scholarly journals The Family and Medical Leave Act: A Policy Analysis and Recommendations to Address Employed Caregiver Burden

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 104-104
Author(s):  
Geunhye Park ◽  
Erin Robinson

Abstract Family caregiving plays a pivotal role in the long-term care system in the U.S, as there are over 40.4 million people providing unpaid care to individuals aged 65+ (U.S. Bureau of Labor Statistics, 2019). The majority are women providing supports to a parent/grandparent and provide an average of three hours of care each day. This places greater demands on family caregivers in balancing their dual caregiver/employment roles. The Family and Medical Leave Act (FMLA) of 1993 enables family caregivers to take unpaid leave to provide supports to immediate family. While FMLA was intended to provide flexibility to employed caregivers, many struggle with family-work conflicts and caregiver burden is high. Therefore, this conceptual paper offers a critical examination of FMLA and how family caregivers of older adults are impacted. Results of this analysis revealed three themes. First, FMLA is largely inadequate for employed caregivers, as only 60% of the workforce are eligible and unpaid leave restrictions create considerable financial hardship. Second, employer discrimination is high and family caregiving discrimination claims have dramatically increased since FMLA was enacted. And third, many employed caregivers are unaware of FMLA policies and eligibility requirements, which results in underutilization of benefits. Based upon these results, several policy and employer recommendations can be made, such as expanding FMLA coverage to include paid leave and non-immediate family caregivers. Additional recommendations will also be addressed. As it has been nearly 30 years since FMLA was enacted, updated policy is vital to continue supporting employed caregivers in their roles.

2017 ◽  
Vol 30 (3) ◽  
pp. 375-384 ◽  
Author(s):  
Ching-Lin Wang ◽  
Li-Min Kuo ◽  
Yi-Chen Chiu ◽  
Hsiu-Li Huang ◽  
Huei-Ling Huang ◽  
...  

ABSTRACTBackground:To develop a theoretical model explaining the longitudinal changes in the caregiving process for family caregivers of persons with mild cognitive impairment (MCI) in Taiwan.Methods:A longitudinal, grounded theory approach using in-depth face-to-face interviews and an open-ended interview guide. We conducted 42 interviews over a two-year period; each participant was interviewed at least once every six months. All participants were interviewed in their home. The participants total of 13 family caregivers of persons with MCI.Results:One core theme emerged: “protective preparation.” This reflected the family caregiving process of preparation for a further decline in cognitive function, and protection from the impact of low self-esteem, accidents, and symptoms of comorbidities for the family member with MCI. Protective preparation contained three components: ambivalent normalization, vigilant preparation, and protective management.Conclusions:Interventions to help family caregivers manage the changes in persons with MCI can reduce caregiver burden. Our findings could provide a knowledge base for use by healthcare providers to develop and implement strategies to reduce caregiver burden for family caregivers of persons with MCI.


2001 ◽  
Vol 19 (1) ◽  
pp. 125-142 ◽  
Author(s):  
MARGARET J. BULL

Family caregivers are the mainstay of long-term care, as they enable chronically ill elders and children to remain at home. The majority of family caregivers are women and historically their caregiving role has been viewed as an extension of their roles as wife and mother. Although numerous studies report the stresses associated with family caregiving and are predictors of burden, less attention has been given to interventions for family caregivers. The objective of this review is to examine reports of interventions to reduce family caregiver burden, to consider their implications for nursing practice, and to identify directions for future nursing research.


2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemisi Okikiade Oyegbile ◽  
Petra Brysiewicz

Family caregivers of patients with end-stage renal disease (ESRD) play a significant role in providing substantial care for a prolonged period for their sick relatives, often with very limited resources, making it a difficult environment. Government support for family caregivers of patients with ESRD is lacking in Nigeria, increasing their vulnerability to caregiver burden and its consequences. An action research study using a complimentary mixed-method approach was used to develop the intervention model for managing caregiver burden. Quantitative data were collected to measure the extent of caregiver burden using a Zarit Burden Interview questionnaire for 96 family caregivers, while individual in-depth interviews with 15 participants provided the qualitative data. Integrating the quantitative and qualitative data led to the identification of four moderators to manage the caregiver burden in this study. The model for managing caregiver burden was developed from the findings, using stressors and associated moderators of caregiving, and the role played by culture and finance in this context. An implementation checklist was developed, which was used by registered nurses to implement the concepts in the model with the family caregivers during the model implementation phase. Family caregivers of patients with ESRD need to be supported by nurses during the caregiving process. Nurses can increase caregivers’ identity and knowledge of the disease as a way of preventing the family caregivers from being overwhelmed by their caregiving role.


