B.C. Elderly Care on the Rise

Eldercare-BC-5.jpg
Belinda Neumann’s struggle to care for her sick mother involved stress, tears and a demotion.

While workplaces long ago adapted to employees’ child care needs, few are 
prepared for the coming tsunami of eldercare demands.

Belinda Neumann’s co-workers could only watch as she buckled under the pressure. At work she was often distracted, forgetful and confused. Her productivity was shot. She never knew when a phone call would demand she drop everything or (as it did more than once) reduce her to tears right there in her cubicle. Her mother was suffering with multiple sclerosis, and caring for her had become a daily worry for Neumann. If it wasn’t finding the time to drive from Vancouver to Abbotsford to help with a mundane task, it was the long, frustrating phone calls. After a few years of escalating eldercare demands, Neumann’s manager called her to a meeting and suggested she should perhaps step down from her position as a recruitment specialist. She was offered a demotion.


For Cora Amador, concern for her bedridden mother turned her from a model sales clerk with WH Smith to an impatient, sometimes rude and unreliable employee. She would regularly call in sick, sometimes as often as twice a week, and if she got a call at work about her mother’s health, she would have to leave. Her mother was constantly on her mind. Her colleagues and manager were sympathetic but ultimately the emotional strain drove Amador to quit.


Susan Dunn’s mother suffers from Parkinson’s and dementia. The dementia would routinely cause her to wander the neighbourhood in seasonally inappropriate clothing, spend hours trying to find the keys she’d hidden from imaginary thieves or just forget to eat – yet she refused to accept care outside of her home. The burden fell on Dunn, managing broker with DFH Real Estate in Victoria, to undo all the things the dementia did. She would close up shop to go locate her lost mother or find the mislaid keys or arrange for a meal service. Care became a juggling act, and it wasn’t until a medical emergency moved her mother out of the house and into a geriatric care facility that the pressure lightened a little. 


There are hundreds of similar stories, each one a little different, which is why eldercare in the workplace is such a complex issue. Dealing with a parent or partner who is no longer able to manage their own care brings on emotional, physical and psychological issues that certainly affect the individual employee but also the company and ultimately the bottom line.


The toll is about to get a lot bigger when you consider the fabric of today’s workforce. Canada’s densest demographic, the baby boomers, are working longer but also caring for parents who are enjoying an extended lifespan (now an average of 81.2 years for British Columbians). 


By the year 2032, approximately 25 per cent of B.C.’s population will be seniors, and as their care needs increase so will the demands on their children. According to a report published by Mount Allison University, 90 per cent of seniors are cared for by family or community care or a combination, but not by institutions. That puts the care of aging boomers squarely on the shoulders of generations X and Y, but the problem is that those generations were born during a birth-rate decline. So while the population of seniors needing care will mushroom in the coming decade, they have relatively few offspring to look after them.


It’s not just age that is increasing the demand for care; it’s also the escalating prevalence of the most common diseases affecting elder health: cancer, Alzheimer’s disease and diabetes. The incidence of cancer is estimated to be growing by six to eight per cent per year. According to Health Canada, the number of Canadians needing cancer treatment will have doubled between 2001 and 2020. Earlier this year, the Alzheimer’s Society of Canada reported that in 2008 there were 103,700 new cases of dementia identified and that by 2038 the annual number will increase to 257,800. The society estimates that, at these rates, by 2038 more than 1.1 million Canadians will be suffering with dementia. As for diabetes, the numbers are shocking. In 2000 1.4 million Canadians suffered with diabetes; by 2016 that number will hit 2.4 million.

[pagebreak]
The approaching eldercare crunch bears some similarity to the crisis that corporations faced in the late ’80s, when child care demands took women out of the workforce. The difference is that eldercare is much less predictable. Unlike raising a family, there is no nine-month planning phase and there isn’t a set timeline. While a newborn will eventually be old enough for daycare, for school and eventually for self-care, an illness has no time frame; it might be a month of recovery or it could be decades of assisted living. 


The one similarity is that the burden often falls on women. John DeHart, co-founder of Nurse Next Door Professional Home Healthcare Services Inc., a service that provides in-home care, says that 75 per cent of the people who make that initial call for help are the daughters or daughters-in-law. They are the ones trying to figure out how to keep all of the balls in the air.


Perhaps the most significant difference between eldercare and child care is its overwhelming emotional toll. DeHart believes most people are caught off guard. “It’s a big impact on your life when something happens to your mom or your dad,” he explains, “and we as a society aren’t quite prepared for it because we’ve sort of stuck our head in the sand.” He knows first-hand how serious that sudden stress can get. Sitting in the open space of the Nurse Next Door offices in Kerrisdale, he remembers a client he had dealt with in the early days of the company. It was the strain in her voice that led him to offer an introduction to another client who was dealing with a similar situation. He recalls, “I got a call back a month later and she said, ‘You know what? I was about to commit suicide because of what I was going through, and the fact that I was able to sit with another person who was going through what I was going through . . . 
it took me down from the cliff.’ That’s how stressful situations become.”


