Elder Care “Tweaks” to Prepare Now, Before It Strikes

I recently appeared on Huffington Post Live to discuss “Elder Care for the Baby Boomer Generation.”  Joining me on the segment was TWEAK IT elder care expert, Denise Brown, founder of Caregiving.com, the amazing, online information and support community that helps men and women succeed with the difficult task of caring for adult family members.

After the segment, I asked Denise to share specific tweaks that we can make today to prepare for future caregiving responsibilities.  As she points out, “Eldercare is not something that happens to someone else. It will happen to all of us.”

You can find more of Denise’s wisdom in TWEAK IT:Make What Matters to You Happen Every Day. Here’s one of her extra bonus “tweaks” from the TWEAK IT Together community site:

“Create back-up plans and then a back-up plan for your back-up plan. Research options in the community, even if you think you won’t need them. You never know. You have to ask the “what ifs.” It’s best to prepared, just in case. Check with your employer about an EAP or Work/Life benefit. Often EAPS and work/life providers will research options in your community (and your aging relative’s if he/she lives in another state) and help you create your back-up plans.(Click here to learn what to do if you don’t have access to an EAP).”

What small actions have you taken today to get ready to take care of your aging family members in the future?  Be sure to share in the comments section below or on Facebook.

5 Years Later, Reflecting Back on Life in the Eldercare Trenches

Today begins a “week of action” for the bloggers who are part of  AARP’s caregiving “kitchen cabinet.”  Not only do I deal with eldercare/family caregiving issues professionally as a work+life strategy consultant, but I have been a caregiver myself.

As my call-to-action, I wanted to go back and reflect on how I felt in August, 2007 as I began to emerge from the eldercare trenches having just lost my mother to an 18 month fight with lung cancer.  I had written a blog post entitled “Mom’s Peaceful Passing–Eldercare True Confessions.”  Reading my words today, I am transported back to the exhaustion, complicated feelings and hard realizations.  But mostly, I am proud.

I am proud of my mom.  Proud of my sisters and even proud of myself.  My mom brought us into this world, and we can honestly say that we shepherded her through her final transition in as loving and peaceful a way as possible.

But we were lucky.  My sisters and I had very flexible jobs. My mother had enough money to get the care she needed (assuming it was available, which is a whole other issue.)  And it was still hard. Harder than I remember.  Clearly, time has softened the edges of the experience, but it hasn’t dimmed the insights and passion that continue to inform my work in this area.

Were you a caregiver in the past?  When you reflect back on the experience today, how do you feel?  What do you wish others knew that you may have learned the hard way?  Here is my story from August, 2007.  I would love to hear yours.

Mom’s Peaceful Passing–Eldercare True Confessions

My mom peacefully passed away on July 6th after waging a heroic eighteen-month battle with lung cancer. I want to thank everyone who has sent messages of support and shared their personal stories of caring for an adult they loved. It has meant so much to me and I thank you from the bottom of my heart.

Over the past six weeks as my sisters and I provided 24/7 care until her death, then arranged my mother’s funeral, I had no capacity for blogging. But now, two-weeks into my “re-entry,” I would like to share some personal observations about eldercare. My experience has radically changed how I will professionally approach this major work+life transition going forward.

I had to save my true confessions about eldercare until after her death, because reading them would have been too painful for her. Because the truth is that eldercare is one of the most difficult things I have ever done.While I would do it again in a heart beat, it’s a responsibility that exacts a tremendous toll—physically and emotionally—straining even the most well-thought-out work+life fit.

The best way to describe what I mean is to compare eldercare to working after having my children, who are now nine and six. (Note that for the purpose of this comparison, I’m assuming that the children do not have special needs. To learn more about those unique challenges, see guest blogger, Linda Roundtree’s, excellent posting).

Like eldercare, becoming a parent is a huge transition. In both circumstances you are often sleep deprived and have absolutely no time for yourself. But, in general, caring for your child is:

  • Happy and rewarding;
  • Based on a relatively predictable curve of development with care readily available, albeit for a price; and
  • Controlled by you. You say how, when, and where the child will be cared for and the child must comply, willingly or unwillingly.

