Posted on

How Can Employers Assist & Support Employees Who Are Caregivers?

caregiving employer

In his spare time, caregiving consultant and healthcare keynote speaker Dr. Aaron Blight takes time to post topics and answer questions on Quora about caregiving organizational development, senior care, healthcare consulting, and many other topics. In this month’s post, we highlight his recent question regarding how employers can support employees who are caregivers.

Employees who are family caregivers find themselves asking this question: which comes first, my job or my family?

The Dilemma

“Checklist care” is faster and easier to provide because it focuses on the physical needs of the care receiver.

Caregiving has the potential to tip the scales of balance that conscientious people strive to achieve in doing good, both at work and at home. Family caregivers go about their daily lives knowing that at any particular moment, they may have to drop what they are doing to attend to the needs of their loved one.

Your family is important. Your job is important. Family and work should not be mutually exclusive, but sometimes, for caregivers, they are. Or at least it seems like they are.

The Family Caregiving Alliance (FCA) has gathered some statistics about caregivers who work. Here are a few of the highlights from the linked page:

  • 70% of working caregivers suffer work-related difficulties due to their dual roles.
  • Many caregivers feel they have no choice about taking on caregiving responsibilities (49%). This sense of obligation is even higher in caregivers that provide 21 or more hours of care per week (59%) and live-in caregivers (64%).
  • 60% of caregivers in 2015 were employed at one point while also caregiving.
  • Only 56% of caregivers report that their work supervisor is aware of their caregiving responsibilities.

Employees bring their “whole selves” to work. As much as an employer might want to tell an employee to keep personal problems at home, it’s never quite that easy, especially for family caregivers. While at work, family caregivers may become distracted or preoccupied with their loved one’s needs; they may show signs of depression or moodiness; or their actual work performance may be affected. In turn, employers are confronted with lost productivity and potential performance management issues.

The Path Ahead

Employers need to understand these caregiving challenges. It has become a business necessity. Our aging population signals that there will be an ever-increasing number of employed family caregivers for the foreseeable future.

Employers need to do better helping employees who are serving as family caregivers. According to the FCA, approximately one-quarter or less of the caregivers surveyed stated that they have access to employer-sponsored support (e.g. support group discussions, ask-a-nurse type services, financial or legal consultation, and assisted living counselors).

What can employers do? They can take steps to ensure that work and family caregiving are not mutually exclusive ideals. Here are some suggestions:

  • create policies that permit accommodations for employees who are family caregivers, such as flextime and flexplace.
  • make counseling services available to employees who juggle family caregiving responsibilities.
  • start a caregiver support group for employees.
  • establish pathways to professional services that meet the needs of employed caregivers, including home care, assisted living, legal and financial help, and/or geriatric medicine.
  • facilitate training opportunities for employees to develop their capacity to care for aging and disabled loved ones.
  • educate managers on caregiver discrimination (strong word, I know) so that employees are not presumed to be less committed to work simply because they care for a loved one in need at home.
  • We hear lots of discussion about equal employment opportunity and fostering supportive workplace environments for people of all races, genders, and ethnic backgrounds. Family caregivers come from all backgrounds, but in the dialogue about supportive workplaces, the needs of this growing segment of the workforce are often overlooked. It’s time for bosses, employers, and governments to take a hard look at the plight of the employed family caregiver.

    Posted on

    Simple Ways To Improve Company Culture With a Low Budget

    Dr. Aaron Blight on Quora


    In his spare time, caregiving consultant and healthcare business coach Dr. Aaron Blight is happy to answer questions on Quora about caregiving organizational development, healthcare consulting, senior care, and many other topics.

    In this month’s post, we highlight his recent answer which deals with ways that can company culture can be improved on a limited budget.

    Anthropologist Clifford Geertz said, “Man is an animal suspended in webs of significance he himself has spun.” I love Geertz’s definition of culture, which has been applied in organizational studies.

    Culture is a reflection of the meaning we make from the world around us. Company culture does not require any budget, although how and where company money is spent says something about its culture.

    If you want to improve company culture, to use the Geertz analogy, you will have to do some spinning. Here are a few tips.

    1. Observe. Become a keen observer. Look for indications of culture throughout your organization, from the physical environment to the things employees say.

