Eldercare & The Workplace: A Professional and Personal Conversation!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

On Thursday, September 18th, Visiting Angels of Cleveland, Ohio will co-sponsor the Health Care Forum sponsored by Crain’s Cleveland Business. I mention this because I am privileged to be a panelist during one of the breakout sessions at the health care forum. The forum will take place in downtown Cleveland at the new Cleveland Convention Center from 7:00AM to 1:00PM. Preceded by networking and breakfast, the morning will begin at 7:30AM with a keynote address.


• J.B. Silvers, Ph.D. John R. Mannix Medical Mutual of Ohio Professor of Health Care Finance, Professor of Epidemiology & Biostatistics – School of Medicine CWRU, Weatherhead School of Management

Visiting Angels’ Cleveland, Ohio office is also participating in a breakout panel titled Your employees, their eldercare concerns, your bottom line: What’s it Crains Health Care Forumcosting you?” This panel will be moderated by Crain’s Cleveland Business Publisher John Campanelli. I encourage you to attend and participate in this 90-minute panel that begins at 8:45AM. Below is an overview of the content that will be discussed along with the panel participants.

PANEL #1 – “Your employees, their eldercare concerns, your bottom line: What’s it costing you?”
• Eldercare costs U.S. Businesses more than $33 Billion each year in lost productivity
• How can you calculate your company’s risk?
• What resources are available to help your employees handle their caregiving duties?
• How can businesses build support systems for employees who have significant caregiving duties?

• Richard Browdie, president & CEO, Benjamin Rose Institute on Aging
• Eiran Z. Gorodeski, director, Cleveland Clinic Center for Connected Care
• Kevin Johnson, managing director, Visiting Angels
• Claire Zangerle, president and CEO, Visiting Nurse Association of Ohio

As readers and subscribers of this blog know, Eldercare and the Workplace is an important topic. So much so, that Visiting Angels of  Cleveland, an independent company that specializes in providing home care for seniors, works with Caring Concierge to extend the assistance available for their clients who are caring for seniors. As a Certified Senior Advisor, and as co-owner of Visiting Angels’ Cleveland, Ohio office, I provide content and subject matter awareness to both company’s.

The health care forum will conclude with a keynote presentation featuring some of northeast Ohio’s national leaders in health care. An overview of the closing keynote presentation and the panel participants are below:

FORUM KEYNOTE PRESENTATION: “Checking the pulse: A conversation with Northeast Ohio’s health care leaders”

• Akram Boutros, MD, President & CEO, The MetroHealth System
• Delos M. “Toby” Cosgrove, MD, President & CEO, Cleveland Clinic
• Terrence P. Kessler, President & CEO, The Sisters of Charity Health System
• Thomas “Tim” Stover, MD, President & CEO, Akron General Health System
• Thomas F. Zenty III, CEO, University Hospitals

I hope you will be able to attend this informative event. We look forward to speaking with you. For all of the information regarding the Forum, please access the following hypertext link, Crain’s Health Care Forum.


Note: Visiting Angels (at Fairhill Partners) is an award wining, full-service senior home care agency providing a comprehensive range of non-medical services. Our experienced caregivers are bonded and insured. We are in our 12th year of operation  and are honored to have served hundreds of seniors in the Greater Cleveland area and surrounding suburban communities.

What Can Management Do…Consider Revisiting MBWA!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

From time-to-time, I’m asked to facilitate “lunch and learn” sessions at companies that list us (Caring Concierge) as a benefit resource to their employees. These are excellent sessions for employees to learn how to get prepared for ‘what’s coming’ with respect to adult caregiving or to ask questions about what they are currently trying to manage with regard to eldercare for an aging loved one.

Recently during one of these sessions, I had a senior manager ask me a great question. To paraphrase, he said, “in light of the reluctance of many employees to reveal that they are having adult caregiving issues that are distracting them from their work, how can management help their employees with eldercare issues”. He specifically referenced my comments that many employees are reluctant to share these issues with their employers. I asked him to consider the following.

