WHAT YOUR EMPLOYER CAN DO

Balancing work and caregiving options can be stressful, even if you've already taken advantage of resources in your community, such as hot meal programs or hospital-based support groups.

As a working caregiver, however, you can also access what has become a growing array of options provided by your employer, either directly at the job site or from outside resources that provide services on a contract basis.

Acknowledging your role

First, however, you might have to acknowledge and accept your caregiving role. Sounds obvious, but researchers say many who provide hours of care to loved ones recovering from cancer or other ailments don't identify themselves as a caregiver. If you provide ongoing help to someone with cancer—driving them to appointments, listening to their input on treatment options to help them decide, supporting them emotionally—you're definitely a caregiver.

The number of hours a week you put in caregiving doesn't define you as a caregiver. No matter how many or how few hours you put in in a given week—and it can vary greatly if you are taking care of a loved one with cancer—it can be mentally and physically exhausting, especially when you are also holding down a fulltime job.

In fact, a caregiving schedule that varies greatly week by week and is unpredictable, while sometimes giving you a break, can also be stressful since it can make it difficult to plan your work obligations and your social life around the caregiving tasks.

You are probably spending more hours than you think in your caregiving role. According to a survey of 750 cancer caregivers who participated in a University of Pennsylvania Family Caregiver Cancer Education Program, 36 percent said their caregiving duties required more than 40 hours a week. (Other interesting findings from that survey: 82 percent of those surveyed were women; 54 percent live with the loved one for whom they are caring and 35 percent said they feel overwhelmed by the role. (For more caregiving statistics, please visit Strength for Caring).

Who to talk to

Who do you approach at your work to tell them you need help in fulfilling your caregiving duties? It depends on your relationship with your immediate caregiver and your comfort level, experts say.

If you're comfortable sharing the request for help with your immediate supervisor, do so. If not, you can call your company's human resources department. Or, you may have in your batch of employee benefit materials a number or other contact information for the Employee Assistance Program (EAP). Some bigger companies maintain websites explaining their EAP programs.

Your immediate supervisor may not be clued in to all the services for which you may qualify. If in doubt, go directly to your human resources office or, if you have one internally, the EAP office. (If there is no internal EAP, which is often the case, your HR department will refer you to EAP programs with whom they contract for services.)

Workplace Programs for Family Caregivers

The best thing an employer can give an overstressed, exhausted caregiver is flexibility.

Most likely to have a program in place to help employee-caregivers are those employers who hire 100 workers or more. But many workers are on staffs at companies that are smaller. If you're one of those who works for a smaller company, your employer's program for caregivers may be as yet nonexistent or a work in progress.

If you as the employee can design and suggest a flexible work option in which you get your needs met as a caregiver and your employer will suffer no lack of productivity from you, each of you wins. The key, experts say, is to think through the accommodations you request so that it impacts everyone else as minimally as possible. Easier said than done, but worth the effort in the long run.

Among the options to consider:

Paid time off (PTO) programs—These programs generally combine all of a worker's paid time off (such as sick leave, vacation and personal time off) into a single block of time or bank. It can reduce hassles for you, as you don't have to submit a reason every time you "withdraw" from the bank. For more information: Supportive Time Off Policies: Paid Time Off (PTO) and Leave Sharing

Telecommuting—Basically a work-at-home plan, either partially or fully, telecommuting can be a boon for a caregiver, especially if you are accompanying your loved one to doctor's visits and treatments. You can set your own hours, arising earlier so you can put in a full day's work, then complete caregiving tasks, or take time in the middle of the day to do caregiving as needed. Avoiding a long real-time commute can save precious hours for caregiving. The plan has to be set up so that you are productive and your employer is assured of that. For more information: Telecommuting (Work-At-Home)

Flex-Time Options—Just as a worker with cancer sometimes welcomes flex time— either taking time out during the day to get to appointments and then working later or varying the start and end times of the workday—so can the caregiver, who often has to deal with transporting loved ones to appointments. The keys are to plan ahead for the flex-time schedule and to be sure the office doesn't need you on the days or hours you plan to be gone. On days when you are able, you might volunteer to work a less desirable shift, if possible, to show appreciation for the flexibility. For more information: Flex Time Work Options

Leave Banks or Pools—Other employees donate accumulated paid time off to help caregivers who have run out of leave time, placing their donations in the leave banks or pools. For more information: Leave Sharing 

Each arrangement, of course, has pros and cons. If you can address the downside of each option for your employer and reassure him that neither productivity nor company morale will suffer, you can probably turn it into a "neutral" point or even a plus.

For instance, if you ask for a work-at-home arrangement, or a part-time work-at-home arrangement, the challenge is to assure your employer you won't goof off. Depending on the nature of your job, you could offer to check in by email or phone with progress reports. If your employer is offered tangible proof that you are doing the job, he probably will not care if you do that work on his premises or yours.