In contrast eldercare is sad, unpredictable, and rarely, if ever, fully controlled by you. Let’s briefly look at each aspect of this comparison.

Sad

Even at its most difficult, caring for a child always involves the possibilities of the future. Caring for an aging or sick adult is about loss. Loss of the vibrant person. Loss of their pain-free existence and control over even the most mundane activities of life. And, ultimately, death. Because the work+life fit equation is based on time and energy, the pervasive sadness of eldercare is an energy drain that doesn’t exist with child care.

Unpredictable

Yes, my children will unexpectedly wake up sick and not be able to go school, we’ll have a snow day, or my nanny will be running late. But for the most part, things are pretty predictable. Not so with eldercare.

While every child is unique, there is a general developmental curve they will follow. With eldercare, there is no such curve. Every adult’s medical, family, financial, emotional, and community circumstance is completely unique. And there is a shocking lack of affordable care. For the most part, unless you are very poor, very wealthy, or have excellent long-term health care, you are on your own. In fact, I don’t think most people, or employers, have any idea just how on your own you will be when dealing with eldercare.

In our case, my mom was single so my sisters and I were her primary caregivers. Thankfully, she had a wonderful community of friends and enough resources to support the care she required. But even so, we had to provide a tremendous amount of care, because there are many things you still have to and want to do yourself. And, both my sisters and I had a great deal of job flexibility. We couldn’t have done it if we didn’t.

Even with the flexibility that comes from working for myself, trying to plan my work around my mom’s care was almost impossible. I just had to take my best guess, and my best guess wasn’t always accurate. I probably should have said “no” more than I did, but I just wasn’t sure what my capacity would be. (Success Blog posting).

As I recently explained to a friend, it was like holding my breath for the last 18 months, always waiting for the other shoe to drop, which it always did at the busiest time for work. Toward the end, when the level of unpredictability accelerated, I began to understand why people would be forced to give up working. The ability to plan anything beyond just making sure your loved one has what they need is almost impossible.

Not Being Fully in Control

Now perhaps I was naïve, but I failed to consider the fact that my mother would have very strong ideas about how, when, and where she would be cared for. Very often those ideas didn’t coordinate with what my sisters and I thought would be best for her and, perhaps, most convenient for us and our work+life fit realities.

It was just one more unique element of eldercare that often added more time, more worry, and more stress to the equation than anything I’d experienced with child care.

As much as I consider my children’s wishes and well-being, their father and I have the last word. When your parent is mentally lucid which my mom was until three days before she died, your ability to dictate the details of care are very limited. In fact, we came up with a mantra, “hey, it’s her journey,” just to help us not worry as much when we disagreed with her choices, which was often. But they were her choices.

I look forward to using my 18 months in the trenches learning first-hand about the unique challenges of eldercare. As a school psychologist who dedicated her life to helping others, my mom would have wanted that. And now, as she would say, “I’d love to hear what your experience has been.” Let me know. And it’s great to be back!

The Eldercare Cliff. It’s Coming. Are You Ready?

(This post originally appeared in Forbes.com)

When I went to the polls, an issue that was barely mentioned during the campaign partially guided my vote. I favored the candidates nationally and locally whom I thought would begin to address the looming eldercare/adult caregiving cliff. Why?

Yes, jobs are very important, but increasingly people will struggle to keep a job as the demand to provide unpaid care for aging relatives (e.g. parents, aunts, uncles, friends, adult siblings) grows exponentially. Ultimately, this demand will far exceed the current level of supports in the community and the public funds available to pay for those minimal supports.

More and more individuals and employers will find they need to fill the gap financially and physically, and the worst is yet to come. But we aren’t talking about it. At least not yet; however, that’s going to have change.

What does eldercare/adult caregiving look like in action?

A couple of months ago, AARP in partnership with the Ad Council launched a three-year public service campaign to raise awareness of the tens of millions of unpaid family caregivers in the U.S. today.

