Testifying recently at a hearing by the Senate Special Committee on Aging, former Supreme Court Justice Sandra Day O'Connor gave the nation a glimpse into what the future may hold for employees with aging parents or spouses. In 1990, O'Connor's husband, John, was diagnosed with Alzheimer's disease. "In the early days of my husband's illness, I often took him to court with me because he could not be left alone," O'Connor related. "I retired from the U.S. Supreme Court in 2006 to find a care center for John in Phoenix, where two of our children live. Many caregivers make similarly difficult decisions each and every day. Sadly, these life-changing decisions are simply part of caring for someone with Alzheimer's."

Today, 9.8 million Americans provide unpaid care for a person with Alzheimer's disease or another type of dementia, according to the Alzheimer's Association.

The Alzheimer's Association estimates that 5.2 million Americans now have Alzheimer's. By 2030, it is estimated that 8 million Americans will be stricken, and by 2050, as many as 16 million Americans will have it. Increasingly, part of your workforce will have to care for them as a family member.

Caregiving strains

Today, about 60% of unpaid caregivers are wives, daughters, daughters-in-law, granddaughters and other female relatives, friends and neighbors. Forty percent are husbands, sons, sons-in-law, grandsons and other male relatives, friends and neighbors. Caregivers range in age from very young to very old. The average age in 2003 was 48. The challenges facing those who care for people with Alzheimer's and other forms of dementia are significant and often overwhelming.

"Many family and other unpaid caregivers experience high levels of emotional stress and depression," states the Alzheimer's Association. "Caregiving also has a negative impact on the health, employment, income and financial security of many caregivers."

"Caregivers face difficult and heartbreaking decisions every day," Suzanne Carbone, a working caregiver in Maryland whose husband has Alzheimer's, said at the Senate hearing. "You constantly face changing levels of ability and behavior."

Just obtaining a diagnosis for Alzheimer's sufferers can be a tremendous drain on a family emotionally, physically and financially. One Alzheimer's patient related that her family went bankrupt trying to find the reason for her behavior.

The problems are compounded when employees are in a long-distance caregiver relationship. It's estimated that 10% of the 9.8 million unpaid caregivers of people with dementia live more than two hours from the person for whom they provide care, and another 4% percent live one to two hours away.

Specialized help available

Employers are increasingly aware of the need to help baby boomers who have eldercare responsibilities. Thirty-nine percent now provide access to information about services for elderly family members, compared with 23% in 1998, according to the Families and Work Institute 2008 National Study of Employers. Also, 65% of employers provide employee assistance programs, up from 56% in 1998. However, EAP and eldercare resources aren't geared toward supporting caregivers of people in advanced stages of cognitive decline. That takes specialized services that haven't been widely available through the workplace.

One company that has begun offering advanced caregiver support as a voluntary employee benefit is My Health Care Manager, a three-year-old company based in Indianapolis. MHCM's Personalized Eldercare Program provides employees with access to nurses and social workers who can help them navigate through the medical and eldercare systems and find the resources they need.

"One-quarter to one-half of the people who engage us care for someone with cognitive decline, which ranges from forgetfulness to Alzheimer's," says Alan Stanford, CEO of MHCM. "We help caregivers come up with a plan for their loved one that encompasses geography and finances. It's an opportunity to have a skilled, independent person assisting you as you work through some pretty big issues."

MHCM differs from local, independent care providers in that it is "heavily informatics based," enabling staff to quickly identify resources around the country, including gerontologists, insurance providers, housing facilities, educational resources and caregiver support groups, says Stanford. MHCM will negotiate discounted rates for covered employees. The company typically charges $195 for the initial fact-finding consultation, $775 for a situational assessment, and $125 an hour for assistance services. Employers can choose to cover some or all of the cost for any type of service. MHCM has several clients that cover all or most of the negotiated cost of the fact-finding consultation.

The typical MHCM client is a professional firm whose most productive employees are in their 40s and 50s, Stanford says. However, younger firms, such as Katz, Sapper & Miller, LLP, a CPA firm in Indianapolis, also recognize the value of this benefit.

"As time goes on, [care-giving] will become more of a reality for our employees," says Kimberly Canada, Katz's benefits coordinator.

"It's great that there are companies like MHCM that can help employees navigate what can be a very complicated system at a time that's very stressful for them and their aging loved one."

Clarian Health, another Indianapolis firm, added the Personalized Eldercare Program to its benefits offering in January.

"We were anecdotally aware that the baby boom generation is [coping] with more parent-care issues, and we knew there was a mathematical certainty we'd be dealing with this in the next few years," says Brian O'Connor, director of employee benefits for the hospital system.

"We thought that even though it might be a low-utilized benefit, it would be greatly valued."

For Clarian, the service will reduce absenteeism and presenteeism. "An employee will perform better at work if he's comfortable with the decisions made regarding a parent," O'Connor says. "They'll be less stressed and more at peace with themselves.

"This is a benefit whose time is coming," he maintains. Organizations considering such a service should look at the provider's geographic network, he advises, because "while your employee is with you, you don't know where the parents are."

Canada believes educating employees about eldercare support options is the most important thing an employer can do - a view echoed by Alzheimer's caregivers.

"Guidance in all aspects of care is important, from where to go for the initial consultation with medical experts to more in-depth services," she says.

"It's important to show employees that they have resources and that they are not alone."