October 21, 2021
One in five employees serve as caregivers to a family member or loved one. They describe their experiences of juggling work and care responsibilities as “stressful” and “difficult”—and this trend has only increased due to the pandemic. More than seven in ten working caregivers report that COVID-19 has negatively impacted them or their loved one.1
While the work of unpaid caregivers can often be invisible, it is inherently valuable to our society. Notably, the annual value of family caregiving in the U.S. is $522 billion, with the cost of substituting paid care ranging from $221 to $642 billion.2 Moreover, caregiving often comes from a place of love; employees want to provide support and companionship when their loved ones need it most. Thus, benefit leaders should be knowledgeable about the plethora of positive outcomes and best practices related to caregiver benefits and leave that appropriately meet the needs of working caregivers and their families.
The following FAQs offer information to help benefit leaders mitigate the current caregiving crisis, understand the business case and design equitable, comprehensive benefits for caregivers.
Caregiver Benefits and Leave FAQs
Though definitions vary, for the purposes of this resource, a caregiver is someone responsible for a child or adult dependent with a serious health condition or one who assists an elder dependent in carrying out activities of daily living. Although a “typical” family caregiver is a 49-year-old woman who takes care of a relative, a rapid shift is occurring.3 Today, more men and millennials are taking on caregiving responsibilities, and this change will only accelerate as we break stereotypes and move toward equity—at work and at home.
Caregiving duties vary case-by-case and thus will impact each employee’s work experience differently. Nevertheless, many working caregivers experience consequences to their careers and their well-being:
- Decreased productivity: More than 80% of employees with caregiving responsibilities said it affected their productivity; in contrast, only 24% of employers responded that caregiving influenced workers’ performance.4 Additionally, the majority of caregivers indicated they did not take on additional work responsibilities or projects and felt the quality or timeliness of their work suffered.1
- Increased unplanned time away: Seventy-three percent of family caregivers had to leave work early or unexpectedly, 70% called out from work for one day and 59% had to take two or more days off in a row. On the other hand, 49% had to postpone, reschedule, miss or cancel a care recipient’s doctor’s appointment or treatment due to work.1
- Employee turnover: One in three caregivers left a job due to caregiving stress. Notably, highly titled, highly paid employees are most likely to leave a company because of a work-family conflict.4
- Mental health: Seventy percent of caregivers report adverse mental health symptoms—55% reported anxiety or depression and 32% reported passive or serious suicidal thoughts. The effects are even worse for sandwich caregivers, those caring for people both under and over 18; 52% report serious suicidal thoughts, 12 times the rate of nonparents/noncaregivers.5
- Well-being: Caregivers are twice as likely to develop chronic illness, and 49% experience exhaustion and stress; 27% point to stress on their marriage or relationship and 60% are overwhelmed by financial stress.6,7,8
For more data and insights on the relationship between caregiving and physical health, mental and financial health, see Business Group’s infographic, The Impact of Caregiving on Work and listen to The Case for Honoring Caregivers podcast, featuring a discussion with Alex Drane, CEO and Co-founder of ARCHANGELS and Rebel Health.
Caring for a loved one is not a role limited to a particular culture, country or region—it is universal, and many caregivers across the globe share common characteristics and challenges. Given this universal idea that caring for a loved one is a natural occurrence, the needs of caregivers have been mostly overlooked and unsupported on the world scale—until recently. Thankfully, support for caregiving is growing. Today, many international organizations focus on supporting caregivers and bringing together helpful resources, including The International Alliance of Carer Organizations (IACO), World Health Organization (WHO) Integrated Care for Older People (ICOPE) and AARP.
While caregiving may be universal, different political, social and economic contexts influence the caregiving experience. Here are a few examples of how caregiving and the benefits available to families differ across the globe:
- Australia: Just over 10% of the population is a ”carer,” the term most frequently used in Australia. National Carers Week, the second week of October, is intended to raise awareness about the diversity of carers and their caring roles. Australian carers have access to financial support, such as the carer allowance, as well as 10 days of sick and carer’s leave per year, unpaid carer’s leave (up to 2 days of unpaid leave each time an immediate family member needs care) and compassionate and bereavement leave.10,11,12
- Finland: There are approximately 350,000 informal (family) carers in Finland, representing 6.3% of the population—and 28% of working Finns are carers.13 Informal carers have access to a care allowance, as well as tax benefits, such as a deduction for expenses and a credit for domestic help or household expenses. Unfortunately, these benefits are not well known and used primarily by middle- and upper-income households. Carers in Finland also have access to unpaid leave.
