What to Do When Work and Caregiving Collide

By Pamela D. Wilson, MS, BS/BA, NCG, CSA

Solutions and steps exist for what to do when work and caregiving collide. The time pressures of trying to balance work, care for family, care for aging parents, and to take care of ourselves can feel like being in a pressure cooker. Dealing with stress and pressure places family caregivers on course for work and caregiving to collide.

As family situations evolve with second marriages, step-parents, and step-children, new options to address care situations must occur. The goal of aging adults is to remain in the home. With family support, this is possible in traditional and untraditional ways.

Dealing with Stress and Pressure

when work and caregiving collideHow many of you remember the old-fashioned type of pressure cooker that your mom used? Very different from the Insta Pots of today.

My mom canned tomatoes and made jelly in the pressure cooker. I remember times watching her in the kitchen when I thought the lid would blow off the pressure cooker because of all of the steam coming out of the opening in the lid.

Managing caregiving stress and pressure means being able to adapt to situations that constantly change. These include the health of aging parents and daily care needs. In caregiving, the unexpected becomes the new normal.

Caregiving Can be Like a Pressure Cooker

Caregiving can feel like being in a pressure cooker when work and caregiving collide. Dealing with stress and pressure can be overwhelming. Tradeoffs occur between family, work, caring for aging parents or a spouse. Time with friends and engaging in hobbies disappears.

Because caregiving is not a life role for which we plan, an overnight accident experienced by an aging parent can turn life upside down. Immediate needs for care may exist.

If you are a married couple, how do you decide to takes the majority of the responsibility? Is it assumed that since women are caregivers for children that they will care for both sets of aging parents? Caregiving is challenging if both sets of parents need care at the same time.

How to Begin Caregiving Conversations

The subject of caregiving rarely comes up before a health emergency or an unexpected event. While aging parents, spouses, and others wonder who will be their caregiver, many wonder instead of ask. Talking about caregiving and power of attorney at the same time can reduce feelings of worry and anxiety about who will be the caregiver. 

Power of attorney is an important subject that should not be left until a loved one is in the emergency room and the doctor is asking for the power of attorney. When to get power of attorney for aging parents is a common question. Caregiving and power of attorney are family matters. The earlier the discussion occurs, the more confident family members will be that when caregiving is a need family will show up to caregive. 

Research Confirms Caregiving is Mainly a Female Role (Even Though More Men are Becoming Caregivers)

How is the decision made about who takes time off work to help aging parents when the income is needed to support a family? Society views women’s roles as more home-centered meaning a higher obligation to care for the family than men. How can women balance caregiving? 

Research studies confirm that women are expected to adopt the role of caregiver, men are not. Coping styles between men and women caregivers also exist. Women use more emotion-focused coping that may be less effective. Men focus on problem-solving, acceptance, detachment, and distancing.  (1)

Significant risks exist for financial hardship for women who reduce working hours or leave work entirely to caregive. Lost health insurance, contributions to retirement plans, and social security place women caregivers at risk years ahead when they may need care. Women caregivers who caregive in mid-life and change work schedules or opt out of the workforce, increase the risk of living in poverty in old age.

When Work and Caregiving Collide

While most bosses understand family situations, having to take time off to care for aging parents can place stress on the employee-employer relationship. Family caregivers arrive late to work, leave early, miss work and have frequent interruptions because of caregiving responsibilities.

I know family caregivers that receive multiple calls in a single day from an aging parent. Other caregivers have to take time off work to take aging parents to medical appointments and treatments. Caregiving can feel overwhelming and can easily become a full-time job. 

Caregivers call in late or sick when midnight phone calls or trips to the hospital emergency room prevent sleep. These emergencies often extend into the day if a parent is admitted to the hospital or transferred for rehabilitation and the assistance of the caregiver is required.

Finding balance is important to manage days when work and caregiving collide. Some work situations may be flexible however this is not always a solution if work then has to be rescheduled during the evenings or on the weekend.

Emotionally challenging caregiving situations are common. Making thoughtful decisions and plans help reduce the feeling that caregiving is a pressure cooker.

Many Women are Double Duty Caregivers

Six in 10 caregivers are female with an average age of 49.1 Forty-nine percent of caregivers felt that they had no choice in taking on the responsibility to provide care for their loved one. These caregivers are mainly women with an average age of 50 years old who have been providing care for at least 4.7 years. (2)

Many women hold down full-time jobs and then caregive for another 10-20 hours a week which equates to having a part-time job. This double duty caregiving in caring for their own families and then caring for aging parents results in high levels of emotional stress and physical illness.

Job security remains a concern of women who experience frequent work interruptions due to caregiving. What solutions exist for what to do when work and caregiving collide for caregivers who do not want to give up a job or decrease working hours?

6 Steps to Manage the Caregiving Pressure Cooker

1 Be Realistic About Caregiving Needs

Talking about the needs of aging parents and caregiving stress is difficult. Many caregivers do not want to admit caregiving stress for fear of burdening loved ones. Others do not want to be judged for their feelings. Initiating caregiving discussions is necessary to survive the challenges and stresses of caregiving. 

Honest and practical discussions must occur with aging parents, spouses, and other family about desires to remain at home and what this will take. Aging parents may have unrealistic ideas about the time that working children can commit to caregiving.

While most caregivers feel that caring for aging parents and a spouse is their responsibility, this does not mean that caregiving stress doe not feel like being inside of a pressure cooker.  The what to do when work and caregiving collide conversation must occur with aging parents.

2) Talk to Siblings About Sharing Caregiving Responsibilities

In families where there are multiple children, family meetings should occur in an attempt to divide up caregiving responsibilities. While one child caregiver usually bears the majority of responsibilities, assigning tasks to brothers and sisters helps reduce the burden.

