Solving an age-old problem

An array of affordable alternatives are available to help your family and your employees cope with the growing problem of "eldercare."

By Grace W. Weinstein

Honey Siegel is quick to tell you how lucky she is. Her 90-year-old mother, who lives with her, required emergency homecare after falling and breaking her arm, and then soon again after fracturing her hip. Both times Honey called an experienced eldercare consulting group retained for just such occasions by her employer, Fel-Pro Inc. of Skokie, Illinois. The consultant put her in touch with an emergency home healthcare service for the elderly which looked after her mother when Honey could not.

"I don't know how I would have managed otherwise," says Honey. She got through the emergency with only minimal time off from her job as assistant to Paul Lehman and the three other family members who preside over Fel-Pro operations. "Eldercare is one of the areas in which a company can help an individual solve problems outside the workplace that impact on job performance," says Lehman. "I know it was comforting to Honey not to have to sit at her desk and agonize over how her mother was making out. She cares about this company and gives 150 percent all the time," he says of his employee of 13 years, "so it was important to the company that we be able to do this for her peace of mind."

In providing eldercare services, FelPro is still a rarity in the business world. It has plugged into the embryonic, low-cost network of private and public eldercare service organizations serving businesses of all sizes. Tapping this resource, Fel-Pro has developed a package of eldercare information services that is nothing short of a lifesaver to those, like Honey Siegel, who need it. And Fel-Pro has done so at a surprisingly low cost — only $10 per employee for information and referral services.

Fel-Pro is in the forefront of what promises to become a major workplace issue of the nineties. Demographics tell the tale. Baby boomers, the largest single group in the work force, are buffeted on one side by the responsibilities of childcare and, on the other, by the obligation to care for aging parents. People have always had to deal with these problems, of course, but in today's typical family, in which both spouses work, problems with kids or seniors translate into time and concentration lost at work.

While giant companies are spearheading the development of formal eldercare support systems, it is small and medium sized family businesses that have the greatest need for affordable solutions. For most family businesses, lacking the management depth of large corporations, eldercare problems can have an immediate impact. Problems can occur when the older generation retires and turns the company over to the kids. Should the need for continuing care arise, the children are distracted from running the business. The family needs to know how to take care of the older generation and the business at the same time.

Family businesses can also be severely hurt when employees face eldercare problems, especially if the person is a high-ranking nonfamily executive. In a study by the American Association of Retired Persons and the Travelers Corporation, workers with eldercare problems reported devoting an average of 12 hours a week to caregiving. Many of those are spent during work hours, in endless telephone calls to doctors, agencies, and insurers available only during the day. Many are also spent during unscheduled days off, late arrivals, and early departures. Many caregivers spend less time with their own families, pay less attention to their own health, and not surprisingly, get sick themselves. Some leave their jobs or cut back on their hours.

It is up to companies, then, either to provide some measure of assistance to their employees or to absorb the costs associated with absenteeism and inattention. Providing such assistance need not be costly or difficult.

How to get started

"Smaller companies need to realize there are many alternatives between the extremes of doing nothing and picking up the cost of nursing homes or home healthcare — incredibly costly alternatives no one realistically expects corporations to adopt any time soon," says Christine DuSell, program director of the Aging and the Workplace Program at the Metropolitan Chicago Coalition on Aging (MCCA) that serves Fel-Pro. "It's important for every family business to understand that there are forms of eldercare services that are not beyond their budget."

In Fel-Pro's case these services include:

Bob O'Keefe, Fel-Pro's vice-president of industrial relations, is almost apologetic about the annual cost for this basic information and referral service for the company's 2,100 employees: "I wish I could tell you it was a big deal, but it's not. Only about $20,000 per year," or less than $10 per employee. Fel-Pro also goes the extra mile and pays up to 75 percent of the $8-per-hour cost of unskilled emergency homecare, such as Honey Siegel's mother received, up to a set limit.

DuSell estimates that the cost per employee for this package would not be much different for companies significantly smaller than the $230 million (sales) Fel-Pro.

Small and midsized family businesses have several sources of inexpensive eldercare services. Nonprofit groups such as MCCA, which assists Fel-Pro, are now marketing the services they developed for giant companies to smaller ones. And 670 Area Agencies on Aging, established under a 1965 federal law, are starting to create corporate packages based on the eldercare services they had originally developed for the poor and needy.

"Over 90 percent of Area Agencies for Aging provide services for employees," estimates Edward Sheehy, manager of membership services for the National Association of Area Agencies on Aging in Washington. Some of the area agencies are private, nonprofit groups, but most are part of local governments. Some of the wide range of services that these area agencies offer are free to community residents. While the level of service varies from agency to agency, they are increasingly eager to provide a package of services to local companies, possibly on a contract basis. Compensation can vary. "You might reach an understanding that your company provides a grant or a contribution," says Sheehy, "or you might agree on a more structured fee, based on time and service."