When I first saw the powerful PSA, “Silent Scream” on television, it was so accurate in how it portrayed of the complicated emotions related to caring for another adult that it took my breath away. (My only wish it that they’d shown someone trying to rush out the door to work while figuring how to keep their mother safe when the caregiver doesn’t show up).

If you haven’t seen it, check it out here. It is worth three minutes.

What is the current state of eldercare/adult caregiving in the U.S.?

There are approximately 314 million people in the U.S. today. According to AARP, of that number, roughly 42 million were unpaid caregivers that provided $450 billion worth of unpaid care to adult relatives and friends in 2009. This is care that we, collectively, would have had to pay for otherwise.

In 2011, the Bureau of Labor Statistics reported that over a three-month period, 39.8 million people over the age of 15 said they provided care to someone over 65 years old because of “a condition related to aging. Of that 39.8 million:

  • • One-third cared for two or more older people
  • • 23% also cared for a minor child.
  • • 85% of caregivers and elders did not live together
  • • 56% of caregivers were women (44% men)

In other words, today about 13% of the U.S. population provides some type of unpaid family caregiving.

What is the projected future of eldercare/adult caregiving in the U.S.? (Click here for more)

The Workplace Challenges Political Candidates Have to Address

It’s not your grandpa’s workplace anymore, but if you listen to the presidential and congressional candidates, it’s easy to wonder if they’re aware that it’s 2012, not 1972. This is especially true for issues related to work and life in a modern, hectic, global, high-tech world.

Addressing these issues isn’t “nice, but non-urgent.” They directly impact the economic growth agenda that the candidates say is their primary focus. Productivity and innovation can’t happen without considering the reality people face on and off the job.

Now, I’m not saying government can solve all of the challenges. In fact, employers and individuals also need to act and think differently if we are going to construct a new model of prosperity for all. But public policy plays a role and must catch up.

I don’t know exactly what that looks like, but we need to start a serious debate grounded in today’s world.  Here are the six present-day work and life questions I wish every candidate for president and Congress would acknowledge. Doing so would let voters know that at least they understand the issues exist.

Questions #1 and #2: Who is going to care for the aging population? How are caregivers supposed to provide that care while working, and how are they supposed to pay for it?

If there’s one issue looming on the horizon that’s going to slam full force into businesses of all sizes and their employees (men and women), it’s eldercare. In terms of who will provide care, it’s not going to be a current or former stay-at-home parent or spouse:

  • First, most parents work for pay. A new study by the Center for American Progress found that, “in 2010, among families with children, 49% were headed by two working parents and 26% by a single parent.” In other words, only 29% of children have a stay-at-home parent.
  • Second, we can’t assume that stay-at-home parents want to become primary eldercare providers. It is a very different and, in many ways, more difficult type of care.
  • Third, today, “more than 50% of U.S. residents are single, nearly a third of all households have just one resident…By 2000, 62% of the widowed elderly lived alone.” In other words, in many cases, there is no one else in a household to provide direct, local care. And that trend is growing.

Employers aren’t dealing with the reality at all. In fact, according to a new study by the National Alliance for Caregiving, only 9% of employers offered referrals for eldercare in 2011, down from 22% in 2007.

And, individuals are equally as unprepared. According to Denise Brown, founder of Caregiving.com, most people believe Medicare will pay for and provide care, which is not true. As a result, families don’t plan or budget and are overwhelmed financially, physically, and emotionally. This makes it very difficult, if not impossible, for a growing number of men and women to fully contribute at work.

Question #3: How are you going to support and promote greater work flexibility?

Work flexibility offers many benefits to businesses and people. After almost two decades in the trenches working with organizations and individuals, I don’t believe the government can mandate flexibility. Each business and each person is too different for a one-size-fits-all approach to flexibility to succeed. However, there are issues the government can address that stand in the way of progress:  (Click here for more on FastCompany.com)

I invite you to follow me on Twitter @caliyost.