    2. Ask. What values are reflected in the indications of culture you observe? What taken-for-granted assumptions are revealed? Why do such assumptions exist?

    3. Think. Come up with a revised set of values and assumptions that you’d like to see reflected throughout the company.

    4. Create. Create ways to explicitly and implicitly convey the values and assumptions you want in your company. This can be anything from break room modifications to employee recognition programs, from company tag lines to business process re-engineering, from storytelling to artistry. Incorporate symbolic meaning into some of your creations.

    5. Reinforce. Continue to communicate, directly and indirectly, the elements of culture you wish to emphasize.

    6. Repeat. Keep in mind that culture change takes time and cannot be forced. As you maintain focus and repeat steps 1–5, you will begin to see signs of progress.

    We hope you learned something from this latest edition! Check back in over the coming weeks and months for more Q&A with Dr. Aaron Blight!

    Posted on

    Why Don’t Caregivers Understand Exactly What Their Participants Need?


    In his spare time, caregiving consultant and healthcare speaker Dr. Aaron Blight is happy to answer questions on Quora about caregiving organizational development, senior care, healthcare consulting, and many other topics. In this month’s post, we highlight his recent answer dealing with caregivers’ understanding of participants’ needs.

    Why don’t all caregivers understand, or at least try to understand, exactly what their participants need, not just the surface stuff, but the deeper things beyond “fed, meds, bed?”

    “Checklist care” is faster and easier to provide because it focuses on the physical needs of the care receiver.

    This “surface stuff” that is described in the question is easy to observe and relatively simple to do, albeit after a bit of training. A bonus is that after you finish the checklist for the day, you can say you’re done!

    “Whole person care” is slower and harder because it adds the emotional, social, and even spiritual needs of the care receiver. It gets messy. There’s not a daily “completion box” that you can check off.

    Most caregivers know that humans actually need more than the satisfaction of basic physical requirements in order to thrive. But when someone is dependent upon you for things as simple as eating or toileting, your caregiving starts there.

    There are many reasons why caregiving may also end there. The scarcity of time, the requirements of those paying for care, emotional exhaustion, or a lack of knowledge on how to “fix” the deeper needs of the care receiver are some of those reasons. The most tragic reason of all, however, would be indifference to the needs of the care receiver, which I’ve seldom observed.

    When a caregiver consciously focuses on “whole person care,” the results may not be immediately visible, but the long-term effects can be life-changing for both the care receiver and the caregiver. It is where the greatest rewards of caregiving are discovered.

    Somewhere in the middle is the best you can really hope for, the best you can expect. If you are an aging parent and your adult child genuinely listens, offers help when you want it and when you really need it, and respects the decisions you have made about your life, then you’ve got a pretty good foundation of “understanding and support” that will make the waning years of your life a little easier to bear.

    Posted on

    Why Does Everybody Assume That a Caregiver is Compassionate?

    holding hands with senior
    Because the very word, care-giver, combines two words that independently imply compassion.

    “Caregiver” is a hybrid of the verb “to give” and the noun “care” or the verb “to care.” The title carries an equal connotation of action and emotion, suggesting not only what a caregiver does but also who a caregiver is.

    Caregiving is comprised of active services and support given to persons who, due to age, infirmity, or illness, cannot take care of themselves and rely upon someone else for assistance with personal or emotional needs.

    “Care” implies attention to the welfare of another person that is motivated by feelings of genuine concern for the other.

    Caregivers are usually motivated by such compassion, but admittedly that is not always the case.

    Is Caregiving Always about Compassion?

    Studies have shown that there is a paradox to “care.” Here are a few of the cited paradoxes of caregiving:

    A caregiver faces existential challenges while regulating feelings during the performance of emotional labor.
    When money is introduced into a caregiving exchange, altruistic motivations to care may become compromised.
    It has been suggested that women’s gendered pre-disposition to care perpetuates the exploitation of women.
    These paradoxical dimensions of the caring aspect of a caregiver’s role may be manifested in a wide range of situations, such as:

    A caregiver hides disgust when cleaning up urine and feces.
    The guilt, anger, or resentment a family caregiver feels is suppressed beneath the daily demands of caregiving.
    A caregiver is expected to do something “extra” that involves significant self-sacrifice.
    “Care” is used as an emotional appeal to induce the caregiver to operate outside the expected boundaries of the role.
    Under the auspices of “care,” a caregiver exploits or abuses a care receiver.
    Thus, it would be a nice but faulty assumption to assume that every caregiver is compassionate or that every act of caregiving is motivated by compassion.

