Family Care Responsibilities and Employment

Abstract

This study compared work–family and family–work conflict for employed family caregivers with disability-related care responsibilities in contrast to employed family caregivers with typical care responsibilities. Using data from the 2002 National Study of the Changing Workforce, a population-based survey of the U.S. workforce, formal and informal workplace supports of employees with disability-related family care were compared with those of employees with typical family care responsibilities. Results reveal that family caregivers with disability-related family care responsibilities face higher levels of both types of conflict, have lower incomes, and receive fewer informal supports compared with family caregivers with typical care responsibilities. In future studies of a diverse workforce, exceptional care responsibilities need to be conceptualized differently than typical care. Efforts are also needed to address the supports within the workplace and community that do assist family caregivers with exceptional care responsibilities maintain their employment and manage their complex care.

Keywords

disabilities work–life integration workplace support work–family conflict family–work conflict social inclusion

Family Care Responsibilities and the Work–Family Interface

An estimated 65.7 million people in the United States serve as unpaid family caregivers to an adult or a child (National Alliance for Caregiving [NAC] & American Association for Retired Persons [AARP], 2009). Among these caregivers, 49 million provide care to an adult, 3.9 million provide care to a child, and 13 million are estimated to provide care to both an adult and a child (NAC & AARP, 2009). Disability research finds that a pattern exists over the life course for family caregivers in which career attainment, social participation, and physical and psychological well-being are limited because of the complexity of the care demands associated with caring for someone with a disability (Seltzer, Greenberg, Floyd, Pettee, & Hong, 2001; Wei & Wu, 2011). These challenges are a result of the social contexts of disability, which include inadequate community and workplace supports, constricted social networks that increase risks of financial insecurity, poverty, stress, and poor health for both the family and the individual with the disability (Parish, Seltzer, Greenberg, & Floyd, 2004; Rosenzweig, Barnett, Huffstutter, & Stewart, 2008; Witt, & Deleire, 2009).

The challenges of balancing employment and family care have been the focus of over two decades of research critical to the development of workplace supports to assist employees with typical family care to manage both their work and family responsibilities (Barnett, 1994; Greenhaus, & Beutell, 1985; S. A. Hill & Zimmerman, 1995; D. A. Major, Fletcher, Davis, & Germano, 2008). To date very little work–life research has examined workplace supports from a disability perspective. Growing evidence from disability samples on the work–life challenges associated with complex family care and employment suggest that the interface between family and work functions differently and may require different solutions than for employees providing typical care (Lewis, Kagan, & Heaton, 2000a; Rosenzweig, Brennan, Malsch, Huffstutter, & Stewart, 2011). To continue seeing disability-related family care as functioning similarly, albeit more intensely, than typical family care limits understanding of how particularly demanding family care responsibilities interact with the employment of family caregivers. As a result, the development of effective programs, policies, and work–life strategies that address potential differences in care demands remain unexamined. Through a secondary analysis of a major workforce survey, this study attempts to address this gap through an exploration of how typical and disability-related family care function within the workplace in relation to two work–life integration barriers: work–family conflict and family–work conflict.

Theoretical Conceptualization

Role and ecological systems theory provide a useful framework to understanding how employees balance their work and family roles and how these roles interact within the work–family interface to produce different outcomes for family caregivers. Role theory posits that human activity involves living up to the social roles, or expectations, of others (Pleck, 1977). Work–family conflict occurs when pressure from the work role is incompatible with that of the family role (Greenhaus & Singh, 2003). Family–work conflict is thought to occur when the demands found within the family role interfere with the demands in one’s work role (Greenhaus & Beutell, 1985). Role theory illustrates how employees with typical care responsibilities can experience greater demands on their caregiving role as a function of their family roles that can lead to elevated levels of family–work conflict. Both types of caregiving use flexibility within the work and family domains as an adaptive strategy to manage work and family demands. For employees who have exceptional care responsibilities, further adaptations within the family domain must be made to meet their complex care responsibilities because of the absence of specialized supports.

Ecological systems theory (Bronfenbrenner, 1989) explains the interface between work, community, and family and illustrates the concept of community integration and the use of flexibility as a mechanism for achieving work–family fit. The better integrated one is within one’s community, the more one’s community resources can provide important supports to coordinate one’s work and family responsibilities (Voydanoff, 2007). Flexibility as explained by ecological systems theory, is an attribute of the environment that allows for “proximal processes,” which are identified as more complex person–environment interactions that are hypothesized to positively affect individuals, families, and their organizations (E. J. Hill et al., 2008). Flexibility within the workplace is explained as “a social or contextual attribute of workplaces that is constructed from both structural (policy availability and the basic nature of tasks performed) and interactional factors (supportive culture and leader-subordinate trust)” (E. J. Hill et al., 2008, p. 154). These two factors create a set of boundaries for flexibility that contribute to variation in workplace flexibility (E. J. Hill et al., 2008). Flexibility for family caregivers with disability-related care responsibilities is thought to be limited by both structural and interactional factors. Whether these are similar to or different from employees with typical care has yet to be determined.