By splitting up tasks and visits, adult children are better able to join together to support aging parents. Caregiving is not the responsibility of one child, but of all children. I also recommend involving young children in caregiving so that they are not isolated from the experience. Doing this will open up caregiving conversations about who caregives for the entire family. 

3) When Possible Involve Children in Caregiving Tasks

There are times when no other family is available to caregive for an aging parent. In these times the necessity of involving children becomes a reality.

When I was young, my mother who was the family caregiver, took me to visit my grandmother, aunts, and uncles and involved me in caregiving tasks. To me, this was a normal part of like and probably the reason that I became a caregiving advocate and expert.

Shielding children from caregiving responsibilities is the same as shielding children from life. Caregiving is part of life. Exposing children to the care needs of grandparents is a practical exercise. By learning about the role of caregiving early in life, children will be more like to care for parents when the need arises.

4) Help Aging Parents to Remain Independent

Caregivers tend to be helpful. Sometimes too helpful. Taking away activities that aging parents can do results in a sense of helplessness and greater dependence on the caregiver. By allowing aging parents to do for themselves, independence will be preserved, and self-esteem will be supported.

Supporting the independence of aging parents includes managing safety risks in the home. It is good for aging parents to bathe and complete hygiene tasks independently. Aging parents want to remain at home instead of having to leave for a nursing home. It is important to notice the little things that might indicate a loved one may need more help to remain at home. 

The bathroom is a high-risk area for falls. Evaluating the area and placing grab bars, a raised toilet seat, a shower seat, and a hand-held shower will preserve independence with hygiene. Other practical tips include double stair railings and removing throw rugs.

Encouraging independence and managing safety risks in the home may reduce work interruptions. More balance may be achieved to reduce situations when work and caregiving collide.

5) Preparing for Advancing Care Needs

As adult parents continue to age, care needs will increase. It is practical to have discussions about other care alternatives and options. These may include in-home caregivers or moving to assisted living.

Discussions about money must occur to know what is realistic in planning for increasing care needs. Planning for power of attorney documents is mandatory.

Preparing for advancing care needs, supports creating a caregiver backup plan so that when one parent passes away, plans to care for the surviving parent are in place. The role of family caregivers will adjust as caregiving circumstances change.

Unexpected events like hospitalizations will increase care needs temporarily. Changes in physical abilities will do the same. As health declines, increased dependence on family caregivers will occur. Having honest conversations with loved ones about medical prognosis helps plan for advancing care needs. 

6) A New Concept: Combining Family Care

The most challenging situations occur when both parents need care at the same time. The addition of one or two more parents needing care increases the idea of when work and caregiving collide. The caregiving pressure cooker ramps up.

There may be situations where combining family care becomes the best plan. Depending on home situations, moving family together, but not necessarily into the home of adult children, is a consideration.

While this may be similar to moving a stranger into the home, it is better than having to move loved ones out of the home into a care community or nursing home. If care tasks can be combined and managed this may be the best for all family involved.

This allows the grouping of care by two sets of adult children for the benefit of aging parents. If or when this idea is considered, serious discussions must occur about caregiving responsibilities and the need for aging parents to make the best of a very difficult situation.

Difficult Caregiving Decisions

There are times when caregiving situations and options feel hopeless. There are also times when out of the ordinary care situations become the best option. If aging parents truly want to remain in a home-like situation, and are willing to consider combining family care, this may be the best option for everyone.

Moving to a care community includes living with strangers. Why not have strangers be a family member? The current concept of a small caregiving group home environment may be transferred to the idea of a small family group home environment.

When combining family care is the decision, written agreements by aging parents and adult children are necessary. Much like a pre-marital agreement, all areas where disagreements are likely to occur should be addressed. The agreement includes money and who will pay for what, use of common areas in the home, private time, avoiding interruptions and how disagreements will be managed.

When adult children can come together to support this plan, the likelihood of success is greater. While combining family care is a new concept, it is an idea that results from the necessity of practicality and the desire of aging parents to remain in a home situation.

Returning to Values of the Past

One hundred years ago, combining family care would not have been an unusual idea. It would have been an idea born out of necessity with the idea that family cares for the family regardless of what it takes.

The family caregiving system will continue to be stressed by the needs of aging parents. Work and caregiving will continue to collide. The pressure cooker of managing life and caregiving tasks can be eased by working together to achieve balance.

Being proactive to talk about and plan for worst case scenarios may result in considering untraditional care options. Bringing the family together may be the best option.

(1) Morhardt, Darby, Ph.D. Gender Differences in Family Caregiving. Northwestern University Feinberg School of Medicine. https://www.caregiving.org/wp-content/uploads/2017/04/9NAC-Morhardt.pdf

(2) National Alliance for Caregiving (NAC) and AARP, Caregiving in the U.S. 2015 (Bethesda, MD: NAC and Washington, DC: AARP, November 2009) Funded by the Met Life Foundation.   https://www.caregiving.org/caregiving2015/

Pamela D. Wilson, MS, BS/BA, CG, CSA is a national caregiving expert, advocate, and speaker who solves caregiving problems. Since 1999, she has been a direct service provider as a court-appointed guardian, power of attorney, and care manager. In response to the need for accessible, accurate, reliable, and trustworthy information Pamela offers on-line caregiving support and programming to solve caregiving problems, advance healthcare literacy, and promote self-advocacy. She collaborates with professionals in the areas of estate planning, elder law, and probate, financial planning, and healthcare to raise awareness of and sensitivity to family caregiving and healthcare issues.

© 2019 Pamela D. Wilson, All Rights Reserved.
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