    Having said that, in my mind there is no question that caregiving is among the noblest of human endeavors. The compassion of many caregivers I know is demonstrated through daily sacrifices of time and energy, complete focus on the wellbeing of another, and obvious gestures of love.

    Select References:

    Bolton, S. C. (2001). Changing faces: nurses as emotional jugglers. Sociology of Health & Illness, 23(1), 85-100. doi: 10.1111/1467-9566.00242

    Folbre, N., & Nelson, J. A. (2000). For love or money – Or both? Journal of Economic Perspectives, 14(4), 123-140. doi: 10.1257/jep.14.4.123

    Husso, M., & Hirvonen, H. (2012). Gendered Agency and Emotions in the Field of Care Work. Gender Work and Organization, 19(1), 29-51. doi: 10.1111/j.1468-0432.2011.00565.x

    Schofield, H., Murphy, B., Herrman, H., Bloch, S. and Singh, B. (1997). Family caregiving: Measurement of emotional well-being and various aspects of the caregiving role. Psychological Medicine, 27, 647-657.

    Stacey, C. L. (2011). The caring self: the work experiences of home care aides. Ithaca, NY; Cornell University Press.

    Posted on

    Learning from Tragedy: A Bittersweet Journey

    Sometimes when life gives you lemons, you make lemonade.

    I can honestly say that I never imagined I’d be traveling to Las Vegas to give a keynote speech on the subject of caregiving and receive a “Top 100 Healthcare Leaders” award. But that’s exactly what happened last month.

    How did it happen? It’s a story of something sour that led to something sweet.

    The Bitter

    Nearly twenty years ago, my mother-in-law got a brain tumor. She was too young for a death sentence, but there it was, and we had no idea how it was going to impact our lives.

    I was working in national healthcare policy as part of the Disabled and Elderly Health Programs Group of the federal Medicaid program at the time. Truthfully, I didn’t have a clue about what it meant to be elderly or disabled until my mother-in-law’s cancer emerged.

    After a surgeon cut open Mom’s skull and removed the golf-ball-sized mass on her brain, Mom needed a place to recover. So she moved in with us to get a couple of weeks of rest.

    She stayed with us for a couple of years. Mom underwent radiation and chemotherapy while in our home. Thanks to miraculous treatments, Mom’s cancer went into remission. She lived for five and a half years after her original diagnosis, but her brain was in steady cognitive decline for the rest of her life. Mentally, Mom was slowly becoming a vegetable.

    As a result, for five and a half years, my wife and I served as caregivers for her mother. It was an extraordinarily unexpected and protracted and difficult thing to do, especially when trying to raise four young children at the same time.

    Eventually Mom’s cancer returned with a vengeance, and we were thankful she died before her mind had entirely disappeared.

    The Sweet

    A year after my mother-in-law passed away, I changed the course of my career to help people in similar situations. I left Medicaid to become the owner of a home care company. In this rewarding role, I was able to assist families who were experiencing challenges incidental to age, illness, disability, and end of life care.

    I could relate to every family we served because of my own experience, and I knew that our team was making a difference. As care providers, we offered welcome relief to family caregivers who were struggling to get by.

    It wasn’t until I studied caregiving as a phenomenon of social science, however, that I came to understand why caregiving is so hard. The insight I gained from research was nothing short of revelatory because it explained, years later, the underlying challenges my family had faced with my mother-in-law’s condition.

    Instead of providing a few hours of respite to family caregivers, today I share knowledge that changes the way people interpret the caregiving experience. It’s illuminating to talk about things experienced but not explained, things visible but invisible, things sensed but not expressed. Caregivers and care receivers understand what I’m talking about.

    After a life and career redirected by caregiving, it’s reassuring when someone says, “You made a difference in my life. Thank you.” That’s exactly what happened in Las Vegas last month. What once was sour has become sweet.