In a work-at-home arrangement, you also have to overcome objections that some business must be conducted face-to-face. You might suggest video conferencing (if it is currently available and won't represent a cash outlay for your company), regular telephone consults, or even instant messaging on the computer as a way to bring together workers for meetings or updates. The point is to maintain your "presence."

Company policies pertaining to caregivers

If your company is like many, it may still be developing policies about caregivers, especially for caregivers to someone who has cancer, rather than to elderly parents or young children.

Employers' awareness of caregiving needs has followed a pattern, experts say. First, they became conscious of the caregiving needs of workers who had children and needed childcare. Next, they became aware of workers who needed to help care for aging parents.

The next wave, say experts, is more awareness of workers who are caring for spouses or other family members with chronic or long-term illnesses such as cancer.

Ask your immediate supervisor about policies on caregivers, or go directly to your human resources department.

HR list of resource for caregivers

Your human resources staff should be able to provide a wealth of resources, whether to the EAP program (internal or external) or to a list of company or community based services.

These might include resources for mental health services such as individual counseling or support groups as well as help with such matters as finding respite care or figuring out insurance coverage.

Employee Assistance Programs (EAPs)—A brief history

While you may have just heard about EAPs, or Employee Assistance Programs, they have been around in some form or another since the early 1940's. In the beginning, the programs focused on workers whose alcohol use adversely affected their on-the-job performance.

But by the early 1970s, the services offered by EAPs had broadened considerably. The programs addressed other stressors besides excess drinking that could adversely affect job performance. These days, EAP programs are common, offered at the worksite, or, more commonly, contracted out.

External programs—ones in which your employer contracts with outside sources to provide specific EAP programs and services—are more common than internal programs due to cost savings. The contract arrangement is less costly to individual employers and, some say, allows your employer to find the cream of the crop for individual services. Your employer may contract out to one "full-service" EAP or may contract with a variety of providers of various services.

Checking out your EAP

Depending on the set up at your company, you may be able to contact EAP directly, via a website or an 800 number, or you may go through human resources. If your employer contracts out for EAP services, you can ask your company contact about the qualifications of such providers as mental health professionals. Those who provide EAP services on a contractor basis might be licensed through the state, such as a licensed clinical social worker. Or, the program could be accredited through such programs as The Employee Assistance Society of North America. Or, the individual offering services might be credentialed through the Employee Assistance Professionals Assn., by earning an individual credential called the Certified Employee Assistance Professional.

The Role of EAP experts The specialists who run the EAP programs might help you broach work option topics with your employer. For instance, EAP staff might talk to your boss about how to set up a modified work plan and other options. They've probably helped set up each of the work options before, so they can allay your supervisor's fears and answer questions with more credibility than you probably can.

One welcoming point about EAP programs: there is usually what the providers call "ease of access." There are no forms to fill out, no copays to worry about. This may be especially welcome if you, as a caregiver, have helped your loved one deal with health insurance paperwork for months or even longer.

EAP providers, as one expert says, look forward to requests for service. They look forward to your call.

You don't need to worry about coworkers and your boss finding out about accessing EAP programs. Confidentiality is an integral part of the service.

The Financial Sense of EAP

You may feel like you're taking up too many of your employer's resources. But from your employer's point of view, EAP services make good financial sense. According to the Employee Assistance Professionals Assn., for every dollar invested in an EAP, employers can anticipate saving $5 to $16, according to a report issued in May 2003 by the Society for Human Resource Management (SHRM). The average yearly cost for an EAP is small—about $12 to $20 per employee, according to the society.

For big companies, the net savings realized by having an EAP can be substantial. For instance, the SHRM report says General Motors Corporation's EAP saves the company $37 million a year. The City of Los Angeles Water and Power reported a $350,000 savings during a period of five years, because employees with alcohol problems called in sick less after enrolling in the EAP.

The Big Picture

Women coworkers may understand your need for time off for caregiving more than male colleagues, experts say. Caregiving has traditionally been a woman's job, when it comes to caring for young children, elderly parents, and now, loved ones with cancer or chronic illnesses.

But as younger workers who have worked at "family friendly" companies move around to different companies, the corporate culture toward caregiving is expected to change, experts say. In the future, you can expect more compassion and understanding directed to workers who care for loved ones in need, whatever their age or their health status.

SOURCES:

David Pecoraro, Director of Clinical Services, Care Resources Inc., an EAP provider, Fountain Valley, California

Tom Farris, Ph.D., Chief Operating Officer, Claremont Behavioral Services, Bay Area, California

John Paul Marosy, president of Bringing Elder Care Home, Worcester, Mass., a consulting firm for employers and community organizations

Society for Human Resource Management

Andrea Booth, independent consultant, New Jersey and Southern California

"Workplace Programs for Family Caregivers: Good Business and Good Practice," August 2003 report by Donna L. Wagner, Ph.D., Director of the Gerontology Program at Towson University, Towson, Maryland