EMPLOYEE BENEFIT INTRANET — It may seem like a ‘no-brainer’, but some companies do not place benefit resources in the most convenient locations for employees to reference them. Some of the ‘best practices’ I’ve seen include using an internal intranet that employees can reference. It must be kept up to date, and the company intranet must not be allowed to be a ‘passive resource’. Companies have to continue to make sure that it is up current, and that their employees are notified of new opportunities which they might avail themselves. So many employees forget to look internally, at company provided resources, when a crisis arises simply because they haven’t seen these resources since their “New Employee Orientation” session!

iStock_Lunch&LearnSession_PMCompanies should regularly create opportunities such as ‘lunch and learn’ sessions, to keep their employees aware of the assistance resources that are available for them to leverage when necessary. So many companies have benefit resources available for their employees, but spend very little effort in making sure their employees are aware of their existence along with how, why, and when to use them. I believe employers can reduce employee lost productivity by keeping available resources fresh in the minds of their employees.

MBO and MBWA — In management theory and practice, there are a number of methodologies used to task employees and evaluate their outcomes with respect to company goals. Management by Objectives (MBO) remains one of the most prevalent; it is both personally and organizationally focused. However, I believe the best managers still employ a form of an older, less direct method that we used to call “Management by Walking Around” (MBWA). With MBWA, managers kept abreast of work progress by regularly interacting with their direct reports at their assigned work locations. It’s value was not only in knowing the progress of work assignments but it also gave managers the perfect opportunity to interact with the employee in a less formal manner. It was during these ‘walking around’ sessions that sometimes personal issues would come to light. In other words, MBWA often facilitated a ‘deeper’ manager-employee relationship whereby personal issues or crises in the lives of employees would emerge. This was management’s window into reminding employees of benefits that are available to help.

My point is that in our current down-sized/right-sized-high efficiency work environments, by and large, MBWA has gone by the way-side. Nevertheless, incorporating some method of indirect communication with employees is a great way for management to know what’s going on and to remind them of resources that your company might already have available. Together, these are great approaches to reducing lost productivity in the workplace. This includes the+ $33 billion per year that employers in the United States lose directly resulting from employees addressing adult caregiving issues.

Employers: Improve Employee Loyalty in the Post ACA World

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

As the Affordable Care Act was coming on line last year, I spoke to a number of employers who suggested that the health benefit plans they offered to their employees were really instruments of competitive advantage. These employers felt that their employees selected to work for their respective company’s, in part, based upon the quality of the health care plan. I thought that was extremely interesting. In my experience, the only employees that actually compare benefits prior to applying to or accepting a job, are those employees that had to address a ‘special-needs’ situation in their immediate family. By far this is a much smaller subset of employees.

Well with the running implementation of the Affordable Care Act, employers might consider another benefit that will provide real value to the majority of their employees. This one has application to a broader employee base and can provide comparative competitive advantage versus other companies that might be competing for great employees.

Addressing the Primary Needs of Working Caregivers

Managing both work life and family life has become a major issue for a large and growing number of family caregivers and their employers. With the aging of the Baby Boom generation will come a dramatic increase in the long-term care needs of our population. As policy-makers consider our options for meeting these needs, supporting working caregivers takes on national importance.” – Margaret Neal and Donna Wagner

There are four areas of need that have implications for structuring workplace settings and providing support for caregivers:Exhausted Business Woman_PM2

  1. Flexibility
  2. Information and assistance
  3. Emotional Support and
  4. Tangible assistance

Employed caregivers routinely note the importance of both flexible work hours and being able to take unscheduled time off to handle caregiving responsibilities when needed. A recent study of working “sandwich generation” couples (e.g. those raising depending children and caring for aged parents) found that couples who felt they had work schedule flexibility experienced less work-family conflict. Work schedule flexibility and other work-based supports offered by employers to their employed caregivers have generally been perceived positively on the part of the caregivers. This, in turn, has led to increased loyalty and satisfaction with those employers.

