you have created a trust, regardless of type, your executor will need to be able to locate and access the governing documents.

There are a number of other actions that I recommend when I speak to groups and families. The information listed above is a very good starting place. Remember, with issues such as these, pre-emptive action will be extremely valuable for you and your loved ones in the future.

Holiday’s usually include great time visiting with family. Gather this information and make your holiday visit as productive as possible.

New Study Encourages Employers to Prepare for Working Caregivers

written by Kevin K. Johnson, CSA

A recent study just published in June titled “The MetLife Study of Caregiving Costs to Working Caregivers”, points out the need for employers to provide workplace accommodations such as flex-time or family medical leave (FMLA) so that caregiving employees can continue to stay in the workforce while caring for elderly parents.

Employers also need to consider the health implications for their caregiving workers. Studies have shown that caregiving has a negative impact on workplace productivity and results in as much as an additional 8% in healthcare costs for employers. (MetLife Mature Market Institute, Feb 2010). Stress is a big factor in working caregivers’ health. Employers can ensure that all workers have the opportunity to know about and access stress management programs to assist them with issues of caregiving for elder loved ones.

One of our January 2011 blogs titled, “Workplace Impact of Caregiving Employees“ outlined employer lost productivity cost due to employee caregiving. This June study by MetLife details a bit of the employee’s financial loss. The fact that without assistance, employees are experiencing significant lost wages and lost social security. In an earlier study using personal files and records for a sample of caregivers, it was estimated that private pension loss might add an additional $50,000 burden for caregivers over ”a career of caregiving”.  ”Total wage, Social Security, and private pension losses due to caregiving could range from $283,716 for men to $324,044 for women, or $303,880 on average for the typical caregiver. When this is multiplied be the 9.7 million people age 50+ caring for their parents, the amount lost is nearly $3 trillion.”

The implications for caregiving employees and their employers are clear. Employee lost income coupled with employer lost productivity adds up to a serious workplace problem. As employers awareness increases regarding the financial impact of lost productivity to their workplace, they are introducing solutions to address this issue. In so doing, employers are showing their employees that they care about issues that impact their lives. These employers actions help to maintain the employ of their critical workers; a win-win outcome.

The most progressive employers are indeed “learning” and leading” the way to a more productive workplace.

Employee Experiencing Caregiving Issues—What are the Signs?

Written by Kevin K. Johnson, CSA

In previous posts, I’ve discussed the fact that employers are most often unaware that their employees are experiencing significant job productivity related issues associated with the care of their senior loved ones. Also, the fact that employer awareness often will not occur until projects are behind schedule, mistakes are being made, or employees are directly inquiring to change their work arrangements to part-time, or work-at-home, or requesting a leave-of-absence.

Employees (people in general) tend to be very private about these issues and try to address the crisis themselves. Unfortunately, this is what causes the significant disruption on the job.

When talking to employers one question that often comes up is, how can we better determine if an employee is experiencing signficant eldercare issues? Here are just a few of the signs your managers might watch for.

On a continual basis normally reliable employees:

1. Begin arriving to work late and/or leaving early on a recurring basis
2. Begin using their allotment of vacation time without prior notification
3. Begin using their sick time and other paid time off (PTO) indiscriminately
4. Begin to show signs of  depression or fatigue
5. Begin to have problems working with teams

Be on the alert and head off this issue. Strongly consider putting in place solutions that enable your employees to act quickly and decisively should the need for senior caregiving suddenly appear. That’s the best approach to limiting lost productivity resulting from this growing workplace  issue.

Career and Workplace Pressures

Written by Kevin K. Johnson, CSA

I recently came across an interesting set of data and was reminded that we care for seniors that are not only immediate family, but also in-laws, step-parents, and even extended family members. According to Genworth Financial, among those family members reporting adverse affects of the long-term care event on their careers, data show that:

						Immediate Family	Step/ In-Law	Extended Family
Had to work fewer hours						44%	39%	32%
Lost a job, changed shifts/missed career opportunities						49%	36%	48%
Had repeated absences from work						40%	32%	32%
Were repeatedly late for work						19%	7%	8%

Regardless of the relationship of the senior to the employee, the impact on the employee’s career is significant. Employers have to be progressive to have solutions in place that assist their employees and minimize this trend and the inevitable negative effect on work productivity.

Workplace Impact of Caregiving Employees

Written by Kevin K. Johnson

No matter how focused or dedicated to their job an employee may be, the need to provide caregiving services for an elderly loved one be it mother, father, grandparent, etc…, will almost always take precedent over all else; over critical projects at work, over business deadlines, over professional advancement, well,…you get the picture! For most people the need to provide eldercare for their parent will circumvent most other high priority issues even their critical job. To quantify this point, MetLife reports that in 2006 alone, employers lost approximately $3,430,263,991 due to employees tending to caregiving issues.