“Yes, I Hear You” Challenge–Acknowledge Work+Life Frustrations to Move Forward

(This post originally appeared in the Huffington Post as part of the National Work and Family Month blog carnival)

This year’s National Work and Family Month blog fest has celebrated successes, articulated pressing problems, and laid out a vision for the future. But for meaningful progress to happen over the next 12 months, we also have to acknowledge the very real frustrations of those touched by the challenge of managing work and life today.

There is no doubt that we are in the middle of a difficult economic and demographic transition. Most likely, the level of work and life frustration is going to grow. What would happen if, for the next twelve months, our first response to every challenge was an affirming, “Yes, I hear you…”? Hopefully, it will coax us out of our respective corners. We’ll release our tight grip on individual agendas (even just a bit) and create a fuller, more flexible shared vision of work and life fit that matches reality.

For the past month, I’ve kept track of some of the work+life frustrations expressed in my presence. It’s by no means an exhaustive list, but it’s a representative sample to get us started.

I thought it would be interesting to see what happens if my initial response was, “Yes, I hear you” rather than launching into an answer or opinion. In my experience, this simple act of validation sets a tone that supports an ongoing conversation and creates even a small opening for progress.

It may sound a bit Oprah, but before we can change, we need to feel like someone is listening.

Here’s what you told me, and here’s what I said (or wished I’d said):

Why do we keep focusing only on the financial return of work and life strategies? Why don’t we demand organizations and leaders put equal emphasis on the human costs and benefits as well?

Yes, I hear you. We do need to find a way to have more “Yes, and…” conversations. “Yes, the research proves that there are significant financial returns from work and life strategies and the benefits to people are equally as important and impressive.”

I understand that people have lives, but we have a business to run in a very competitive, difficult economy. If there’s no business, there’s no job at all. I just wish sometimes I heard a little bit more about that important fact in the debate.

Yes, I hear you. The reality is that businesses are facing incredible competitive pressures. We need to find a way to acknowledge this fact without shutting down the conversation about how we can work and live smarter and better to meet that competitive challenge. And do it from a place of strength and well-being for all.

Why can’t a mother take time to focus on her family and not suffer such a severe career penalty? Why are retirees who want to come back to work viewed as ‘valuable’ and mothers aren’t?

Yes, I hear you. Whether for parenting, illness, education, retirement, career breaks or slowdowns are going to happen. They just are. So how do employers adapt the ideal career track model and how do we shift expectations about our own career trajectory?

Stop telling me I need to do more and more for my child or I’m a bad mother. Should I sacrifice my family’s financial security to spend more hours that I don’t have on even more activities that experts tell me are critical to his success? What if I just can’t and run my business?

Yes, I hear you. The cultural expectations of mothers have not caught up to reality and the guilt can be withering especially when the message is that you need to do even more and you just can’t.

What burns me is that a mother in my group walks out every night without a second thought saying “Gotta get home,” and we’re sitting here expected to do the work. But guess what? My wife works. I have kids I’d like to see. And yes, our colleague is single, but she has a life too.

Yes, I hear you. You and your colleague’s interests and responsibilities outside of work are just as important. This is one of the great challenges, broadening the understanding that we all have full lives. And we all need greater flexibility in how, when and where we work as individuals and together as teams. How do we communicate and coordinate better and smarter to get the job done while living our lives?

Why do we celebrate the parent who calls in sick to care for a child with strep throat, but then give the person who’s walked the halls all night with his mother who suffers from Alzheimer’s a hard time?

Yes, I hear you. We don’t do a very good job acknowledging the prevalence of adult care giving or understanding the unique challenges these caregivers face.

New York City’s Christine Quinn abandoned working families when she pulled her support for paid sick leave legislation.

Yes, I hear you. Choices being made in the current economy are difficult for all. It’s frustrating that we are not able to find solutions that address the economic concerns voiced by business owners and the equally compelling needs of families who can’t afford to not get paid when they get sick.