    Posted on

    Aging Parents & Emotional Support From Their Adult Children

    Dr. Aaron Blight on Quora


    In his spare time, caregiving consultant and healthcare speaker Dr. Aaron Blight is happy to answer questions on Quora about caregiving organizational development, healthcare consulting, senior care, and many other topics. In this month’s post, we highlight his recent answer dealing with aging parents and emotional support from their adult children. At the time of publishing this piece, Dr. Blight’s response (posted below) has nearly 500 upvotes!

    When I owned my home care company, our team took care of an elderly married couple. The couple lived in a house alone together, and one of their daughters, Connie, lived down the street.

    Connie had moved there in order to provide support and understanding to her parents. In connection with that support, she hired us to regularly visit her parents’ home for help.

    Because of our presence in the home, we had learned that one night the couple’s son, who lived in another area, was planning to come to town to have dinner with his parents. In a conversation that morning with Connie, our employee mentioned the upcoming dinner.

    Connie was startled to hear that her brother was coming to town and having dinner with their parents. “What? I didn’t know about any dinner tonight! Nobody told me that my brother was coming!”

    Connie whipped up some mashed potatoes and walked down the street to join the dinner with her family.

    The next morning, a fuming elderly mother called me. In her trembling voice, she yelled, “We didn’t tell Connie that our son was coming to dinner last night because we didn’t want Connie to be there!”

    I can still hear the 81-year-old woman scolding me on the phone. But it makes me smile as I write about it today.

    It was one of many instances within this family where the aging parents’ expectations of “understanding and support” were markedly different from what was offered by their adult daughter. On a number of occasions, the elderly mother expressed to me that she wished Connie would stop “smothering” them. In Connie’s mind, she was doing what any dutiful adult daughter would do for aging parents.

    Often I have seen “understanding and support” turn into “smothering and control” as adult children get involved in the lives of their aging parents.

    I have also seen situations where “understanding and support” could be better described as “disappearing and denial” insofar as aging parents assert, or adult children believe, that no help whatsoever is necessary.

    Somewhere in the middle is the best you can really hope for, the best you can expect. If you are an aging parent and your adult child genuinely listens, offers help when you want it and when you really need it, and respects the decisions you have made about your life, then you’ve got a pretty good foundation of “understanding and support” that will make the waning years of your life a little easier to bear.

    Posted on

    A Day with Providers Serving People with Developmental Disabilities

    Today I had the privilege of speaking in New York City at the Annual Conference of the Interagency Council of Developmental Disabilities Agencies Inc. (IAC). IAC exists to help make a better world for people with intellectual and developmental disabilities living throughout New York State.

    Throughout the day, I found myself remembering my days working at the Centers for Medicare & Medicaid Services. It has been over a decade since I interacted so extensively with professionals working at agencies serving people with intellectual/developmental disabilities. For the last decade, my focus has been on providing services to the aging population.

    Provider Issues

    Today taught me, however, that there are many similarities between agencies serving people with disabilities and agencies serving the aging population. For instance, here’s a list of a few of the issues we discussed today:

    • Recruiting and retaining direct support professionals while there is a care workforce shortage
    • Adapting to financial constraints imposed by value-based reimbursement models
    • Complying with regulations that impact service delivery and administration
    • Fostering an organizational culture that promotes the hallmarks of care: empathy, compassion, judgment, and reliability
    • Confronting the social stigmatization of those who receive care
    • Providing consistently outstanding service to clients
    • Generally “doing more with less”

    The truth is that every one of the above topics could have been extracted from a conference of providers serving the aging population, whether the industry is hospice, home healthcare, nursing homes, or the like.


    My Favorite Moment

    My favorite part of the day was the performance of the Astoria Heart & Soul Dancers and Movers. This group of adults with intellectual and developmental disabilities braved the traffic and traveled across New York City to take the stage and dance for us.

    iac new york

    Wearing ill-fitting tutus and chasing the music’s rhythm, this distinguished group gave everything they had in a performance that was choreographed, energetic, and heartwarming. They circled the stage in a collective jive, but they also allowed the superstars to take the spotlight individually to show off their most impressive moves.

    Watching them brought tears to my eyes.

    When the dancers left the stage, the emcee emerged. “There’s no disability in personality,” he said. “And there’s no disability in artistic expression.”

