The Employee Hot Button of the 2000s:
The "Sandwich Generation" Wants Eldercare

by Alexis Abramson

A recent online poll asked women which healthcare issue they would most like to have discussed by the presidential candidates this election year. The answer might surprise you. Nearly two-thirds of the respondents listed eldercare as their most pressing concern, leading such evergreen healthcare issues as cost of care, patients’ rights and insuring the uninsured.

The answer is less surprising, however, when you consider that an estimated 22.4 million U.S. households–nearly one in four–currently provide informal care to a parent or relative age 50 or older. That number is expected to rise significantly as the population ages. In fact, more than half of Americans say it is likely that they will be responsible for the care of an elderly parent or relative in the next ten years.

The issue of eldercare has become especially important to women, since they make up a full three-quarters of the caregivers in the United States. And nearly half of those women are raising children under the age of 18–comprising the so-called sandwich generation, caught between taking care of both their parents and their children.

Most troublesome for caregivers is the fact that most are working full or part-time in addition to tending to their parents or other elderly relatives an average of 13 hours per week. Indeed, eldercare is quickly catching up to childcare as the hot button issue facing female employees today–and they want to know how their employers can assist them in the future.

Fortunately, corporate America has recognized these trends. Eldercare has become the fastest growing "work-family" employee benefit to emerge in the past decade. And, because recent estimates by MetLife put the aggregate costs of caregiving in lost productivity to US business at $11.4 billion per year, about a third of Fortune 500 companies now offer eldercare benefits above and beyond flextime.

So, what exactly can an employer do to make eldercare easier for their employees? The benefits usually include some combination of the following:

• Unpaid leave: All employees in the US working for companies with 50 or more employees are eligible under the Family and Medical Leave Act of 1993, which guarantees workers 12 weeks of unpaid leave, with retention of full medical and dental benefits. But the trend among nearly a quarter of Fortune 500 companies is to offer even more to their employees. Some companies, for instance, allow workers to take up to one year of unpaid leave for every two years of employment; most receive full medical and dental for the first six months and their seniority and jobs are guaranteed upon their return.

• Referral services: These services link employees with a range of eldercare services nationwide, making it possible to arrange for the care of a parent across town or across the country. Referrals are the most common approach to eldercare assistance and are offered by nearly all employers with eldercare programs. Referrals help employees find everything from check writing services to bonded help for at-home care. Referral services cost an estimated $8 to $12 per employee, yet they save an employee approximately 15 hours of legwork.

• Eldercare reimbursement: Similar to childcare reimbursement, this benefit helps employees manage financial obligations. A percentage of the employee's paycheck is automatically deducted and set aside, then reimbursed at the end of the year.

• Long-term-care insurance: An increasingly common benefit was offered by 25 percent of the employers with eldercare programs last year. Since the beneficiaries of long-term-care insurance can vary, some can be extended to parents or even parents-in-law. A sample package offers $21,000 a year in nursing home care or $10,950 a year for in-home nursing care.

• Counseling: Usually offered through an employee-assistance program, counseling is available for the employee and family members affected by the care giving, as well as for the aging parent.

• Flexible spending account: This benefit eases the strain of paying medical expenses of an older person in your care. From your pretax income, money is automatically set aside and reimbursed upon receipt of health-related expenses.

Even if benefits exist on paper, most employees say their supervisor's attitude and behavior also influences the usage of eldercare benefits. Some managers send mixed signals if employees try to use the benefit; the success of eldercare programs in the workplace is tied directly to managerial encouragement and supportiveness from the work environment.

If demographic projections and increased life expectancies bear out in the next 25 years, we can expect to have the largest senior population in US history. For most of us, this is a good thing which means we will be spending more years with our loved ones than ever before. For others, it is a mixed blessing that comes with its share of difficulties. Now that corporate America is paying attention, perhaps we can lessen those burdens.