The “Yes, I hear you” Challenge: I’m going to try. It doesn’t mean that I’m always going to agree with every perspective or have all of my ideas agreed with. But simple validation does increase the likelihood that someday everyone — business leaders, public policymakers, academics, mothers, fathers, those who are single, those caring for aging adults, and anyone else — can sit around the same table and begin to answer the question, “Now what?” Together.

Let’s see how far we can come by National Work and Family Month in October, 2011.

Have Aging Parents AND Siblings? READ THIS BOOK! I Wish I Had.

I love serendipity (or “serendestiny,” as Sam Horn calls it).  I keep an eye out for it in all aspects of my work and life.  Late last year, I attended a party for the launch of Donna Fenn’s excellent book, Upstarts, in New York City.   At that event, serendipity hit in the form of Francine Russo and her new book, They’re Your Parents Too! How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy (Bantam, 2010), which is a must read for everyone with parents and siblings.

Shortly after arriving at the party, Donna pulled me aside and introduced me to Russo saying, “You two have to connect.  Francine has just written a terrific book on elder care.”  Five minutes into my conversation with Russo, I was hooked.   I only wish They’re Your Parents Too! had been written two years ago when my sisters and I cared for our mother until her death from cancer (here and here for posts recounting that experience).

In addition to being incredibly well-written (Russo is a career journalist who most recently covered the aging and boomer beat for Time magazine), it addresses many important issues that my sisters and I intuitively navigated blindly.  Our elder care experience, while rewarding and very challenging, was aided by the fact that three of us get along well, had flexible work+life fit realities, and lived relatively close to our mother.   In many instances, this is not the case which makes Russo’s book even more valuable.

Recently, I spoke with Francine Russo about They’re Your Parents Too! Here are some highlights from our conversation.

CY: Having coordinated a very intense two-year period of elder care with my two sisters, this book really hit a chord.  I haven’t seen anything written on the subject of siblings sharing care of their aging family members.  Why do you think that is, and what do you hope your book does?

FR: In the past, grandparents usually died quickly and didn’t live to be that old.  They didn’t need help for 10 years.  This is the first time in history that original family members have to engage intimately, perhaps for the first time in 40 years, over important issues that may go on for a decade.

People always had to go through the psychological passage of losing parents and facing their own mortality.  But we never had to do it while gathering with original family members and negotiating how to coordinate care for so long.

The family has changed.  You’re not the little sister.  You’re not the big sister.  Everyone is an adult, and it’s a challenge to adapt in this new period as adults especially in a crisis when we tend to revert back to old roles.  We learned these roles as little kids.  You may have to deal with favoritism, or that so-and-so is the “incompetent” one.  All this needs to be reexamined as you are today.

Caring for your parents is a wake up call to become conscious.  Be aware of your feelings as you navigate uncharted waters.   You need to know that huge emotions can sweep you up, and you want to be prepared so you can react in ways that are productive.

CY: In the book you talk about the process of picking a primary caregiver.   You point out that who that main person might be isn’t always obvious.  Can you say more about the process?  And how much of this conversation can take place between siblings before an elder care crisis hits?

FR: Caring for a parent is not a job for one person.  It is a major family passage.  And the conversation should take place if at all possible before a crisis happens.   In a perfect scenario, the parent should be involved directly in that discussion.  That’s not always possible because you might get, “Oh, I don’t want to talk about that.  I’m going to die at 89 years old in my sleep.”  Well, that rarely if ever happens.

My hope for the book is that the sibling who buys it and reads it first passes it along and initiates the dialogue.   For example, it is often assumed that location determines who will provide care, but that is not the case.  In addition to the responsibilities and location of individual siblings, you should consider who has the closest relationship with the parent or parents.  In some instances, that will mean the parents will decide to relocate closer to the child with whom they have the strongest emotional bond.  This is especially true if a parent is moving to assisted living or continuous care.

Yes, caring for a parent is a family job; however, it is helpful if one person, with everyone’s agreement, takes responsibility.  But that doesn’t mean assigning jobs.  Many of the complaints I’ve heard have to do with a caregiver feeling overburdened, or being highly controlling.