Family Care Responsibilities and the Work–Family Interface

Family care responsibilities refer to the financial, physical, and emotional context of caring for a dependent relative. Recent conceptualizations suggest that family care responsibilities may be composed of two dimensions: typical care and exceptional care (Roundtree & Lynch, 2006). Typical care responsibilities refer to the general care experiences of parents of children with typical development. The care involves providing daily assistance and adult supervision, such as preparing children for school in the morning, arranging transportation to and from school, helping out with homework, and acts of nurturing. The care generally lessens over time as children mature (Roundtree & Lynch, 2006).

Exceptional care responsibilities refer to the informal care provided by family members of a person with a disability (Roundtree & Lynch, 2006). This type of care requires intense physical, emotional, and financial resources from families that can change over time as the family member with the disability advances through key developmental stages (Grant & Whittell, 2000; Roth, Perkins, Wadley, Temple, & Haley, 2009). Other challenges associated with exceptional care include that the caregiver must have specialized knowledge related to the chronic condition, extensive collaboration with health professionals, and the acquisition of specialized home care skills (S. A. Hill & Zimmerman, 1995; Leiter, Krauss, Anderson, & Wells, 2004). Studies that examine the impact of exceptional care responsibilities on employed family caregivers are extremely limited. Most of the research stems from studies conducted in the late 1990s and early 2000s, and given the economic changes that have occurred over the past 10 years, much may have changed for family caregivers. However, the research that does exist suggests that there is a stark difference in physical, emotional, and financial impact for family caregivers with exceptional care responsibilities, compared with those providing typical care.

To date research that has examined the impact of exceptional care responsibilities on the work–life interface has done so without comparing whether having a child, adult, or older adult with a disability results in similar levels of conflict. Although there are some cross-sectional studies that have compared the health and financial well-being of families with and without a child with a disability, research has not been extended to determine whether employees providing exceptional care have similar experiences within the workplace to those with typical family care responsibilities.

Antecedents of work–family conflict have been associated with a number of environmental variables within the work domain (work stressors, time pressures, unsupportive supervisor, organizational culture, absence of formal supports, ability to use flexibility; Frone, 2003; V. S. Major, Klein, & Ehrhart, 2002). Research has demonstrated that it is workplace conditions such as flexibility and control that reduce work–family conflict (Barnett & Gareis, 2002; Galinsky, Bond, & Friedman, 1996). Workplace supports that have been found to decrease work–family conflict are having control over the timing of work, formal flexibility supports, a family-friendly supervisor, and supportive coworkers (Hammer, Kossek, Anger, Bodner, & Zimmerman, 2011; Jacob, Bond, Galinsky, & Hill, 2008). Having a supportive workplace culture is also thought to decrease work–family conflict in that it provides the organizational context that encourages supervisors and coworkers to decrease the work interference demands on family needs (Kossek, Lewis, & Hammer, 2009; Lapierre & Allen, 2006; D. A. Major et al., 2008). To date research has not included an examination of the impact of formal and informal workplace support on work–family conflict for employed family caregivers with exceptional care responsibilities, nor has it drawn comparisons with typical care responsibilities.

Family–work conflict is thought to originate in the family domain and occur as a result of time, behavior, or stress/strain (Greenhaus & Beutell, 1985). For employees raising children with typical development, flexibility at work allows them to leave work early, arrive late, or remain at home when breakdowns in child care or child illnesses occur (Moen, Kelley, & Huang, 2009). These breakdowns are typically infrequent and are usually of short duration. For employed caregivers with exceptional care responsibilities, breakdowns in care can be frequent, are cyclical or irregular, and can involve long periods of time away from work (Parish & Cloud, 2006; Roundtree & Lynch, 2006; Ward et al., 2006). Research demonstrates that in addition to flexibility within the workplace, employed family caregivers also access flexibility within the community (Barnett & Gareis, 2006). Formal care provided by child care centers and after-school programs can often help families negotiate time constraints, whereas family and friends can provide both instrumental support such as child care and emotional support when crises occur (Williams & Boushey, 2010). For employed family caregivers with exceptional care responsibilities, lack of specialized supports in the community to help manage their care responsibilities and constricted social networks force them to seek flexibility within the family (Neal & Hammer, 2007; Rosenzweig et al., 2011). This can involve having employed caregivers adjust the timing and duration of work schedules to accommodate the care needs of the family member with a disability. A recent national survey of caregivers illustrates this point by finding that 66% reported needing to arrive late, leave early, or take time off; 20% reported taking a leave of absence; 12% reported having to reduce work hours; 6% reported having to quit work; and 6% reported having to turn down a promotion to meet their exceptional care responsibilities (NAC & AARP, 2009). Other research finds that, as a result of an inability to use flexibility, some even lose their jobs altogether (Barrah, Schultz, Baltes & Stoltz, 2004; Riebschleger, Sosulski, & Day, 2010). To date research has not been extended to examine whether employees engaging in different types of disability-related family care experience similar levels of family–work conflict; nor has research compared family–work conflict between employees with typical and exceptional care responsibilities. This has limited understanding of and organizational responses to exceptional family care responsibilities, resulting in emotional and financial hardship and limited career trajectories for family caregivers and their families (Seltzer et al., 2001; Ward et al., 2006).

