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Running after a two-year-old and a 78-year-old all day, every day was not Steve Sable's idea of a career path.

But working full time became impossible when Mr. Sable's father moved into his Toronto home two years ago, just after his wife, Jordana, gave birth to their son.

Ms. Sable commutes to suburban Mississauga to run the company she owns, Transtek Graphic Systems, which makes vinyl signs. So her husband was forced to give up a marketing job to take on the full-time responsibility of caring for both his only child, Max, and his dad, Hyman.

"It's Alzheimer's. Physically, Dad's fine, but he can't feed himself, and if it was up to him, he would go all day without eating or cleaning himself," Mr. Sable, 46, explains.

"It's either this or bring in professional help just to babysit him and that doesn't make sense."

The Sables have become part of a growing "sandwich generation," coping simultaneously with the needs of young kids and aging parents.

On both the home front and the career front, this has really become the issue of the decade, says Barbara Jaworski, director of work/life solutions for FGI employee assistance programs.

"For the first time in our history, many workers have more responsibility for elder care than for child care," she says, citing the most recent Statistics Canada general social survey.

In the 2001 census, 11.6 per cent of Canadians 15 and over reported spending up to five hours in the week before the census providing unpaid care or assistance to seniors.

The total for unpaid child care was 9.8 per cent.

Child care remains a much more time-consuming process, so the total number of hours working Canadians spend caring for children still exceeds the number of hours spent with elders.

The gap, however, is narrowing for people aged 45 and over.

As well, an analysis of the numbers in last year's Statscan report, Caring for an Aging Society, found that 20 per cent of women and 13 per cent of men aged 45 to 54 reported they had to reduce their hours of work to meet elder-care demands. And 25 per cent of women and 32 per cent of men who provide care to one or more adults over the age of 65 in their home are also caring for children under the age of 15.

The demands can become an unending drag on their job performance. A recent survey conducted for the Conference Board of Canada found that people who find that the demands of providing care at home regularly conflict with their job miss nearly 12 days of work a year -- four times the average for people with low family demands.

A study by human resources firm Watson Wyatt Worldwide last year estimated the annual costs to Canadian companies are $16-billion a year.

Half of that is in salaries paid for workers who are not on the job and the rest in lost production and the cost of replacement staff.

"Absenteeism, lowered productivity, altered work schedules, health and psychological impacts, foregone career opportunities" are all among the effects that employees squeezed by sandwich-generation demands bring to the workplace, says Jacqueline Roy, managing director of Crawford Healthcare Management of Kitchener, Ont., which does insurance risk analysis for companies and government agencies.

As a result, "employers are being forced to respond with more flexible scheduling and support services because it is a good investment to provide for people whose personal needs are affecting the operation," she says.

A number of companies are taking up the challenge of helping employees respond to their elder-care needs, with new programs that allow leaves and benefits, flexible work scheduling, job sharing and help in finding care assistance and services.

Lawmakers are also responding, with moves such as a new federal compassionate leave program that pays employment insurance for up to six weeks to people who must take time off to care for a dying family member.

Outside employee assistance programs (EAP) that started out a decade ago arranging help for employees with drug or mental health problems have seen much of their business shift to family care issues in the past few years.

Provisions for elder care are now the fastest-growing area for EAPs, says Rod Phillips, president and CEO of Warren Shepell, a Toronto-based firm that provides assistance to 2,000 companies with a total of three million employees.

"It's getting on the agenda of employers because it's on everyone's personal agenda," says Mr. Phillips, noting that requests for help with child care and dependent elder care rose by 15 per cent last year and are expected to rise by 20 per cent this year.

In a recent work-life survey that IBM Canada Ltd. conducted of its nearly 20,000 employees in Canada, 53 per cent said they care for children at home, 25 per cent care for parents or other elderly adults and 13 per cent have responsibilities for both.

But 55 per cent of employees said they expect to be caring for aging relatives within the next five years. "That certainly tells you why our focus is now on elder care," says Susan Turner, director of diversity and workplace programs for IBM Canada in Markham, Ont.

Until recently, employees couldn't demand a flexible schedule because there weren't many ways that people could adjust their work to meet competing needs at home, Ms. Turner says. "But people coming into the job force today expect to have more flexibility because they know that technology allows that to happen." As a result, the company developed a job-sharing program that allows people working part time to share tasks and it now has managers assigned to co-ordinate shared jobs.

Ms. Turner says she is receiving huge response to a conference she is organizing in Toronto in April with representatives of supplier companies that are interested in developing policies to assist their employees with elder-care needs.

The company is also running "elder-care fairs" in its offices, where providers discuss issues and services with employees.

Some of the most innovative work-life programs have come from financial companies that have predominantly female staff, because the squeeze is the greatest for women, who still take on the majority of care-giving tasks.