The needs of employed caregivers vary according to the care situation and the needs of the care recipient. Regardless, however, just as do their non-employed counterparts, employed caregivers need information on the community services that are available to support the needs of elders. Most caregivers of elders have had little or no previous experience either with providing care to an elder or with negotiating the aging services system. Thus, information about caregiving, health conditions, and where to turn for help is a critical need for employed caregivers. Because of the complexity of many elders’ health care situations, employed caregivers, like other caregivers, can find it difficult to know even what is needed, let alone decide which service approach is best for their elder. Professional expertise can be invaluable for assessing the elder’s needs, providing referrals and advice, determining eligibility and payment options, and packaging the needed services.

Emotional support for employed caregivers can come in the form of support from co-workers and supervisors at the workplace, support from other family members, and support from friends. A recent study found that, not surprisingly, lower levels of family related supervisor support were associated with higher levels of work-family conflict. Similarly, a less supportive workplace culture was also associated with work-family

Employed caregivers need help with legal, financial, and health insurance matters and the paperwork associated with these. Helping an elder manage the paperwork associated with his or her medical care is a daunting task. Similarly, securing and completing the legal forms for durable power of attorney, wills, reverse mortgages, and the like can be frustrating and time-consuming.

Adding assistance with eldercare benefits that apply to most of your employee base can provide real competitive advantage versus other companies that are competing for great employees; including employees that are currently on your staff. In the process you can differentiate your company from your competition in a way that is really important to your workforce. Caring Concierge can help you create an affordable, elder care benefit program that makes sense for your company.

Referral: University of Wisconsin

The Causes and Costs of Absenteeism in the Workplace — Part 1

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

Over the past few years, our blog has discussed in detail, issues associated with lost productivity resulting from employee absenteeism that is brought about by elder caregiving. But what are other ‘common’ causes of workplace absenteeism?Risk Management

Causes of Workplace Absenteeism — Absenteeism is an employee’s intentional or habitual absence from work. While employers expect workers to miss a certain number of workdays each year, excessive absences can equate to decreased productivity and can have a major effect on company finances, morale and other factors. This article looks at the causes of absenteeism, the costs of lost productivity and what employers can do to reduce absenteeism rates in the workplace.

People miss work for a variety of reasons, many of which are legitimate and others less so. Some of the common causes of absenteeism include (but are not limited to):

  • Bullying and harassment – Employees who are bullied or harassed by coworkers and/or bosses are more likely to call in sick to avoid the situation
  • Burnout, stress and low morale – Heavy workloads, stressful meetings/presentations and feelings of being unappreciated can cause employees to avoid going into work. Personal stress (outside of work) can lead to absenteeism.
  • Childcare and eldercare – Employees may be forced to miss work in order to stay home and take care of a child/elder when normal arrangements have fallen through (for example, a sick caregiver or a snow day at school) or if a child/elder is sick.
  • Depression – According to the National Institute of Mental Health, the leading cause of absenteeism in the United States is depression. Depression can lead to substance abuse if people turn to drugs or alcohol to self-medicate their pain or anxiety.
  • Disengagement – Employees who are not committed to their jobs, coworkers and/or the company are more likely to miss work simply because they have no motivation to go.
  • Illness – Injuries, illness and medical appointments are the most commonly reported reasons for missing work (though not always the actual reason). Not surprisingly, each year during the cold and flu season, there is a dramatic spike in absenteeism rates for both full-time and part-time employees.
  • Injuries – Accidents can occur on the job or outside of work, resulting in absences. In addition to acute injuries, chronic injuries such as back and neck problems are a common cause of absenteeism.
  • Job hunting – Employees may call in sick to attend a job interview, visit with a headhunter or work on their resumes/CVs.
  • Partial shifts – Arriving late, leaving early and taking longer breaks than allowed are considered forms of absenteeism and can affect productivity and workplace morale.

Just think, the total cost of productivity loss due to eldercare alone is well over $33 billion per year for U.S. employers. Risk management planning is essential for employers to achieve the success they need.

