Abstract
A family caregiver, or informal caregiver, is defined as an individual who is not paid to assist a child or adult with activities of daily living or instrumental activities of daily living which include thinks like medical tasks, managing finances, shopping and housework. 1 Research conducted prior to 2020 focused primarily on this type of caregiver. During the pandemic, parents of young and school-aged children assumed more daily care and educational responsibilities while schools and daycare facilities shutdown. This article will discuss both types of caregivers (with a focus on the U.S.), noting when parents are included. Long-term effects from the pandemic have altered how employers support their working parents as well as traditional caregiving employees.
Prologue
The coronavirus pandemic has underscored how U.S. employers are reliant on caregiving supports. As care systems broke down in 2020, family caregivers took on more caregiving responsibilities and are struggling, now more than ever, to balance their careers and family. As a result, their overall well-being is suffering, their productivity is lower, and many are leaving the workforce altogether.
Therefore, the onus is on organizations to update and implement more effective approaches to support this group of key talent. For their efforts to succeed, organizations will not only have to expand flexible work arrangements and reimagine policies and benefits to support working caregivers, but also take steps to strategically plan and coordinate these actions across their business.
Basic Caregiver Demographics
Most family caregivers in the U.S. are women. 2 While the average age is just under 50 years old, an increasing number of caregivers are millennials or part of generation Z. 2 Today’s family caregiver typically cares for multiple people while employed and expects to continue working. 2,3 Organizations will undoubtedly experience an increase in the prevalence of caregiving employees in the immediate future and their ability to support this growing sector will have a significant impact on employee well-being, productivity and corporate profitability.
The challenge is compounded by the difficulty that organizations face in identifying all caregiving employees in their population. 4 Employees might be less willing to self-identify due to psychological safety, stigma around talking about caregiving, and fear that careers may be impacted. 5 During the pandemic, employees became more comfortable talking about childcare needs as schools and daycare providers closed. Employers rushed to implement solutions for parents with young children, such as daycare and nanny access, but most approaches did not address the full continuum of caregiving needs in their diverse populations. The initial shock of the pandemic has subsided, allowing organizations to settle into a more strategic approach to caregiving benefits.
Key Considerations for Employers to Support Working Caregivers
Understand caregiving needs through a Diversity, Equity and Inclusion (DEI) lens through formal or informal assessments (e.g., surveys, segmentation) so that caregiving policies and programs can meet the disparate needs of workforce sectors Benefits and policies should address all aspects of well-being (financial, emotional, physical, social) Promote flexibility in conjunction with other caregiving benefits and policies (including paid leave) Train managers to facilitate a lasting culture of support that is exemplified by senior leadership to increase utilization of benefits and policies Modify performance management goals for all employees through the pandemic to remove stress and anxiety and allow employees to focus on caring for their family Advocate for systemic change or be a source of positive change for communities where employees live
Caregiving Benefit Basics
Caregiving solutions are specialized resources for employees to access when they need help navigating their situation or securing a care provider. Services range from robust digital caregiving resource libraries to a complete white glove care concierge experience through a dedicated care navigator. Employees rank child and elder care benefits among the top 10 most wanted benefits for 2021. 5 Yet, employer confidence in the effectiveness of current programs and policies to support caregiving employees has declined since the beginning of the pandemic. 6
Many caregivers enter this role without adequate and affordable supports. 2 Caregivers say it is becoming harder to coordinate care across various providers and report challenges in securing affordable services. 2 Caregiving solutions are most often available direct to consumer. However, employers may sponsor options to improve access and affordability to the caregiver who otherwise may not have been able to afford the service. Especially when inclusive of navigational support, caregiving programs are one of the few employer-sponsored benefits that both address social determinants of health and promote DEI.
Caregiving Through the Lens of DEI
Amid a backdrop of racial injustice and social unrest, the pandemic did not affect all sectors of the workplace equally. There are disparities in how the pandemic has impacted certain racial groups and communities and affected low-wage earners. Employers responded by increasing their budgets for DEI programs in 2020 7 and stepping up efforts to support all employees, especially diverse employees and parents. 7 Caregiving solutions and policies can be a key component to a successful DEI strategy if employers focus on equity.
Consider that: Over 2.3 million women have left the workforce at the start of 2021 due in large part to lack of childcare
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Women are more likely than men to hold jobs that do not allow for remote work or flexible schedules
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Black and multiracial families are far more likely than white families to leave a job because of problems securing childcare
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Black families are more likely than white families to spend more than half of their income on childcare
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Caregivers are more likely than non-caregivers to stop saving, take on debt, or deplete their savings as a result of their caregiving responsibilities 2
Equality and Equity Are Not the Same
Organizations can take action to understand the differences in their employees’ needs based on socioeconomic, culture, community and other factors. Then, they can design strategies that provide greater support to more vulnerable populations (e.g., salary banded cost for caregiving support). They can also connect (virtually or in-person once safe) Employee Resource Groups and other communities for employees with caregiving responsibilities to increase social supports and reinforce a supportive culture within an organization. Caregiving benefits and policies that are structured through a DEI lens will inevitably help employers support employees who are most in need.
