Business of Well-being

Women, Work and Long-Term Care

Women, Work and Long-Term Care

In the past several decades, women have made great gains in the workplace. Today, more than 40 percent of women are in management positions, and 28 percent of all U.S. businesses are owned by women [1].

With those gains, though, has come a negative impact on women's health and an increase in heart disease, and other ailments that were more common to men in an earlier time. These health issues are a direct result of the stress and pressure that come from working in a competitive business environment [2].

One stressor that is often overlooked when looking at women's health though, is the significant impact that long-term care-giving for a disabled family member puts on the caregiver. This is not to minimize the effect of caregiving on men's health as well, but recent statistics show 59 to 75 percent of caregivers in long-term care situations are women [3].

This can be due to economic factors if others in the family are the main breadwinners, and is also an effect of women's natural tendencies toward nurturance and caregiving. While caregiving for a long-term care patient is a noble and selfless act, it can create significant and sometimes traumatic damage to the caregiver, in many aspects of her life. Care giving impacts a person's physical, mental and emotional health and impacts their job performance, their earnings, and their savings.

There is also a ripple effect on the caregiver's family, as the caregiver becomes less available to spend time with their spouse or partner, children and friends. In reality, there is more than one type of caregiver. The primary caregiver is the person who provides hands-on care and often financial support for the long-term care recipient, while a secondary caregiver may make arrangements for care, oversee primary caregivers, find resources and give financial support to the long-term care recipient.

Even though the secondary caregiver may not be as intimately involved with day-to-day issues, the stress on them is similar to the primary caregiver and cannot be overlooked. A recent study was done by Genworth Financial on the true impacts of caregiving, and the findings are sobering. First, almost half of long-term care recipients had never considered the possibility of needing long-term care [4].

Therefore they had no plan in place and their children were compelled to provide hands-on care and financial support, often without warning or preparation. This creates havoc with the adult children's careers, businesses, children, and social life. And, many of the care recipients moved into a family member's home for a period of time, creating further pressure and stress on the caregiver and the caregiver's spouse and children.

Currently, the average age of primary caregivers is 53 [5]. This is a major career and family-building time of life. Caregivers in this group find themselves in the "sandwich generation," caring for ailing parents at the same time they're raising their children. The stress and pressure from juggling these responsibilities cannot be overstated, along with the guilt that comes from the caregiver feeling they're not giving enough, and continually disappointing someone they love.

Other stresses on the caregiver's family come into play, including spouse's resentment at losing time and emotional nurture with the caregiver; children feeling neglected and missing the parent's companionship; conflicts with caregiver's siblings over how care will be provided, and how physical and financial support will be shared, and resentment from the caregiver's spouse and children if they feel the caregiver's siblings are not contributing as much as they should.

As if the emotional stresses weren't enough, there is also a financial impact to providing care that impacts the caregiver and their family. Over 80 percent of caregivers reported that they contributed financially to the care of the recipient, at an average cost of $8,800, not including facility care costs. More than 50 percent of caregivers had to dip into their own savings and/or retirement funds, and 63 percent reported a loss of income (an average of 23% loss) due to their inability to work at full capacity or to take advantage of promotions or other career opportunities.

Almost two-thirds of caregivers reduced their family's savings, 40 percent reduced family vacations and 45 percent cut back on their own family expenses [6]. The resentment and hurt to spouse and children by these occurrences can only be imagined. In addition to these family stresses, there are continual pressures from trying to maintain a career or business while providing care. Many of us don't work just to get a paycheck: we find work a creative outlet for our talents and a source of satisfaction and personal growth.

But primary caregiving takes a big toll on this aspect of the caregiver's life as well. Almost half of caregivers had to give up a job, reduce their hours or pass up promotions, while 38 percent incurred repeated absences and lateness to work. The inability to focus on the job creates additional stress on the caregiver, along with the physical exhaustion they feel from providing care in addition to their time at work.

57 percent of caregivers provide care for more than 16 hours each week, and 31 percent provide care for more than 30 hours each week [7]. It is not hard to see how a job or career will quickly suffer when an employee needs to spend this much time in caregiving. At the macro level, the losses to American businesses from employee care-giving is huge: an estimated $33.6 billion per year in lost productivity [8].