- Germany: Like many developed nations, Germany’s growing elderly population has contributed to the ongoing global caregiving crisis. There are currently over 4 million care-dependent Germans—75% of whom receive that care at home. And according to estimates, Germany will need half a million caregivers by 2035—about 120,000 more than it already needs today.16 While there is no government-sponsored financial support for caregivers in Germany, care dependents are given a care allowance or home care in-kind benefits through long-term care insurance.17
- India: In India, it’s a cultural norm for family members to be primary caregivers for older adults. While 97% of caregivers in rural areas live in poverty, caregivers do not receive any form of a caregiver allowance. COVID-19 has shed a light on the importance of caregivers among employers, and there’s hope for systemic change to support working caregivers in the future.17
- Israel: Israel has over 1 million family caregivers, 21% of its population. Not only does Israel have a long-term care benefit, but family caregivers are also paid to care for their relative in need.17,18 Family caregivers have access to leave. The duration is based on the relationship and situation. For example, 90 days can be taken for a child with a malignant illness, up to 18 days can be taken for a child with disabilities (36 for single parents), and 6 days are permitted for a parent.17
- Japan: More than 6 million people are considered family caregivers—or “kazoku kaigosha” as they are referred to in Japan.19 Family caregivers have access to up to 93 days of leave to care for a family member and can apply for shorter workdays, as well as an exemption from overtime work when caring for a loved one.17
- Taiwan: Cultural norms in Taiwan support “filial piety” that forbids placing elderly family members into assisted living and/or nursing homes.20 A subsidy of NT$180 (U.S. $5.80) per hour for up to 25 hours is provided for those with mild disabilities, with up to 50 hours available for those with moderate disabilities.21 The Ministry of Health and Welfare provides case management, care technique instructions, trainings, counselling and groups to support the mental health of caregivers.17
Even though caregiving is common across the globe, a social stigma is attached to it that has a real impact on caregivers and their care recipients. Stigmatized groups have a greater risk for depression, hypertension and stroke compared to non-stigmatized groups.22 Stigma can lead to isolation and consequently cause caregivers to miss out on resources and support they need.
According to 59% of employees in today’s workforce, caregivers are perceived to be less committed to their careers than non-caregivers. Men (40%) and employees with salaries greater than $100,000 (46%) are more likely to strongly agree with this perception than women (25%) and employees earning below the poverty line (16%). Likewise, the majority (55%) of employees agree caregivers are less likely to progress at the same rate as their peers even when their input is similar.4
When asked about their own experiences at work, one in four caregivers indicated that their caregiving responsibilities have negatively affected their careers, and notably, men, senior leaders and those with $100,000+ salaries were more likely to acknowledge the impact. Fifty-four percent of those with affected careers said they received less challenging and motivating work, 50% received lower salary increases/bonuses, 46% were no longer satisfied with their career path and 32% were passed over for a promotion. Additionally, 17% indicated they lacked access to mentors or senior leaders who could coach them.4
Caregiving stigma can have a detrimental effect on the well-being and productivity of not just one employee but on the overall workforce morale. Therefore, it is understandable that caregiving stigma has pushed many employees to purposely not disclose their status as a caregiver with their employers out of fear of repercussions.23 Thus, it is crucial that employers act strategically to lessen the harm caused by stigma.
Large employers can address caregiving stigma by:
- Getting leaders involved: Have senior leaders break the silence, share their own caregiving experiences (including how they used company benefits) and send a clear message that your company supports caregivers. Equip them with tools and information on best practices to address caregiving stigma through storytelling/fireside chats from CEOs, inclusion of engagement in caregiving support in a worksite scorecard, connecting/consulting with strategic global and regional advisors, initializing calls to action, and other strategies.
- Launching communication campaigns: Address stigma through targeted communications campaigns and inform employees of available internal benefits, external organizations and community services. Consider taking advantage of national campaigns, such as National Family Caregivers Awareness Month.
- Training managers: Offer training to help managers recognize and regularly affirm genuine support for caregivers. For example, managers can provide practical, flexible solutions that express this positive support and work to dismantle preexisting assumptions that exacerbate this stigma.
- Connecting with diversity, equity and inclusion efforts: Integrate family caregiving into company efforts to enhance diversity, equity and inclusion. If your company does not have a Parents and Caregivers Employee Resource Group (ERG), consider starting one.
