Podcast Title: Health and Safety to Go!

Episode #: 164 – Carer-Inclusive Standard for Workplaces :  Bridging the Gap Between Caregiving and Work

Introduction: Welcome to Health and Safety to Go! broadcasting from the Canadian Centre for Occupational Health and Safety.

Host:  Thank you for joining us for this episode of Health and Safety to Go! Our guest today is Dr. Allison Williams.  She's a professor at McMaster University, holds the CIHR Research Chair in gender work and health and chaired the committee that created the recently released CSA standard – Care-Inclusive and Accommodating Organizations’ Standard.  The standard was created to help employers support workers in Canada who provide care and assistance to family or friends living with ongoing conditions, while working at the same time. Thanks for joining us today Dr. Williams.

Allison:   My pleasure, happy to be here.

Host:  What is the situation or the conditions that motivated you to create the Carer-Inclusive and Accommodating Organizations’ Standard?

Allison:  In St. Catharines, the local Public Health Authority called me and asked if they could have me engaged in some of the work they were doing around home care. I obliged and began working with them quite closely before our healthcare system was, you know, significantly restructured, particularly around contracting out home care services.  And it was through that experience that I was able to actually get into the homes of carers and understand what sort of pressures, intentions and issues they were dealing with on a day-to-day basis, particularly in the case of caring for elderly family members with chronic illness and in some cases terminal diagnosis.

And then spent about a decade looking at the Compassionate Care benefit when it was first unveiled, that's a federal program offered to all Canadians and specifically Canadians who are employed.  And so we spent about 10 years, me and my research team including research assistants, graduate students and so forth, evaluating the Compassionate Care benefit from a family caregiver’s perspective, as well as from various other perspectives, including healthcare professionals, specifically social workers, nurses and physicians. Through that research, you know, sort of changed the dial a little bit with respect to the inclusivity criteria around who in fact could apply and who could be cared for in the case of the Compassionate Care benefit.

So that was my first introduction to recognizing that carers A: are managing multiple stresses and strains as informal unpaid family members or friends or sometimes even neighbors.  And then when they have the additional stress of employment, it becomes increasingly challenging for them to be able to manage both the spatial and the temporal tensions involved, not to mention the attention specific to the fact that we all have limited energy in any typical day.   So that sort of sparked my interest and as I moved into this area looking at carer employees, people who are employed while simultaneously providing informal or family caregiving. I recognize that many of these carer employees are wearing multiple hats above and beyond being a caregiver and an employee. Some of them are also apparent to multiple young dependents. They often have one or more older dependents that they also have to be concerned about, siblings, extended family and neighbors and community members.   So, you know recognizing again that there's limited time, energy and space within any typical day has become an issue of really managing work family balance.

So the work on the Compassionate Care benefit really led me to recognize the workplace as an agent if you will or a facilitator, in supporting carer employees and best managing both their work and their caregiving role, in addition to multiple other rules that they often play.  And so in thinking about again this trajectory and recognizing that the state, that is the government whether it be at the federal provincial and local level, has really limited capacity to intervene and given that again personally agency with respect to individual’s families and neighbors, community are increasingly limited, given that we're experiencing smaller family sizes and Canada. We're also experiencing increased mobility for work. We're also increasingly seeing families of different shapes and sizes with respect to blended families and single families.

So the family structure itself is changing.  As a society we are generally being characterized as having decreased social cohesion and social capital. And so when we think about all these variables in totality, it's really the workplace that is the only institution left that can actually support the work life balance component.  And so it's really been focusing on how that workplace itself, across all sizes, across all sectors, can in fact play a role, be an agent and better enabling care employees to balance and sustain their role, both as caregivers and as employees.

Host:  What types of organizations and workplaces can use the standard and who should take the lead in the implementation?

Allison: There is a certain set of certain characteristics that organizations typically have if they are in fact accommodating carer workers and we call these workplaces Carer friendly workplaces.  These Carer friendly workplaces are generally workplaces that are large enough to have a Human Resource department.  So they have the capacity to facilitate accommodations, a lot of healthcare service organizations, for example, educational organizations, a lot, again in the service sector more broadly, that again have that particular employee pool. All types of organizations and workplaces can in fact use the standard, as the standard itself is basically a protocol that can be tailored to any workplace organization. The only prerequisite is that there's an intentionality and a motivation to in fact create a set of accommodations, or again, a caregiver friendly program that allows care workers to maintain their position in the workforce, while also doing their best to sustain their role as an informal and paid caregiver.

Host: How can the guidelines found in the standard be implemented?