Research Questions

This study is exploratory and is guided by the following research questions:

Research Question 1: Do employees with different types of exceptional care responsibilities such as caring for a child, an adult, or an older adult with a disability report similar work–life supports and barriers (work–family conflict, family–work conflict)?

Research Question 2: When participant sociodemographic characteristics (gender, age, ethnicity, income, marital status, number of children in the household, number of children younger than 6 years), and whether respondent assumes primary responsibility for child care, are considered, do workplace supports function similarly to decrease work–family conflict and family–work conflict for employed family caregivers with typical and exceptional care responsibilities?

Data and Method

The 2002 National Study on the Changing Workforce (NSCW) is the third in a series of four nationally representative telephone surveys of the U.S. workforce (1992, 1997, 2002, 2008) sponsored by the Families and Work Institute (Bond, Thompson, Galinsky, & Prottas, 2003; Families and Work Institute, 2002) and conducted by Harris Interactive Inc. The sampling frame used in the study was an unclustered random probability sample, stratified by region. Participation in the survey was limited to individuals who worked at a paid job or income-producing business, were 18 years of age and older, were noninstitutionalized, were members of the civilian population, resided in the contiguous 48 states, and lived in a household with a telephone. The size of the total sample was 3,504, representing a 61% participation rate (Bond et al., 2003). For this analysis, only the data from wage and salaried workers who identified as parents of children 18 years of age and younger were analyzed (n = 1,902).

Table 1 provides the demographic characteristics of the sample. Data are presented for the overall sample of family caregivers, followed by subsample groupings for typical and exceptional family care. The sample of family caregivers was mostly female (51%), 76% were legally married or living with a partner. Seventy four percent of the sample was White, 11% were African American, 9% were Hispanic/Latino, and 4% were of other ethnicities. Median family income was $53,040. Thirty one percent of the sample of family caregivers had a high school diploma, 30% had some college or technical training, 18% had a 4-year college degree, and 9% had a master’s level or professional degree. The median age of the youngest child among all caregivers was 9 years. An average of two children younger than 18 years lived in the home.

Table 1.

Descriptives of Demographics and Major Study Variables for Employed Family Caregivers

	Total		Typical Family Care		Exceptional Family Care
Characteristic	n	Percentage	n	Percentage	n	Percentage
Gender
Female	966	51	861	51	103	52
Male	936	49	840	49	94	48
Race
White	1,409	75	1,271	75	135	69
Black NH	214	11	178	11	34	18
Hispanic	176	9	156	9	20	10
Other	89	5	82	5	7	4
Marital status
Single	444	23	392	23	49	25
Married/cohabitating	1,451	77	1,302	77	146	75
Education
Less than high school	220	12	181	11	34	17
High school/GED	591	31	532	31	59	30
Some college/technical training	574	30	516	31	58	30
College degree (4 years)	351	18	319	19	32	16
Graduate/professional degree	166	9	152	9	14	7
Supervise others	749	40	663	39	86	44
Characteristic	n	M (SD)	n	M (SD)	n	M (SD)
Age	1,856	43.25 (10.92)	1,657	43.28 (10.96)	194	43.48 (10.28)
Family income ($)^a	1,814	64,824.04 (51, 844.83)	1,617	66,063.05 (52,760.79)	192	56,109.34 (41,927.68)
Number of children <18 years	1,902	1.25 (1.4)	1,701	1.23 (1.3)	196	1.5 (1.99)
Number of children <6 years	1,902	0.36 (0.68)	1,701	0.36 (0.68)	196	0.36 (0.69)
Number of hours worked	1,868	37.68 (8.47)	1,674	37.73 (8.51)	188	37.27 (8.21)
Spouse works <30 hours	1,413	23.44 (25.09)	977	43.47 (8.51)	98	45.66 (13.71)
Number of years with current employer/work	1,900	8.36 (8.36)	1,698	8.45 (8.30)	196	7.92 (8.86)
Schedule control	1,897	3.37 (1.73)	1,695	3.38 (1.73)	196	3.31 (1.74)
Organization size	1,890	5.69 (3.28)	1,692	5.73 (3.29)	192	5.12 (3.17)
Formal policies^b	1,840	2.54 (1.68)	1640	2.59 (1.67)	194	2.23 (1.70)
FWA	1,869	2.28 (1.82)	1640	2.59 (1.67)	194	2.23 (1.70)
Uses FWA	1,632	2.28 (1.09)	1466	2.27 (1.08)	164	2.44 (1.12)
Coworker	1,877	10.29 (1.90)	1678	10.29 (1.89)	192	10.34 (1.98)
Supervisor	1,715	36.15 (7.43)	1536	36.16 (7.50)	175	36.12 (6.90)
Family and friend support^c	1,888	3.53 (0.69)	1692	3.55 (0.68)	196	3.31 (0.80)
Workplace culture	1,817	15.06 (3.59)	1628	15.12 (3.56)	187	14.58 (3.90)
FWC^d	1,882	10.56 (3.62)	1689	12.43 (4.51)	194	14.30 (4.60)
WFC^e	1,885	12.63 (4.56)	1683	10.33 (3.50)	196	12.35 (3.72)