In the current economic climate, it is one more challenge employers can ill afford, especially if key employees are affected. So what can be done to help employees and businesses better deal with employee caregiving? There are a number of solutions that approach the problem from different angles. One of the simplest solutions is for employers to offer long-term care insurance to their employees.

There are several types of group programs available, and smaller businesses can take advantage of individual policies with simplified underwriting and discounts off standard premiums. These are called "multi-life" policies and have a number of advantages over a true group model of providing coverage, such as:

  1. Policies are owned by each employee instead of by the employer, and thus are completely portable;
  2. If an employee leaves, there is no administration for the employer, such as COBRA, conversion, or continuation policies. The employer simply removes the employee from their billing and the insurance carrier will offer the employee the option to pay directly;
  3. Because the plans are individual, the employer has great flexibility in to whom the plan is offered and the type and amount of contribution;
  4. Benefit options are flexible and can be tailored to the employer's and the employee's budget; and
  5. Premium discounts are also offered to the employee's family members, such as spouse or partner, parents, grandparents and in-laws. This is a direct benefit to the employer, because these are the very individuals for whom the employee is likely to be a caregiver.

Depending on the state where the employer is located, requirements differ regarding the minimum number of employees needed for multi-life coverage. And, while purely voluntary plans are available, it is often in the employer's best interest to make even a small contribution. This ensures greater participation and more protection for the employer's bottom line. Employers have been surprised at the number of employees who enroll, with a contribution as small as 50 percent of monthly premium, to a maximum of $25 per employee.

Many employers have found it necessary to cut back on medical and dental benefits in the past couple of years. Some of them are helping boost employee morale by offering small LTCi benefits to make up the difference. LTCi is actually an essential part of retirement planning, and even a $50 daily benefit for two years creates an immediate benefit of $36,500, which protects the employee's savings and investments. The cost for a benefit like this will average from$20 to $40 per month per employee, depending on employee ages.

This can be a valuable investment for an employer, especially if the option for family members to apply is well publicized. In addition to making long-term care insurance available to employees, employers who have employee assistance programs in place can provide valuable support to employees who are in caregiving situations. The long hours, stress, and exhaustion caused by long-term caregiving often deprive caregivers of emotional support, and the opportunity to get some counseling can be a huge relief and can provide important perspectives the employee may not see when they're mired in the daily grind of caregiving.

Another option may be to offer key employees more flexible hours or to allow them to work offsite for all or part of their work schedule. This may allow them to trade caregiving duties with other family members, and may relieve some of their stress due to daily commuting and the rigidity of fixed hours. As the U.S. population ages and 75 million Boomers race into retirement age, the need for long-term care will multiply exponentially.

The U.S. Department of Health and Human Services estimates that 70 percent of people aged 65 and older will need long-term care at some point in their lives [9]. Individuals and employers can plan ahead for this eventuality by having open discussions with their families and their work teams, and take steps to protect the health, stability, and finances of their employees by facing the issue squarely.

Caregiving for long-term care patients is a growing issue for women workers and their families, and an increasing cost to business in lost productivity, but the losses can be minimized and managed with some foresight and planning. It is in the interests of all men and women, employers and agents to understand and plan ahead for the realities of long-term caregiving.


  1. U.S. Department of Labor, Statistics on Women Workers, 2009
  2. Job Strain, Job Insecurity, and Incident Cardiovascular Disease in the Women's Health Study, presented at American Heart Association Annual Meeting, November 2010
  3. Family Caregiving Alliance, Women and Caregiving: Facts and Figures
  4. Genworth Financial publication, Beyond Dollars: The True Impact of Long Term Caring, September 2010
  5. Ibid.
  6. Ibid.
  7. Ibid.
  8. MetLife Mature Market Institute, Caregiving Cost Study: Productivity Losses to U.S. Businesses, July 2006
  9. U.S. Department of Health and Human Services, National Clearinghouse for Long-Term Care Information,

About the Author

Susan Blais is a principal of Barry J. Fisher/Paradigm Insurance Marketing, a brokerage general agency focusing on long-term care insurance and related products. Barry J. Fisher/Paradigm Insurance Marketing has offices in California and Arizona, and works with agents across the country. You can reach Susan at 818-444-7757 or at, A national listing of professional long-term caregivers and facilities can be found on this page:

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