In early 2006, a growing number of key employees were choosing early retirement or reducing schedules to care for aging parents.  Losing seasoned and valued employees prompted Clackamas County to review exit interviews, EAP FMLA and leave data.  Finding data about caregiving absences through these sources proved difficult, as caregiving absence data had not been collected.  So, to gain insight into our employee population EEOC reports were examined.  These reports indicated the median age of employees had increased to 45 years.  The reports also indicated the ratio of females to males for many departments exceeded 60% with a few departments at 80%.  By comparing our EEOC data with the National Caregiving Alliance, AARP and MetLife caregiver studies, it became evident that a significant percentage of the county’s employee population mirrored the typical caregiver profile.  Additional data from a Pfizer wellness assessment completed by 35% of employees indicated more than 5% were caring for an aging parent or spouse with Alzheimer’s; missing on average six (6) days of work per year at an estimated cost of $90,000.  However, Pfizer’s wellness assessment did not query employees’ caregiving for elders with other illnesses.  By using the typical caregiver profile, the percentage of caregiving employees can be estimated at 25 to 30%.  Theoretically, using the profile assumption along with the Pfizer wellness assessment, absenteeism cost due to caregiving could be as much as $500,000 annually.  Additionally, the cost of healthcare for caregivers is typically higher than non-caregivers due to stress and depression stemming from a lack of self-care, unawareness of resources and feelings of isolation as reported by the Agency on Aging and AARP.

Example of Innovation
The Department of Employee Services, Risk & Benefits Division’s Wellness Program was uniquely positioned to address caregiver issues.  We have experts on staff in the Department of Human Services, Social Services Division’s (DHS-SSD) Agency on Aging Program.  The departments worked together to identify caregiver issues, gaps in existing EAP services, types of services and how best to offer these services on-site.

Through these collaborative efforts, an Interagency Agreement was crafted for the DHS-SSD Agency on Aging to provide enhanced on-site caregiving services.  The agreement allows EAP eligible employees and retirees to receive six (6) sessions of personal advocacy, individualized information and referral services, a monthly support group, a 6-week education program “Powerful Tools for Caregivers” developed by the Legacy Health Care System in Portland Oregon, and receive all learning materials without cost.  Additional educational opportunities were developed on a variety of subjects to include: Introduction & Overview of the Aging Process, Mental Health Issues, Dementia & Depression, Working with Dementia Behaviors, Navigating Community Resources, and Financial Planning for Older Adults.  New resources were added to the employee lending library to include “Hardships into Hope – The Reward of Caregiving”, “Daily Comforts for Caregivers”, “Caregiver Wellness”, and “Quick Tips for Caregiving”. 

The enhanced caregiver services rolled-out November of 2006 during National Caregivers month.  The county held the first Elder Caregiving Symposium entitled “Caring for Those Who Cared for You".  The event had several exhibitors providing resources from our local community and the keynote speaker was Oregon's Senior Law Project Volunteer of the Year, Timothy McNeil.  Mr. McNeil discussed elder rights, guardianship, legal concerns and estate planning.  Mary Ann Hard, of Clackamas County DHS-SSD presented "Powerful Tools for Caregiving" giving employees an overview of the educational opportunities, information about the new support group and the additional enhanced services.   Brochures, posters, flyers and payroll stuffers were created to announce the fair and outline the new services.  E-Brochures were posted on the county’s internet and intranet web pages and distributed via e-mail and U.S. mail to all employees and retirees homes. 

The program was well received and in 2008 the county expanded the interagency agreement to provide caregiving services to include adults and children with special needs.

Outcomes/ROI
Internal reporting procedures for exit interviews, EAP, FMLA and leave data have been updated to include caregiving absences.   Although program evaluations are anonymous, questions are being reviewed and updated to provide quantifiable absence data before and after an employee accesses caregiving services.

Employee adoption of enhanced caregiving services was slow the first year, but by mid 2008 there was a 50% increase in participation.  From program evaluations, employees self-reported fewer absences, perceived greater control to handle challenging situations, felt better able to make caregiving decisions and indicated receipt of helpful information regarding community resources.