Alzheimer's Foundation of America

Foundation of America

Do You Have to Choose Between Work and Caregiving?

by Pam Ostrowski

You’re struggling to balance work and caregiving. You went into the office early, spent a day in meetings, and now it’s 5:30 p.m. You still have to stop by your parents’ house with dinner, make sure they’ve taken their medications, and then get home to fix dinner and catch up with your family, spend a couple of hours doing “real” work before you hit the bed, exhausted and overwhelmed, knowing tomorrow will be the same. The thought “maybe I can’t do it all” crosses your mind as you drift off to a restless sleep.

You are not alone.

Balancing work and caregiving is tough

According to the National Council on Aging, 70% of caregivers who provide care for an aging loved one suffer work-related difficulties due to their dual roles—they take time off, forgo promotions and sometimes leave the workforce altogether. Employees lose up to $3 trillion in wages and benefits while employers lose $17-33 billion due to absenteeism and turnover.

Dementia caregiving can affect employees 24/7, due to worry, middle of the night calls, and physical care for their loved one. Most caregivers for aging loved ones are the most experienced employees, possibly in management or executive roles. Caregiving employees also may be the sole breadwinners of the household. They want to be successful in their work but businesses are forcing them to choose between work and their aging loved one.

Employers have the opportunity to help their employees who are caring for aging loved ones be successful at work. Let’s look at some options that support the employee caregiver.

Communicate with Your Employer

A Harvard Business School report, “The Caring Company,” stated that in the absence of a supportive “care culture,” employees worry that admitting to caregiving responsibilities will impact their career growth, compensation, and fulfillment at work.

Advice for balancing work and caregiving:

Talk with your manager and the Human Resources (HR) department at your work. Share your commitment to your job as well as your need to be supportive of your family. Ask how you can work together to make this happen so that you can be at your best at work and not burn out due to trying to do it all. A few ideas to discuss include job sharing, flexible hours, working remotely, working a different shift, and adjusting job responsibilities.

Performance at Work

Presenteeism (lack of focus, more errors, less productivity when an employee is not fully functioning) and absenteeism (not coming to work at all) are the first signs of quiet quitting, the term used when employees do the bare minimum to get by in their work. You may feel so overwhelmed you may even want to leave your job for something else.

Advice for employee caregivers: Moving to another job is not likely to solve the problem of trying to provide care to an aging loved one while working. Instead, try to learn some task management skills to support your performance, such as focused time blocking (read and respond to emails at fixed times of day), complete the task you dread the most first, and prioritize, e.g., identifying the three tasks you must get done that day.

Often, it’s the inability to focus that paralyzes caregivers into not being able to make progress in any area of their lives. Establish work, family, and caregiving boundaries so that you also have time for you. It’s too easy to just say “I’ve got this” when, in your heart, you know it’s not sustainable.

Some great reads that are short and you can start using their advice immediately are Brian Tracy’s Eat That Frog and David Allen’s Getting Things Done.


Financial strain can affect work performance. It is not uncommon for dementia caregivers to spend their own money to pay for their loved one’s expenses (everything from medications to food). This means the money earned at work goes to additional expenses incurred by caregiving. According to AARP, eight out of 10 caregivers report having routine out-of-pocket expenses, with those caring for a love one with dementia spending twice as much as other caregivers. (See p. 17, “Did You Know?” for additional information about this issue.)

Advice for balancing work and caregiving:

Speak to a money manager to review your budget and assets. Avoid using any of your retirement savings to help pay your aging loved one’s expenses. Sit down with an estate attorney and a certified financial adviser to get their ideas on how to best pay bills. Most will provide a complimentary first meeting to address your questions. Check out the National Elder Law Foundation (NELF) and the National Association of Personal Financial Advisors (NAPFA) for a professional in your area.

Respite and Self-care

Respite or self-care is usually the last priority of an employee caring for an aging loved one, especially if that individual has dementia. Not getting “down time” creates both mental and physical health issues. These issues negatively affect the employee’s ability to successfully contribute at work and impacts their feelings of success and happiness.

Advice for balancing work and caregiving:

Make it a priority to make quiet time for yourself, even if it’s just 10 minutes in the morning and afternoon. In order for you to perform best at work, you need seven to eight hours of sleep and restorative time for your mind and body. Build supportive relationships while at work and get professional caregiver help so you’re able to focus on your work and enjoy it more.

Company, state, and federal resources

Employee Assistance Program (EAP): This work-based program assists employees with personal or work-related problems that may impact job performance, health, and mental and emotional well-being. Services for employee caregivers may include video-based counseling, online chats, e-mail interactions and face-to-face consultations. Family and Medical Leave Act (FMLA): The FMLA entitles eligible employees of covered employers (with 50 or more employees) to take unpaid, job-protected leave for specified family and medical reasons. Learn more here:

Paid Family Leave (PFL): PFL policies are state-paid regulations that vary from state to state and supersede federal law when the benefits are more generous than the national regulation under FMLA. Learn more here:


Pam Ostrowski is the CEO of Alzheimer’s Family Consulting ( and the author of It’s Not That Simple: Helping Families Navigate the Alzheimer’s Journey.

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