Note: NH = non-Hispanic; FWA = flexible work arrangements; FWC = family–work conflict; WFC = work–family conflict.

t(1,807) = 2.15, p < .05.

t(1,833) = 2.82, p < .01.

t(1,886) = 4.07, p < .001.

t(1,881) = 5.45, p < .001.

t(1,877) = 7.56, p < .001.

Measures

Type of family care responsibility

“Typical care responsibility” included those participants who answered “yes” to “Are you a parent or guardian of a child of any age?” and “one or more children 18 years of age or younger living at home for at least half the year” and “no” to “Do you provide special assistance or care for a disabled, emotionally disturbed or seriously ill child in your home” and “no” to “Do you provide special assistance or care for a disabled, seriously ill nonelderly adult relative in your home” and “no” to “Did you take time off work or work fewer hours during the past year than you would otherwise have done to be able to provide this attention and care?” and “no” or “irregular” to “Are you helping on a regular basis or only intermittently when special needs arise” (n = 1,701). Those who answered “yes” to one or more of the disability questions and “yes” to “having taken time off to provide this attention and care” and “regular” to “Are you helping on a regular basis or only intermittently when special needs arise” were coded as having “exceptional care responsibilities” (ECR).

To examine whether types of exceptional care responsibilities have similar or different effects among employees with different types of disability-related care responsibilities, three additional dummy variables were created: (a) exceptional care: child with a disability or chronic condition (n = 99), (b) exceptional care: adult with a disability or chronic condition (n = 40), (c) exceptional care: older adult with a disability or chronic condition (n = 57).

Formal family-friendly benefits

Following the work of Thompson and Prottas (2005), two types of family benefits were assessed: formal family benefits offered and availability of alternative work arrangements. The family benefits index consisted of seven items related to types of benefits offered. A sample item is “Does your organization have a program or service that helps employees find child care if they need it?” Responses were summed for this study to create a Formal Family Benefits Index (range = 1-7; α = .71).

Availability of alternative work arrangements

Availability of alternative work arrangements consisted of seven items that assessed available alternative work arrangements within the respondent’s organization. A sample item asked if participants could “choose [their] own starting and quitting times.” Responses were summed for this study to create the availability of alternative work schedules index (range = 1-7; α =.64). Higher values indicated more options.

Supervisor support

The Supervisor Support Scale was created by summing 11 items that tapped level of perceived support from supervisors for both work and family needs (range = 11-44; α = .78). A sample item is “My supervisor keeps me informed of the things I need to know to do my job well.” Responses were measured on a 4-point Likert-type scale ranging from 4 = strongly agree to 1 = strongly disagree. Having higher values indicated a more supportive supervisor.

Coworker support

The Coworker Support Scale was a summed measure of three items that assessed type of support respondents felt they had from their coworkers (range = 3-12; α = .91). Responses were measured on a 4-point Likert-type scale ranging from 4 = strongly agree to 1 = strongly disagree. High scores indicate supportive coworkers, whereas low scores indicate unsupportive coworkers.

Friends and family support

Friends and family support is the extent to which participants perceived that they could draw on informal supports in their network of family and friends in time of need. One item was used to assess perceived level of social support: “I have the support I need from family and friends when I have a personal problem.” Responses were measured on a 4-point Likert-type scale ranging from 1 = strongly agree to 4 = strongly disagree. The item was reverse coded so that high values indicated high levels of friends and family support.

Workplace culture

Workplace culture was examined using a 5-item scale relating to the perceived culture of the organization. A sample item is “There is an unwritten rule at my place of employment that you can’t take care of family needs on company time.” Responses were measure on a 4-point Likert-type scale ranging from 4 = strongly disagree to 1 = strongly agree. Items were reversed coded and summed to create the workplace culture scale (range = 5-20; α = .72). Higher values indicated participants perceived a more positive workplace culture.

Use of flexible arrangements

Use of flexible work arrangements was assessed through a single item: “How much do you use the flexible schedule options available to you at work?” Responses were coded on a 5-point Likert-type scale ranging from 1 = a lot to 5 = don’t have any options. Responses were reversed so that higher values indicated greater use (range = 1-5).

Number of years with current employer/position

Number of years that the respondents worked in their current position or for their current employer were assessed through a single item. Values ranged from 0 through 42 years.

Supervises others

Supervising others refers to whether participants’ major job responsibilities involved providing supervision to others (0 = no; 1 = yes).

Schedule control

Schedule control was assessed through a single item that measured the degree to which participants felt like they had control over the setting of their work hours. Responses were measured on a 5-point Likert-type scale with 1 = complete to 5 = none. Items were reversed scored so that higher values indicated more control over one’s schedule (range = 1-5).

