Health

The silent cost of family care


At first, Dana Guthrie thought she could help care for her parents, whose health had begun to decline, and continue to manage a busy dental clinic in Plant City, Fla.

“It was a well-paying job and I didn’t want to lose it,” Guthrie, 59, recalled recently. So she tried to switch to a four-day schedule, working in the evenings to keep up with the demands of the office, and she started spending a few nights a week at her birth parents’ home instead of closer to home.

Eventually, however, her mother’s liver disease progressed and her father was diagnosed with dementia. The family learns that the cost of hiring a domestic helper for two ailing 82-year-olds even exceeds the income and retirement savings of the middle class. “They really need me,” Ms. Guthrie said. In 2016, she left her job “and switched to full-time”.

Estimate 22 to 26 million American adults currently providing care for family members or friends, mostly older people, who need help with daily activities; more than half of those caregivers are employed. “There is no doubt that juggling the two can be very difficult,” says Douglas Wolf, a demographer and gerontologist at Syracuse University.

Research has shown that employed carers often reduce their working hours or leave the workplace. However, some recent research shows the impact of these decisions in more detail, not only on working carers but also on employers and the economy at large.

Yulya Truskinovsky, an economist at Wayne State University, and her coauthors combined data from the Census Bureau survey with Social Security records to on an unusually long employment trajectory for nearly 13,000 people.

Among those who became caregivers, employment fell by nearly 8% compared with demographically similar non-caregivers, the authors found. “It happened within the first year,” Dr. Truskinovsky said. “We see little evidence that they reduced their hours or turned to self-employment. They leave the workforce and don’t last for quite a while.”

She added, “Younger caregivers are just as likely to leave the workforce as older people.” Seven years later, the study found, those caregivers had not returned to the labor participation levels of those who did not receive demographically appropriate care.

Furthermore, there are significant gender differences among those leaving the labor force.

Men begin to reduce their workload before they become carers; After that, “they leave the workforce and they don’t come back,” says Dr. Truskinovsky. The study could not provide an explanation; Maybe men should take care when their work life has gone downhill.

In contrast, caregivers of women leave the workforce more suddenly and are more likely to return – after just two years on average – “but for less pay or fewer hours,” says Dr. Truskinovsky. .

Truskinovsky and colleagues found in another study that the pandemic increased the conflict between work and care. “Caregiving arrangements are fragile,” she notes. While families often work together to deal with paid and unpaid care services, “it is volatile, and if something happens, your entire arrangement will fall apart.” disintegrate”.

In a national sample that included adults over 55 years of age, half of household caregivers reported that Covid-19 has disrupted their care schedule, forcing them to care more (because paid help is not available) or less (because of isolation and fear of transmission). Before the pandemic, more than a third were employed.

Carers facing interrupted placement are more likely to be laid off or lose their jobs; they also showed much higher rates of depression, anxiety, and loneliness than those with no care or uninterrupted caregivers.

Fees for working carers take many forms. Susan Larson, 59, a US Army educational services specialist, refused a promotion, even when her superiors urged her to apply. “I am not geographically mobile,” she said.

She could not leave her home in St. Paul, Minn., where she and her husband built an accessible disability supplement facility for her mother, 83, who needs a lot of support. Ms. Larson said the Army has been very supportive. But she estimates that her salary would be nearly 25% higher if she accepted the promotion, thereby supporting both her final pension and Social Security benefits.

Shawn French, 51, a video game writer in Limerick, Me., and his wife welcomed her widowed father into their home three years ago. Because Mr. Phap works remotely, he can help his father-in-law with food, medicine, and transportation; His wife handles doctor visits and other duties.

“I wouldn’t have it any other way,” said Mr. French. But stress led him to give up his weekend freelance job that generated $200 to $300 a week. “We rely on it whenever things get a little tight,” he says. His wife also rearranged her job, which caused him to be dropped from her health plan and became uninsured.

Even when caregivers keep their jobs, another recent study found that nearly a quarter reported miss work (absence) or reduce productivity (known as currentism).

Senior author Jennifer Wolff, a researcher in gerontology and health services at Johns Hopkins University, says presentations are the biggest cause of lost productivity. “The absence is visible, the presence is less,” she said. “You show up, but you’re calling the doctor or the insurance manager.”

Among affected employees, productivity fell by a third on average. Based on 2015 data, the most recent figures are for adults 65 and older, which is $49 billion in annual losses.

Family paid leave, while better configured to meet the more predictable needs of new parents, can also help those in aged care jobs. When California passed paid leave, effective in 2004, The rate of residence in nursing homes decreased Dr. Wolf of Syracuse and his co-author Kanika Arora found about 11%.

Although the study could not determine the reason, Dr Wolf speculated that “the change in the law kept people working, but they took enough time off to keep their parents out of nursing homes.” . The authors’ more recent work shows that paid sick leave also enhances family care.

President Biden campaigned on an ambitious care plan that would provide 12 weeks of annual paid leave, plus tax credits to offset the cost of care, and Social Security credits for time family caregivers spend out of the workforce labor. Republican opposition in the Senate prevented passage.

Debate about how best to support family carers will continue, but there is little debate about their need for help. While many workers are able to meet the more predictable needs of aging parents and spouses, some face great pressures that are not suitable for the modern workplace.

After her parents Guthrie died, she moved to Radcliff, Ky., where her sister lived. She found positions at dental clinics there but never matched the compatibility or salary of the job she left in Florida.

Currently unemployed, Ms Guthrie went to a job interview and wondered if she would ever retire, although she has no regrets about the sacrifices she made to take care of her parents.

“We are a close-knit family and I would do it again,” she said. “But I’ve been beaten, emotionally and financially, and I haven’t really recovered yet.”



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