Eldercare

The Eldercare Cliff. It’s Coming. Are You Ready?

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(This post originally appeared in Forbes.com)

When I went to the polls, an issue that was barely mentioned during the campaign partially guided my vote. I favored the candidates nationally and locally whom I thought would begin to address the looming eldercare/adult caregiving cliff. Why?

Yes, jobs are very important, but increasingly people will struggle to keep a job as the demand to provide unpaid care for aging relatives (e.g. parents, aunts, uncles, friends, adult siblings) grows exponentially. Ultimately, this demand will far exceed the current level of supports in the community and the public funds available to pay for those minimal supports.

More and more individuals and employers will find they need to fill the gap financially and physically, and the worst is yet to come. But we aren’t talking about it. At least not yet; however, that’s going to have change.

What does eldercare/adult caregiving look like in action?

A couple of months ago, AARP in partnership with the Ad Council launched a three-year public service campaign to raise awareness of the tens of millions of unpaid family caregivers in the U.S. today.

When I first saw the powerful PSA, “Silent Scream” on television, it was so accurate in how it portrayed of the complicated emotions related to caring for another adult that it took my breath away. (My only wish it that they’d shown someone trying to rush out the door to work while figuring how to keep their mother safe when the caregiver doesn’t show up).

If you haven’t seen it, check it out here. It is worth three minutes.

What is the current state of eldercare/adult caregiving in the U.S.?

There are approximately 314 million people in the U.S. today. According to AARP, of that number, roughly 42 million were unpaid caregivers that provided $450 billion worth of unpaid care to adult relatives and friends in 2009. This is care that we, collectively, would have had to pay for otherwise.

In 2011, the Bureau of Labor Statistics reported that over a three-month period, 39.8 million people over the age of 15 said they provided care to someone over 65 years old because of “a condition related to aging. Of that 39.8 million:

  • • One-third cared for two or more older people
  • • 23% also cared for a minor child.
  • • 85% of caregivers and elders did not live together
  • • 56% of caregivers were women (44% men)

In other words, today about 13% of the U.S. population provides some type of unpaid family caregiving.

What is the projected future of eldercare/adult caregiving in the U.S.? (Click here for more)

3 Reasons Why Card-Carrying Capitalists Should Support Paid Family Leave

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In business school, we were taught that a solid strategy recognizes the exogenous (external) and endogenous (internal) challenges facing your business and addresses them. Employee child care and eldercare responsibilities are not only two major external business challenges, but they become internal issues the minute an employee walks in the door or signs onto his or her computer.

In the U.S., we pride ourselves on our capitalistic, profit-oriented savvy; therefore, given the growing magnitude of employee caregiving realities, you would assume that employers would support a clear, consistent uniform strategic response.  One that minimized business disruption and kept employees engaged and productive over the long-term. Unfortunately, the reality is the exact opposite.

Status of Paid Family Leave in the U.S.

Out of 178 countries worldwide, the United States is one of three that does not guarantee new mothers paid leave. The other two countries are Papua New Guinea and Swaziland. Nationwide, in March 2011, only 11% of the private sector workers and 17% of public sector workers reported having access to paid leave through their employer.

Only two states in the country, California and New Jersey, offer six weeks of paid family leave to men and women who are caregivers.  Even in the face of state budget challenges, both programs are healthy and successful. Unfortunately, the state leaves are not job-guaranteed which makes the time difficult to take. (New Jersey Paid Family Leave Fact Sheet / California Paid Family Leave Fact Sheet)

Yes, there are 12 weeks of job-guaranteed FMLA, but it is unpaid and employers with fewer than 50 employees are exempt which eliminates a large percentage of workers.

In terms of private paid leave offered directly to employees by employers, 58% of mothers who gave birth and were offered leave by their employer received some form of maternity disability pay, but only 14% of men on paternity leave received any replacement income (2012 National Study of Employers). That means 42% of mothers and 86% of fathers with employer supported leave received no income at all.

A Brief History

Historically, a coalition of labor, women’s, child and health advocates have promoted paid family leave. They’ve emphasized the well-documented public health benefits, the peace of mind of employees, benefits for children and eldercare cost savings. While valuable and important, these rationales haven’t withstood the “job killer and “anti-business” arguments used by groups like the Chamber of Commerce to fight approval. (Note: at the end of the post, you will find new information that could indicate the Chamber’s position on caregiving as an important business challenge is evolving, at least in their organization.)