In Part 2, I will take a different view of the costs associated with lost productivity.

CARING CONCIERGE eNEWSLETTER — Readers of our blog “Eldercare and the Workplace” may be unaware that we also have a monthly newsletter. Our electronic newsletter, simply titled “News from Caring Concierge” has been produced every month for the last 2 years. Its contents consists of articles and related resources regarding workplace productivity as it relates to the conservatively estimated +$30 billion aggregate cost lost to U.S. companies every year as their employees are challenged to address adult caregiving issues. If you would like to be included in our growing list of companies that receive this monthly eNewsletter, just send an email titled “Caring Concierge Newsletter—Subscribe” to me at kevin.johnson@caringconcierge.com. I’ll simply add you our distribution list. Should you wish, you can easily unsubscribe and please know that we never share your contact information with any other entity.

Assess Your Company Against the Data!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

It is thGenerations @ Christmas1ae end of another year and I truly hope it has been a good one for each and every one of you.

First, I’d like to refer you to my blog post from December of 2011 titled Home for the Holiday’s … Gather Critical Information on Your Aging Parents, and my blog post of December 2012, Home for the Holiday’s — Time for an Assessment! I believe that each contain timeless information that you should reference with respect to your aging loved ones. Each of these blogs are less focused on employer/employee issues of lost productivity resulting from the urgency of adult caregiving. Instead, they ask that each of us pay special attention to their older loved ones during this time of the year when family visits are so prevalent.

Secondly, when speaking with employers or writing our newsletters and blogs regarding the +$30 Billion in lost workplace productivity attributed to adult caregiving, I usually provide information based on specific research that I’ve uncovered. I’m closing my last blog post of the year with additional factoids and ask that you examine your workplace accordingly.

UNDERLYING DATA — Sixteen percent of the U.S. civilian non-institutional population age 15 and over (39.6 million people) provided unpaid eldercare in 2011 and 2012.  Eldercare providers are defined as individuals who provide unpaid care to someone age 65 or older who needs help because of a conditioiStock_data_PMn related to aging.

During the 2011–2012 period, 17.4 percent of women provided eldercare, compared with 14.7 percent of men.

The eldercare provider rates for Whites and Blacks were 16.6 percent and 15.8 percent, respectively. For persons of Hispanic or Latino ethnicity (who may be of any race) the rate was 10.4 percent.

Overall, 16.7 percent of workers provided eldercare. Part-time workers did so at a higher rate (18.1 percent) than did full-time workers (16.3 percent); those not employed provided eldercare at a lower rate (15.2 percent).

People without children at home and parents with children age 6 to 17 (and none younger) provided eldercare at higher rates (17.3 percent and 16.8 percent, respectively) than parents with children under age 6 (9.0 percent). Those with a spouse or unmarried partner present provided eldercare at a higher rate (17.3 percent) than those without a spouse or partner present (14.6 percent).

Among persons age 25 and over, those with higher levels of education spent more time caring for those over 65. Among those with a bachelor’s degree and higher, 19.1 percent provided eldercare and among those with some college or associate degree the rate was 18.8 percent. High school graduates and those with less than a high school diploma provided eldercare at lower rates (15.9 percent and 9.0 percent).

Findings from the 2011-12 surveys:

  • Of the 39.6 million eldercare providers in the civilian non-institutional population, the majority (56 percent) were women. Eldercare providers are those who provided unpaid care to someone over the age of 65 who needed help because of a condition related to aging.
  • Individuals ages 45 to 54 and 55 to 64 were the most likely to provide eldercare (23 and 22 percent, respectively), followed by those age 65 and over (16 percent).
  • On a given day, nearly one-fourth (23 percent) of eldercare providers engaged in eldercare. Eldercare providers who were ages 65 and older and those who were not employed were the most likely to provide care on a given day.

