You're already juggling work, spouse, and kids. Chances are, someday you'll have to cope with a sick parent, too.

On any given workday, John Hawks, 37, might be flying to Dallas on business, organizing a conference in Atlantic City, or conducting a training session onboard a Caribbean-bound cruise ship.

My office knows where to reach me 24/7/365, even if it's on a plane or a ship, says Hawks, owner of a company that manages events for professional and trade associations. More than once he's raced from the departure gate to the airport business center to fax critical documents. A couple of times, I've even used the machine in the airport manager's office.

But business crises aren't the cause of these mad dashes through airports- Hawks is the sole caregiver for his mother, who is hospitalized frequently for rheumatoid arthritis, diabetes, and heart disease. Hawks sometime feels he's all alone balancing work and family obligations, but he's not. Elder care is to the 21st century what child care was in the last few decades of the 20th - insidious in its power to reduce productivity and increase workers' stress, according to human resource managers.

About 6 in 10 of the nation's estimated 44 million caregivers to the elderly either work or have worked while providing care, according to a recent study by the National Alliance for Care-giving and AARP, funded by MetLife Foundation. And 62 percent of these jugglers said they had to make trade-offs in their work life, from coming in late or leaving early to switching to part time, even quitting altogether, And care-giving isn't just a women's issue: Nearly 40 percent of caregivers are men, and 60 percent of them work full time like Hawks.

Indeed, the costs of stress and burnout run high for both workers and businesses. U.S. companies lose anywhere from $11 billion to 29 billion a year depending on who's doing the estimating from absenteeism, turnover, and lost productivity. And according to MetLife study, the care-giving employee who passes up a promotion, declines a transfer, takes a leave of absence, or retires early, loses thousands in wages, pension, and Social Security benefits over a lifetime a total of almost $660,000 per person.

YOU CAN'T PLAN FOR CATASTROPHE

Hawks knows all about the sacrifices working caregivers make. Besides handling insurance and medical matters, he provides emotional support for his 61 year old mother. He regularly makes the 12 hour round- trip drive from his home in Lexington, Kentucky, to see her in McKenzie, Tennessee, and talks to her daily on the phone. Sometimes, she's in tears, he says. It's tough on me because I try to be sympathetic, but I'm juggling projects and staffers. To have uninterrupted work time, he's blocked out no-Mom-calls periods in his schedule.

It's the unpredictability of elder care that creates special challenges for business- people, says Diane Piktialis, work-life product director at Ceridian, a human resource service company. At least with child care, you can plan ahead a bit. But with an elder, your parent may be fine for six months and then have a sudden fall and end up in the hospital or worse.

That's exactly why Hawks often avoids managing conferences in lucrative international destinations. He's reluctant to be away from his mother so long, for fear of what might happen while he's away. Normally on those overseas trips we net from $10,000 to $20,000 per event, he says. We do about 2 a year, but if we could add 6 to 8 more annually, that would be a big chunk of change for a small firm.

But he doesn't dare. During a rare conference in Argentina this spring, his mother was hospitalized for emergency surgery. While short-handed on-site and micromanaging a post-conference snafu, Hawks was faxing medical authorization forms and calling the hospital every few hours. I was putting out fires in Buenos Aires, but my mind was back in Tennessee, he says, and the trip just about killed me.

SICK PARENT TIMES TWO

Combine caring for parents with raising children the fate of the so-called Sandwich Generation and the challenges multiply. That's the case for Jeanie Wakeland and Craig Von Bargen of Walnut Creek, California, who have been on a treadmill of long-distance care-giving and work for more than two years. With Von Bargen's parents in Bellingham, Washington, and his wife's in Southern California, the couple have been buffeted by a cascade of ever-worsening medical crises.

It began two days after Christmas 2001, when Von Bargen's mother died in a nursing home after a long illness, leaving him in charge of his father's care. A water resources engineering consultant for an international company, Von Bargen, 53, was soon immersed in medical, insurance, legal, and financial issues so complex even professional care managers have difficulty keeping up with regional differences and changes in regulations. Von Bargen surfed the Internet and interviewed hospital discharge planners to learn the ropes and the lingo of elder care: ADLs, SNFs, Triple-A's. (For the uninitiated, that's activities of daily living, skilled nursing facilities, and Area Agencies on Aging.) He researched trust law for his mother-in-law and regularly checks WebMD for information on his father's 20 medications for diabetes and other ailments. In the last year, he helped his father move three times, sold his father's condo, and helped draw up a prenuptial agreement for his dad's second marriage.

Meanwhile, Wakeland's father was diagnosed with cancer, requiring chemo, radiation, risky surgery for removal of his esophagus, and more than two months in the hospital. Because Wakeland's mother doesn't drive, she, Von Bargen, and her sister took turns flying to Orange County, California, for a week at a time. It was a lot of juggling, says Wakeland, 54.

At the peak of these health crises, Wakeland, then city editor at a Bay area daily newspaper, took over responsibilities for another editor sidelined with breast cancer. Plus, on top of 12 hour workdays, the couple was steering their son through the college process, these days a full time job itself. The week we flew east for the college tours, Wakeland says, I told everybody, Okay, nobody is allowed to get sick.