Allison:  As I mentioned they’re pretty much sort of a protocol or a recipe that would need to be followed by any organization, where first they would want to build the foundation of such a program or a set of policies.  And they would do that through basically doing a review of their current leadership, as they would need leadership and they would need a champion to drive the process moving forward. They would also need to engage workers in setting up a committee, in order to again have the work shared amongst a committee of employees.  So ideally you'd want employees, stakeholders and HR involved.  If there is no HR department, then you'd want some executive administrators involved, such as managers and supervisors.

And the next stage is basically identifying and communicating what's already working. So there may be, for example already, you know, a family leave policy or there may be some flexibility or teleworking already in place.  So they want to basically look at what's working, look at the lay of the land with respect to what benefits and accommodations are already in place. And what is in fact being used and look for gaps.  And again, what's available and what's being used and to better establish and implement the program itself, which are again the specific guidelines that work within the specific sector and workplace proper.

And then finally they want to move into the monitoring process where they're measuring, analyzing and improving the program, and as well as auditing to identify opportunities for improvement. So I mean as you can see it's really, the standard really represents a process, if you will for any workplace to create a set of guidelines that works within the limitations and the parameters of their particular type of work, size and demographic profile.

So, you know, the policy itself is really about setting goals and objectives, reviewing the requirements, committing to the accommodations, checking in on how they're working and be committed to continuous improvements.  It really varies from workplace to workplace, with respect to what the actual accommodations may look like, but again by setting a committee with an engaged workforce, you're able to build the worker care policies from inside. So ideally the organizational committee would include a number of worker carers, who may have or may have not been accommodated by their workplace.  

And so it really represents a workplace taking a commitment and recognizing that there are some legal requirements, as well as social and ethical responsibilities that they need to pay attention to.  If they want to in fact retain their workforce and either manage or decrease disability cost, if they want to ensure that their workforce is productive, if they want to ensure that they're best managing presentism and minimizing absenteeism, they'd be able to improve productivity and reduce absenteeism. They'll be able to reduce the number of employees coming in sick. They'll have an engaged workforce with fewer employees taking disability leave or sick leave because they've been able to manage the work family balance appropriately in order to minimize the spiraling effects of negative mental health, which then moves into negative physical health, which would potentially increase the disability costs that an employer would need to pay out in the long run.

And so, you know the whole idea of doing this environmental scan of current benefits and practices for accommodation really requires looking at support services, for example, as is offered by Employee Assistance Programs (EAP programs).  Looking at what's currently offered with respect to flexible work arrangements, such as working from home or a job sharing.  Also looking at strategies that support employees, such as an educational workshop, lunch and learns, worker care supports, such as for example, establishing a caregiver support group that would meet over lunch once a month at work.

So it's really about again open education and looking for opportunities that fit within the particular structure and expectation of any particular workforce. It could be as simple as having a couple of parking spots closest to the exit door so these carer employees could be able to jump out over lunch if they had a specialist appointment to bring their care recipient to, or in order to get home in order to be able to be present while the personal support worker, the home care nurse was visiting their care recipient.  

So again, it's you know, small and large as far as you know, the potential accommodations, but ultimately the goal is to improve carer work, carer worker health through providing improved work-family balance.  So what we've recognized from the larger research around carer employees is that, if they're not accommodated at work, they often leave work, so they'll basically either retire early or hand in their notice and literally leave.  Some will move from full-time to part-time or part-time to casual or they may change workplaces all together in order to be closer to the care recipient, whether the care recipient lives with them at home or the care recipient lives in independently in the community.

Ideally if the employer is keen on retaining their skilled staff and we know that the typical care employees between the ages of 35 and 65, so they're often the most well trained and experienced staff. So it's really incumbent upon the workplace actually recognize that there is a role that they can play in order to retain and sustain employment for carer workers.  Because the last thing that care workers would want to do would be to leave work because work often provides not only a paycheck but also provides a sense of belonging and a sense of identity.

Host:  Before we wrap up, are there any closing thoughts you'd like to leave us?

Allison:  If there are any final thoughts that I would like to share is encouraging carer employees to self-identify as carers.  So again supervisors line, managers, co-workers can do what they can to support them because we will in fact all be in this position at some stage. If not in this position multiple times throughout our working lives.

The second is to really encourage the culture change required in the workplace where the workplace recognizes that caregiving is an issue, it’s a reality.  And so when a care worker requests to for example start work early in order that they can leave work early, or to potentially work two out of five days from home, or potentially job share, consider those as real possibilities in order to and not only retain that that trained worker but to allow that trained worker to continue playing a role and reaping the benefits of being employed.  And consequently keep carer employees that work for the benefits of not only the employer but the benefits of the carer as well as the care recipient.

Host: Thank you again for joining us today. Dr. Williams.  Links to the Carer Inclusive Standard for Workplaces and the accompanying Implementation Guide can be found on the CCOHS website at ccohs.ca and on the Canadian Standards Association website csagroup.org. Thanks for listening everyone.