Your workforce is filled with caregivers. According to a Harvard Business School report, 73% of employees have some type of caregiving responsibility. This might be caring for children, aging parents, a spouse, or other family members with special needs.

Because access, or lack of access, to care and resources affects the physical and mental well-being of caregivers and the people they care for, these members of your staff need more than flexible schedules and paid time off to relieve their stress and potential burnout—they may need a new network of support that considers their whole experience.

“Caregiver support is not just about care navigation,” said Wendy Whittington, MD, a pediatrician and the chief care officer at Cariloop, a company that supports and equips caregivers to take care of their loved ones. “It’s not just helping that caregiver find the right doctor. It’s a lot more than that, because the burden upon caregivers is really broad and wide. Caregiver support is about supporting that caregiver with whatever he or she needs.”

Even if their care responsibilities at home aren’t top of mind for you as an employer, they’re top of mind for your employees, and it could be encroaching on their work performance: Only 24% of employers believe that caregiving at home influences performance at work, while 80% of caregivers say it does, according to surveys in the Harvard report.

It can be a long-term career distraction as well. Twenty-eight percent of caregivers surveyed worry that disclosing their caregiver status at work will hurt their career, getting them fewer challenging assignments, lower salary increases, and an “unsatisfactory” career path.

Whittington said Cariloop provides traditional help, like assistance finding doctors and in-home care, and helps in creative ways to remove that burden from the caregivers in your workplace. She shared the story of one Cariloop client: “One of the things our care coach helped her find was volunteer opportunities for her spouse who has dementia, to help him preserve his own dignity. And at the same time, it gives her a little break.”

I spoke to Whittington about Cariloop, the growing awareness around caregiver needs and experiences, and the relationship between caregiving and the social determinants of health. Excerpts:

Cariloop looks at caregiving as a social determinant of health. What do you mean by that?

This is a pretty well-known terminology in health care. What it describes is those conditions that affect our health and well-being that we didn't traditionally think of as medical—whether or not you have a roof over your head, whether or not you live in a food desert, your opportunities for transportation. All of those things actually affect your health and your health outcomes a lot more than we originally understood, and we know that caregivers really contribute in that regard.

How do caregivers contribute?

Two ways that we think of social determinants of health as it relates to caregivers: One, if I’m a caregiver for my mother, the chances of her having her social determinant needs met, like a roof over her head and transportation that she needs and food, are higher. I’m helping her complete what she needs to have the social determinants in place, and that makes for a better outcome for her.

But caregiving itself is also a social determinant because caregiving is hard in many ways, particularly on the mental health of the caregivers. We hear more and more about caregivers reporting, particularly during the pandemic, that their own health, particularly their mental health, has taken a hit.

When we think about caregivers, many people think of parents first. How should we expand our understanding of who a caregiver is?

Depending on who you talk to, there’s a little different definition. But for the most part, when we throw around the term “family caregiver,” when you see it written in the literature, it’s the 53 million Americans providing care to an older adult or a child with special needs.

You point out that many people think of parents first when they think of caregiving. I would actually like to see more recognition of the challenges that parents face. Too often, parents under-identify as caregivers and their employers expect them to be productive regardless of what they are dealing with at home. These may not be the parents of a child with special needs, but the reality is we have seen a massive increase in chronic conditions in children. Diabetes, attention deficit disorders, and mental illness in kids are all on the rise. [Cariloop’s] mission is to relieve the stress and anxiety felt by all caregivers. Doesn’t matter who you're caring for. If you’re a caregiver, we’re out to help you. We provide support for working parents. We provide support for parents who need help understanding their children’s educational needs. It’s broad.

Some employers might hear what you do and think Cariloop is an Employee Assistance Program (EAP). Is that a fair assessment?

We are a much more involved, active participant with our members. We are really, truly a partner with your employee. If you’re the employer, we are going to help you by reaching out to your employees directly, making sure that your employees have every opportunity possible to engage with us. And it’s really easy. We’re more hands-on [than an EAP].