Why?

There are workplace and public policies that plan for time off and income replacement in case of illness or injury. There are 401Ks and social security for when you retire and can no longer work. Why isn’t there a coordinated, uniform workplace and public policy that offers time off and at least partial income replacement when people, inevitably, have babies or an aging parent needs care? Why?

I wanted the question “why” answered when I attended last month’s Paid Family Leave Forum at the Ford Foundation sponsored by the National Center for Children in Poverty, New York State Paid Leave Coalition and A Better Balance. What I learned reinforced my long-held belief that every card-carrying capitalist should support paid family leave public policy because:

  • Paid family leave acknowledges and addresses a reality that directly impacts every business and, therefore, should be planned for strategically, uniformly and deliberately;
  • Paid family leave is NOT a tax, but income replacement insurance program funded by employees at minimal cost and
  • We are paying for a cost for caregiving already, albeit indirectly and inefficiently.

But, First, Don’t Shoot the Messenger

Before we dig deeper into each of the reasons listed above, I have to establish my business credibility, or “cred.” Too often when someone tries to engage the business community on issues that they consider “soft” or societal in nature, the messenger is dismissed as “not understanding business.” This, in turn, dismisses the message. I’m a messenger who can’t be easily dismissed with that argument because I do “get” business.

I was a banker for seven years, specializing in lending to closely held companies and I graduated, with honors, from Columbia Business School. I can rock a balance sheet and cash flow statement with the best of them, and I’ve even been known to find a strange joy in deciphering the “story” within the notes at the back of an annual report. I am a flexible work strategy consultant who works inside of organizations regularly, and I believe that both people and the business must benefit if flexible work is going to succeed.

As advocates for paid family leave found in California, I am not alone. Many business people support a uniform, public policy to address this challenge, but their voices were drowned out by the groups lobbying against it.

3 Reasons Every Card-Carrying Capitalist Should Support Paid Family Leave

My knowledge of and respect for business is why I think every card-carrying, profit-oriented capitalist should support paid family leave policy (or at least not stand in its way):

Reason #1: Paid Family Leave acknowledges and addresses a reality that directly impacts every business and, therefore, should be planned for strategically and deliberately.

The truth is that we are all potential caregivers. We may not end up having children, but all of us have parents and aging relatives who will very likely at some point require care.

Most mothers and fathers have to work and will be in the workforce when they have children. According to studies by the Center for American Progress, “in 2010, among families with children, 49% were headed by two working parents and 26% by single parents.” In 2009, employed wives of dual-earner families contributed 47% of total family earnings. In most cases, the income of both parents is critical to a family’s financial well-being.

With regard to eldercare, in 2010, 45% of employees surveyed said they had eldercare responsibilities over the past five years, and 49% expect to have responsibilities in the next five years. As the population ages, the eldercare challenges are expected to grow and many of those caregivers—men and women–will be in the workforce.

Paid family leave as public policy acknowledges the reality of caregiving by creating a uniform, clear response. Disruption is minimized because everyone knows the rules of the road. Business can plan in advance how the work will get done should an employee take leave for the prescribed six week period of time. This is especially true for maternity leave where, usually, you have months to plan. For example, perhaps the business can use the wages not paid to the employee on leave to hire a temporary worker, or to pay exist staff to take on the extra work during the leave.

It’s worth noting that a follow-up study of employers in California found that a majority felt paid family leave had either a positive or neutral impact on their business.

Reason #2: In the case of California and New Jersey, Paid Family Leave is NOT a tax, but an income replacement insurance program funded by employees.  In fact, some advocates feel a more accurate name is Family Leave Insurance. (Click HERE to go to Forbes.com for more)

How to Advocate for Family Leave Insurance, a.k.a “Paid Family Leave,” in Your State