It is best if everyone is asked what they want to contribute, and what they are comfortable doing.  This then becomes a regular assignment that’s part of schedules and lists outlining tasks and responsibilities.

The important thing is to maintain a sense that we are all in this together.  It’s easy for caregivers to feel let down by their siblings.  They expected help but didn’t say anything, and they feel rejected.   The stress can tap into so many unhelpful, often counterproductive things we learn in families like, “I shouldn’t have to ask my brother.”  It’s so wrong, but does a great deal of damage to a relationship.  By the time the siblings finally begin to interact, there’s lots of anger.

CY: Disagreements between siblings about end of life treatment can be incredibly difficult.  My sisters and I are very close, but toward the end of my mother’s life it was interesting to watch how we each dealt with what was a heart wrenching situation so differently.  Why is it important for siblings to recognize the unique challenges of this particular time, and what can they do to avoid as much of the confusion as possible?

FR: You’re right.  This is possibly the most difficult moment in life, and it will bring up equally difficult emotions.  Some siblings will not want to let go and will want to keep Mom or Dad around no matter what.

Siblings need to have compassion for each other.  All I can say is don’t wait to have this conversation!  This book is a manual to help you prepare emotionally for the end-of-life reality now.  A great way to do this is to initiate the conversation over the holidays when everyone is gathered.  You could start by saying, “I heard this horrible story about a friend’s parent going into a coma having not discussed what they wanted their children to do.  It was a mess. I hope that never happens to our family.   (Mom/Dad), while we are in the same room, can you tell us what you would want us to do?”

When handled this way, siblings get beyond emotional distortions, needs, and competitions.  There’s a much better chance you’ll all be on the same page when it happens.  However, some siblings may still have trouble letting go.  If you think it is going to be really difficult, make a trusted relative who is not a sibling the health care proxy.

CY: One of my favorite parts of the book talks about “Reinventing Your Family,” and establishing new rituals.  This is so important and yet it’s not top of mind as you are knee deep in the care giving.  Why is it important and what should sibling caregivers do to start that reinvention process?

FR: Many times original family rituals formed around the parents.   Whether during an illness or after they die, new rituals need to take their place.

If siblings have started a dialogue around caregiving that’s reasonable and friendly, they can extend this.  For example, commit to meet once a year at a particular time.   There were sisters who hadn’t spoken in a year because they were very angry.  As part of their negotiation to try to repair their relationship that had broken down over care giving, they agreed to meet once a year.

Another idea is to make phone calls or video conferences part of every holiday.  Make it a ritual.  Another story I heard that I like was of three sisters who didn’t live in the same city but agreed to all fly to Chicago, which is where there mother had lived, every year on her birthday for the weekend.

It’s about connecting but also being flexible because everyone has busy lives.

CY: Thank you, Francine.  As someone who charted the elder care trenches with my sisters and made it out the other side, I wish we had had this book to guide us.  Thank you for seeing an unmet need and providing such a comprehensive, helpful how-to.

Have you spoken with your siblings about how you plan to coordinate care for your parents?  If you have, what was the experience like?  If you haven’t, why not?

For more about They’re Your Parents Too! and Francine Russo, go to www.yourparentstoo.com, and @YourParentsToo on Twitter.

Missing from David Brooks’ Older People’s Revolution: Greater Work+Life Flexibility

David Brooks‘ thought-provoking piece in this morning’s New York Times calls older Americans on the carpet for, “Far from serving the young, the old are now taking from them.”  He then urges the older generation to use their time, energy and the internet to reverse this trend by starting a spontaneous national movement that demands changes in health care spending and the retirement age, “to make life better for their grandchildren.”

