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Balancing Self-Employment With Elder Care: Solutions And Resources You Can Use

In 2009, 48.9 million Americans provided unpaid care for an adult in their lives, reported a study conducted by the National Alliance for Caregiving and the AARP.

Fifty percent of those caregivers also worked full time, trying to find time for doctors’ appointments and other tasks in schedules that were already packed.

The physical and emotional tolls of caring for another adult are high. They are also expensive for employers. In 2010, researchers from the University of Pittsburgh found that caregivers cost their employers $13.4 billion a year in increased health care costs alone.

Productivity losses from missed days and flagging performance add a whopping $33.6 billion to that tab annually, found a 2006 study sponsored by MetLife and the National Alliance for Caregiving. Those losses are deeply felt by self-employed caregivers who—unlike salaried employees—have incomes that are tied directly to the health of their businesses.

As caregivers (and as the employers of caregivers), the challenges that small-business owners face vary widely. Each situation is unique and can unfold over time in ways that are unpredictable.

There are, however, a number of strategies you can use to effectively balance elder care responsibilities with all the other demands on your time and energy.

Get Organized

In a perfect world, everyone’s elders would maintain careful personal archives—file cabinets filled with neatly labeled folders and critical paperwork. Unfortunately, most people aren’t that organized.

When you become a caregiver in any capacity, do yourself a favor and gather all essential information so it’s easy to find whenever it’s needed.

To get started, round up the following documents:

• Personal information, including birth and marriage certificates, divorce papers and Social Security card
• Medical records
• Financial records for bank accounts, savings accounts, investments (stocks, bonds, retirement funds, etc.), debts (including loans, mortgages and credit cards), and safe deposit box keys
• Will and living will 
• General power of attorney and health care power of attorney
• Insurance policies (health, life, car, home, etc.)

All paperwork should be sorted and stored in a safe place. Use a binder for information that will be accessed more often, including:

• Contact information (phone numbers, addresses and e-mail addresses) for health care providers and personal contacts
• Receipts and invoices
• Medication log (a record of what—and when—prescription drugs were taken)
• Appointment calendar 
• Doctors’ appointment notes (diagnoses, instructions, etc.)
• Care notes (observations made by elders and caregivers)
• Insurance cards

Identify Your Team

Caring for an elder is a complicated project. Gathering your team is a crucial step toward getting things done. Even when you’re the sole caregiver, it’s possible to recruit help.

• Have a frank conversation with the core caregivers. Core caregivers include anyone—local or long distance—who will help with the heavy lifting. Whether you’re going it alone or part of a small group, it’s important to be honest as you discuss what kinds of assistance you can provide for your elder.
• Take stock of your resources. Your resources fall into three main categories: time, emotional support and financial aid. Core caregivers must decide which resources they are able—and willing—to give. Also consider each caregiver’s strengths and weaknesses. If your sister is a lawyer, she might become the point-person for insurance issues. If your brother is always late, he probably shouldn’t handle doctors’ appointments.
• Don’t forget the casual caregivers. Friends and other community members that will not be involved in your elder’s day-to-day care can still do a lot to support the efforts of the core caregivers. Small gestures like homemade dinners or afternoon visits can quickly add up to an important source of assistance when you engage the outer circle of your elder’s social network.
• Meet the professionals. Think about any long-standing relationships your elder already has with professional service providers. This could be anything from the doctor your father has seen for the last 25 years to the salon your aunt has visited every Saturday since you were a child. Lawyers, religious leaders, accountants—these are the people who might be willing to go the extra mile with house calls or help you get a handle on your elder’s affairs after an unexpected health crisis.

Coordinate The Caregivers

Caring for the elderly is a logistical challenge. This is particularly true when you’re coordinating the schedules of people from different households.

Make sure you keep track of all your commitments in a centralized place, such as a planner or a calendar application that syncs between your computer and your cell phone.

Better yet, use an online tool to coordinate calendars across caregivers. You can create a free website at lotsahelpinghands.com or carecentral.com to streamline common tasks associated with elder care, including:

• Coordinating with other core caregivers. This is especially helpful if any member of your team lives in a different city. You can share a calendar and use other tools to make sure everyone is on the same page.
• Letting casual caregivers know what they can do to help. Create a “registry” of specific tasks (grocery shopping, rides, etc.) to make it easy for people to see where the need is and to find ways to contribute to your elder’s care.
• Keeping people informed. You can send updates and share stories to let people know how your elder is doing. Most websites also provide a forum for people to send messages, which will cut back on time-consuming calls and e-mails.

Find Service Providers

Increasingly, your elder will rely on a variety of health care providers and other professionals for everything from acute illness to assistance with day-to-day tasks.

If you are in charge of securing such services, the options can be overwhelming. You’ll find a good overview of what’s out there by visiting Merck’s Geriatrics Manual.

To find the right providers, you’ll need to weigh factors such as:

• Costs
• Insurance coverage 
• Location
• Office hours

Consider an integrated facility that offers a variety of specialties and services to take advantage of one-stop shopping. Collect referrals from your social network and consult with staff at senior centers and institutions that target your elder’s demographic (such as religious organizations or associations for certain diseases).

The Internet is another great tool. Start with the Eldercare Locator, which is provided as a public service by the U.S. Administration on Aging.

Other good resources for locating service providers include:

• National Adult Day Services Association
• Hospital Compare from the U.S. Department of Health & Human Services
• Home care services from the National Institutes of Health
• Nursing homes from the National Institutes of Health

Take Care of Business

It can be difficult to juggle the responsibilities of running your business, overseeing your family and handling elder care responsibilities. Here are some tips for staying on top of it all.

• Be your own advocate. Often, people who aren’t self-employed don’t understand the challenges of running your own business as you care for an elder. You, on the other hand, know those challenges all too well. Be open about your struggles with other caregivers, your family and, above all, yourself.
• Keep good stats. Track all the time you spend coordinating and administering care. Notice how long different kinds of tasks take. Also track expenses, financial contributions you make toward elder care and opportunity costs (such as projects you turn down). If at any point your schedule or finances veer out of control, consult these records to see where you can save time and money.
• Prioritize ruthlessly. Acknowledge upfront that you can’t do it all. Rank tasks by importance and decide which items require your participation (as opposed to someone else’s). Delegate when you can and consider the consequences if you let low-priority tasks slide. Don’t underestimate emotional consequences.
• Try to avoid caregiving duties during work time. It’s fine to break out your laptop when you’re stuck in a waiting room, but you should also dedicate uninterrupted time to your work. Whenever possible, schedule caregiving in blocks at the beginning or end of the workday so you can focus on one responsibility at a time.

Support Employees

Your status as a caregiver might inadvertently affect employees’ workloads as well as their attitudes.

Make sure they have the support they need to do their jobs well. Stay attuned to their changing needs and provide training, extra hands, recognition and rewards when you can.

If you have an employee who is caring for an elder, do all you can to be a compassionate ally. Direct them to resources (like this article) and help them set boundaries that promote productivity.

Part of that process is identifying the areas in which you can afford to be accommodating. Possibilities include:

• Flexible hours
• Job sharing
• Paid or unpaid leave
• Telecommuting 
• Reduced hours

Whether you’re the caregiver or the employer of one, you should cultivate an atmosphere of openness and honesty at work and at home. Good communication will go a long way toward mitigating problems as they arise.


For More Information

Find more information on caregiving at these websites.

1. A host of helpful links on aging from the U.S. Department of Health & Human Services
2. The AARP’s Resource Center
3. Information and advice from the Family Caregiver Alliance