Most agencies provide excellent information and referral services, including much information that allows the company to take additional action. Among the services area agencies may provide are interviews and consultation with experienced social workers, help in setting up caregiver support groups and training group leaders, educational seminars for caregivers at the worksite, training for supervisors who have to manage people with eldercare problems, financial and estate planning services for retirees who need to care for an elder, and publications and policy handbooks designed specifically for your company. To find out how to contact the area agency nearest you, call 1-800-Age-Help.

While the costs of information, referral, and support are modest, the returns are incalculable. "When we have our caregiver fair twice yearly on a Saturday, we get quite good attendance, even last February after a horrible snowstorm. We think we see a good feeling throughout the company based on the availability of these services, but it's hard to measure the overall impact," says Fel-Pro's O'Keefe ."We do know that for those who use them, the services are often an answer to their prayers," he says.

Honey Siegel agrees. She's now in the process of seeking long-term care for her mother. "Thank God for the program. Even with their help, this hasn't been easy.

Going beyond information

Beyond providing printed information or referrals for your employees, you can take action that shows your concern and support. You can provide a formal or informal setting in which employees can meet and bring their eldercare problems out into the open and get direct guidance on them. Perhaps the most supportive action is to allow employees reasonable flexibility in their work hours when they need to deal with eldercare problems. You might try some of the following:

Alternatives to nursing homes

The average annual cost of sustaining someone in a nursing home is now close to $30,000, and double that in high-cost areas like New York City. Round-the-clock care at home can cost considerably more.

But many elderly people can get along very well at home — and be a lot happier — with periodic support services. The problem for caregivers is coordinating the services. Here's a sampling of what to look for in your community for both yourself and your employees:

Lifecare communities

Life care communities (sometimes called continuing care communities) offer the ambulatory elderly a range of housing options within the same facility, from independent living in their own apartment through assisted living to nursing home placement. Many are sponsored by religious organizations; the Quakers, for example, run a number of well-regarded communities that have long waiting lists for admission. Others are owned and operated by commercial hotel chains such as Hyatt and Marriott.

Some communities operate on a monthly rental basis; some require an initial fee of $150,000 or even more, followed by monthly fees. It's important to investigate the financial stability of a community that requires a large up-front payment — you might ask your accountant to review their financial statement — before signing a contract. You should also visit, talk to residents, and sample food and recreational programs before making a commitment.

For more information, send a postcard to AARP for its publication, "Continuing Care Retirement Communities" (D12181).

High-tech help at home

An elderly person with health problems may not need round-the-clock company if an emergency response system is installed. These electronic tools consist of two parts: a lightweight battery-powered "help" button carried by the user (actually a portable radio transmitter), and a console connected to the user's telephone. If the wearer should trip in the bathroom and be unable to get up, for example, pressing the button activates the console to dial one or more preselected emergency telephone numbers. Most systems can dial out even if the phone is off the hook.

Emergency response systems may be one-way or two-way. In a one-way system, a call is generally made to verify the emergency; if the phone isn't answered, help is sent. In a two-way system, voice contact is established via speakers attached to the phone, and the need for help ascertained. Two-way systems are more expensive but may offer more reassurance.

Systems may be purchased at prices ranging from $400 to over $2,000, or may be rented, often through your local hospital (at $25 to $50 a month). Renting may be preferable. "So many companies are getting out of the business," says Lee Norrgard of AARP's consumer affairs department, "that you might buy a machine programmed to dial a number that no one is answering."

For more information, send a postcard to AARP Fulfillment (EE178), 1909 K St. N.W., Washington, D.C. 20049; ask for publication number D12905, "Meeting the Need for Security and Independence."

Long-term care insurance

Begun just a few years ago, long-term care insurance is now offered by about 120 insurance companies. Following earlier abuses, the National Association of Insurance Commissioners (NAIC) has issued model legislation governing its terms; the model act, or similar statutes, are now in force in about two-thirds of the states.

Most policies are individually issued, but some companies are sponsoring group plans for employees. Not true group insurance — in part because Congress hasn't yet clarified the tax status of employer-paid long-term care benefits — most plans have employees paying the full cost. That cost may be less than that of an individually purchased policy, but it may be a case of comparing apples and oranges. Group policies tend to have a richer menu of benefits, costing more; they also tend to be taken out at younger ages, therefore costing less.

Because long-term care insurance doesn't have favored tax status, it can be offered as an executive perk for family members or key employees. It hasn't caught on as such, however, in part because it's still so new and in part because most employers are preoccupied with lowering the escalating costs of basic healthcare rather than taking on new obligations.

The Health Insurance Association of America reports that the average annual premium at age 50 for an individual plan providing $80 a day for nursing home care (with an inflation rider), a 20-day deductible period, and four years of coverage is $658. At age 65, the average annual premium for this constellation of benefits becomes $1,395, and at age 79 a staggering $4,199.

Group or individual, here's what to look for in a policy:

As you consider various policies, be careful. There are a number of situations that should be avoided:

A guide to eldercare resources

You may not be able to provide an onsite adult daycare center for relatives of employees, but you can ease the frustration your employees experience in trying to locate appropriate eldercare services. You might simply make an information sheet available, listing locally available support services. If you'd like to do more, read on.

Where to start