And in that nerve-racking time, getting answers and advice can be one of the biggest challenges, according to Peter Silin, an expert in eldercare and principal of Diamond Geriatrics Inc. As a self-titled “care concierge,” he helps clients navigate through public and private care options. He finds that most people assume the government will look after everything and are surprised to discover there is often a gap in care. He explains, “For assisted living in the public system, you can wait between six months and two years. For complex care (nursing homes) in the public system, you can wait between one and three months.”


This reality leaves people searching for alternatives or trying to manage things on their own, both of which lead to a decreased capacity at work. And most of them do it silently. Silin says, “It’s more acceptable or understood about child care than about eldercare. I do find that people hide their issues and just take a sick day.” This all stems from employees being ill prepared for the situation; they don’t know what to expect and they don’t have any answers. They don’t know what they can ask for from their supervisors, so they don’t ask. 


Erica Pinsky, author of Road to Respect: Path to Profit, says, “If the company is not adopting what I would call a respectful attitude, respecting the whole employee, then in general it’s going to cause those employees to feel that they are not able to speak up about those issues, those needs, and that is going to affect their ability to be focused at work and their connection and loyalty to their employee as well.” 


She cites examples from her book where employers engage in an “adult-to-adult” relationship with their employees, ensuring they know what is expected of them but giving them the flexibility to get the work done however that fits into their life. That could mean an employer offers telecommuting, shift work, delegation or even a leave of absence. 


Pinsky believes that when employers approach all outside stresses this way and they empower their employees to be in charge of managing their own work, it pays off. She further explains, “Employees are committed because they feel that responsibility to the company because the company shows them the respect that they feel they want and deserve and, as a result, they give that back. It really does build loyalty. It does build productivity amongst employees.” This is the approach she feels will help companies survive the coming eldercare issues. 

[pagebreak]
Several companies are ahead of the curve in addressing the need for eldercare benefits. KPMG has a back-up eldercare program for its employees that assists them with in-home care. And if those care hours get used up, other employees can gift their unused eldercare hours. Vancity offers family care days to its employees, which can be used for self-care, child care or eldercare. Ernst and Young provides access to 24-hour counselling and has an eldercare fund. Nurse Next Door offers its staff flexible shifts and access to caregivers. 


But perhaps the biggest benefit available is education. Silin believes that preparing employees for the possibility of eldercare issues, giving them a road map to the various forms of assistance and talking to them about the unexpected expenses of eldercare is one of the best ways to keep employees focused at work. 


DeHart also advocates for education. He believes that management training is the key, not only in how to handle employees with eldercare issues, but in being able to spot the signs of someone who may be dealing with it in silence. 


Employees tend to keep their situation to themselves because they initially underestimate the impact. Even DeHart, who is in the business of eldercare, didn’t fully understand it until he had a personal experience. “I got a call out of the blue that my dad had cancer, with two months to live,” he says. “I took off literally for two months and was his caregiver 24-7 and up until that point – even though I ran a business doing it – I didn’t get it. I didn’t get it until I was immersed in the emotional, the physical, the spiritual, just the turmoil that you go into, and the hardship. And I remember that a month into it I burnt out. One month into it. Pretty young, high-energy guy and I burnt out. And being off work too – I wasn’t even working.”


The connection between an overwrought employee and a company’s bottom line is a fuzzy one. Currently, there are few gauges measuring the economic impact of eldercare. A recent Watson Wyatt report estimates the cost of lost productivity at $16 billion in Canada. A 1997 study done by the insurance provider Metropolitan Life estimates that eldercare cost American companies around $3,142 per employee each year. These numbers may seem astronomical, but they incorporate loss of employee productivity, administration, staff replacement, health and mental care, as well as absenteeism. 


Belinda Neumann had worked for Vancity for more than 20 years when her manager called her into a meeting to discuss her job performance. She had mastered many challenges during her career, including balancing work and life while sharing care of her two children with her husband. But it seems the task of caring for her mother was simply too much. Neumann was told that she was an important member of the team and that was why she was being offered a demotion. Initially it was a blow to her ego. Her first instinct was to try harder, to pull up her socks and prove she could do it all. But when she looks back on it now, she says she’s relieved she got the chance to stay on at the company. 


She took the demotion and never regretted it. Three years later, after the unfortunate loss of her mother, Neumann is in line for a promotion, and she feels her career is back on track. In hindsight, she says, “I believe that my manager at the time just felt that I was overwhelmed and that the demotion would help my situation. In the end, she was correct, and I was able to feel more in control of my work life.”