The burden of caregiving: A growing workforce challenge

When Pat Kessler stepped up last year to provide help for an aging aunt after her uncle died, she had no idea what she was really in for.

Her aunt, 91, lives in her own home and wants to stay as long as possible. She is largely able to manage her daily needs, but has a history of falls and is vulnerable to being taken advantage of by others. Providing support was even more challenging because Pat lives in Minneapolis and her aunt lives in Denver.

Through cross-country trips and frequent phone calls, Pat patiently worked to convince her aunt that she was there to help her. She also had to work on building trust and take the right steps to ensure her aunt had the local care and oversight she needed. And, like thousands of others, Pat had to do this while working full time at UnitedHealthcare® as a project manager.

“Caregiving is much more work than I would ever have expected it to be,” Pat said, reflecting on her experience. “I don’t know how people do this — and I have a supportive manager and a fairly flexible job.”

Navigating caregiving — one challenge at a time

Over about 8 months, Pat was able to persuade her aunt to agree to participate in a home assessment administered by a professional caseworker. The assessment evaluated her cognitive and physical needs, as well as safety issues in her home. Pat now helps manage her legal, financial and health care issues, and she hired a care manager to support her aunt’s needs locally.

Despite building out a local care team, distance remained a significant concern for Pat. Her aunt now is part of a pilot program offered by UnitedHealthcare in 2019. Under the program, her aunt wears a personal emergency pendant that is connected to a monitoring center. If her aunt falls or presses the button on the pendant, it alerts the monitoring service to respond and arrange for help. The service also alerts Pat, providing her additional peace of mind.

Although Pat accessed helpful resources through her employer to help guide her through the caregiving landscape, she still found herself juggling professional and caregiver responsibilities — an often difficult balancing act.

“Part of the challenge with caregiving is that you need to make calls during business hours. You can’t do it at the end of the day or at night, because the people you’re trying to reach aren’t working then. For the majority of caregiving, between personal time and work time it’s extremely difficult to juggle.”

Throughout the economy more and more workers double as caregivers 

As a full-time professional, Pat is not alone. One in 6 American workers—nearly 20% of the workforce — are engaged in caregiving roles. More than half of them work full time, and they spend an additional 20-plus hours a week providing care to another, usually an older adult.1

AARP® and the National Alliance for Caregiving (NAC) estimate that 43.5 million adults were providing unpaid care to an adult or child in 2015,and that the number of older Americans needing such care will grow to 117 million by 2020 as the baby boom generation continues to age.Moreover, many Americans are “sandwiched” between the needs of aging parents and their own children. In fact, 1 in 7 adults in their 40s and 50s provide financial support to both an aging parent and a child, according to the Pew Research Center.4

For employers, the consequences of this trend mean employees and their families are increasingly drawn into caregiving roles that can reduce their productivity. As a result, employees risk becoming so exhausted from the stress and strain of caregiving that it affects their own health. According to one study, caregiver absenteeism is costing U.S. employers up to $33 billion in productivity and $13.4 billion in increased health-care costs annually compared to non-caregiving workers.5

“Awareness and understanding of caregiving have been increasing among employers, lawmakers and consumers generally,” said Jim Murphy, vice president — innovation, Medicare & Retirement for UnitedHealthcare. “But many companies have yet to fully diagnose the root cause of productivity issues in their organizations, and at the heart of it many times are issues associated with caregiving.”

Employer strategies to better support caregivers

The first step, according to Murphy, is to instill a more supportive company culture for caregiving.

“Executives need to first acknowledge caregiving as a workforce challenge and foster a culture of support among managers so employees know it’s OK to talk about it,” he said. “Then, put in place caregiver-friendly policies and provide resources to support employee-caregivers.”

Dr. Katherine Evans, chief nursing officer with UnitedHealthcare’s Retiree Solutions, says employers should take a page from a similar workforce challenge they’ve already tackled: child care.

“Companies are clear on the importance of supporting their workforce with child-care resources and supportive policies. Caregiving can be as much or more work than child care. It can also be insidious, in that care needs often increase over time for older adults — and that takes a toll on caregivers,” she said.

Dr. Evans said employers stand to gain tangible benefits by addressing caregiver needs. These include a more engaged workforce, better productivity through reduced absenteeism, retention of employees who might otherwise leave the workforce and healthier employee-caregivers, which can help “bend the cost curve” on a company’s total health care expenditures.

Some examples of caregiver-friendly workplace policies employers may want to consider include:

  • Flexible hours and telecommuting.
  • Paid sick days.
  • Paid family leaves for caregivers.
  • Eldercare programs that help a caregiver navigate to helpful caregiving resources.
  • Access to discounted, reliable backup care.
  • Onsite or virtual caregiver support programs. 6

Pat credits her supportive manager and co-workers for the flexibility and understanding they provided as she worked to address her aunt’s needs, as well as UnitedHealthcare’s Solutions for Caregivers product, which she accessed early on.

Established in 2000, Solutions for Caregivers provides eligible UnitedHealthcare members, employees and retirees with access to a suite of supportive tools and resources. These include a Care Resource Center for coaching and support from caregiver advisors, information on community and government-funded programs to support caregiving needs, identification and screening of local public and private care services, as well as the development of personalized care plans and on-site assessments by care managers. 

“My aunt’s situation is better,” Pat said. “She is in a better place now than when I started caregiving 8 months ago. She still has challenges living on her own, but it’s rewarding for me to be able to go in and make an impact and hopefully improve her life at this stage.”

Learn more about UnitedHealthcare’s Solutions for Caregivers,* and reach out to your Retiree Solutions representative with any questions.

Sidebar: Coping with the challenges of caregiving

Navigating a caregiving role carries many challenges. Most come to it unprepared. Although it can be fulfilling, it can also be lonely, frustrating and time-consuming. Sometimes all at the same time. Here are some tips from Pat Kessler, based on her own experience providing care to an elderly relative:

  • Learn what resources your employer may have to support you, and explore community resources. There are many, though it can be overwhelming at first. 
  • Talk to your manager — he or she needs to know what’s going on. “They will eventually notice anyway, so engage your supervisor as early as possible in the process.”
  • Stay organized and focused. As complicated and time-consuming as caregiving can be, the various tasks are fundamentally a project to be managed. “It’s about getting things organized and working through a punch list and prioritizing the needs.”
  • Write down what you accomplish. “There are many challenges to caregiving, and it’s too easy to focus on what isn’t getting done. So, write down what you do accomplish.”
  • Have a support system and someone who can listen. “Everybody deserves a pity party occasionally.”

1 Gallup, news release: “More Than One In Six American Workers Also Act as Caregivers”, 2011.

2 AARP and National Alliance for Caregiving, “Caregiving in the U.S.”, 2015.

AARP, AARP Caregiving Innovation Frontiers, June 2017.

Pew Research Center, “The Sandwich Generation: Rising Financial Burdens for Middle-Aged Americans”, 2013.

5 MetLife Mature Market Institute,  The MetLife Study of Working Caregivers and Employer Health Care Costs, 2010.

Family Caregiver Alliance, Caregiver Statistics: Work and Caregiving.

*Solutions for Caregivers assists in coordinating community and in-home resources. The final decision about care arrangements must be made by the beneficiary. In addition, the quality of a particular provider must be solely determined and monitored by the beneficiary.

For non-beneficiary facing materials only: Not for distribution to retirees or beneficiaries.