Okay, makes sense, but here’s the rub.  And I think Seth Godin said it best in a recent blog post:

“Baby boomers are getting old. Dreams are fading, and so is health. Boomers love to whine and we love to imagine that we’ll live forever and accomplish everything. This is the decade that reality kicks in. And, to top it off, savings are thin and resource availability isn’t what it used to be. A lot of people ate their emergency rations during the last decade. Look for this frustration to be acted out in public, and often.” (Emphasis mine)

This means that for David Brooks’ older people’s movement to take off a couple of things need to happen:

  • First, we must address the harsh reality that for many older Americans the demand for greater government support is grounded in real (or perceived) financial need.
  • Second, we have to get more creative.

Yes, expensive mandates like health care spending and Social Security require new approaches.  But what else can we do that would give older Americans non-governmental financial support, and greater time and energy for other parts of their life?   The answer: more later-in-career, work+life flexibility.

As part of the movement, older Americans should ban together, learn how to present a well thought-out plan, and propose creative, flexible work+life fit solutions to their employers.  This might include but is not limited to:

  • Reducing hours and shifting responsibilities. For example, the seasoned newspaper editor who reduced his schedule and took on responsibility for teaching younger reporters how to write compelling stories, faster.
  • Becoming a consultant who supports the business during specific busy periods, or in a particular area of expertise.  For example, experienced accounting firm partners who consult during busy season doing audit reviews.
  • Job sharing with another older worker covering a specific function. For example, two plant managers takeover shared responsibility for the quality review process at their facility.
  • Becoming part of a “coverage pool” that supports the business when people call in sick or go out on leave. For example, a group of experienced tellers are “on call” to cover a group of five offices in a region.  They work on average two to three days a week.

Another option would be for older workers to pursue an Encore Career where they earn money and give back.

Adding greater work+life flexibility to Brooks’ spontaneous, national movement would do more than just reduce the public financial burden on the younger generation.  Companies would retain valuable knowledge and experience.  And older workers, especially those “who ate their emergency rations over the past decade,” would make money and get time for other parts of their lives.  This is important because, quite frankly, I haven’t met too many 70+ year olds who are thrilled about the thought of going to work all day, everyday.

So why isn’t work+life flexibility part of the vision?  How do we get the movement started?  What do you think?

Fast Company: Health Care Reform and Budget Cuts Put Future Elder Care on Your Radar Screen…Now More Than Ever

We spent Thanksgiving with my cousin and her husband, who is moving into the advanced stages of Alzheimer’s.  Over three days, I watched in awe as she patiently and lovingly cared for her partner of 23 years even though most of the time he didn’t recognize where he was or whom he was with.

Over the past few years as his disease has advanced, my cousin has worked full-time and cared for him at home.  She’s done this with the help of a  group of outside caregivers, but at great cost.  Right now their hours are 8:00 to 5:30 pm everyday, which costs her $800 per week, after taxes.

Fortunately (if you can call any part of this story fortunate), because he is fifteen years older and had already retired, his pension covers most of the costs.  But she must work to pay for everything else.  No one knows how long this situation could continue and she wants to keep him at home as long as possible.  Although he is severely impaired cognitively, he’s in great health physically.  She must earn a living, plus work reenergizes her. It gives her the deep reserve of patience and understanding that caring for him requires.

As the debate regarding health care reform rages on, and state budget crises make headlines, I often think about my cousin and the millions of other caregivers who currently or will care for an adult family member.  Why?  Because the outcome of these challenges will profoundly affect access to the already minimal level of affordable elder care support that exists.  No one seems to be talking about it, and we need to.

Over the years, I’ve blogged about my personal, eye-opening experiences with elder care, as well as the realities of others.  I come back to the same questions I originally asked in a post I wrote in July, 2008 about caregiving-gone-very-wrong,“Heartbreaking Reminder—There’s No Elder care:”

Over the years when I’ve brought up the challenges facing parents trying to find child care, more than a few people have commented, “Well, if you can’t care for your kids don’t have them.”  Okay, let’s assume for a minute that argument has merit (which I don’t think it does) and explains why child care should be the problem of individual parents rather than the broader community.  How does that argument hold for elder  care?  “Well, if you can’t care for your parents don’t have them?”  We don’t have any choice in having parents.  We all have them.  And increasingly the responsibility to care for an ever-growing number of aging adults is going to fall to all of us.  Where are we going to turn for support and help so that we don’t find ourselves making the same misguided, perhaps desperate choices as Theodore Pressman?