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This week I wrote a post for Forbes.com entitled “3 Reasons Why Card-Carrying Capitalists Should Support Family Leave.”  To help individuals advocate for Paid Family Leave (which is really Family Leave “Insurance”) in their state, Ellen Bravo the Executive Director of Family Values @ Work, a national network of 16 state and local coalitions helping spur the growing movement for family-friendly workplace policies, offered the following get-started tips:
  1. Stay informed about legislation in your state or nationally by signing up with a group or coalition working on this issue. You can find more information on these websites: Family Values at Work and the National Partnership for Women and Families.
  2. Spread the word. Urge any group you’re involved with to become a part of the coalition. Speak up on your Facebook page or on Twitter, in a letter to the editor or in a post for a community or congregation newsletter.
  3. Share your personal experience, positive or negative, with legislators (contact information for state legislators can be found online). Let them know the impact on babies, on those dealing with chronic illness or aging, on families and on caregivers like you when employees do or don’t have access to affordable family leave.
  4. Create a personal network of at least 5 people, urge each of them to share their own experience with legislators – and if possible, urge your 5 people to create their own network of 5.

For more, connect with me on Twitter @caliyost.

“The Iron Lady” and the Truth About Aging We’re Afraid to Face

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As I watched Meryl Streep accept the Academy Award for her portrayal of Margaret Thatcher in “The Iron Lady”, I reflected the following reactions I had to the movie:

  1. How did Meryl Streep literally transform herself into Margaret Thatcher?  (It’s truly unbelievable)
  2. Even though I’d been in high school, college, and even lived in England briefly during Margaret Thatcher’s term as Prime Minister, I’d forgotten how tumultuous and violent that period had been. It puts today’s global economic turmoil into perspective.
  3. I completely understand why Margaret Thatcher would imagine that her beloved husband, Dennis, was still alive long after he’d died. I’d probably do the same.
  4. And finally, no matter how rich and powerful we may be at one time in our lives and careers, we all grow old. None of us will escape it. I hope the contrast between Margaret Thatcher’s ascent to power and her eventual descent into dementia finally sparks an important conversation about the truth of aging.

So, imagine my surprise when I read reviews of the film that expressed the absolute opposite response. Commentators were dismayed over the portrayal of her advancing dementia. They felt it was “unkind,” “unnecessary, “despicable.”

While I respect the desire to focus solely on the noteworthy and sometimes controversial achievements of Prime Minister Thatcher, her aging is also part of the story.

As Meryl Streep explained so eloquently when she received the best actress award from the British Academy of Film and Television Arts for her role (link to video):

(The goal of the film was) to look at the life of the Iron Lady inside and out and to locate something real, maybe hidden, but truthful in the life of someone we all decided we know everything about already.”

If we can’t witness the entire arc of the life of one of the most powerful leaders in modern history, how can we begin to grapple what the later stage of life will require of us personally, of our families, and of our society? To me, doing so doesn’t take away from achievement and contributions; it only makes them more human.

What do you think? How can we become more comfortable discussing all of the stages of life and work? Our own, but also of those we love? Does it matter?

Work+Life Flexibility “How to” in Pictures: #2 Change requires employee+employer partnership (some gov’t) and shift in broader cultural conversation

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How Employees Can Partner with Employers: Work+Life Fit in 5 Days Series

Work+Life Flex “How to” in Pictures: #1 Don’t get stuck on the innovation curve

Work+Life Flex “How to” in Pictures: #3 Focus on fact that same flexibility keeps business open in snowstorm, cares for aging parent (and more)

Work+Life Flex “How to” in Pictures: #4 Making flexibility real takes more than traditional policy, toolkit and training

(Fast Company) Change the Game: Add Aging to the Parent-Centric Work+Life Debate

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The other day, as I read Sharon Meers’ (author of Getting to 50/50) clear and compelling article in The Washington Post, “How Joe Biden Can Help Working Parents,” I had two conflicting reactions:

  1. First was, “Go Sharon!” because she did a great job laying out the powerful data that support why we all benefit from helping parents manage their work and life. And she honestly addressed the common roadblocks that get in the way. But then …
  2. I thought “Are we still having this same conversation 15 years later?!” You see, I could dig back through my files and probably find a similar article making many of the same arguments from 1990.

I’m becoming more and more convinced that the power of parenthood alone to catalyze a radical change in the way business, individuals and government approach work and life is limited.

No matter how many smart people, like Meers or Vice President Biden, join in the conversation, no matter how many pieces of research objectively state the need and benefits, we just can’t seem to move the needle.

We need a game changer. We need something that breaks us out of the rut we’ve been stuck in for 20 years and takes the debate to the next level. We need an issue that drives home the reality that finding new and better work+life strategies is not optional, or a “nice thing to do in good times.”

