The Working Caregiver: Issues Faced With Working & Caregiving
By Valerie VanBooven RN, BSN, PGCM
Many adult children find it financially impossible to leave their current employer and give up a much-needed salary to take care of an aging adult. Caregivers are the most effective and efficient when they arm themselves with as much information as possible about their aging loved one's current situation. This is not limited to gathering medical information about their diagnosis or an illness. Looking into their financial situation is critical as well.
Once armed with the right information, most caregivers who work find themselves in a position where they may have to occasionally take time off in order to assist their aging loved one. Some caregivers will have to leave the workplace completely in order to help a senior through a crisis.
Many employers are aware that caring for an aging parent is overwhelming both emotionally and physically. As of 2014, about 43 percent of American companies offer basic elder care benefits—mainly referrals to help find caregivers, adult day care and legal services.
Workers who care for elderly relatives cost US businesses about $34 billion annually in absenteeism, replacement costs and lost productivity, according to a survey by the National Alliance for Caregiving and the MetLife Foundation. The loss amounts to $2,110 for each of the estimated 15.9 million caregivers working full time, according to the survey. The survey estimates that by 2020, one in three U.S. households will be responsible for taking care of an elderly relative, compared with one in four today.
According The Family Medical Leave Act, covered employers must grant an eligible employee up to a total of 12 workweeks of unpaid leave during any 12-month period for one or more of the following reasons:
- For the birth and care of the newborn child of the employee
- For placement with the employee of a son or daughter for adoption or foster care
- To care for an immediate family member (spouse, child, or parent) with a serious health condition
- To take medical leave when the employee is unable to work because of a serious health condition.
Many larger companies have an Employee Assistance Program that helps locate resources to care for an aging parent. Smaller employers may also offer some form of information including pamphlets and lists of local organizations that may be useful.
States That Offer Compensation for Caregivers
In some states, caregivers are offered at least some level of compensation for caring for a family member. Below are a few examples of states who provide for their resident caregivers. For more information on compensation programs in your state, contact your local Area Agency on Aging (AAAs) or state Medicaid program.
Colorado: In rural areas, family members providing assistance to loved ones may be eligible to receive up to $400 per month as compensation to provide personal care services.
North Dakota: This state pays up to $700 per month to spouses and other family members who care for Medicaid beneficiaries living in rural areas who would otherwise require admission to a nursing home.
Wisconsin: A family member may be eligible for compensation either for caregiving or, in some situations, for performing services normally provided by a social worker.
North Carolina: Family caregivers supporting loved ones may be able to reduce out of pocket expenses through the use of state-funded vouchers that can be used to buy nutritional supplements, incontinence products, and personal emergency response systems among other items. In some circumstances, caregivers may be eligible for direct cash compensation. In most cases compensation is provided to family members who are not immediate family, but there are times when immediate family is eligible for pay, such as when they are caring for a loved one with dementia who lives in a rural area.
Massachusetts: Elders who meet MassHealth (Massachusetts Medicaid) criteria and need assistance with at least two activities of daily living (ADLs) can receive compensated 24-hour home-based care from family members or friends. This prigram is known as the MassHealth Personal Care Attendant (PCA) Program.
How a Dependent Care FSA Helps Working Caregivers
Consider utilizing a Dependent Care Flexible Spending Accounts (FSA) to help pay for medical/elder care expenses. These plans allow employees to contribute a portion of their salary, before taxes, to accounts designated for health care expenses, including premiums and child or elder care expenses. Then employees are reimbursed from their accounts with tax free dollars for unreimbursed medical expenses and child or elder care expenses. The funds must be used before the end of the plan year or grace period, or else unused dollars are forfeited. If a caregiver has access to these plans, they should use them, but plan carefully so that contributions do not exceed an amount that can be used in a year.
If an elderly parent lives with a participant and relies on that person for at least 50% of their support, the Dependent Care FSA may be used for adult day care expenses. However, the care must be necessary to allow the participant to work, and cannot be custodial nursing care. If the participant is married, the care must be necessary because the spouse also works, is looking for work or is a full-time student.
When an aging parent needs help at home, talk to your employer about the options available to you. Research local resources that may lessen the stress and complication for you as a caregiver. Education and information are the keys to getting organized and minimizing stress. Surround yourself with people who can help. Assemble your team. That team includes your Human Resource representatives and coworkers. Sharing your situation may be more helpful than you realize.
Valerie VanBooven RN, BSN, PGCM is an author, professional speaker, and professional geriatric care manager. Valerie is the Director of Marketing and Public Relations for Next Generation Financial Services, a division of 1st Mariner Bank .