VanCity Credit Union in Vancouver, which began allowing flexible scheduling for child care 10 years ago, is now expanding the option for people with elder-care needs, says Donna Wilson, vice-president of human resources.

VanCity employees are entitled to take as many as 12 days off each year for personal needs. "We don't ask how you use it. If you've got a need, you can take the time. Rather than having people call in and lie about being sick, we don't call them sick days, we call them care days," she says.

Well over half of the company's employees opt to work on compressed weeks or part-time with full benefits. Ms. Wilson says other companies have been studying VanCity's flexible work options with the hopes of emulating them. But she cautions that it can't just be a buzzword and must have the active support of management to accommodate the needs of employees.

Even small things can be important, Ms. Wilson says. VanCity began lending pagers to the husbands of employees who were due to give birth to let them keep in touch. Now they are also available to employees who want to keep in touch with elderly relatives. "It's reassuring. Employees find the fact that they are available comforting," she says.

Canada's big banks have also been liberalizing policies for personal needs. "We have a policy that we don't penalize employees who need to [take time off to]take care of their personal needs," says Bank of Montreal spokesman Michael Edmonds. And when they return from an extended leave, they can work part time.

BMO's "people care days" program can be used to take children to the doctor or to help an elderly parent who is sick. The leave is with pay and benefits and there is no time limit, although the amount of time that can be taken is at the discretion of the employee's supervisor. Another personal leave plan is available to take care of ailing parents for an extended time.

One of the most innovative new concepts, being tested by Telus Corp., is a concierge service, which gives employees "credits" that can be used to pay for services such as doing research by phone, running errands or even hiring a care giver. It was introduced as a pilot program last year for managers of the divisions of Telus across Canada. "The whole idea is if you have someone doing your chores, it puts more time into your day," says Kendra Innes, director of corporate health services for the company, which has 24,000 employees.

Options for balancing home care issues have not been as common in the public sector but, in the past year, elder-care provisions have become a negotiating issue for contracts in the social services, where the majority of workers are women.

"We're finding workers in social services do an average of five unpaid hours of work per week to care for the needs of children or parents," says Margot Young, national research officer for the Canadian Union of Public Employees in Ottawa.

CUPE covers a range of sectors and each local tends to bargain individually but the union is proposing policies on child care and elder care in new contracts with employers. Improved leave provisions are the goal for elder care.

CUPE recently negotiated a provision for compassionate leave of up to five days with pay in a contract with Simon Fraser University in Vancouver and a provision for extended leave up to 52 weeks, without pay but with accumulation of seniority, for Quebec health and social services employees.

In contracts this year, CUPE will also seek "time off programs," in which employees can request and be given extended blocks of time off for family care, Ms. Young says.

The Canadian Union of Postal Workers last year won an innovative expansion of its child care fund to cover adult children with special needs. Under the plan, a fund helps cover the cost of child care, transportation costs and equipment such as hearing aid batteries. Demands for expanding the coverage to the costs of caring for ailing parents were not accepted but will be reintroduced in the next contract in 2007, says Jamie Kass, co-ordinator for CUPW in Ottawa.

Last month, the B.C. Council for Families, a Vancouver-based non-profit resource service with funding from Health Canada, launched Collaboration Work/Life Balance, comprised of B.C. government agencies, unions and businesses.

A background paper prepared by executive director Carol Matusicky proposes employers encourage managers to be supportive, build in more flexibility in hours and workloads and make support programs available to employees with care responsibilities at home.

It also recommends that governments, which are among Canada's largest employers, take the lead and develop a national child- and elder-care program

"Employers have to look at being flexible because it helps them recruit and retain employees," Ms. Matusicky says.

Indeed, in the future, people may be more likely to take potential care responsibilities into account when planning a career, suggests Daniel Quinn Mills, professor of business administration at Harvard Business School and the author of Having it All . . . And Making it Work, whose subtitle is "Six Steps for Putting Both Your Career and Your Family First."

"It's important to decide what is really important to you and make decisions that make time. One of the most important things is to choose a career that makes you more flexible in your time," Dr. Mills advises.

That may mean steering clear of such all-consuming careers as investment banking, consulting or any job that requires large amounts of travel.

"You have to make space and time to deal with both children and parents. You get destroyed if the competition gets too intense," Dr. Mills says.

That's a lesson Ms. Sable, 42, has learned. Because she is her own boss, she can set her own hours and occasionally work from home to give her husband a break.

"We've gone to all the caregiver seminars and we kept hearing you have to stay healthy and take care of yourself," Ms. Sable says. "But you don't understand what that means until it hits for a long term of 24-hour-a-day commitment."

Having options makes it manageable, Ms. Sable says. "If we had to do nine-to-five jobs, it would be impossible. You've got to do what's best for you."

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