Percent of population who were eldercare providers

Thank  you 2013! We trust you found our blog postings informative and actionable. We look forward to working with more employers in 2014 to implement our risk management practices. These practices are designed to minimize workplace lost productivity from employees that have to tend to the eldercare needs of their aging loved ones.

We wish you a great year-end holiday season!

These data are from the American Time Use Survey conducted by the Bureau of Labor Statistics.

Adult Caregiving: A Crisis at Home…and at Work!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

In prior blog posts and newsletters, I’ve made mention that employees that are adult caregivers, often do not share this fact with their colleagues. Did you know that according to AARP, 61% of caregivers age 50+ also work. Do a quick assessment. What percentage of your workforce are over 50-years of age? Do the math and back into the number of your employees age 50+ that are being challenged by adult caregiving; responsibilities that can take your employee’s time and attention away from their work, no matter the profession.

In a recent article in the November 2013 edition of AARP Bulletin, Amy Goyer penned a story titled “A Crisis Around Every Corner”. The article discusses a few of her life experiencesOld couple and their daughter smiling outdoors as a daughter providing caregiving needs for her aging mother and father while working full-time. She mentions the employment choices she faced balanced against the needs of her parents and how she worked her way through. Here’s a quote from Amy.

“Working caregivers like me are everywhere. Some of us are open at work about our caregiving roles, but others keep it to themselves. Those who don’t disclose their caregiving situations may do so for personal reasons, but many keep quiet because they are concerned about repercussions at work. Working caregivers are in the position of keeping (or finding) work while meeting the constantly changing needs of the people we care for. We never know when a crisis is around the corner.”

Amy’s journey as an employee is playing out at almost every company in our country. As an aggregate, it now costs U.S. employers in excess of $32 Billion dollars in lost productivity every year. Here at Caring Concierge, we have been able to positively address this workplace issue to the benefit of the employer and the employee. First, we’ve been able to help employers to understand and acknowledge the degree of lost productivity (in dollars and critical milestones), that they face due to their employees that are adult caregivers. Then we’ve been able to work with employers to implement solutions that effectively assist their valuable employees with their adult caregiving needs while incurring a minimum impact on workplace productivity.

I encourage you to read the short article in the November 2013 issue of AARP Bulletin. It’s a great read and it’s definitely non-fiction!

Employers Can Help Employees…and Help Themselves When it Comes to Eldercare!

by Kevin K. Johnson, Certified Senior Advisor (CSA)®

Part 2: Family Responsibilities Discrimination (FRD)

This post is a continuation of a discussion about how employers can avoid not only lost productivity costs, but also avoid employment discrimination issues that could arise from employees that are family caregivers. In our previous post we shaped the issue. Now let’s discuss the legal issues companies face.

iStock_000014696872XSmall_PMFamily Responsibilities Discrimination is discrimination against workers caring for children, older adults, or ill or disabled family members. FRD comes about from treating employees with caregiving responsibilities less favorably that other employees due to unexamined assumptions that their family obligations may mean that they are not committed to their jobs. For detailed information regarding employer history with FRD issues, consider reviewing the database of the Center for WorkLife Law. It contains over 3,000 cases involving some form of FRD. The include examples such as:

  • An employee is fired when he asks for leave to care for his chronically ill father.
  • After being told that his employer has “paid enough” for his ailing wife already, an employee is terminated when he refuses to take his wife off of the employer’s insurance plan.
  • An employee is denied leave when her employer asserts that it is not her responsibility to care for her ailing mother as long as her father is still alive.
  • An employee is called lazy and then fired after taking leave to care for his mother, who is near death.

For a frame of reference, take a look at my blog posts of July 9, 2012 and January 8, 2013, where I’ve quantified the number of employees that ask for some employer provision in order to provide eldercare for a spouse, parent, grandparent, etc…

Claims of FRD in eldercare include denial of leave and retaliation for taking leave. They usually involve employees’ needs for periodic time off to take an aging parent to medical or other appointments, to administer medications, or to perform other health care tasks in the home, such as wound care. Blocks of time off may be requested to care for an older family member who is hospitalized unexpectedly. Flexible schedules may be requested to help a grandparent who may need personal care at home (such as dressing, bathing, eating), or need advanced illness care. In addition, some employees have brought claims related to leave requests to take care of their own health problems caused by the strain of being a caregiver for a frail older parent.