2015 ◽  
Vol 32 (2) ◽  
pp. 91 ◽  
Author(s):  
Eniola Salami ◽  
Bonnie Lashewicz

In Canadian law, the concept of autonomy is individualistic in nature, manifest as the capacity, or legal ability of an individual to actively understand the purpose and consequences of their actions according to whether they have faculties to comprehend and weigh risks and benefits.  Feminist scholars critique such conceptualizations of autonomy and, instead, argue the importance of “relational autonomy” which is predicated on the view that actions result from one’s own volition in combination with the influence of one’s social and relational connections. In this paper, we examine the dynamics and implications of relational autonomy in decision-making by adults with developmental disabilities by studying adults with developmental disabilities in interaction with their caregiving family members.  Our purpose is to contribute understandings of how and in what ways family caregiving relational contexts both support and hinder decision-making by adults with developmental disabilities.  We begin with an overview of conceptualizations and applications of autonomy, then illustrate relational autonomy dynamics through comparative analysis of data from two women with developmental disabilities who were interviewed together with their family caregivers about successes and struggles in giving and receiving care and making decisions. These two women, and their family caregivers (N=9) are selected from a larger sample of adults with developmental disabilities and their family caregivers (N = 26) because the contrasts, as well as the similarities, between their family care situations are striking, and taken together, illustrate a range of ways in which decision-making is supported and hindered.  We conclude by upholding the importance of relational autonomy for legal understandings of decision-making, yet we caution that critical examination of relationship dynamics is vital. En droit canadien, le concept de l’autonomie est un concept individualiste de par sa nature et est perçu comme l’aptitude, physique ou juridique, d’une personne à comprendre activement l’objet et les conséquences de ses actes en fonction de la question de savoir si elle possède les facultés voulues pour apprécier et soupeser les risques et les avantages en jeu. Des universitaires féministes critiquent ces conceptualisations de l’autonomie et mettent plutôt l’accent sur l’importance de l’« autonomie relationnelle », qui repose sur l’interaction entre la volonté de la personne et l’influence de ses contacts sociaux et relationnels. Dans le présent document, nous nous penchons sur la dynamique et sur les incidences de l’autonomie relationnelle dans les décisions que prennent les adultes handicapés en étudiant l’interaction d’adultes handicapés avec leurs aidants familiaux. Notre but est de favoriser une meilleure compréhension de la mesure dans laquelle les contextes relationnels dans lesquels se trouvent les aidants familiaux peuvent à la fois appuyer et entraver le processus de prise de décisions chez les adultes handicapés. Après avoir présenté un bref aperçu des conceptualisations et des applications de l’autonomie, nous illustrons la dynamique de l’autonomie relationnelle au moyen d’une analyse comparative de données provenant de deux femmes handicapées qui ont été interrogées ainsi que leurs aidants familiaux au sujet des défis et des réussites liés à la prestation et à la réception de soins et à la prise de décisions. Ces deux femmes et leurs aidants familiaux (N=9) ont été choisis à partir d’un plus grand échantillon d’adultes handicapés et de leurs aidants familiaux (N=26), parce que les contrastes, tout comme les similitudes, entre leurs situations sont frappants et que, examinées ensemble, ces données illustrent différentes façons dont la prise de décisions est appuyée et entravée. Nous concluons en insistant sur l’importance de l’autonomie relationnelle pour la compréhension des aspects juridiques de la prise de décisions, tout en soulignant qu’un examen critique de la dynamique des relations est vital.


2021 ◽  
Vol 26 (8) ◽  
pp. 781-793
Author(s):  
Alison Pattison ◽  
Elissa Torres ◽  
Lori Wieters ◽  
Jennifer G. Waldschmidt

Background As the United States’ population ages and health concerns rise, the family caregiver occupation will continue to be an integral part of the health care system. Aims It is important to examine the burden that family caregivers experience so they can seek out additional training and services to maintain their own well-being. The researchers examined caregiver burden from a perspective of developmentally disabled and long-term care. Methods The researchers examined difference in Zarit scores, guilt, burden and personal strain for 72 caregivers of people with developmental disability (DD) or people with long-term care (LTC) needs. The researchers also examined differences in these based on whether the individual was caregiving for family or “others”. Results For DD, there were significant differences in Zarit, role strain and personal strain; caring for others has significantly lower scores on these. Role strain was significantly higher than personal strain, which was significantly higher than guilt for both LTC and DD groups. Conclusions Given these findings, it is important to support family caregivers first and foremost with role strain, especially for those caring for family members with DD. This support could be given through personal counselling, caregiver training, non-profit social service resources, and support groups for family caregivers.