Are we as a country and as individuals prepared for the reality of elder care?  Do we truly understand how little support is out there, and are we planning accordingly?

I wrote that post just before the worst of the financial crisis began to challenge already strapped state Medicare and Medicaid budgets.  At the time, I’d asked an elder care expert where she thought the support would come from and how it would be paid for.  She responded without missing a beat, “Medicare.  We’ll demand it.”  Well, we can demand all we want.  But you can’t get blood from a stone.  A recent story in The Washington Post reports many states are already cutting the daily reimbursement rates for adult day-care centers.  These are critical, relatively affordable supports for individuals who are providing elder care at home but need to work.

What should we be doing?  Here are a few thoughts, but I very much welcome the insights of my colleagues who specialize in elder care related issues, so please comment: (Click here for more)

Fast Company Blog: New President and Your Work+Life Fit: Highlights…Concerns

Symbolism is important for driving cultural change.  Within this presidential campaign, there have been many powerful symbolic conversations and actions related to work+life fit.  For the first time:

  • The male and female candidates on both Obama and McCain tickets and their spouses talk about how they manage their unique work+life fit choices and challenges; and
  • Both campaigns list work+life front and center as part of their economic agendas.

The question then becomes how do the McCain and Obama administrations plan to translate that shift in awareness into action that impacts the reality of individuals?

Ellen Galinsky of Families and Work Institute recently hosted two unprecedented conference calls in which representatives from both campaigns outlined the specifics of their philosophy, policies and programs related to a broad range of work+life issues.  Detailed transcripts and commentary on these calls is available at www.familiesandwork.org.

Having listened to both calls and read the transcripts (which I urge you to do), two very different approaches emerge in a number of areas.  To provide a context in which to compare the two strategies, here is an overview of the trends in work and life presented by Brad Harrington, the Executive Director of the Center for Work and Family at Boston College in a recent presentation at Cornell University:

• Aging workforce and generational diversity
• Challenges of working in a more diverse workplace (e.g gender, race, ethnicity, religion)
• Increasing workload, stress and dramatic increase in health care costs
• Globalization, working across cultures, and the 24×7 workplace
• Pervasive use of technology and working virtually
• Growing importance of work-life.

I would add:

  • Increasing pressure on businesses to cut costs and work smarter/better, and additional financial uncertainty and work-related pressures for individuals.
  • Ever-increasing pace of change that requires organizations and individuals to adapt and respond by being even more flexible in the way work is done, life outside of work is managed, and business is run in order to thrive.

In the context of this work+life reality, my thoughts on the Obama and McCain work+life strategies are as follows: (click here to read more at Fast Company)

Eldercare–One Year Later

At Easter I realized that one year ago my sisters and I were sitting in my mother’s hospital room eating Easter dinner from the cafeteria while she recovered from surgery. It was that Easter Day operation that marked the beginning of her rapid decline and the most intense three-month period of care we needed to provide until her death in July.

About the same time I had this realization, I came across a newspaper article and a website that reinforced two of the main insights from my eldercare experience that I’d blogged about here and for the New York Times. First, is plan! The second is that eldercare is incredibly hard and you need support.

First, planning. The article entitled, “Facing aging: Families avoid crucial conversations,” was from the Pittsburgh Tribune-Review and talked about the “40-70 Rule.” The rule is that you need to have an honest conversation with your parents about how they want to be cared for, and what their financial situation is when you are at least 40 years old and your parent is 70 years old.

Even though I am over 40, my father and stepmother aren’t yet 70 years old. However, that has not stopped me over the past year from starting to talk with them about what they want. Knock on wood, they are both healthy. But as I know too well, that can change overnight. And when you are in crisis is not the time to have those important discussions. DON’T WAIT…Talk to your aging parents now. (more…)