    Posted on

    Family Caregiving Q&A With Dr. Aaron Blight, June 2019

    Dr. Aaron Blight on Quora


    In his spare time, caregiving consultant and healthcare speaker Dr. Aaron Blight is happy to answer questions on Quora about caregiving organizational development, healthcare consulting, senior care, and many other topics. In this post, we will examine some of his most recent answers dealing with caregiving within the family.

    How can I be a better caregiver to an elderly relative with dementia, a sore leg, and diarrhea? It’s so challenging sometimes.

    Dr. Aaron Blight:

    Suggestion #1: Proper medical care. With regard to the conditions you described, it’s advisable to take your relative to the doctor.

    The sore leg and diarrhea might be caused by conditions that are treatable. Certain conditions that involve diarrhea can also be infectious, so you want to ensure that you’re not contracting something like C.diff, which can also be fatal. The doctor will tell you what you can do to better care for your loved one, given his or her health conditions.

    Suggestion #2: Skill building. Seek opportunities to develop your capacity to care for your loved one.

    While there is no cure for dementia, there are approaches to managing behaviors that can be learned. You can learn by reading books, watching videos online, attending classes or support groups on Alzheimer’s care, or even spending time in observation at a dementia care unit of a nursing home. You might start by checking out books by David Troxel.

    Similarly, you can improve your hands-on care skills by taking a class or asking for some one-on-one training and tips from a professional. At my home care company, we offered extensive personal care training for our employees, but we allowed family members to participate in these classes, too. Here again, you may also benefit from online videos or observational visits in a nursing home.

    While there is no cure for dementia, there are approaches to managing behaviors that can be learned. You can learn by reading books, watching videos online, attending classes or support groups on Alzheimer’s care, or even spending time in observation at a dementia care unit of a nursing home. You might start by checking out books by David Troxel.

    Suggestion #3: Help from others. Caregiving for an elderly relative can be physically and emotionally depleting, but you don’t have to do this alone.

    You can engage other people to help your loved one with the tasks of caregiving. These helpers may be other members of your family, or they may be caring professionals. Either way, by “sharing the caring” for your elderly relative, you can restore your energy and your soul – thereby finding yourself in a better place when you return to your loved one.

    In addition to bringing others into the care of your loved one, you may also consider seeking help for yourself. Sometimes family members are so wrapped up in caring for their loved one that they disregard their own self-care or they’re actually unaware of how much they are struggling. Often it is a cathartic experience when family caregivers get help from professional counselors, pastoral counselors, or even support groups.

    How do you be both a good Caregiver AND spouse at the same time?

    Dr. Aaron Blight:

    Your question presumes a dualism of roles.

    What if being a good spouse of a husband/wife with care needs encompasses caregiving? If you think about it this way, you’re no longer struggling with an “either-or” proposition.

    Many spouses are able to persist in caregiving tasks by changing their assumptions about the marriage relationship. They come to essentially say to themselves, “Being the spouse of a disabled or aging person includes caregiving, and I’m okay with that.”

    If you redefine your relationship to allow your conjugal role to include the caregiving tasks you’re performing, then you will ultimately resolve the internal conflict you’re feeling.

    I know that this is easier said than done because your relationship with your lifelong partner is not what it used to be.

    Your desire to be there for your spouse – and to “do good” by your spouse – is a reflection of your love and the importance you place on your relationship.

    I encourage you to talk to a counselor, pray for divine assistance, and access caregiver supports that are available in your community and online.

    Things will be different, but you can do this. You will stretch, learn, and grow; you’ll also become a better spouse and human being.

    When did it become necessary to get home health assistance for your parent(s)?

    Dr. Aaron Blight:

    My wife and I engaged professional home care assistance for her mother based on a referral from our local hospice agency. Mom received care from that company during the last two months of her life.

    We wished we had called that company sooner. We had spent more than five years doing everything ourselves.

    I later became the owner of a home care company to help families like mine, and then I formally studied caregiving as a phenomenon of social science.

    I learned that every family, and every family member, has different capacities to care for an aging parent. In addition, your capacity to care can expand and contract, depending upon the needs of your parent, the circumstances of your life, and how you’re honestly feeling about caregiving.

    So when does it become necessary to get home health assistance for your parent(s)? For some families, the answer is never. For others, the time to get help is when your parent’s needs exceed your family’s capacity to care.