We need … to include the aging population. Why? It’s one of the greatest challenges both those who are aging and their caregivers (and, in turn, employers) are going to face in terms of the sheer number of people affected. Turns out, I’m not the only one who feels this way. Last week in The New York Times, David Brooks ranked “the aging population” first in the list of “deep fundamental problems” we are facing as a county.

As the parent of two beautiful children and as someone who can recite the bottom line benefits of work+life strategies in her sleep, am I frustrated that the argument for supporting parents hasn’t been enough to make more meaningful change happen? Yes, very.

But I’m also a realist who knows that at the end of the day change happens when people understand the “WIFM” or what’s-in-it-for-me. Adding the challenges of an aging population to the argument expands the base of people who “get it” and who are, therefore, invested in seeking solutions.

Here are some of the reasons I believe the work+life debate will finally get teeth if we add the challenges of aging. I’d love to hear your thoughts as well: (Click here for more)

How Employers Can Love (or Stop Hating) Maternity Leaves

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Last week, The New York Times included a quote from me in a great article, “Taking a Positive Approach to an Employee’s Maternity Leave.” Because this is an important topic that many employers struggle with, here are a couple of the key points from the article I wanted to highlight and expand upon:

Of all of the inevitable work+life realities a workforce will experience, maternity should be the least feared.   Unlike illness, accidents, eldercare or spouse relocation, you can plan for it in advance.

Every small business owner should take note of how effectively and proactively the leaders in the article addressed the work+life issues of their employees.  Unfortunately, this is still unusual.  From my experience, most employers refuse to acknowledge and build into their day-to-day operating model contingencies for dealing with the intersections between work and other parts of life even though they are inevitable.  Everyone has a personal life.  Everyone.  Not just women who become mothers.

I’m always baffled by the panic of these same in-denial business owners every time someone becomes pregnant, takes care of a sick parent, has a heart attack, or stays home because of their child’s snow day.  By facing the reality that work+life conflict is a business issue, they’d create a culture that encouraged an open, ongoing, problem-solving dialogue about how to flexibly manage and adapt.  Everything would run so much more smoothly.

Whereas eldercare, illness, accidents, swine flu and snowstorms are usually unexpected, in most cases maternity gives you months to plan!  As the article shows, companies benefit from an open dialogue even if a new mother decides not to come back to work or returns on a part-time basis.  And it’s important to note that new mothers aren’t the only ones who may choose not to come back to work or who would be helped by a phased return after a work+life challenge.  People with elder care responsibilities, a long illness or accident can also benefit.

Prepare employees with the skills and tools to create a solution-oriented plan.

The article does a good job emphasizing the need for employees to start the conversation by thinking through an initial solution (for a contrasting example of what can go very wrong when an owner/manager tries to figure out the right answer for a pregnant employee, click here).

But knowing how to create and present a well thought out plan is a skill set.  Most employees need to be shown “how.”

A step-by-step process for developing a win-win flexibility plan is outlined in my book “Work+Life: Finding the Fit That’s Right for You” and is a great place to start (excerpted in the Work+Life Fit in 5 Days blog series).  In fact one of the reasons I wrote the book five years ago was to give small business owners a resource to help their employees create win-win flexible work+life fit solutions.

A one-size-fits-all, across-the-board “policy” related to how maternity or any other work+life reality will be addressed doesn’t work.  BUT, it is a good idea to have a consistent process in place to which everyone has equal access.

This consistent process should outline the unique circumstances of an individual employee’s job and life that they should consider to determine the solution that will work for them personally and for the business.  Even though the outcomes will vary, a clear process maintains consistency by virtue of the fact that everyone had access to the same approach and parameters.   Again, check out the work+life fit process in my book to get started.

What do you think?  How do we get more companies of all sizes to come out of denial and face the fact that work+life realities are just part of their day-to-day operating reality that they need to plan for?  And how do we get them to embrace an ongoing, process-based, solution-oriented flexible response?

Have Aging Parents AND Siblings? READ THIS BOOK! I Wish I Had.

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I love serendipity (or “serendestiny,” as Sam Horn calls it).  I keep an eye out for it in all aspects of my work and life.  Late last year, I attended a party for the launch of Donna Fenn’s excellent book, Upstarts, in New York City.   At that event, serendipity hit in the form of Francine Russo and her new book, They’re Your Parents Too! How Siblings Can Survive Their Parents’ Aging Without Driving Each Other Crazy (Bantam, 2010), which is a must read for everyone with parents and siblings.

