The Sandwich Generation: Work/Life Balance of Child and Elder Caregiving

1. The Sandwich Generation:Work/Life Balance of Child and Elder Caregiving Module #14 Work/Life balance: “…..healthy work environments that value people and support personal life and family issues.” The Alliance for Work-Life Progress, 2003

2. Area Agency On Aging

3. Introductions • Name • Who you care for over age 60 • Number and age of children you care for • What are your expectations today? Area Agency On Aging

4. Overview/Learning Objectives Through this workshop you will be able to • Identify statistics and demographics related to child and elder care. • Identify strategies to balance work and life challenges. • Know community and internet resources. • Develop a plan. Area Agency On Aging

5. Demographics, Statistics and Issues of the Sandwich Generation Area Agency On Aging

6. Does This Sound Familiar? • Post staff meeting in the hallway between co-workers: “What a meeting, huh? “ “What a day….no, what a year! I got back to my desk and my mom had called to ask if I could pick up her medicine this afternoon on my way home. But that’s a problem because I have to pick my son up from school after his SAT study group. Then I would have to backtrack to the pharmacy. Her church is great about checking on her and helping out when they can but this is just not something they can help her with.”

7. Or This? • You are on a business trip and get a call from your mother. She tells you that she hasn’t been feeling well for a few weeks and needs to get to the doctor. Of course you can’t take her. You hastily arrange for a neighbor to take her, but this one visit spirals upward to a series of tests and visits, that ultimately forces you to return from your trip early. • You are in a car pool with other parents to get your two school age children back and forth to school each day. While you are on your business trip your spouse, who also works, is flexing time so that your week of car pooling is covered. Area Agency On Aging

8. Demographics • 44% of Americans between the ages of 45 and 55 have aging parents or in-laws as well as children under 21. The Sandwich Generation phenomenon. • 59%-75% of family or informal caregivers are women. • The average caregiver is age 46, female, married and working outside the home earning an annual income of $35,000 per year. • Nearly half of all baby boomers aged 45-55 have children still living at home and elder care responsibilities. • 64% of caregivers are employed full-time or part-time. • More than 14 million US workers care for aging family members. • Fastest growing population group is older Americans. • Most rapid population growth is among people 85+ with the majority being females. • An estimated 7 to 10 million adult children are caring for their parents from a long distance. • Nearly two-thirds of Americans under age 60 think they will have elder care responsibilities in the next ten years.

9. Elder Caregiver Statistical Profile • 61% elder caregivers are between the ages of 18 and 49. • Typical caregiver is a married woman in her mid-forties. • Provides an average of 18 hours/week of caregiving. • Works full-time. • Lives near the care recipient. • Has an annual household income of approximately $35,000.

10. ”One of the biggest dilemmas for people in the field of caregiving and for grassroots organizations has been how to reach family caregivers. The majority of family caregivers don’t self-identify. They don't know that they are caregivers.” “Who, me? I’m not a caregiver.” Survey on Caregiver Self-Identification, 2001 National Family Caregivers Association nfca.org Area Agency On Aging

11. Driving to and from doctor and other health care appointments. Communicating with health care professionals. Contacting or helping someone communicate with community service organizations such as the Area Agency on Aging or the Alzheimer’s Association. Assisting someone to pay their bills. Helping someone clean their home or arranging for housecleaning. Assisting someone or arranging for home repairs. Arranging for or helping someone to arrange for Meals on Wheels. Helping arrange for home health care or hospice services. Elder Caregiver __________ Caregiver Continuum You are an elder caregiver if you help someone who cannot or is limited from doing any of these things for themselves. Area Agency On Aging

12. The vast majority of long-term care is provided informally and privately, at no public cost. American Society on Aging, 2000 Research has shown a marked increase in the number of sons who are primary or co-caregivers in the last 3-5 years. Area Agency On Aging

13. Gender and Realities of Working Families • 73% of all family elder caregivers are women with an increasing number of sons involved in caregiving. • Research shows that fathers and sons are taking an increased role in caregiving. • Less than 25% of new mothers leave the paid labor force for a substantial period after childbirth. • 63% percent of women with children under age six are in the labor force, and 78% of women with children 6-17 are in the labor force. • 25%, 14 million, of all U.S. households with children are headed by women alone. • 4.2 million were below the poverty level which represents 34.6% of all families with female householders. Area Agency On Aging