2020 ◽  
Vol 7 (6) ◽  
pp. 1602-1609
Author(s):  
Olalere Omoyosola Gbolahan ◽  
Ogunmuyiwa Stella Amiede ◽  
Olowookere Anu Samuel

Different stages along the trajectory of cleft care may present with different and peculiar challenges that may negatively impact family caregivers, leading to considerable stress and burden. This study aims to evaluate the family caregiver burden and perceived stress of caring for patients with cleft deformities. Contributing factors to family caregivers’ burden in the perioperative period of cleft repair was also identified. A cross-sectional design that included 90 adult caregiver–patient pairs was employed. Semi-structured questionnaire was used to collect necessary information. The level of caregiver’s burden was assessed using the Zarit burden interview score. The results demonstrated the levels of caregiver burden as severe (4.4%), moderate to severe (21.1%), mild to moderate (40%), and little or none (34.5%). The only significant and independent predictor of caregiver burden was earning less than US$50/month (odds ratio = 2.30, 95% CI = 0.95-5.61, P = .066). Coping strategy was mainly family support (98.9%), while the greatest need expressed was financial assistance (66.7%). Our findings suggests that efforts geared at reducing direct and indirect cost of cleft care may help in reducing caregivers’ burden.


2018 ◽  
Vol 2 (S1) ◽  
pp. 82-82
Author(s):  
Judith Vick ◽  
Jennifer Wolff

OBJECTIVES/SPECIFIC AIMS: Family members are often critical in the delivery of hands-on care and decisions about care for persons approaching end-of-life (EOL). Prompted by concerns about the poor quality and high costs of care at the EOL, recent delivery reform efforts—such as the growth of hospice and palliative care—have been directed at improving EOL care for both patients and family. Trends of the characteristics of EOL family caregivers and care recipients over time have not been well described. The goal of this study is to evaluate changes in EOL family caregiving from 1999 to 2015. METHODS/STUDY POPULATION: This study uses reconciled data from two nationally representative surveys and their linked caregiver surveys: the 1999 wave of the National Long-Term Care Survey (NLTCS) and the Informal Care Survey (ICS), and the 2015 wave of the National Health and Aging Trends Study (NHATS) and the National Survey of Caregiving (NSOC). RESULTS/ANTICIPATED RESULTS: Crude analysis shows that older adults living in the community and receiving help from family caregivers in the last year of life were significantly better educated (72% with greater than 12 years of education vs. 46%), and more diverse (78% White vs. 89%) in 2015 compared with 1999. Family caregivers in the last year of life were less likely to be female in 2015 compared with 1999 (74% vs. 68%, NS) and significantly less likely to be spouses (45% vs. 38%) in 2015. In 2015, a significantly greater proportion of older adults received help with five or more activities of daily living (47% vs. 34%), but family caregivers reported significantly lower levels of caregiving-associated distress: financial strain (80% reporting none in 2015 vs. 53%), emotional (51% vs. 39%), and physical strain (70% vs. 45%). In addition, a significantly greater proportion of EOL family caregivers used respite care in 2015 compared to 1999 (15% vs. 4%). DISCUSSION/SIGNIFICANCE OF IMPACT: Changes in the experience of EOL family caregiving may be impossible to capture in studies of single interventions, but tracking nationally representative trends can be used as an indicator of broader changes that take place cumulatively over time. Although studies of this nature cannot identify causal mechanisms of change, they are important to monitor long-term impact of program implementation and to guide future research, policy, and resource allocation.


2018 ◽  
Vol 46 (3) ◽  
pp. 629-635 ◽  
Author(s):  
Richard L. Kaplan

The United States relies on uncompensated family caregivers to provide most of the long-term care required by older adults as they age. But such care comes at a significant financial cost to these caregivers in the form of lower lifetime earnings and diminished (or even no) Social Security retirement benefits, ineligibility for Medicare coverage of their healthcare costs, and minimal retirement savings. To reduce the impact of uncompensated caregiving on the intergenerational transmission of poverty, this paper discusses three possible mechanisms of compensating family caregivers: public payments, deemed wage credits under Social Security, and income tax incentives.


2005 ◽  
Vol 11 (1) ◽  
pp. 91 ◽  
Author(s):  
Michele Foster ◽  
Delena Amsters ◽  
Glenys Carlson

As survival rates and life expectancies of individuals experiencing acquired disabilities such as spinal cord injury improve, greater demands are placed on health, rehabilitation and long-term care services. Further, family caregivers are assuming much of the caring responsibilities. This paper examines family caregiving in relation to individuals with spinal cord injury (SCI) in an Australian context. The paper is based on a descriptive survey conducted with 206 individuals with SCI, referred to a specialist SCI outreach service in Queensland, and 179 family caregivers. The survey collected social and demographic information and details of the type of care provided by family caregivers. It also explored family caregivers' perceptions of the types of services they require to assist them in their caring roles. Family caregiving typically involved physical, practical, and emotional support, and in many cases this occupied in excess of three hours a day, with no additional source of caregiving provided. The most frequently reported service types required by family caregivers included respite, personal support, information services, and health professional services. Mapping caregiver needs in this area establishes a critical basis for service planning and more importantly provides a guide for the development of a range of services dedicated to maintaining the health and well-being of family caregivers of individuals with SCI.


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