FRD has caught the attention not only of attorneys and human resources professionals, but also of unions, employers, courts, policymakers, caregiver advocates, and the press.

The number of FRD lawsuits grew from about 444 cases in 1989 to about 2,207 cases in 2008, an increase of nearly 400 percent over the two decades. The dramatic rise in the number of FRD cases heightens attention to the extent of this type of discrimination, during an era in which the number of employment discrimination lawsuits heard by federal courts overall has been decreasing.

To date, only a small—but growing—number of FRD cases involve workers caring for older family members, because current public policy does not offer as much protection for workers with eldercare responsibilities as they need. An analysis of 204 eldercare cases found that only 23 cases were filed before 2000. The other 181 cases were filed between 2000 and 2009.

Lawsuits show the kinds of problems that American workers with eldercare responsibilities face.

The largest individual jury verdict in an FRD case to date ($11.65 million) involved a hospital maintenance worker, Chris Schultz, who was fired while caring for his father with Alzheimer’s disease and mother with congestive heart problems and severe diabetes. To help manage his parents’ care, he asked to take intermittent leave, to which he was entitled under the federal Family and Medical Leave Act (FMLA). While he was on leave to care for his parents, his supervisor suddenly instituted a new quota system that was impossible for Schultz to meet (and may have been designed to drive Schultz out). As a result, Schultz was fired for poor performance after 26 years as a dedicated employee with a record of excellent evaluations—the year before he began taking leave, his picture hung in the lobby as the hospital’s outstanding worker of 1999.

Not only is FMLA coverage limited, the protections it provides also are limited: Employers often treat employees with caregiving responsibilities differently for reasons that relate more to their need to alter (or keep) their schedule than to take a period of leave.

Why is Family Responsibilities Discrimination (FRD) a Policy Matter? — With very few exceptions, most federal and state statutes do not expressly prohibit FRD. No laws protect working caregivers of older adults or people with family responsibilities asiStock_SeriousSeniorExecutive_PM a specific group or class from discrimination. Rather, FRD-related claims in the workplace have been framed from other legal theories in federal and state law—for example, as sex discrimination, discrimination based on association with a person with a disability, or a violation of state or federal family and medical leave laws.

While the majority of American workers have to balance work with family responsibilities, today’s workplaces are still designed around the breadwinner-homemaker workforce of the 1950s. This outdated workplace model assumes that workers have someone at home to take care of family caregiving and domestic responsibilities. Changing workplace demographics have led to more working parents and more workers with eldercare responsibilities.

New research shows that workers who make their caregiving responsibilities known on the job, for example by requesting family leave or a flexible work schedule, often encounter bias based on assumptions that they are less competent than other workers or not committed to their jobs.

This mismatch between today’s workplace and today’s workforce is an important public policy issue. Americans rely heavily on family members to provide care for children, relatives with disabilities, and older adults—without the kinds of leaves or subsidies available in most other industrialized countries. In addition, the American health care and  Long Term Services & Support (LTSS) systems rely on family members to provide substantial, complex, and often time-consuming care for adult relatives or friends with chronic conditions or disabilities. The estimated value of their unpaid contributions was approximately $450 billion in 2009, more than total Medicaid spending ($361 billion) that year.

For many workers experiencing FRD, “opting out” of the workforce is not a viable option, and for some, losing their job may mean living in poverty. In this context, it is imperative that employers not impose job penalties and job loss on workers who have eldercare responsibilities. This imperative is all the more important in an era of high unemployment. It may no longer be an option, for someone who lost a job due to workplace bias, to simply get another job.

Next Post — Protections that exist for employees under Federal Employment Laws.

Reference: AARP Public Policy Institute

%d bloggers like this: