Paid Family Leave: An Emerging Benefit for Employed Family Caregivers of Older Adults

Abstract

As our population ages, the ability to take time off to care for an ill family member or close friend without losing income or a job is a growing social, health, and economic issue for American families. Therefore, the need for paid family leave policies for workers with caregiving responsibilities is an important topic for employers and policymakers, in the clinical care of older adults, and at kitchen tables across the United States. Despite this growing need, paid family leave is not available to most workers, and there is no national paid family leave policy. Health care and social service providers have a role in ensuring that family members of their patients with a serious health condition or disability are aware of the potential availability of paid family leave benefits in the states and businesses that provide them. Building a better system of care for older adults means changes not only in health care settings and in long‐term services and supports, but in workplaces too. This article describes the challenges faced by workers with family caregiving responsibilities, explains why paid family leave matters, indicates which states have adopted these protections, and reviews research on existing paid family leave policies. Finally, actions by clinicians and other stakeholders are offered to advance awareness about paid family leave benefits, including coverage for workers with care responsibilities for older people.

When Women Rise, We All Rise: American Geriatrics Society Position Statement on Achieving Gender Equity in Geriatrics

“…For example, of mothers, 39% report taking a significant amount of time off from work to care for a child or other family member . Women also provide the majority of care to older adults . This is particularly true for mid‐career women who face competing demands on their time in the form of caring for aging parents or parents‐in‐law and children .…”

“…2 Women also provide the majority of care to older adults. 21 This is particularly true for mid-career women who face competing demands on their time in the form of caring for aging parents or parents-in-law and children. 11 Research using data from the Health and Retirement Study from the University of Michigan found that women faced with caregiving in midlife were 8% less likely to work, and that after providing care, were 4% less likely to continue working.…”

Beyond Parental Leave: Paid Family Leave for an Aging America

“…With this backdrop, Feinberg's timely review speaks to the history and significance of workplace leave for family caregivers of older adults: a group that has been largely missed in paid leave policy deliberations to date . Feinberg summarizes economic consequences that may result from caregiving, such as lost income, lower savings, foregone retirement benefits, limits on career growth, and out‐of‐pocket expenses related to transportation, housing, or services that are not reimbursed by insurers .…”

“…California was the first state to enact a paid family leave policy in 2002, and five states and the District of Columbia have since followed; 25 state legislatures have active legislation under consideration . State paid leave policies are self‐financed through modest employee and/or employer payroll taxes that range from 0.34% to 1.2%, with spending curtailed through caps on replacement wages, benefit duration (typically 4 to 12 weeks), and eligibility restrictions related to work requirements and waiting period . Three states (California, Washington, and Massachusetts) and the District of Columbia have incorporated graduated wage replacement rates to better compensate wage loss among the working poor and increase program equity, participation, and sustainability.…”

“…With this backdrop, Feinberg's timely review speaks to the history and significance of workplace leave for family caregivers of older adults: a group that has been largely missed in paid leave policy deliberations to date. 8 Feinberg summarizes economic consequences that may result from caregiving, such as lost income, lower savings, foregone retirement benefits, limits on career growth, and out-ofpocket expenses related to transportation, housing, or services that are not reimbursed by insurers. [9][10][11] Population aging and greater female labor force participation will amplify the importance of policies to reconcile work and family responsibilities in the coming decades as more Americans face the prospect of managing workplace responsibilities and simultaneously caring for an older family member while the available supply of geographically proximal working-age adult children contracts.…”