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CLARKSBURG, Md. (AP) — There have been times these past few years when Samira Siddiqi couldn't wait for Monday morning to get back to work.
The days were a blur for her and her husband, Shaz, as they juggled their work — his as an allergist, hers for an IT company in Gaithersburg — and caring for not only their two daughters, but also all four of their elderly parents, who were living with them in their Clarksburg home. They raced from school drop-off to chemotherapy appointments to pharmacy visits.
And they never knew when the next crisis would erupt, like when one parent began hallucinating and wanting to eat his plate.
Takeout replaced cooking. Samira, 38, felt guilty that she was too exhausted to read to her daughters, now 10 and 6. Shaz's vision became distorted with a stress-induced eye disorder. And their marriage became strained as Samira, with more flexible hours and the ability to work remotely, shouldered more of the burden.
On the other hand, Sidiqqi says she could not have managed without that flexibility from her employer, OpenText.
"My work was my sanity. I could sit at my desk, and it was so ... peaceful," said Siddiqi, whose father-in-law has since died. "My immediate boss is in Idaho, so it's not like she's actively looking in on me. She just wants the work done. It's extremely flexible."
As the population ages and more people live longer with chronic medical conditions — for instance, the number of Americans with Alzheimer's disease is expected to nearly triple by 2050 — companies are beginning to grapple with growing numbers of workers who have elder-care responsibilities.
Some, including pioneers such as Fannie Mae in the Washington area, are offering not only flexibility, but also benefits such as emergency backup adult care, geriatric assessments, social workers to assist with referrals for adult day-care programs, and help with legal, financial and emotional counseling. For caregivers whose parents live far away, some companies offer privacy and time for workers to Skype into parents' appointments with doctors.
"We're starting to see pockets of innovation," said Drew Holzapfel, who heads React, Respect a Caregiver's Time, a network of more than 75 corporations, academic institutions and nonprofits seeking to change workplace culture so people can better manage work and elder care. "But with elder care, we're finding that if you haven't experienced it, you have a hard time understanding it."
The share of employers providing information about elder-care services to their employees has increased from 31 percent in 2008 to 43 percent in 2014, according to the 2014 Families and Work Institute's National Study of Employers. Three-fourths of employers say they offer time off for elder care without penalizing workers, yet few offer paid leave. The share of companies allowing workers to pay for some elder care with pre-tax dollars, much like child care, has nearly doubled, to 41 percent, since 2008. Yet only 7 percent offer short-term respite care to provide working caregivers with a break.
Two-thirds of those who take care of an aging relative are working, surveys have found. A majority have been women, but a growing share are men. And as many as 40 percent of elder-caregivers say they work in inflexible environments and have been forced to reduce their work hours or quit.
Lisa Winstel, chief operating officer of the Caregiver Action Network, found herself in such a bind a few years ago.
Winstel was working for a company in Olney. Once, after her father had just had surgery in Baltimore and her mother was struggling, she told her boss that she had to leave. Winstel had plenty of leave saved. Nothing urgent was happening at work. "But their response was, 'If he isn't dying, sit back down and go after work,' " she said. "All of them were in their 20s, and not a single one of them understood what it was like to have aging parents. I did not last there much longer."
MetLife estimates that failing to support workers with elder-care responsibilities can cost as much as $34 billion a year in lost productivity, absenteeism, disengagement, turnover and increased health-care costs. Workers stressed with elder-care duties, like Shaz Siddiqi, are sicker.
Among the biggest drivers of innovative elder-care benefits, advocates are finding, are CEOs and organizational leaders who are struggling to care for aging parents.
"It really starts at the top," said Jonathan Schall, executive director of the Caregiver Action Network, a nonprofit that supports elder-caregivers. "They get religion on what it takes to keep people with elder care responsibilities in the workforce, and then they push it through the culture."
Leaders at Pfizer were working on a potential Alzheimer's drug when they began to think seriously about the elder-care responsibilities of their workforce, said Jack Watters, vice president of external and medical affairs in the pharmaceutical company's Washington office.
They first surveyed their employees and found that many were silently juggling care for aging parents and feeling overwhelmed and isolated. They began to offer more flexible work arrangements, trained managers to better handle flexible workers and de-stigmatize caregiving, and offered resources such as free geriatric assessments.
"It behooves all serious-minded employers today to recognize that a significant proportion of their employees may be caregivers," he said. "If the informal caring network were to disappear, it would be a catastrophe for the country."
More than 80 percent of the care of the elderly is done by family members, said Jody Gastfriend, senior vice president of Care.com, a company that helps families find care.
In recent years, the number of companies seeking elder-care benefits through Care.com has increased by 50 percent, she said. "Universities have been at the head of the pack thinking about elder care, because their workforces tend to skew older, as do health-care, law and financial services companies," she said. "But now, as industries and companies look at what their competitors are offering, it's becoming more of an expectation."
Johns Hopkins University in Baltimore is one of three universities, along with Emory and Duke, recognized nationally by React for their practices in elder-care benefits.
Fannie Mae, with more than 6,000 employees in the Washington area, has had an uptick in the use of the elder-care benefits it pioneered in 1999. In addition to flexible work, lunchtime seminars, crisis counseling, an Elderkit planner and reimbursing emergency backup care up to $40 a day, Fannie Mae also offers employees unlimited one-on-one time with an elder-care consultant to help them research options and arrange care.
"One MetLife study found it costs $2,100 per employee because of workday interruptions, reductions in hours and supervisor time trying to figure out how to cover for employees with elder-care duties," said Michelle Stone, Fannie Mae work-life benefits program manager. "So we can look at how many people the elder-care consultant has seen and see there is a huge return on investment."
Since the company's Silver Care program began, nearly 40 percent of Fannie Mae employees have sought help, Stone said.
While elder-care needs are growing, they are often more challenging than child care for employers and employees, said Ken Matos, senior director of employment research and practice at the Families and Work Institute.
"With child care, you know you're going to need constant care for several years. But with the elderly, their needs wax and wane, and care is intermittent, which is frustrating to employers because so often what they rely on is predictability," he said. "And elder care is draining. You're inevitably heading toward the loss of someone you love."
For two years, Janet James juggled her work as a law librarian with work caring for her mother, who was suffering from dementia. Because the adult day-care program in Tenleytown closed at 5 p.m., James routinely had to leave work early to catch the Metro to make it before closing time.
Her employer, she said, was understanding as she shifted her hours and never took vacation. "I did worry. At a law firm, nobody's job is safe these days," she said.
Isolated, exhausted and sad, James had no time for anything but work and her mother's care. Even so, it was harder to yearn for relief, knowing what that would mean. Her mother passed away five months ago.
"Elder care is a lot like being a parent in some respects," she said. "But without the joy."
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