14. Caregiving Trends of the Future • Continued increase in prevalence of caregiving for American families. • Increasing numbers of working caregivers. • Increase in male caregivers. • Increase in long-distance caregivers. Area Agency On Aging

15. Time and Money • TIME: Average length of time spent on caregiving was about eight years, with about one-third of the respondents providing care for 10 or more years. • MONEY: Almost all respondents reported helping the care recipient with some expenses, most frequently with food, transportation, or medications. On average, caregivers helped with expenses for two to six years and spent a total of $19,525 in out-of-pocket expenses. Area Agency On Aging

16. Caught in the Middle • Most women will spend 17 years caring for children and 18 years helping an elderly parent. • 89% percent of all women over age 18 will be caregivers to children, parents or both. Area Agency On Aging

17. The Adult Child and the Family2, 3 • Relatively new phenomenon of adults balancing three major responsibilities. • Raising their own children. • Leading their own lives, including full time jobs. • Helping their aged parents. • Significant number of families are three and four generation families. Area Agency On Aging

18. Time Calculator Including travel time write down and total for one week (168 hours per week): • “Average” hours sleep = ___ • “Average” hours work per week = ___ • “Average” hours spent with your children = ___ • “Average” hours spent with your older relative(s) = ___ Total Number of Hours____ Note: do not duplicate any of these hours *i.e., hours spent with children and elders together

19. Workplace and Business Impact Area Agency On Aging

20. Business Impact of Elder Caregiving MetLife Mature Market Institute, National Alliance for Caregiving, and the National Center on Women and Aging, 1999, The MetLife Juggling Act Study: Balancing Caregiving with Work and the Costs Involved. • US businesses have lost between $11.4 billion and $33 billion in retention, absenteeism and productivity due to elder caregiving. • Estimated the national economic value of informal caregiving in 1997 = $196 billion, equivalent to about 18 percent of total national health care spending ($1.1 trillion in 1997). • Elder caregiving impacts an employee’s ability to work and to advance their career: • 11% of caregivers took a leave of absence. • 7% reduced their work hours. • 3% turned down a promotion. • 10% took early retirement or quit their jobs. • According to National Center for Women and Aging the average caregiver will lose over $600,000 in wages, pensions and Social Security Benefits over a lifetime.

21. Business Impact of Elder Caregiving (cont’d) • Late arrivals and/or early departures from work. • Lost hours of work. • Missed days of work due to caregiving responsibilities. • Work interruptions. • High incidence of need to take unpaid leave of absences. • On-the-job accidents and mistakes (i.e., workers comp claims). Primarily because of care giving responsibilities, Women average 11.5 years out of the paid labor force and Men average 1.3 years. Area Agency On Aging

22. Deferred promotions and/or re-locations. • Reduced personal productivity. • Replacement costs (recruitment and retention issues). • Supervisory Costs (indirect expense). • For 17% of working caregivers, the demands are so intense they give up work entirely or take a leave of absence in order to provide the care their family members require. Area Agency On Aging

24. Work Strategies Area Agency On Aging

25. Company Benefits and Policies • Know what your company offers: • Know your company benefits. • Read related policy materials. • Talk to your human resources department. • *Learn about FMLA (Family Medical Leave Act). • Use Employee Assistance Program (EAP) benefits. FMLA entitles eligible workers a maximum of 12 weeks a year of unpaid leave without loss of job security or health benefits. There are a variety of restrictions such as company size and the amount of time the worker has been employed. Area Agency On Aging

26. The 2002 National Study of the Changing Workforce by the Families and Work Institute • “One work/life program that has increased significantly is elder care resource and referral services. In 1992, only 11 percent of employees had access to this benefit, versus nearly a quarter (24%) today. And more and more employees are needing elder care services as the population ages: 35 percent of workers, men and women alike, say they have provided care for a relative or in-law 65 or older in the past year.” Area Agency On Aging

