Note to President Obama: Families don’t just care for young children. They also care for aging parents, spouses, and adults with disabilities.
In his State of the Union address last night and in an announcement last week, Obama proposed a number of steps aimed at helping working parents care for sick kids. Among his ideas: requiring employers to offer up to seven days of paid sick leave each year, expanding access to paid family and medical leave, providing up to six weeks of paid family leave to federal workers, and allowing federal agencies to advance up to six weeks of paid sick leave.
But all of these ideas were described as benefits for families with young children. And while some may provide limited assistance to those whose parents face a short-term acute medical crisis, they’d do little to someone help care for a frail parent or spouse with a chronic illness, or a child with a disability.
In his State of the Union address last night, Obama was unambiguous about what he has in mind: “Today, we’re the only advanced country on Earth that doesn’t guarantee paid sick leave or paid maternity leave to our workers…. And that forces too many parents to make the gut-wrenching choice between a paycheck and a sick kid at home.”
All true, Mr. President, but what about the adult daughter who has to make the gut-wrenching choice between a paycheck and her widowed mom with dementia?
Think about these proposals in the context of that daughter trying to balance work and caregiving for a parent. Seven days of sick leave, even if it could be used for a family member who is ill, can help a worker manage an immediate crisis. Say dad breaks his hip. A worker might be able to use some of that time off to talk to doctors, arrange rehab, and the like. But if dad needs years of personal assistance, seven days is close to meaningless.
Paid family leave could be more helpful–if it includes time to care for a chronically ill relative. But it must be more flexible than time off for the birth, adoption, or foster placement of child, as Obama is proposing.
Still, these ideas fall far short of what family members need when caring for someone with chronic illness. A woman over 65 will likely need some level of personal assistance for an average of 3 years before she dies. About 80 percent of that care is provided by family members. That’s trips to the doctor, doing laundry, shopping, balancing the checkbook, shoveling the walk, fixing the leaky faucet. Maybe it’s helping mom with cooking and dressing. Or even with bathing, eating, or going to the bathroom.
Even for those relatively few families who can afford paid care, it is time managing aides and arranging emergency help when the aide calls in sick or does not show up. It is visiting the nursing home, working with staff to prevent or fix problems. It is trips to the emergency room. And it is time to just hold mom’s hand.
Seven days of sick leave barely scratches the surface. Six weeks of family leave is better—if it can be used to care for a chronically ill parent.
But even if these ideas are expanded beyond Obama’s limited vision of childcare, none of his proposals will really address the challenges of this kind of family caregiving. It is unreasonable to expect employers to pick up the costs for an obligation that is this time consuming, even if they do so for more limited paid sick leave or paid family leave.
Families caring for aging loved ones or for adults with disabilities need support that can be measured in years, not days. One solution could be a well-functioning insurance-based program that can provide the resources to hire paid assistance, make homes safe, and link long-term supports with medical care. Another is a more efficient and effective way to tap the largest single source of wealth for most Americans, their home equity. A third is a robust system of community-based, grassroots supports where neighbors can help neighbors with basic caregiving tasks.
Mostly, Obama and the Congress need to reimagine caregiving. Sure, it is about kids. But, as 77 million Baby Boomers age, it is about much more than that. Already more than 40 million Americans are caring for a frail elder or younger adult with a disability. They can no longer be ignored.