In 2002, the couple calculated they had spent $6,000 on airfare, not counting trips paid for with frequent flyer miles or Von Bargen's business trips to Seattle, when he'd visit his father on the weekend. We weren't taking any vacations because we'd used up all our holidays taking care of family, Wakeland says. We couldn't even get the housework done.

A year ago April, on the day Wakeland's father died, her mother was hospitalized with pneumonia and was on oxygen for three months at home. It was really hard on Jeanie her mother couldn't go to the funeral, says Von Bargen. Three weeks later, Wakeland was laid off from her newspaper job, along with 47 other employees.

Instead of looking for another full-time job, she deliberately chose a one year stint teaching journalism at a community college, leaving her free last summer to spend more time with her mother. Mom really needed me then, says Wakeland. I still fly down once a month to shop, cook meals, and freeze then for her. Craig helps her with paperwork and home repairs. Von Bargen says he is lucky to have an understanding supervisor, a flexible job, and advanced technology to balance work and elder care responsibilities.

I can work remotely with no problem, says Von Bargen. I travel with company letterhead so I can print out a report at Kinko's and drop it in the FedEx box, or transmit big files for a presentation on their high-speed Internet connection.

In the new era of strict medical privacy laws, Von Bargen says having durable power of attorney is crucial to discussing an elder's condition with healthcare providers. Otherwise they can't tell you anything. His name is also on his father's and mother-in-law's banking accounts, so he can monitor financial details online and spot questionable expenditures for telemarketing get-rich-quick schemes or overpriced magazine subscriptions. He's also initiated difficult conversations with the parents on advance directives legal documents specifying how they want to be treated in extreme medical circumstances, such as prolonged coma burial requests, wills, and trusts. It's difficult to bring this up ahead of time, but you don't want to wait until it's too late, he says.

On his PDA, he stores contact information for all the doctors, hospitals, insurance companies, and home healthcare agencies. And I never turn off my cell phone, he adds. He keeps copies of the elders' medications in the event of emergency hospitalizations and uses encryption software on his laptop to take notes on sensitive medical and financial information.

To prevent caregiver burnout, Von Bargen knows the location of nearby running trails and bike-rental places so he can get some exercise during parental visits. Medication and counseling also helps with stress and emotional burdens. The problem is you feel guilty no matter where you are, says Von Bargen. You feel guilty you're not getting your work done and you feel guilty you're not spending enough time with your loved ones.

LONG-DISTANCE AID

Neither Von Bargen nor Wakeland's companies offered much in the way of elder care benefits, which is the norm, says John Paul Marosy, a former healthcare executive, caregiver, and the author of Elder Care: A Six Step Guide to Balancing Work and Family. Though ever-lengthening life spans are making elder care a hot human-resource issue, companies are reluctant to offer new benefits. In a tight economy, when many businesses are facing double-digit increases in health insurance costs, one-third of employers say they can't justify the cost of offering help for working caregivers, according to the Society for Human Resource Management. Only one-quarter offer elder care benefits.

And if you're at a small company or self-employed, Marosy says, you're on your own.

Some companies offer or outsource benefits such as low-cost lunch and learns with logical aging experts, health fairs, web seminars, or virtual water coolers on the company intranet so employees can share advice and problems. More elaborate company resource and referral programs offer online or phone consultations with case managers who assess elders' problems and help find solutions. Some companies subsidize in-home assessments of a parent's health, a service that can cost $300 to $800 at a private care manager, with an added $50 to $150 per hour for follow-up services. Fannie Mae even has a geriatric care manager on-site.

Mike Bartlett, 49, a former Texas Instruments vice president, is one of the lucky ones. Four years ago, Bartlett was often in Taiwan and Japan on business, while wrestling with his Georgia father's failing health. His mother was struggling to care for his father, who had been partially paralyzed from a series of strokes. It was a huge problem, says Bartlett . She could barely lift him. The TI resource and referral network put Bartlett in touch with an Atlanta-based care manager who provided help from choosing the right wheelchair to finding a day nurse. His name was George, and I talked to him maybe once a week for four years, says Bartlett . I would call him long distance from Tokyo , and he'd explain everything, and then I'd call my mother and brother. We would have made a lot more mistakes, costly in both money and emotional toll, if it hadn't been for his advice.

That advice became even more critical when Bartlett 's father fell and broke his hip. My mom was dead set against putting him in a nursing home, Bartlett says. She said, It means I'm abandoning him. And my brother was very worried about the costs.

The caseworker warned Bartlett that if his father went home from the hospital instead of straight into a nursing facility, he'd fall to the bottom of a yearlong waiting list. That was an amazing insight, and I was able to convince my mom that Dad should go to a nursing home. Bartlett says. And the wonderful thing was, my dad got better care and was much happier and more mobile in the nursing home, so it was a relief for all of us.

As more executives like Bartlett experience care-giving quandaries firsthand, businesses may begin offering more benefits, says John Paul Marosy, the elder care/work balance consultant. And the U.S. economy improves, more companies may be able to afford to offer elder care benefits, in part to help retain workers, he adds. I think we are going to see things moving more and more in that direction.

Source: Elizabeth Pope, AMERICAN WAY MAGAZINE (November 15, 2004)

Heritage Enterprises Inc. 
115 W. Jefferson St., Suite 401
P.O. Box 3188  Bloomington IL 61702-3188
PH: (309) 828-4361   FAX: (309) 829-5477