27. Communicate With Your Supervisor • Determine what and how much your supervisor needs to know about your situation. • If you and your supervisor are not clear about the tasks for which you are accountable, there is no clear basis for a discussion about such alternatives as part-time work, flexible hours, etc. • Be specific about what you need. • Is flex time possible where your hours could be adjusted to come in at times other than those currently scheduled? • Offer suggestions that will help your do your job but will allow you flexibility to meet your non-work demands. • Ask about job sharing with another employee to cover times that you must be away. • Set a timeframe to evaluate new work arrangements. Make adjustments, as needed. Area Agency On Aging

28. Strategies That Work • Honestly assess your job. • Assess the “climate” at work. • Speak to others in your company about options that may have worked for them. • Be proactive and creative. • Make use of resources at work. • If you do not have a job description, ask for one or create one to present to your supervisor. • Remember that you are being paid to do a job. Use lunch and break times to make phone calls or use other resources. • Other ideas? Area Agency On Aging

29. Resources and Supports Area Agency On Aging

30. Information and Referral Caregiver Education and Training Caregiver Respite Caregiver Support Coordination Case Management Transportation Benefits Counseling Ombudsman Home Delivered Meals Congregate Meals Help such as light housekeeping What Assistance is Available through the Area Agency on Aging (AAA)? Caregiver Services Services for persons age 60 and older Area Agency On Aging

31. Resources For Caregivers • Call • 2-1-1 throughout Texas. Provides information and access to health and human service information for all ages • 1-800-252-9240 to find local Texas Area Agency on Aging • 1-800-677-1116 -Elder Care Locator to find help throughout the U.S. • Online • www.benefitscheckup.org for an online way to determine benefits for which someone qualifies. • To schedule a caregiver presentation in your community at your church, business, library, or other • Contact Zanda Hilger, (817) 581-5890 or zanda@flash.net To find this and other information quickly Go online to: www.familycaregiversonline.org online education, resources, links, FAQs Area Agency On Aging

32. www.familycaregiversonline.net Area Agency On Aging

33. Elder Caregiver Basics Behavior and Emotions of Aging Chronic Illness, Medication Management and Communicating with Health Care Providers Sensory Loss Communication and Relationships Safety and Independence Legal Issues and Financial Planning Community and Internet Resources Caring for the Caregiver Long Distance Caregiving Housing Options and Long Term Care End of Life Issues Loss and Grief Sandwich Generation Nutrition, Kitchen Safety & Preparing Meals for Elder Care Receiver Aging & Mental Health: Depression, Alcohol and Prescription Drugs Safe caregiving Communicating with Health Care Professionals At Work ‘Brown bag’ or ‘lunch and learn’ Manager training Management consulting Family Caregiver Education Libraries, churches, civic groups, and other venues Internet FamilyCaregiversOnline.net Electronic Newsletters Area Agency On Aging

34. Planning and Time Management • Make a list of things that you need to do for your elder and/or your child. • Ifpossible, try to schedule time off the job at the least disruptive times when your duties can be done another day or do not affect the work of others. • Negotiate with others to cover each others’ job, with the approval of your supervisor. • Prioritize your list so that you can accomplish the most important tasks first. Break overwhelming tasks into a series of small steps. • Delegate responsibilities to other family members whenever possible. Ask specifically for what you want. • Document completions/note successes. • Communicate, communicate, communicate. Ask yourself the question “What is the best use of my time right now? Am I over-committing?” Area Agency On Aging

35. It Takes a Community • Engage natural supports, especially within the family itself. • Talk to family members: • Have a family conference by telephone or in person. • Clearly define what the needs are and ask for specific help. • Ask siblings for help: • What needs most closely match the skills of you and individual family members. • Who makes decisions in the family? Is that working? • What adjustments need to be made to how caregiver responsibilities are shared? • Communicate, communicate, communicate! Area Agency On Aging