How have caregivers’ responsibilities changed since early 2020? What's it like to be a caregiver who also does paid work?

It’s more stressful. The silver lining here: The pandemic has brought to light the plight of a lot of caregivers. Many of those 53 million were struggling to make ends meet, keep down a job, and continue to be a caregiver before the pandemic, but the pandemic has just brought it more to light, and it has really highlighted the fact that those folks that we called “just parents” are really shouldering a much heavier load now when kids are home. Kids have had increases in mental health issues and other health issues. It’s just a lot more stressful.

Do you think employers have a good sense of how someone’s responsibilities as a caregiver can affect their working life?

The short answer is no. Most employers are not aware of the magnitude of caregivers among their employee base, and there's a number of reasons for that.

One is that there’s still a lot of stigma attached to caregiving, so many employees are loath to admit that they’re caregivers to their employers for fear of being passed over for promotions, for fear of losing their job.

There’s another layer to it in that employers are unaware of the demographic breakdown. They don't know who their caregivers are. When we work with employers, one thing we’ve been able to do for them is help them understand X percentage of your caregivers are Millennials, and X percentage are Baby Boomers, and here’s the other problems that they're dealing with.

So the good news—it’s not all negative—is that we are seeing an increased interest in understanding it among employers.

How does the strain of being a caregiver show up in the workplace?

One of the things that the pandemic highlighted—we saw folks leaving the workforce in droves, particularly women. Why is that? Women by far outnumber men when you look at proportions and caregiving.

Number one, they’re leaving if they don't have support. Number two, we talk a lot now about the concept of presenteeism and what that really means. That employee is there and maybe sitting at her desk, but not really focusing on the job, but is focusing on, “Where the heck am I going to send my child tomorrow because the schools are closed again?” Or, “How am I going to find long-term care for my parents?” It manifests in productivity.

How can employers serve the needs of caregivers in different types of working environments? For example, how do the caregiver needs of remote workers compare to caregiver needs of in-person workers?

They do differ, and we certainly serve employers across the spectrum.

Some of our employers have a large remote workforce and others are more hands-on service industry. It’s important for both, certainly for the folks that have to be there every day.

I’m thinking of frontline healthcare—they really need the help because they need to give their employees every possible tool in the toolkit to keep them at work, to keep them present. But when you think more of the remote workforce, a lot of employers have gotten a window into how stressful their employees’ lives are. We’re seeing folks dealing with crying children in the background and environments that are less than optimal. Across the board, it’s equally important, but differently important.

I’d like to know how employers can support caregivers with benefits, policies and culture. Let's start with benefits.

There have been some great studies, one that came out of The Economist at the beginning of the year that talked about how your basic old health and dental benefits are not going to cut it anymore.

If we want to retain employees, we have to be more creative and we have to really address what matters to them. Offering something like caregiver support not only helps keep your employees on the job, but it really demonstrates that you get it. You, as an employer, understand what they're going through and you care.

Policies?

We remain a big proponent of the movement toward a national paid leave program. We find that employees really appreciate it when they don’t have to take their vacation time because they have to care for sick loved ones. Here at Cariloop, one of our employee benefits that we just put into place is caregiver leave. We try to set the example for employers.

Culture?

I think, a lot of times, employers have this unwritten rule that, yes, you get PTO, but don’t take it. We’re seeing a shift—we’re seeing more and more companies that are really insisting that employees use their PTO.

I think one of the things that is important, too, is to help employees understand what benefits they do have and to properly take them. I think employers can just get smarter about that. Not only have the policies in place—but then put some punch behind it and really encourage a culture where employees take advantage of it.

Editor's Note: From Day One thanks our partner, Cariloop, in sponsoring this thought-leadership spotlight.

Emily McCrary-Ruiz-Esparza is a writer, editor, and content strategist based in Richmond, Va.