    That’ll be all for this edition. How do you feel about caring for aging relatives? Feel free to interact with us on Quora or email us here at info @ caregivingkinetics.com with your thoughts – and be sure to check back on our blog over the coming weeks and months for more Q&A with Dr. Aaron Blight!

    Posted on

    Getting Older Q&A With Dr. Aaron Blight, May 2019

    Dr. Aaron Blight on Quora

    In his spare time, caregiving consultant and healthcare speaker Dr. Aaron Blight is happy to answer questions on Quora about caregiving organizational development, healthcare, support for family caregivers, senior care, and many other topics. In this post, we will examine his recent answer to a very popular question. What is different about this answer, though, is that Dr. Blight tackles the question from a societal view.

    What’s the hardest part about getting older?

    Dr. Aaron Blight:

    I have read several of the 100+ compelling responses to this question and originally thought I don’t have too much to add to what has been expressed by other writers. Then I considered the fact that the responses I read address this question on a micro-level, at the level of the individual. I’d like to address the question on a macro-level, at the level of society.

    Our society is getting older. People are living longer than ever before, with chronic conditions, and there are fewer children. In 2019, for the first time in history, there will be more people over age 65 than under age 5.

    The hardest part about getting older – as a society – is that we must culturally redefine what it means to grow older, as a society.

    Instead of marginalizing older adults because of their age, we should revere them.

    Instead of pushing older adults into retirement homes, we should integrate them into communities.

    Instead of looking upon retirement as “checking out,” we should see retirement as an opportunity to contribute in new and meaningful ways.

    Instead of accepting ageism as the socially acceptable form of discrimination, we should reject it.

    Instead of rushing past that old person we see in the store, we should smile and say hello.

    Instead of emphasizing youthful attractiveness, we should focus on learned experience.

    Instead of highlighting the disease, we should acknowledge the whole person.

    Instead of treating the age 65+ population as a single cohesive unit, we should recognize the broad diversity among them.

    That’s all for this edition. So, what do you think the hardest part is about getting older? Feel free to chime in on Quora or email us here at info @ caregivingkinetics.com with your thoughts – and be sure to check back on our blog over the coming weeks and months for more Q&A with Dr. Aaron Blight!

    Posted on

    As Consumers Age, Gerontologists Are Becoming Valuable Hires

    benefits of hiring gerontologists
    The consumer population in the United States is aging, and businesses who want to continue to grow are being forced to adapt to that reality. In order to make sure they are remaining relevant to those who are now in an older age bracket, the idea of hiring a gerontologist is quickly becoming an appealing concept. Simply by hiring someone who understands how to target an older segment of the market, brands may be able to avoid making mistakes that could cost them dearly in the end.

    It’s Not That Simple

    An easy mistake to make, and one that has certainly been made by businesses in the past, is to think that all senior citizens can be lumped into the same consumer category. That is just as incorrect as trying to consider all buyers in their 30s to be similar in their wants and needs. Just because seniors happen to be the same age as each other does not mean they suddenly all have the same expectations as consumers. These people remain individuals as they age, and a gerontologist can help a brand sort out exactly what kinds of expectations their target market is going to possess.

    Adapt or Die

    For a long time, it seemed to be the case that brands would simply build their products with younger buyers in mind – and basically force older consumers to just deal with it. Now, however, with seniors making up such a sizable part of the market, it is necessary for brands to adapt to the needs of those in their retirement years. Since the market is so big, with so much buying power, businesses can no longer afford to basically ignore this segment. After all, if one business decides not to cater properly to the needs of their senior customers, one of their competitors will be more than happy to do so.

    The Right Markets

    Clearly, not every business is going to be able to benefit from bringing a gerontologist onto the staff. This is a valuable field of study, but it needs to be applicable to a business’ regular operations in order to make sense. Some of the markets which have been finding gerontology to be a useful addition to their office include financial services companies like investment companies and banks. Of course, that is in addition to the companies that have long sought out people trained in this area, such as senior living facilities.

    Business is Business

    At the end of the day, the idea behind hiring a gerontologist is the same as anything else a business does as part of its operations – it’s an attempt to serve customers. As those customers age, some of their expectations and needs will change, while others will stay the same. Having a person or people on staff who can analyze how those changes will intersect with a company’s offering of products or services can be huge.