Without adequate caregiving supports and an inclusive culture, organizations run the risk of erasing years of DEI progress. 10 Taking time to embed caregiver supports into corporate DEI initiatives can shift culture and ensure sustainability of efforts. Assessing population needs can ensure the right programs are put in place for long-term success.
Understanding the Needs of a Population
Surveying employees is one of the easiest and most common methods to get a quick pulse on employee needs. Another more comprehensive method is segmentation based on factors such as demographics, income and attitudes.
Segmentation can help uncover social determinants (i.e., the social and physical environmental factors) that could impact an employee’s ability to participate in any programs or policies allowing companies to target specific programs to employees who need them most. Yet, only 20% of companies segmented their workforce to identify employees most in need of caregiving support in the fall of 2020. 11
If a formal segmentation analysis is not feasible, understanding baseline workforce demographics (using census data or other available reporting) and general trends can help employers prioritize resources. After assessing employee needs, organizations may still need to sort through the variety of caregiving support programs in the market.
Caregiving Impacts Mental Health
Caregiving has a compounding effect on employee mental health. Mental health insurance claims have increased through the pandemic and employers believe that caregiving is a primary cause. 6,11 It is not just employees who need assistance, a growing number of pediatric office visits and emergency room visits are due to mental health issues including anxiety and depression. 12 The increased mental health needs of family members has the potential to further increase demands on caregivers. Organizations remain committed to enhancing mental health services to employees and their families. The greatest challenge may be engagement and affordability, especially for caregivers and parents. Families are under greater financial strains during the pandemic with more care and schooling happening at home. Less financial security has a negative impact on overall well-being, especially emotional well-being.
Digital therapeutic apps and virtual clinical supports are widely available to employers and will improve employee access to mental health services. What’s more, digital access makes it easier for caregivers to use services and get the real-time emotional support they need. Coordinating mental health services with caregiving solutions is ideal since working caregivers may not have time to engage in programs for themselves. Impactful benefits will integrate offerings for a seamless user experience to maximize the time they have an employee engaged.
Flexibility Reinforced by Leadership
Organizations are currently offering flexible work to retain talent during the pandemic and most expect to make new flex work policies permanent after the pandemic subsides. 5 This should include updating old policies to remove unintended barriers to access. Time to access benefits is still time away from something else. Flexible schedules have become the primary method to support working caregivers, but flexibility alone may not be effective if employees are overwhelmed with work and caregiving responsibilities. Flexibility is most effective in conjunction with caregiving programs and policies 5 because many caregiving employees cannot take advantage of a flexible schedule due to job responsibilities. 13 Access to an affordable care provider or meal delivery service, for example, could have a much greater impact for a caregiving employee that cannot take advantage of consistent flexibility. Organizations can also take steps to create a culture of support for caregivers through leadership endorsement and realigning performance management goals for employees.
Creating fair goals and resetting performance expectations for all employees would alleviate the stress of meeting standards that are largely unattainable, especially for caregivers and parents of young children during the pandemic. Managers should be trained to make employees feel safe in accessing flexibility and programs without judgment or career repercussions. The training will also ensure managers apply corporate policies consistently and equitably.
Future Expectations
Breakdowns in caregiving infrastructure contribute to massive economic interruptions. Supportive employer programs and policies are essential as burdens on caregiving employees will remain, and even increase, once we emerge from the pandemic. The U.S. is likely to see increased burden on caregivers as a result of childcare shortages families moving loved ones home to receive care, 14 and COVID “long-haulers” (individuals with persistent COVID-19 symptoms months after infection) who may require ongoing care. 15 In response, employers are establishing or refining their programs to be inclusive to help caregivers navigate and reduce the related administrative burdens and thereby helping their employees avoid burnout and remain in the workforce. Caregivers will continue to experience greater levels of stress and decreased overall well-being if left untreated.
Organizations are uniquely positioned to influence systemic change through advocacy and financial support for working caregivers. Employers should strive to set a good example through involvement in non-profits, mission-based organizations and even grassroots initiatives. Organizations that understand their population’s needs may find it is easier to advocate on behalf of their employees and step-up to be the change the caregiving system needs to address the root causes of employee challenges. 16
Closing Thoughts
A holistic, multigenerational approach to caregiving is important. The most beneficial employer programs will address all employee needs from preconception through child and elder care, inclusive of special needs and conditions and keeping in mind that access and equity vary across segments of their population. Approaching caregiving strategy through the lens of DEI can help reduce barriers and improve overall employee and corporate wellbeing.
Employers can seize the momentum and support behind corporate DEI initiatives and mental health to push a strategic program for caregivers. Doing so will improve corporate culture, reduce turnover and ultimately enhance business performance. Caregiving supports benefit all employees. As Rosalyn Carter 17 aptly summed up, “There are only four kinds of people in the world—those who have been caregivers, those who are currently caregivers, those who will be caregivers and those who will need caregivers.”