Work and Elder Care: Effects on Work and Elder Care: Effects on Health, Well-Being, and WorkHealth, Well-Being, and Work

Margaret B. Neal, Ph.D.Margaret B. Neal, Ph.D.

Portland State University Portland State University Institute on AgingInstitute on Aging

School of Community HealthSchool of Community Health

Occupational Health Psychology seminar:Occupational Health Psychology seminar:

"Work-Family Stress: Implications"Work-Family Stress: Implications

for Safety and Health“for Safety and Health“November 7, 2008November 7, 2008

Presentation OutlinePresentation Outline

The context – the aging of America: a few key The context – the aging of America: a few key trendstrends

The stresses/challenges of caregiving for an aging The stresses/challenges of caregiving for an aging parent parent

The rewards/opportunities/benefits of caregiving The rewards/opportunities/benefits of caregiving

Effective coping strategies for adult child Effective coping strategies for adult child caregivers of aging parentscaregivers of aging parents

What can be done, where to turn for help: What can be done, where to turn for help: some resourcessome resources

Trends Affecting the Care of EldersTrends Affecting the Care of Elders

Increasing number, proportion of older adultsIncreasing number, proportion of older adults

Greatest increases among the “oldest old”Greatest increases among the “oldest old”

Advanced age, disability Advanced age, disability more need for care more need for care (paid/formal and unpaid/informal)(paid/formal and unpaid/informal)

Heavy reliance on informal care by family Heavy reliance on informal care by family and friendsand friends

Trends (continued)Trends (continued) Women , the traditional family caregivers, Women , the traditional family caregivers,

increasingly are engaged in the paid labor forceincreasingly are engaged in the paid labor force

Among family caregivers who are employed, almost Among family caregivers who are employed, almost as many men as women provide care to aging parentsas many men as women provide care to aging parents

Growing numbers of people are caring for/helping Growing numbers of people are caring for/helping out elderly family members and friends. out elderly family members and friends. Estimates vary depending on definition (any elder vs. Estimates vary depending on definition (any elder vs.

parent; any help at all vs. particular type or specific amount parent; any help at all vs. particular type or specific amount of help or time spent helping; study methods): 10 - 25% of of help or time spent helping; study methods): 10 - 25% of employeesemployees

Some caregivers of elders have multiple caregiving Some caregivers of elders have multiple caregiving roles (for aging parents and children – the roles (for aging parents and children – the “sandwiched generation”)“sandwiched generation”)

Changes in family structure Changes in family structure more aged parents more aged parents

Indicator 1 – Number of Older Americans

Indicator 1 – Number of Older Americans

Indicator 2 – Racial and Ethnic Composition

Indicator 3 – Marital Status

For older adults needing care, 80% is provided For older adults needing care, 80% is provided informally by family members or friendsinformally by family members or friends

Only 5% of adults aged 65+ are residing in Only 5% of adults aged 65+ are residing in nursing homes at any one point in timenursing homes at any one point in time

Alzheimer’s Disease and other forms of Alzheimer’s Disease and other forms of dementia, while associated with advancing dementia, while associated with advancing age, are not experienced by all older adults: age, are not experienced by all older adults: 12% of those 75-79, 54% of those 80-89, 84% 12% of those 75-79, 54% of those 80-89, 84% of those 90+of those 90+

Who here is caring for an agingWho here is caring for an aging

- parent- parent- grandparent- grandparent- other relative- other relative

- friend or neighbor?- friend or neighbor?

Prevalence – How Common is Prevalence – How Common is Combining Caregiving and Work?Combining Caregiving and Work?

AARP’s Caregiving in the U.S. study (2004) AARP’s Caregiving in the U.S. study (2004) found 59% of caregivers worked found 59% of caregivers worked

Based on workplace surveys, Based on workplace surveys, 13%13% of the of the workforce is involved in elder care workforce is involved in elder care (Wagner, 1999), (Wagner, 1999), with with 25% - 35%25% - 35% involved in caregiving at involved in caregiving at some point during the past year some point during the past year (Bond et al., 2003)(Bond et al., 2003)

What are the stresses, or What are the stresses, or challenges, of care?challenges, of care?

The Challenges of CareThe Challenges of Care

Ample research on Ample research on negativenegative outcomes of caregiving: outcomes of caregiving:

Caregiver burden/stress (objective and subjective) Caregiver burden/stress (objective and subjective)

Depression Depression

Other negative effects on well-being (e.g., poor physical Other negative effects on well-being (e.g., poor physical health, poor overall role performance, marital strife)health, poor overall role performance, marital strife)

Negative effects on work – absenteeism, lateness, leaving Negative effects on work – absenteeism, lateness, leaving work early, telephone interruptions, poor work work early, telephone interruptions, poor work performance, lack of advancement, quitting job entirelyperformance, lack of advancement, quitting job entirely

These affect employee AND employerThese affect employee AND employer

Nuancing FactorsNuancing Factors

Care at a distance (e.g., 1+ hour’s travel time)Care at a distance (e.g., 1+ hour’s travel time)

Other caregiving roles (e.g., for children)Other caregiving roles (e.g., for children)

Support available from others (e.g., spouse, Support available from others (e.g., spouse, siblings)siblings)

Mastery (skills in caregiving, time caregiving)Mastery (skills in caregiving, time caregiving)

Role involvement and meaningRole involvement and meaning

Role quality (rewards over stresses)Role quality (rewards over stresses)