Work–family conflict

Work–family conflict measures the extent to which work is thought to interfere with family and was measured through five items (Netemeyer, Boles, & McMurrin, 1996). The five response categories ranged from 1 = very often to 5 = never. Items were reversed scored as required and summed to form a scale (range = 5-25) with higher numbers indicating higher degrees of conflict (α =.88). A sample item is “How often have you not had enough time for your family or other important people in your life because of your job?”

Family–work conflict

The family–work conflict measure assesses participants’ perception of the extent to which family interferes with work. Five items were used to assess family–work conflict (Netemeyer et al., 1996). A sample item is “How often have you not been in as good a mood as you would like to be at work because of your family life?” The five categories ranged from 1 = very often to 5 = never. Items were reversed scored as required and summed to form a scale (range = 5-25) with higher numbers indicating higher degrees of conflict (α = .82).

Results

Possible differences among participants who stated that they provided care to a child with a disability, an adult with a disability, or an older adult with a disability were assessed using analysis of variance (ANOVA) tests on the major study variables. No between-group differences were found on the major variables of interest. Comparisons proceeded between the exceptional care group and the typical care group using independent samples t tests and Cohen’s d to assess effect sizes. Guidelines for the interpretation of Cohen’s d are as follows: 0.2, small; 0.50, moderate; 0.80, large; and 1.3, very large (Tabachnick & Fidell, 2001).

Table 1 shows the frequencies, means, and standard deviations of the major study variables for employees with typical and exceptional care responsibilities. Results of the bivariate tests showed that there were no differences between the two groups on most of the sociodemographics (i.e., age, gender, race/ethnicity) with the exception of income. Although the magnitude of the effect was small (d = 0.12), employees with typical care responsibilities reported higher incomes than employees with exceptional care responsibilities (mean difference = $9,953.71). A post hoc test to determine if there was an association between type of care responsibility and employment type (hourly vs. wage) suggested that there was a trend-level difference (p < .10) indicating that employees who were in the exceptional group were more likely to be employed in jobs that paid hourly wages.

Employees with typical care responsibilities also reported significantly higher levels of family and friend support (mean difference = 0.38; d = 0.20), positive workplace culture (mean difference = 0.27; d = 0.09), formal benefits (mean difference = 0.35; d = 0.12), and lower levels of work–family conflict (mean difference = 1.87; d = 0.25), and family–work conflict (mean difference = 2.02; d = 0.35) than those with exceptional care responsibilities. However, employees with exceptional care responsibilities reported using more flexible work arrangements than those with typical care responsibilities with a small effect size (mean difference = 0.16; d = 0.09).

Table 2 presents the relationship of type of care responsibility to the major study variables. Type of care responsibility had statistically significant positive correlations (p < .001) with work–family conflict and family–work conflict. Type of care had significant negative correlations (p < .001) with income, organization size, social support, formal benefits (p < .01) and workplace culture (p < .05).

Table 2.

Correlations of Major Study Variables

	Variable	1	2	3	4	5	6	7	8	9	10
1	Age	1	.179**	−.275**	−.473**	−.010	−.070**	.378**	−.001	−.060**	.005
2	Income		1	−.062*	−.039	.138**	.090**	.189**	−.151**	−.123**	−.060*
3	Children <18			1	.361**	−.135	.032	−.122**	−.031	−.030	.037
4	Children <6				1	−.157**	.001	−.217**	.037	−.002	−.004
5	Spouse work hours					1	−.079**	−.074**	.054*	.021	−.012
6	Hours worked						1	.093**	−.151**	.091**	−.017
7	Number of years in current position							1	−.061**	.005	−.029
8	Supervise others								1	.152**	−.029
9	Schedule control									1	−.012
10	Type of family care (ECR=1)										1
11	Organization size
12	Formal policies
13	FWA
14	Uses FWA
15	Coworker
16	Supervisor
17	Family and friend support
18	Workplace culture
19	FWC
20	WFC
	Variable	11	12	13	14	15	16	17	18	19	20
1	Age	.018	.038	−.050*	−.084**	.094**	.027	−.371***	.009	−.124**	−.118
2	Income	.165**	.237**	.162**	.088**	.099**	.029	−.069***	.144**	.055*	−.012
3	Children <18	−.064*	−.024	.062*	.024	−.016	.024	.117***	−.061*	.094**	.079**
4	Children <6	.012	.026	.109**	.103**	−.022	.018	.275***	.038	.049*	.032
5	Spouse work hours	.012	.020	−.030	−.009	.002	−.042	.038	.083**	−.035	−.003
6	Hours worked	.127**	.167**	−.039	−.089**	−.064**	−.062**	−.011	−.037	.182**	.040
7	Number of years current employer/work	.176**	.184**	−.030	−.014	.001	.030	−.104***	−.049*	−.006	−.015
8	Supervise others	−.023	−.051*	−.064**	−.003	−.048*	−.076**	−.028	−.036	−.084**	−.021
9	Schedule control	.033	−.047*	−.454**	−.312**	−.250**	−.226**	−.062**	−.069**	.155**	.045
10	Type of family care (ECR=1)	−.058*	−.067**	−.007	.047	−.045	.009	−.098***	−.114**	.124**	.173**
11	Organization size	1	.430**	.037	−.028	−.160**	−.149**	−.016	−.022	.121**	.017
12	Formal policies		1	.145**	.057*	.037	.017	.095***	.087**	.048*	.004
13	FWA			1	.455**	.233**	.164**	.119***	.069**	−.101**	−.035
14	Uses FWA				1	.073**	.054*	.056*	.001	.012	.091**
15	Workplace culture					1	.446**	.083***	.168**	−.393**	−.175**
16	Coworker						1	.136**	.198**	−.288**	−.076**
17	Family and friend support							1	.192**	−.082***	−.071**
18	Supervisor								1	−.203**	−.176**
19	FWC									1	.582**
20	WFC										1