- Assessing needs: Proactively track the needs and responsibilities (where legally and ethically appropriate to do so) of employees who are caregivers through surveys, focus groups or other listening opportunities.
- Advocating: Advocate for legislative actions and initiatives that aim to diminish the harms and/or challenges associated with caregiving.
There are a variety of ways employers can support working caregivers. Solutions will vary by individual situations, so flexibility and compassion are key.
To support caregivers, employers can consider:
- Paid caregiver leave, even better with equitable access for employees regardless of their status as a full- or part-time employee.
- Schedule flexibility, such as flexible hours, reduced hours or shift- swapping opportunities. For part-time employees, schedule predictability can be critical to planning care responsibilities and avoiding missed appointments and treatments.
- An integrated care coordination/navigation benefit that connects employees with care experts who can advise and assist with care plans, medical care, insurance, legal needs, financial counseling, emotional support and more.
- Backup elder care.
- Child and elder care subsidies or reimbursements.
- Access to specialty providers, Centers of Excellence and diagnostics tools to support children with disabilities.
- Parents and Caregivers ERG or support group.
According to the Business Group’s 2020 Large Employers' Leave Strategy and Transformation Survey, 35% of large employers offered paid caregiving leave in 2020 and another 28% reported they were considering it for 2021/2022.
Following the structure of the Family and Medical Leave Act (FMLA), all employers with caregiver leave cover the employee’s children, spouse and parents. And many employers have implemented broader and more inclusive policies that cover a variety of other family members and loved ones: siblings (46%), parents of a spouse/partner (46%) and grandparents (38%). Some employers even extend caregiver leave to all loved ones, defined by the employee.
The survey also revealed that almost half (46%) of large employers offered more than 10 days of paid caregiver leave. More specifically, 23% offer more than 20 days, 23% offer 11-20 days, 40% offer 6-10 days and 14% offer 5 days or less (Figure 1).
By designing benefits that support the unique and diverse needs of working caregivers, employers are simultaneously signaling their broader commitment to workforce equity, diversity and inclusion (EDI). The Business Group webinar, Diversity, Inclusion & Caregiving: A Case Study with Merck, describes existing caregiving disparities and how they manifest in different populations. Below are examples of the disproportionate impacts on women, BIPOC and caregivers earning lower wages.
- Working female caregivers spend, on average, approximately 60% more time caring for aging loved ones compared to their male counterparts, and women are three times more likely to retire earlier than expected to become a caregiver.24 By offering and communicating gender neutral caregiving support, employers can help counteract disparities due to gendered norms, stereotypes and/or expectations tied to caregiving work.
- Latinx families are significantly more likely to take care of a loved one than Black or white families. Black and Latinx caregivers are in high-intensity care situations more often than either white or Asian caregivers. During the pandemic, Black and Latinx families experienced a greater increase in time spent on care than white families.24
- Caregivers with higher incomes report significantly higher levels of health. Those with lower incomes are in high-intensity situations more often, provide longer hours of care weekly and feel less supported by their employers.24
- 1 | Harrington E, McInturff B. Working while caring: A national survey of caregiver stress in the U.S. workforce key findings. Rosalyn Carter Institute for Caregivers—Pubic Opinion Strategies. 28 September 2021. https://www.rosalynncarter.org/wp-content/uploads/2021/09/210140-RCI-National-Surveys-Executive-Summary-Update-9.22.21.pdf. Accessed October 5, 2021. .
- 2 | Chari AV, Engberg J, Ray KN, Mehrotra A. The opportunity costs of informal elder-care in the United States: New estimates from the American Time Use Survey. Health Serv Res. 2015;50(3):871-882. doi:10.1111/1475-6773.12238. Accessed September 23, 2021.
- 3 | Caregiving in the United States 2015 revised report. AARP. 2015. https://www.aarp.org/content/dam/aarp/ppi/2015/caregiving-in-the-united-states-2015-report-revised.pdf. Accessed October 5, 2021.
- 4 | Fuller JB, Raman M. The caring company: How employers can help manage their caregiving responsibilities— while reducing costs and increasing productivity. Harvard Business School Project on Managing the Future of Work. 2019 January 17. https://www.hbs.edu/managing-the-future-of-work/Documents/The_Caring_Company.pdf. Accessed October 5, 2021.