Shortly after arriving at the party, Donna pulled me aside and introduced me to Russo saying, “You two have to connect.  Francine has just written a terrific book on elder care.”  Five minutes into my conversation with Russo, I was hooked.   I only wish They’re Your Parents Too! had been written two years ago when my sisters and I cared for our mother until her death from cancer (here and here for posts recounting that experience).

In addition to being incredibly well-written (Russo is a career journalist who most recently covered the aging and boomer beat for Time magazine), it addresses many important issues that my sisters and I intuitively navigated blindly.  Our elder care experience, while rewarding and very challenging, was aided by the fact that three of us get along well, had flexible work+life fit realities, and lived relatively close to our mother.   In many instances, this is not the case which makes Russo’s book even more valuable.

Recently, I spoke with Francine Russo about They’re Your Parents Too! Here are some highlights from our conversation.

CY: Having coordinated a very intense two-year period of elder care with my two sisters, this book really hit a chord.  I haven’t seen anything written on the subject of siblings sharing care of their aging family members.  Why do you think that is, and what do you hope your book does?

FR: In the past, grandparents usually died quickly and didn’t live to be that old.  They didn’t need help for 10 years.  This is the first time in history that original family members have to engage intimately, perhaps for the first time in 40 years, over important issues that may go on for a decade.

People always had to go through the psychological passage of losing parents and facing their own mortality.  But we never had to do it while gathering with original family members and negotiating how to coordinate care for so long.

The family has changed.  You’re not the little sister.  You’re not the big sister.  Everyone is an adult, and it’s a challenge to adapt in this new period as adults especially in a crisis when we tend to revert back to old roles.  We learned these roles as little kids.  You may have to deal with favoritism, or that so-and-so is the “incompetent” one.  All this needs to be reexamined as you are today.

Caring for your parents is a wake up call to become conscious.  Be aware of your feelings as you navigate uncharted waters.   You need to know that huge emotions can sweep you up, and you want to be prepared so you can react in ways that are productive.

CY: In the book you talk about the process of picking a primary caregiver.   You point out that who that main person might be isn’t always obvious.  Can you say more about the process?  And how much of this conversation can take place between siblings before an elder care crisis hits?

FR: Caring for a parent is not a job for one person.  It is a major family passage.  And the conversation should take place if at all possible before a crisis happens.   In a perfect scenario, the parent should be involved directly in that discussion.  That’s not always possible because you might get, “Oh, I don’t want to talk about that.  I’m going to die at 89 years old in my sleep.”  Well, that rarely if ever happens.

My hope for the book is that the sibling who buys it and reads it first passes it along and initiates the dialogue.   For example, it is often assumed that location determines who will provide care, but that is not the case.  In addition to the responsibilities and location of individual siblings, you should consider who has the closest relationship with the parent or parents.  In some instances, that will mean the parents will decide to relocate closer to the child with whom they have the strongest emotional bond.  This is especially true if a parent is moving to assisted living or continuous care.

Yes, caring for a parent is a family job; however, it is helpful if one person, with everyone’s agreement, takes responsibility.  But that doesn’t mean assigning jobs.  Many of the complaints I’ve heard have to do with a caregiver feeling overburdened, or being highly controlling.

It is best if everyone is asked what they want to contribute, and what they are comfortable doing.  This then becomes a regular assignment that’s part of schedules and lists outlining tasks and responsibilities.

The important thing is to maintain a sense that we are all in this together.  It’s easy for caregivers to feel let down by their siblings.  They expected help but didn’t say anything, and they feel rejected.   The stress can tap into so many unhelpful, often counterproductive things we learn in families like, “I shouldn’t have to ask my brother.”  It’s so wrong, but does a great deal of damage to a relationship.  By the time the siblings finally begin to interact, there’s lots of anger.

CY: Disagreements between siblings about end of life treatment can be incredibly difficult.  My sisters and I are very close, but toward the end of my mother’s life it was interesting to watch how we each dealt with what was a heart wrenching situation so differently.  Why is it important for siblings to recognize the unique challenges of this particular time, and what can they do to avoid as much of the confusion as possible?