Note: NH = non-Hispanic; FWA = flexible work arrangements; FWC = family–work conflict; WFC = work–family conflict.

p < .05. **p < .01. ***p < .001.

Work–family conflict had mostly significant and negative correlations with the study variables and was most strongly correlated with family–work conflict (r = .580, p < .001). For example, it was negatively correlated to most of the support variables such as coworker support, supervisor support, social support, formal policies, flexible work arrangements, and workplace culture. Family–work conflict was significantly and positively associated (p < .001) with number of children younger than 6 years and number of children younger than 18 years. Like work–family conflict family-work conflict had mostly negative correlations to the other variables of interest.

Table 3 presents the results of the regression models for work–family and family–work conflict. The models were constructed using hierarchical regression techniques that assessed (a) the influence of demographic factors (Step 1); (b) the influence of work–life supports (Step 2), on work–family conflict, family–work conflict; and (c) tested for interactive effects between type of care and sociodemographic (age, gender, ethnicity, education number of children, income) or work characteristics (number of years with current employer/type of work, supervise others, schedule control). To construct a parsimonious model, that weighed both theoretical and statistical considerations, nonsignificant independent variables were removed manually one at a time to reach the final models.

Table 3.

Standardized Betas, F, and R² values for Multivariate Regressions of Employed Family Caregivers’ Work–Family and Family–Work Conflict

Predictor	Work–Family Conflict β	Family–Work Conflict β
Step 1
Age	−.11***	−.13***
Ethnicity: White NH	.06*	.07*
Education	.07**	.08**
Marital status: single	—	.09***
Number of children <18 years	.07**	.07*
Number of children <6 years	—	—
Work hours	.15***
Supervise others	−.07**
Schedule control	.16***
Step 2
Age	−.14***	−.14***
Ethnicity: White NH	.13***	.11***
Education	.10***	.11***
Marital status: single	—	.06*
Income	—
Number of children <18 years	.05*	.07**
Number of children <6 years	—	—
Work hours	.13***	—
Supervise others	−.08***	—
Schedule control	.06*	—
Number of years in current position	—	—
Type of family care (ECR=1)	.11***	.16***
Coworker support	−.10***	—
Supervisor support	−.11***	—
Social Support	−.13**	−11***
FWA	—	—
Uses flexibility	—	.08**
Workplace culture	−.23***	−.17***
	F(13, 1618) = 42.09***	F(13, 1618)=14.98***
R²	.25***	.12***
R²	.17***	.09***
F	23.29***	7.51***

Note: NH = non-Hispanic; FWA = flexible work arrangements; FWC = family–work conflict; WFC = work–family conflict; ECR = exceptional care responsibilities.

p < .05. **p < .01. ***p < .001.

The main effects model accounted for 25% of the variance in work–family conflict by the above set of predictors. In Step 1, the demographic or person-level work characteristics variables predicted a modest 9% of work–family conflict, F(8, 1623) = 18.88, p < .001. When type of care responsibility; workplace supports such as coworker support, supervisor support, family and friend support; and workplace culture were added to the equation, the proportion of variance accounted for by the model increased by 18% (F change = 72.57, R² change = .17, p < .001). The most significant contribution made to the prediction of work–family conflict was positive workplace culture (β = −.23, p < .001). Having exceptional care responsibilities also significantly predicted work–family conflict (β = .11, p < .001). The interaction model did not achieve statistical significance.

The main effects model predicting family–work conflict accounted for 12% of the variance. In Step 1, the demographic variables predicted a modest 4% of family–work conflict, F(7, 1463) = 7.48, p < .001. When types of care responsibility, use of flexibility, family and friend support, and workplace culture were added to the equation, a significant increase in variance was accounted for by the model, F change(7, 1456) = 21.72, p < .001; R² change = .09. The most significant contribution made to the prediction of family–work conflict was workplace culture (β = −.17, p < .001). This was followed by having exceptional care responsibilities (β = .15, p < .001). The interaction model did not achieve statistical significance.

