HealthCommentary

Exploring Human Potential

Long-Distance Caregiving

Posted on | May 14, 2009 | No Comments

Colliding mega-trends are increasingly pitting family loyalties against workplace loyalties. As the U.S. population has aged, families have become more mobile, separated by distance, and occupied by work demands. Large numbers of women have entered the workplace and global competitiveness has placed increasing emphasis on worker retention and productivity. Thus, family caregiving from a distance has become a fact of life for millions of Americans, according to a recent survey commissioned by MetLife Mature Market Institute and the National Alliance for Caregiving.1

Approximately 34 million Americans are providing care to older family members. Fifteen percent of these caregivers live an hour or more away from their relative. Nearly one-fourth of these long-distance caregivers are the only or primary care provider, and 80 percent work part or full time, according to the MetLife survey of 1,130 long-distance family care providers.1,2

Long-distance caregivers provide a wide array of services at great cost to themselves. According to the survey, they spend an average of $392 in caregiving-related expenses per month: about half of this is spent on out-of-pocket purchases and services for the care recipient and half on travel and long-distance communications.1

The expenditure in time is no less than the expenditure in dollars. Half of the survey respondents reported spending 13.6 hours a month arranging care services, and half said they spend another 16 hours a month checking on their care recipient or monitoring the care being received. Nearly three-quarters of these long-distance caregivers provide help with instrumental activities of daily living (IADL) such as transportation, shopping, cooking, cleaning, managing finances and medications for an average of 22 hours per month. And 40 percent are involved in basic activities of daily living (ADL) such as bathing, dressing, feeding, and toileting, for an average of 12 hours per month.1

What effect does long-distance caregiving have on professional work schedules? Employed caregivers are often required to make significant adjustments to allow for their caregiving responsibilities. These include coming in late or leaving early, missing days of work, rearranging work schedules, and taking unpaid leave. Twenty-five percent of the surveyed long-distance caregivers had shortened their workday and 36 percent reported missing full days of work. Twelve percent had taken a leave of absence.1

Distance, of course, makes a difference in the work accommodations caregivers make. Those caregivers who live closer to the care recipient are more likely to come into work late or leave early, as opposed to missing full workdays.1

The forces that have created today’s long-distance caregiver realities are unlikely to reverse themselves in the near future. Rather, the challenges and work-balance issues are likely to accelerate. Clearly, long-distance caregiving already impacts retention and productivity. Physical distance is a key determinant in terms of complexity, as is the presence or absence of other relatives in the area. In the void of "on the ground" family support, paid support becomes more critical earlier in the aging cycle.1,2

What can an employer do? Certainly, sensitizing line managers to the issue is a reasonable starting point. Adjusting policies to allow job sharing and short-time relief, as well as providing information and help in coordinating eldercare, are definitely worthwhile investments, compared to the cost of attrition and lost productivity. Since long-distance caregivers usually have financial burdens as well as time conflicts, programs that offer help with these are beneficial. For example, voluntary pooling of frequent flyer miles for employees who need to travel on family emergencies is an idea worth considering.1,3 These tangible expressions of support face the issue head on while reinforcing shared values and joint commitment.

For Health Commentary, I’m Mike Magee.

References

1.MetLife, National Alliance for Caregiving. Miles Away: The MetLife Study of Long-Distance Caregiving. July 2004.

2.National Alliance for Caregiving, AARP, MetLife. Caregiving in the U.S.. April 2004. MetLife, National Alliance for Caregiving. Miles Away: The MetLife Study of Long-Distance Caregiving. July 2004.

3.Shellenbarger S. When Elderly Loved Ones Live Far Away: The Challenge of Long-Distance Care. The Wall Street Journal. 29 July 2004.

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