EMPLOYEES AS CAREGIVERS

With the ‘graying of America’ upon us, no company can avoid productivity issues associated with employees who have to provide caregiving for elder loved ones. In fact, because employees are directly affected, businesses are now directly subjected to the ‘sandwich generation’ issues of their employees. Not only are their employees having children (as has always been the case), more and more employees are also responsible for providing some degree of Activities of Daily Living (ADL’s) for their elder parents. This can cause employees to experience incredible stress. It also means that employers, who have ‘right-sized’ as much as possible, are significantly impacted if even one of their employees is not able to give 100% to their work due to distractions or tardiness or absence brought about by any reason including senior caregiving.

Just as employers found it beneficial to develop and implement solutions for employees having children, today’s reality is that employers will have to develop and implement solutions for employees who have to provide eldercare for their senior loved ones.

EMPLOYEE/EMPLOYER CAREGIVING ISSUES — Activities of Daily Living (ADL’s)
For employers that may not know, let’s fill in the blanks regarding the issues involved with providing eldercare. Activities of Daily Living (ADL’s) is a term given to a broad range of capabilities that define the level of independence or conversely the amount of care required by a senior. ADL’s define the relative independence of seniors. ADL’s include bathing, dressing, toileting, transferring, continence, and feeding. In short, can the senior do these things for themselves. There is an analytical approach used to determine and score ADL’s along with a quantifiable sub-categorization of associated tasks required for independence.

As the name implies, ADL’s are daily and ongoing requirements as opposed to occasional tasks. Therefore, employees that have to assist with a parent’s ADL’s are burdened on a regular basis. This is what leads to the loss in productivity that the employee experiences and the organizational efficiency loss that the employer unfortunately absorbs, oftentimes unknowingly. Whether an employee arrives at work late, leaves work early, experiences additional fatigue while on the job, requests flex time, or applies for a leave of absence, the employer is significantly impacted. Often, the work productivity loss has become quite severe by the time the employer becomes aware of the issue. Think of the financial impact that has already taken place.

QUANTIFYING EMPLOYER LOST PRODUCTIVITY
In an earlier posting I provided a few telling statistics. Here’s a few more statistics provided from The MetLife study “Productivity Losses to U.S. Business”, that define the extent of the issue from the employers’ perspective.

Employee Involvement
Consider these workplace factoids.

• The average age of the caregiver for a person over the age of 50 is only 47 years old.
• Nearly 40% of caregivers are men.
• Nearly 60% of those caring for an adult over the age of 50 are working; the majority of those work full-time.
• The estimate is that over 7 million employed caregivers are working full-time providing more intense care for someone over the age of 18.
• In 2006, 10% or 280,421 men missed on average 12 work days per year, while
• 18% of women or 757,136 missed on average 33 days a year.

Economic Impact on Businesses — Absenteeism

• The estimated 280,421 men who missed work to attend to caregiving issues cost employers approximately $491,921,602,
• The estimated 757,136 women who missed work to attend to caregiving issue cost employers approximately $2,938,293,389.
• In total employers lost approximately $3,430,263,991 due to employees tending to caregiving issues.
• Employers lost another $824,512,465 due to partial absenteeism associated with caregiving. This includes coming in late to work and leaving early and being unable to make up the time.
• Finally of these overview numbers, employers lost an estimated $2,832,971,162 but to presenteeism; costs due to workday interruptions.

EMPLOYER ACTION
A number of proactive companies, some of which were leveraged for the data stated in this posting, have begun to provide solutions that their employees can access when senior caregiving issues arise. More progressive companies have gone further. They have also incorporated solution sets to help their employees plan for their own care needs when they become seniors. Ironically, in the process of attending to the immediate and urgent eldercare needs of their loved ones, many employees discovered that they were totally unaware of eldercare needs; that they had been making no plans to proactively address their own eventual senior care. Solutions are best when provided by subject matter experts in the area of eldercare and not generalists. Employers generally implement bundled solutions and not one-off solutions. However, few bundled solutions exist when it comes to the broad and complex area of eldercare services.

Future posts will address employee eldercare needs and help employers consider how to approach this issue.

Women Struggle More with Work/Life Issues

Written by Kevin K. Johnson

Statistics quantifying the depth of the problem employees face in providing caregiving needs are finally becoming more prevalent. The following information was recently posted on plansponsor.com.

A North Carolina-based work-life benefit provider has found that women are three times more likely than men to spend at least 25% of their time at work on caregiving responsibilities.

The Workplace Options’ poll of 998 workers indicates women are more likely to see a negative impact in their work due to caregiving responsibilities (25%) in comparison to men (17%). In addition, women are also more likely to suffer from stress (39%) than their male counterparts (27%).

According to a press release, nearly half (48%) of adult caregivers are employed full-time. While 63% of workers considered benefits such as flex time, telecommuting, and counseling to be important in balancing work and personal responsibilities, more than half (53%) are employed at companies that do not offer such benefits, and another one in five workers are not even aware if such benefits exist at their workplaces.?

The survey found 78% of workers say family is their top priority. Only 12% claim themselves as the top priority, and 10% indicate work is their top priority.