Discussion

The current study expands the understanding of the influence that different types of family care responsibilities have on the work–life interface through an examination of different types of disability-related dependent care as dimensions of the concept called exceptional care. It also explored the differences between exceptional care responsibilities and typical care responsibilities in relation to work–family and family–work conflict. Results suggest that compared with workers with typical care responsibilities, workplace supports are weaker, barriers are stronger, and outcomes more negative for workers with exceptional care responsibilities. The findings are consistent with previous research studies focusing on employed family caregivers with children with disabilities that indicate as employees they experience greater barriers in locating care resources and finding support at work and in the community to facilitate work–life integration (Brennan & Brannan, 2005; Lewis et al., 2000b; Parish et al., 2010; Seltzer et al., 2001; Ward et al., 2006) and are more likely to make adjustments to manage their exceptional care responsibilities through modified work patterns (Lewis et al., 2000b; Parish, Grinstein-Weiss, Yeo, Rose, & Rimmerman, 2010; Seltzer et al., 2004). The findings also point to the notion that the time adjustments families make for exceptional care responsibilities intensify the challenges of meeting any increased demands at work, a situation that relates to the “scarcity hypothesis” (George, Vickers, Wilkes, & Barton, 2008; Rosenzweig, Brennan, & Ogilvie, 2002). This analysis of the NSCW data reveals that employees with exceptional care responsibilities tended to work in jobs that paid hourly and were possibly more likely to permit reduced work hours. This supports what has been found within disability samples and within studies of certain sectors of the workforce (Parish & Cloud, 2006; Rosenzweig et al., 2011; Wharton, Chivers, & Blair-Loy, 2008).

Financial resources may represent a major challenge to families providing exceptional care as seen through the significantly lower incomes of employees with this type of care responsibility. Lukemeyer, Meyers, and Smeeding (2000) found in their study based on a nationally representative sample of families who received Aid to Families With Dependent Children, that families with children with disabilities were poorer than those families who had typically developing children. Lower accumulation of wealth was due to out-of-pocket expenses such as specialized services and supports not covered by Medicare (Brennan & Lynch, 2008; Williams & Boushey, 2010). The NAC and the AARP in 2009 found that most family caregivers financially contributed to their family members’ support on a regular basis. Furthermore, those respondents who provided more intense care (up to 40 hours a week) reported higher average monthly expenditures. Reasons given for the expenditures as with the care of children with disabilities, include out-of-pocket expenses such as food and clothing and medical supports and services not covered by Medicaid (Gross, 2006). Medicaid coverage is significant for families with a member with a disability as often the coverage is more comprehensive than employer-sponsored insurance plans and out-of-pocket expenditures under Medicaid are less (Busch & Barry, 2007; Lilly, Laporte, & Coyte, 2007). Further evidence supporting the assertion that having a family member with a disability increases financial hardship on families providing exceptional family care is seen in the emerging research on low-income families with children and adults with disabilities, which finds that having a family member with a disability has long-term financial impacts on the family. Parish et al. (2010) found a significant income and asset gap with married households containing at least one adult member with a disability reporting a 20% lower monthly income and 15% less mean net worth than households with no adults with a disability. Family members may in fact decrease their employment participation as a strategy to meet the income and asset restrictions necessary to receive disability transfer payments of Medicaid and Social Security Income (Busch & Barry, 2007).

The difference in the levels of support from family and friends between the two groups of caregivers is another important finding that increases our understanding of how family caregivers with exceptional care responsibilities may indeed have constricted social networks. These less extensive networks may be because of the time demands associated with their family care (Neal & Hammer, 2007), but they may also result from the courtesy stigma they experience as a result of their association to a person with a disability (Corrigan & Miller, 2004). In their study that investigated the effect of having a family member with a mental health disability, Angermeyer, Schultze, and Dietrich (2003) found that families often withdraw from social interactions as a means of containing discriminating comments and feelings of “guilt” and “shame.” Social support plays a crucial role in mitigating negative effects such as stress by increasing feelings of self-worth and involvement in one’s community (Kagan, Lewis, & Brennan, 2008).

There are limitations to this study that warrant discussion. First, the data were collected in 2002 and since then the American employment landscape has undergone significant change as a result of the economic downturn of 2008 and subsequent slow recovery. The exact impact on families with exceptional care responsibilities is unknown. Although the Families and Work Institute did conduct another National Survey of the Changing Workforce in 2008-2009, the disability care questions were removed from the survey. This renders the 2002 NSCW the only workforce survey in which disability care is captured along with work–family conflict. The findings suggest that questions assessing this type of care should be reintegrated into newer iterations of the NSCW so that the impact of the economic crisis can be assessed for possible differential effects. Another limitation is found within the use of secondary analysis as a means to assess different types of care responsibilities. Specifically, the selection criterion for the exceptional care group was limited to individuals caring for a child, adult, or older adult with disabilities, using a single response item to identify these care responsibilities. The severity of the family member’s disability and the level of care required of the employee could not be determined. Research consistently finds that the severity of a family member’s disability affects employment status of caregivers (Brennan & Brannan, 2005; NAC & AARP, 2009; Witt & DeLeire, 2009). This is a significant limitation as it inhibits conclusions that can be made about the work–life experiences of the exceptional care group in the sample and in the population. Major research efforts that examine exceptional care that include specific measures of types of exceptional care (child, adult, elder) and type of disability or chronic condition (physical, developmental, sensory, mental) are needed to further explore differences within the construct. Another limitation to the study is found within the cross-sectional nature of the survey design. Inferences cannot be made regarding how the various constructs might behave over time. Replication of the models using similar groupings with longitudinal data is needed.

