More than one in six U.S. employees has a secondary job their employer might not know about: informal caregiving for a relative.

As the older adult population in the U.S. is projected to nearly double in size by 2050 from 48 million to 88 million, employers need to expect that employees might be distracted with the financial and emotional burden of caring for a relative and are looking for support in the form of peer support groups, medical tools, flexible schedules and more.

In fact, 23% of employees are spending 41 hours or longer each week caring for a relative, according to a new report from the Northeast Business Group on Health. On average, employees spend four years in the role of caregiver and 24 hours a week providing caregiving assistance.

[Image: Bloomberg]
[Image: Bloomberg]

“Many employees providing care for loved ones don’t think of themselves as caregivers but rather as ‘just doing what’s necessary,’ and that in itself can be an obstacle in adequately supporting those struggling with this burden,” says Jeremy Nobel, medical director of the NEBGH and lead author on the report.

See also: Employers pursue new eldercare ideas as baby boomers retire

Only 56% of employees reported that their work supervisor is aware of their caregiving responsibilities, according to the report, which can hinder employer support.

Employees worry that disclosing their caregiver status could negatively affect their career similar to workplaces that stigmatize women who take maternity leave, according to the report.

Nobel, also the executive director of Solutions Center, an NEBGH initiative that conducted the research, says it’s unlikely that employers are hyper aware of the issue to stigmatize caregiving.

“I think the bigger stigma is the caregivers themselves don’t always recognize or self-identity as caregivers,” he says. “It’s not the workplace imposing it on the caregiver. It’s the caregiver imposing it on the caregiver.”

Despite the perceived stance of an employer, distracted employees do affect absenteeism, productivity levels, healthcare costs and retention rates — factors that result in a loss of almost $38 billion each year for employers, according to the report.

On average, caregivers miss six to seven days of work each year and cost about 8% more, or $13.4 billion per year, in healthcare spend, according to NEBGH’s study.

“This is an area of growing interest,” says Nobel. “There’s a growing awareness at the risk caregiving represents for the health and well-being of the employee caregiver.”

So what’s an employer to do?

Employers, Nobel says, can help their caregiving employees in a number of ways, such as tackling company culture, facilitating access to logistical, legal and medical services and training managers to be more aware of the challenges.

For example, Big Four firm EY offers two telephonic peer support groups managed by its internal employee assistance program team. Employees can join EY’s caregiver group to share resources, information, ideas and experiences, according to the report. The firm also has a group to support parents of children with special health needs, where employees can address trends in care and parenting.

Employer-formed networks, such as EY’s support groups, are crucial for many millennial caregivers — the fastest-growing demographic — who might not have coworkers in their peer group to discuss these issues with, Nobel says.

Employers can also offer millennials and tech-savvy employees web-based tools and services. For example, Prudential Financial offers referral service Best Doctors to its employees and their families as a benefit, according the NEBGH. As a result, 65% of the insurance company’s employees or their relatives using the service received a changed diagnosis.

Similarly, CBS Corp. offers assistance company Health Advocate to help employees, their parents, and in-laws with Medicare enrollment and claim issues.

“There’s a growing set of online and digital tools that may be helpful in assisting employee caregivers,” Nobel says. “The millennial generation is more attentive and interested in using these tools.”

If caregiving benefit services aren’t enough, flexible scheduling or leave policies can make the difference for employees.

While more than three in five workers in the United States are covered by the Family Medical Leave Act, which guarantees up to 12 weeks of unpaid leave, it isn’t possible for most caregivers to lose their salary.

On average, family caregivers spend $7,000 on out-of-pocket caregiving expenses annually, which is close to 20% of overall income for many Americans, according to the report.

Some employers, like Big Four firm Deloitte and pharmaceutical company Pfizer Inc., offer paid time off to take care of a relative. Other companies offer paid family leave that employees can use for maternity and paternity leave, or for taking care of a sick or disabled parent, spouse or child.

Above all, Nobel says, employers need to “make sure that the right set of support activities are not just available but actively communicated to the employees around logistical and emotional support.”

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