FR: You’re right.  This is possibly the most difficult moment in life, and it will bring up equally difficult emotions.  Some siblings will not want to let go and will want to keep Mom or Dad around no matter what.

Siblings need to have compassion for each other.  All I can say is don’t wait to have this conversation!  This book is a manual to help you prepare emotionally for the end-of-life reality now.  A great way to do this is to initiate the conversation over the holidays when everyone is gathered.  You could start by saying, “I heard this horrible story about a friend’s parent going into a coma having not discussed what they wanted their children to do.  It was a mess. I hope that never happens to our family.   (Mom/Dad), while we are in the same room, can you tell us what you would want us to do?”

When handled this way, siblings get beyond emotional distortions, needs, and competitions.  There’s a much better chance you’ll all be on the same page when it happens.  However, some siblings may still have trouble letting go.  If you think it is going to be really difficult, make a trusted relative who is not a sibling the health care proxy.

CY: One of my favorite parts of the book talks about “Reinventing Your Family,” and establishing new rituals.  This is so important and yet it’s not top of mind as you are knee deep in the care giving.  Why is it important and what should sibling caregivers do to start that reinvention process?

FR: Many times original family rituals formed around the parents.   Whether during an illness or after they die, new rituals need to take their place.

If siblings have started a dialogue around caregiving that’s reasonable and friendly, they can extend this.  For example, commit to meet once a year at a particular time.   There were sisters who hadn’t spoken in a year because they were very angry.  As part of their negotiation to try to repair their relationship that had broken down over care giving, they agreed to meet once a year.

Another idea is to make phone calls or video conferences part of every holiday.  Make it a ritual.  Another story I heard that I like was of three sisters who didn’t live in the same city but agreed to all fly to Chicago, which is where there mother had lived, every year on her birthday for the weekend.

It’s about connecting but also being flexible because everyone has busy lives.

CY: Thank you, Francine.  As someone who charted the elder care trenches with my sisters and made it out the other side, I wish we had had this book to guide us.  Thank you for seeing an unmet need and providing such a comprehensive, helpful how-to.

Have you spoken with your siblings about how you plan to coordinate care for your parents?  If you have, what was the experience like?  If you haven’t, why not?

For more about They’re Your Parents Too! and Francine Russo, go to www.yourparentstoo.com, and @YourParentsToo on Twitter.

Fast Company: Success: Advancement and Caregiving–Challenge Work+Life Fit Roadblocks (More Day 2)

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On Day 2 of the “Work+Life Fit in 5 Days” series of how-to basics, we’re challenging work+life fit roadblocks.   It’s important to know how to see, avoid and challenge the roadblocks related to success, fear, resistance and in-the-box-thinking before you begin the process of creating your work+life fit plan.

We started on the Work+Life Fit blog by defining and challenging the Success Roadblocks related to money and prestige that can trip you up unless you flexibly redefine success to match the fit you want to pursue.

Now, let’s identify and challenge the Success Roadblocks related to advancement and caregiving before they derail you.

Advancement—Redefining Success

Excerpt from Work+Life Finding the Fit That’s Right for You

“Advancement=Success.  Advancement is one of the cornerstones of our personal and cultural definition of success. As part of the FWI/Whirlpool New Providers Study, 1,502 women were asked “What makes you feel successful at work?” The answer with the highest percentage of responses by far was “quality of work/doing a good job/doing job right or well,” with 51% citing it as their top measure of success.  How do we gauge how well we’re doing our job? By whether or not we advance—whether or we’re given higher ratings, bigger titles, bigger offices, more money, more responsibilities, better projects,etc.

It’s not surprising then that the idea of plateauing or even stepping back is difficult, especially if you’re a Type-A person who is used to always grabbing for that next rung onthe ladder. If you aren’t advancing, you must be failing. Right?   But this belief is built on myth. Avoiding the red flags and roadblocks caused by an attachment to advancement requires dispelling the following myths…”  (Click here for more and to print or download PDF)

Takeaway Action Steps to Redefine Success Related to Advancement:

There are three lanes in the Work+Life Fit highway—fast lane, stop at the side of the road, and the “slower lane.”  We need to use them all. We pursue, yet resist, life in the fast lane.  When we are overwhelmed and feel there’s no other choice, we look for an off-ramp with the promise of being able to find an on-ramp someday.   We’ve limited our choices to an all-or-nothing highway.  I’m either in, or I’m out.