This research has implications for theory, organizational policy, and practice. Findings extend the “scarcity hypothesis” of role theory by suggesting that family caregivers with exceptional care responsibilities experience intense levels of demands that fluctuate as a result of their family members’ needs and produce higher levels of work–family conflict because of the fact that they have already made accommodations within their work and family roles (Barnett & Gareis, 2009). The result of these accommodations coupled with more constricted social networks suggests that work and community flexibility as an adaptive strategy is more limited for employed family members with exceptional care responsibilities. The findings also add to our understanding of the concept of flexibility by suggesting that employees with exceptional care responsibilities may meet their extra demands through flexibility within domains outside of the workplace as a result of the unpredictable, intense nature of their care demands and the absence of specialized supports in the community such as disability supportive child care, adult day homes, and transportation support to and from medical appointments. How these adaptive strategies are articulated remains unclear. Last, the findings contribute to an evolving understanding of ecological system theory, in particular of how flexibility allows for the “proximal processes” hypothesized to occur within the workplace and community seen through more complex person–environment interactions. Findings from this study suggest that it is within these interactional factors (supportive culture and supervisor–subordinate trust) that employed family members with exceptional care responsibilities are more constrained. Whether further efforts aimed at changing organizational culture to be more inclusive of people with exceptional care responsibilities would increase the use of these proximal processes and result in decreased work–family conflict for employees providing exceptional family care is unclear.

Ultimately, the results of the study point to the notion that family care responsibilities should be conceptualized and measured as a multifaceted construct that affects the work–life integration abilities of individuals in different ways. Given the increasing number of employed family caregivers with exceptional care responsibilities, theoretical development is needed that further explains how this care is different from typical care, what circumstances change typical care to exceptional care, and what kind of adjustments or supports occur within the family, workplace, and community that help families achieve better work–life integration. By identifying these care demands and resources, human resource professionals within workplaces, community resource professionals, and work–life researchers can begin to identify what adjustments work to keep employed family caregivers engaged with paid work and what supports are needed to help them manage the stress that often accompanies their intense care demands.

The research further highlights the notion that employer-based flexibility does not meet the work–family fit needs of employees with exceptional care responsibilities, and that they may have different ways to achieve fit from other domains, such as the family. Employers may enhance the work–life integration experiences of employees with exceptional care responsibilities by understanding that exceptional care is a type of family care that follows a different trajectory than typical care, which can be conceptualized within organizational responses to diversity and inclusion concerns. Research has shown that organizations that offer support for employees’ lives outside of work outperform companies with only weak or moderate work–life programs (Lingle, 2005). Furthermore, supportive environments inevitably foster feelings and behaviors of reciprocity, which have been shown to increase organizational commitment (Eaton, 2003), increase productivity, enhance job satisfaction (Baltes, Briggs, Huff, Wright, & Neuman, 1999), and increase retention of employees with complex care demands (Barnett, Gareis, Gordon, & Brennan, 2009).

Communities can enhance work–life integration of families with exceptional care responsibilities by increased flexibility and availability of formal and informal specialized support services such as referral centers, child care, after-school supports, respite care, transportation to medical appointments, and sick care so that families’ exceptional care responsibilities are met with increased flexibility and access to resources in emergencies (Kagan et al., 2008). The lack of cohesive structure of referral and information regarding benefits and services for families with exceptional care responsibilities can result in unnecessary emotional, logistical, and financial hardship (Friesen, Brennan, & Penn, 2008; Kagan et al., 2008), which signals a lack of fit for families with complex care responsibilities. Informal community supports such as community networks or peer-support services should be established to provide ways of caring for children, adults, and older adults with exceptional care needs while their employed family members are at work (Kagan et al., 2008).

To date research has focused almost exclusively on the work–life needs and challenges of employees with typical care responsibilities. Disability-related family caregiving has until recently, not emerged as a workplace issue. The inclusion of diverse work–life experiences into the research base is needed to gain a greater understanding of the varied needs that working families have regarding family caregiving. This research advances understanding of exceptional care by suggesting that family caregiving may operate along a continuum with typical care at one end and exceptional care the other. Furthermore, the need for workplace supports is very different for employees with exceptional care responsibilities compared with those with typical care responsibilities. By examining the different types of disability-related dependent care experiences together, these findings add to our growing understanding of exceptional care by showing that it is a different type of family care responsibility that results in more intense outcomes for family caregivers with these needs.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by the 2008-2009 John Longres Dissertation Award, School of Social Work, Portland State University.

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