Employment and Caregiving
Employed family caregivers face difficult choices as they try to balance work and caregiving commitments. A large number of family caregivers to older adults are employed or working part time in addition to their caregiving responsibilities. In Canada, approximately 72% of women and 83% of men caregivers are employed (Lilly 2011). Role responsibilities divided between caregiving and working frequently compete and conflict; employed caregivers are described as feeling “sandwiched” (Neal and Hammer 2007) as they struggle with balancing and combining both responsibilities (Wang et al. 2018). Consequently, some working caregivers are likely to make adjustments in their work and caregiving activities (Scharlach et al. 2007; Lee et al. 2015a; Lee and Tang 2015). It is estimated that about 25% of working caregivers in Canada made work-related adjustments in order to take on caregiving responsibilities (Duxbury et al. 2009; Fast 2015). However, working can also provide the advantage of taking a respite from caregiving for some caregivers (Hansen and Slagsvold 2015).
Key Research Findings
In research on caregiving and employment, many studies have examined the relationship independently, assuming a unidirectional relationship (Pavalko and Henderson 2006; Young and Grundy 2008; Lee and Tang 2015). That is, they distinguish caregiving interference with work from work interference with caregiving, and address each model separately, with more attention directed to the impact of caregiving on work.
Several studies (Pavalko and Woodbury 2000; Dentinger and Clarkberg 2002) have shown that caregivers are likely to work. As family caregiving often causes a financial burden, caregivers may want to remain employed due to financial considerations or health insurance (Carmichael and Charles 2003; Dentinger and Clarkberg 2002; Eales et al. 2015). In addition, some caregivers consider their workplace a respite from the demands of caregiving (Carmichael and Charles 2003; Hansen and Slagsvold 2015). From this perspective, employed caregivers consider their employment as a means of buffering the strain and stress of caregiving demands, (Pavalko and Woodbury 2000). However, a large body of literature has also documented that caregiving is negatively related to employment, showing that many caregivers left the labor force or retired or shifted from full-time to part-time employment as a result of providing care to parents (Pavalko and Henderson 2006; Spiess and Schneider 2003; Longacre et al. 2016).
Compared to the literature on the effects of caregiving on work, relatively fewer studies have examined how caregivers’ employment is associated with the decision to take on caregiving responsibilities. Some research has suggested that employment limits the likelihood and amount of time that family members provide care (Scharlach et al. 2007; Young and Grundy 2008; Feinberg et al. 2011), though women are likely to become caregivers regardless of their employment status unlike men. This suggests that employment was not significantly associated with stopping caregiving for women (Moen et al. 1994). However, the cross-sectional designs of these studies limit the ability to infer causality. Mentzakis et al. (2009) examine the determinants of informal care using a longitudinal data and show that participation in the labor force negatively affects the decision to be a caregiver for men and women.
A few studies have examined the reciprocal relationship between employment and caregiving (Berecki-Gisolf et al. 2008; Pavalko and Artis 1997; Lee et al. 2015a). Boaz and Muller (1992) are among the first researchers to suggest the potential for the simultaneity of both relationships based on cross-sectional design. By distinguishing full-time and part-time employment, their findings show that full-time employment of caregivers reduces the hours of caregiving and women caregivers are much less likely than their male counterparts to have full-time employment. However, there is no significant effect for part-time employment. More recently, Lee et al. (2015a) test the association using longitudinal panel data and show no reciprocal relationship between caregiving and labor force participation. Instead, the findings show that there is negative effect of caregiving on employment for women, whereas employment reduces the possibility of being a caregiver for men.
Areas for future research include more diverse approaches to address employment and caregiving. Rather than focusing on employment status itself and distinguishing those who are employed and those who are not, the experiences and perceptions of employment need to be examined. Caregiving should be measured the same way. Instead of simply indicating whether a person is providing care or not, how caregivers perceive their care experiences might help an understanding of not only the negative outcomes but also the positive perspectives of caregiving. These perspectives have been raised previously by pointing out the lack of insight into the relationship between caregiving and employment and applied mostly to examine caregiver outcomes such as caregiver burden, well-being, and self-esteem (Reid et al. 2010). For example, Reid and colleagues (2010) examine the effects of employment status and work interferences on caregiver well-being, respectively, and suggest that subjective assessment of work interferences may play a more important role than does employment status.
Implications for Policy and Practice
These empirical findings regarding the association between caregiving and employment have implications for policy and practice. In the long term, the substantial earnings loss for caregivers raises questions about their retirement income because caregivers accumulate fewer future pension benefits (Lee et al. 2015b). Therefore, efforts to address poverty issues among caregivers, such as providing family caregiver credits, may improve their pension entitlements and add value to their caregiving work. Also, providing direct cash transfers or offering tax credits for purchasing long-term care insurance may compensate caregivers for their financial loss (Mellor 2000).
The workplace is a primary arena for supporting working caregivers to manage care and work responsibilities (Neal and Hammer 2007; Ireson et al. 2018). Workplace supports including flexible work schedules, paid leave, or supportive supervisors, and co-workers positively influence family caregivers’ employment outcomes by reducing stress and role strain and helping them to meet their caregiving responsibilities (Kossek et al. 2001; Feinberg 2018). On the other hand, limited job flexibility and fewer workplace supports are likely to increase lateness for work and absenteeism, thus decreasing the productivity of employed caregivers (Scharlach 1994; Dembe et al. 2011) as well as their mental health outcomes (Li and Lee under review).
Paid family leave and supportive social services are important to assist family caregivers in the labor force and improve caregiving outcomes. Increased availability of publicly supported home care systems and caregiving leave can both increase flexibility in the workplace and increase the possibility for caregivers to remain in the labor force (Pavalko and Henderson 2006).
Given that many older adults are likely to live in the community, the number of family members and friends who provide care to these individual is and will be increasing. Research is needed to identify who are most vulnerable in the labor force and how the intersectionality of socioeconomic status affects employment as well as caregiving outcomes among caregivers.
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