- 5 | Chatterji P, Markowitz S., Brooks-Gunn J. Early maternal employment and family wellbeing. Cambridge, MA: National Bureau of Economic Research; July 2011.
- 6 | Ho A, Collins SR, Davis K, Doty MM. A look at working-age caregivers' roles, health concerns, and need for support. Commonwealth Fund Issue Brief. 2005 Aug;(854):1-12.
- 7 | Unum. Adult caregiving: Generational considerations for America’s workforce. June 2018. https://www.unum.com/caringreport. Accessed August 6, 2021.
- 8 | Fidelity Investments. Fidelity® study: More than three-quarters of caregivers report financial, social, mental or Professional setbacks. May 27, 2021. https://newsroom.fidelity.com/press-releases/news-details/2021/Fidelity-Study-More-Than-Three-Quarters-of-Caregivers-Report-Financial-Social-Mental-or-Professional-Setbacks/default.aspx. Accessed August 5, 2021.
- 9 | Australia Population (2021) - Worldometer. Worldometers.info. Accessed October 14, 2021. https://www.worldometers.info/world-population/australia-population/
- 10 | Fair Work Ombudsmen. Sick & carer’s leave. Australian Government. https://www.fairwork.gov.au/leave/sick-and-carers-leave. Accessed October 14, 2021.
- 11 | Fair Work Ombudsmen. Unpaid carer’s leave. Australian Government. https://www.fairwork.gov.au/tools-and-resources/factsheets/minimum-workplace-entitlements/personal-leave-and-compassionate-leave#unpaid-carers-leave. Accessed October 11, 2021.
- 12 | Fair Work Ombudsmen. Compassionate and bereavement leave. Australian Government. https://www.fairwork.gov.au/leave/compassionate-and-bereavement-leave. Accessed October 11, 2021.
- 13 | Eurocarers. Towards carer-friendly societies: Finland. https://eurocarers.org/country-profiles/finland/ Accessed October 14, 2021.
- 14 | Finnish Red Cross. Family caregiving in Finland. December 18, 2019. https://www.redcross.fi/get-help-and-support/coping-as-a-family-caregiver/family-caregiving-in-finland/. Accessed October 14, 2021.
- 15 | Pieper O. How Germany fails to manage care for the elderly. DW. January 8, 2021. Accessed October 12, 2021. https://p.dw.com/p/3yCmH. Accessed October 12, 2021.
- 16 | Germany: Top court’s order on foreign nursing home workers’ pay triggers debate. DW. June 26, 2021. https://p.dw.com/p/3vYPf. Accessed October 12, 2021.
- 17 | International Alliance of Carer Organizations. Global state of care. https://internationalcarers.org/global-state-of-care/. Accessed October 14, 2021.
- 18 | Omaishoitajat. Carers Finland. April 24, 2017. https://omaishoitajat.fi/carers-finland. Accessed October 14, 2021.
- 19 | Statistics Bureau of Japan. 2017 Employment status survey. https://www.stat.go.jp/english/data/shugyou/index.html. Accessed October 11, 2021.
- 20 | Zeldin, W. Taiwan: Amendment to criminal law provides "exclusion clause" for fulfillment of filial obligations. Library of Congress. 2010. https://www.loc.gov/item/global-legal-monitor/2010-02-19/taiwan-amendment-to-criminal-law-provides-exclusion-clause-for-fulfillment-of-filial-obligations/. Accessed October 14, 2021.
- 21 | Ferry T. Foreign caregivers fill the gap. Taiwan Business TOPICS. October 18, 2018. https://topics.amcham.com.tw/2018/10/foreign-caregivers-fill-the-gap/. Accessed October 11, 2021.
- 22 | Centres for Studies on Human Stress (CSHS). The stress and stigma of caregiving. 2019. https://humanstress.ca/stress-and-you/elders-and-stress/caregivers. Accessed October 5, 2021
- 23 | Yin Y, Zhang W, Hu Z, et al. Experiences of stigma and discrimination among caregivers of persons with schizophrenia in China: A field survey. PLoS One. 2014;9(9):e108527. Sep 26, 2014. doi:10.1371/journal.pone.0108527. Accessed September 28, 2021.
- 24 | Business Group on Health and Wellthy. Diversity, inclusion & caregiving: A case study with Merck webinar. June 17, 2021. https://www.businessgrouphealth.org/get-involved/events/diversity-inclusion-and-caregiving-a-case-study-with-merck. Accessed July 8, 2021.