But in today’s reality there’s no guarantee of staying in the fast lane forever.  On-ramps are rare, if not non-existent; therefore, taking a career break really means stopping at the side of the road.  To stay on the highway, requires using the “slower” lane.

In this new era, over the course of a career, we will flexibly move, voluntarily and involuntarily, back and forth among the fast lane, the shoulder and increasingly, the slower lane.

What I love about this imagery is that even if you are pulling over into the slower lane you are still moving forward, just at a different pace.  Making the decision to not take a promotion, to take a pay cut to save your job, to take a lower level job in a new industry, to give up some of your responsibilities, to become a project-based consultant or to reduce your schedule doesn’t mean you are off the highway or moving backward.  You’re still in the game, just in a different lane for a period of time.

We need to recognize that the theory of spending time in the slower lane doesn’t sound so bad, until you look back over at the fast lane.  What’s happening?  Someone is passing you by.  That can be very difficult if we hold on to our traditional, rigid standards of success.  Moving among all three options means managing our expectations so that we are satisfied when we find ourselves reducing our momentum.   And then, when the time is right, pulling right back over into the fast lane.

Directly challenge common advancement related myths:…(Click here to go to Fast Company for more)

Fast Company: Health Care Reform and Budget Cuts Put Future Elder Care on Your Radar Screen…Now More Than Ever

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We spent Thanksgiving with my cousin and her husband, who is moving into the advanced stages of Alzheimer’s.  Over three days, I watched in awe as she patiently and lovingly cared for her partner of 23 years even though most of the time he didn’t recognize where he was or whom he was with.

Over the past few years as his disease has advanced, my cousin has worked full-time and cared for him at home.  She’s done this with the help of a  group of outside caregivers, but at great cost.  Right now their hours are 8:00 to 5:30 pm everyday, which costs her $800 per week, after taxes.

Fortunately (if you can call any part of this story fortunate), because he is fifteen years older and had already retired, his pension covers most of the costs.  But she must work to pay for everything else.  No one knows how long this situation could continue and she wants to keep him at home as long as possible.  Although he is severely impaired cognitively, he’s in great health physically.  She must earn a living, plus work reenergizes her. It gives her the deep reserve of patience and understanding that caring for him requires.

As the debate regarding health care reform rages on, and state budget crises make headlines, I often think about my cousin and the millions of other caregivers who currently or will care for an adult family member.  Why?  Because the outcome of these challenges will profoundly affect access to the already minimal level of affordable elder care support that exists.  No one seems to be talking about it, and we need to.

Over the years, I’ve blogged about my personal, eye-opening experiences with elder care, as well as the realities of others.  I come back to the same questions I originally asked in a post I wrote in July, 2008 about caregiving-gone-very-wrong,“Heartbreaking Reminder—There’s No Elder care:”

Over the years when I’ve brought up the challenges facing parents trying to find child care, more than a few people have commented, “Well, if you can’t care for your kids don’t have them.”  Okay, let’s assume for a minute that argument has merit (which I don’t think it does) and explains why child care should be the problem of individual parents rather than the broader community.  How does that argument hold for elder  care?  “Well, if you can’t care for your parents don’t have them?”  We don’t have any choice in having parents.  We all have them.  And increasingly the responsibility to care for an ever-growing number of aging adults is going to fall to all of us.  Where are we going to turn for support and help so that we don’t find ourselves making the same misguided, perhaps desperate choices as Theodore Pressman?

Are we as a country and as individuals prepared for the reality of elder care?  Do we truly understand how little support is out there, and are we planning accordingly?

I wrote that post just before the worst of the financial crisis began to challenge already strapped state Medicare and Medicaid budgets.  At the time, I’d asked an elder care expert where she thought the support would come from and how it would be paid for.  She responded without missing a beat, “Medicare.  We’ll demand it.”  Well, we can demand all we want.  But you can’t get blood from a stone.  A recent story in The Washington Post reports many states are already cutting the daily reimbursement rates for adult day-care centers.  These are critical, relatively affordable supports for individuals who are providing elder care at home but need to work.

What should we be doing?  Here are a few thoughts, but I very much welcome the insights of my colleagues who specialize in elder care related issues, so please comment: (Click here for more)