36. Explain that some needs are better met with professional help. Explain that the services are designed to help them remain independent. Explain the service. Offer to supplement the cost of care, if possible or necessary. Assist with arrangements to pay for the service. Offer the services as a gift. Engage someone they respect to suggest the services. Accompany the individual to gather information about the service. Engage Your Family Memberwhen they don’t want “outside help” or “charity” 2, AARP Area Agency On Aging

37. Caregiver Stress Management

38. Survey Highlights of People Who ‘Self-Identify’ as Family Caregivers, National Family Caregivers Association, 2000 • 91% believe “preserving your health” is a message that should be told to all family caregivers. • 30% exercise regularly since becoming caregivers, compared with 61% who exercised before becoming caregivers. • 47% seek prompt medical attention for themselves compared to 70% who did so before becoming caregivers. • 92% like the idea of caregivers being considered a special group within the population. Area Agency On Aging

39. Sources of Stress “Caregiving calls on you in a way nothing else does. But it shouldn’t be the all-encompassing piece of a person. If you fall apart, what happens to your loved one?” Suzanne Mintz, President, National Family Caregivers Association • Work/Life balance. • Grief. • Guilt. • Lack of support. Area Agency On Aging

40. Important Caregiver Tasks • Set healthy boundaries • Ask for help Area Agency On Aging

41. Identifying and Meeting Needs “Adapted from Four Principles to Live By,” National Family Caregiver Association. 1. Choose to take charge of your life. 2. Honor, value and love yourself. You're doing a very hard job and you deserve some quality time, just for you. Self care isn't a luxury. It's a necessity. 3. Seek, accept, and at times demand help. Don't be ashamed to ask for help.  When people offer assistance, accept it and suggest specific things that they can do. 4. Stand up and be counted. Stand up for your rights as a caregiver and a citizen. Area Agency On Aging

42. Establish and Maintain Winning Relationships • Communicate; take the initiative. • Surround yourself with winners. • Avoid negative and critical people. • Be real and true to yourself. • Believe that “what goes around comes around.” • Listen. Area Agency On Aging

43. Keep Your Sense of Humor Area Agency On Aging

44. Re-Evaluate and Re-Balance Your Priorities • “Am I sure about what matters most?” • “What am I learning?” • “What am I doing to take care of myself?” • “What can I delegate or ask help with?” • “What can I say “no” to?”

45. 10. Get rid of unnecessary stuff ‘chunk the junk.’ 9. Be realistic. 8. Prioritize. 7. Decide. 6. Rid yourself of as many interruptions as possible. 5. Ask for help. 4. Make lists and do what is written on them. 3. Plan “if you don’t know where you are going you will end up somewhere else.” 2. KISS-keep it simple and sane. 1. Take one day at a time and value it as if it were your last. Top 10 Ways to Manage Your Time and Your StressApologies to David Letterman

46. Taking Care of Yourself! • What would you tell someone else in your shoes? • Make a commitment to yourself to take your own advice and take care of you! • If you do, you will take better care of your loved one. Area Agency On Aging

47. Summary of Options • Find out what the issues are: medical, ability to care of self • Find help in the community • Ask for help and be specific • Communicate with supervisor and human resource departments • Initiate family meetings • Organize life and work • Practice stress management techniques Area Agency On Aging

48. Serenity Prayer • Grant me • The Serenity to accept the things • I cannot change;Courage to change the things I can; and • The Wisdom to know the difference. Area Agency On Aging

49. Sources • Written by Zanda Hilger, M. Ed., LPC • Includes materials adapted from • 1. Family Caregiver Education: Getting The Support You Deserve, 2002. • Administration on Aging, 2001. • 2. National Council of Women’s Organizations, 2003. • 3. The MetLife Juggling Act Study: Balancing Caregiving with Work and the Costs Involved, MetLife Mature Market Institute, National Alliance for Caregiving, and the National Center on Women and Aging, 1997-1999. • 4. In the Middle, A Report on Multicultural Boomers Coping with Family and Aging Issues, 2001.“Balancing Work and Caregiving,” AARP online www.aarp.org, 2003. • 5. Child Care Data, Corporate Champions, 2003. • 6. Elder Care: a Six Step Process, John Paul Marosy, 2001. • 7. Working Caregiver Factsheet (Source: Towson University, 2000)