Are You Prepared for an Eldercare Challenge?

"We prepare for education and for marriage. We read 40 books on pregnancy and childbirth. But we don't prepare for the idea that we'll likely spend years taking care of an older relative. Instead, we cling to this hazy idea that we'll all be healthy for many years then just die."

With passages like this, Paula Span attempts to open our eyes to the reality of eldercare and the possibility that many of us will someday find ourselves "parenting our parents." Her new book When the Time Comes: Families with Aging Parents Share Their Struggles and Solutions; Springboard Press, 2009, is recommended reading for a generation in denial that needs to realistically address challenges ranging from taking away a parent's car keys to finding alternative living environments, possibly more than once.

The average lifespan continues to increase and that's a good thing. But along with it come responsibilities that previous generations rarely had to face. Span observes, "When my dad was my age, both of his parents had died and he was retired. I'm never going to be able to retire and I might be caring for my dad when I'm in my 70's and he's in his 90's." Seventy-six million baby boomers are already entering their 60's and probably find themselves in this same situation. Over 34 million working adults are already actively providing at least some care for frail, aging family members and most never anticipated nor prepared for this caregiver role. The surprise for many reluctant caregivers is that the experience can truly elevate one's life. Span quotes gerontologist Kenneth Doka who observes that "the self-sacrifice that caregiving entails offers a deep sense of personal fulfillment. It demonstrates a persistent ability to transcend self, to sacrifice for another without regard to one's own needs." This may be the perfect antidote for many who have failed to find fulfillment living in a narcissistic, "me-centered" society.

Your Employee Assistance Program is aware of the daunting balancing act that you may be facing daily when attempting to meet both work and eldercare responsibilities. We are available to help you with a wide range of services and information, including:

• Personal stress management counseling
• Senior nutrition resources for in-home or communal meals
• Elderlaw resources and guidance regarding power of attorney
• Web resources to help you locate in-home care services
• Web resources to help you locate appropriate assisted living facilities
• Web resources to help you locate nursing home options
• Becoming knowledgeable about Medicare and Medicaid

Adults over 80 are the fastest growing segment of the population. Most will eventually become reliant on their adult children. The professionals at Employee Health Systems are committed to helping you care for those who once cared for you.

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Dealing With Health Anxiety

Health anxiety can be a serious medical condition that requires professional counseling and medication.

Here are other steps that might help keep it at bay:

Go to the doctor. Share your specific fears and have a physical exam or needed tests to "hopefully" set your mind more at ease.

Don't switch doctors too much. Find a doctor you like and do your best to trust the diagnoses. While second opinions can be good, don't keep seeking out other doctors willing to run more and more tests.

Avoid the internet. It's too easy to match up your symptoms with a long list of serious health problems that you probably don't have.

Read selectively. Skip magazine articles warning of diseases that doctors often miss or misdiagnose, which often list vague - and common - symptoms.

Don't over-monitor yourself. Constantly checking for growths or taking pulse or blood pressure readings isn't helpful. Ask your doctor what self-exams to do; stick to that advice.

Share your fears. Talking about anxiety can help reduce if. Find patient family members and friends and look for support groups.

Recognize your problem. The earlier you accept you have hypochondria, the easier it is to get help. Health anxiety is a form of obsessive-compulsive disorder - not something to feel guilty or helpless about - and can be very treatable.

Educate yourself. The more you know about hypochondria, the more likely you'll be to stick to a treatment plan.

Exercise regularly. Working up a sweat helps fight many types of anxiety.

Limit alcohol and avoid illegal drugs. Substance abuse can increase paranoia and also interact badly with anti-anxiety medications.

By Alison Johnson, Daily Press (Newport News, Va.)

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Companies Re-evaluate Wellness Programs

They look at health care costs vs. bottom lines

Companies, desperate to slice fat from their budgets during this recession, increasingly are targeting workplace wellness programs.

Smoking cessation and weight-loss programs are among those being considered for the chopping block, says Laurel Pickering, executive director of the New York Business Group on Health, a coalition representing employers on health benefit issues.

"When (companies) are looking for something to cut, and the CFO comes to the HR people and says, 'Why should we keep this program?' it's difficult for the HR person to say, 'It's important,'" Pickering says.

A big problem: It can take years to analyze the impact of these programs, and even then, the return on investment isn't always clear.

The attack on such programs comes even as political power players, benefits officers and top health care academics aggressively tout workplace wellness as a way to boost productivity and reduce health care costs.

Just last month, President Obama hosted a wellness gathering at the White House with top company executives, as well as union and public health officials, to learn more about such initiatives. He deemed the confab the start of an "ongoing process," and his advisers have already had a follow-up meeting with corporate and academic experts on the topic.

Other governmental leaders also have latched onto the issue. For instance, a bill making its way through the Senate would give tax credits to firms that offer wellness programs.

But even with all the high-profile attention, some companies have had to revamp those initiatives in the quest for healthier bottom lines.

Pfizer, dealing with the sour economy and a corporate restructuring, scaled back on the monetary incentives it offers employees to participate in its wellness program, says Janet Rodriguez, a senior manager at the company.

A strong history

Faced with the uncertainty of what shape the health care overhaul will take and with health care expenses rising more than 6% a year, companies aren't willing to completely abandon wellness.

Pfizer, for instance, didn't cut the number of programs it offered, just the amount it gives to employees who participate.

One-third of employers said they had such programs in an August MetLife survey. That's up from just over a quarter in 2005.

Big firms are almost all self-insured for health insurance plans and, therefore, pay for employees' health care costs from their own coffers. Slightly more than 60% of companies with 10,000 or more employees said they had a wellness program in 2008, up from 47% in 2005, according to the MetLife survey. In 2008, the median health care cost per employee was $7,173, according to a survey by human resources consultants Watson Wyatt and employer coalition National Business Group on Health.

IBM, which spent $1.3 billion on health care for its employees, dependents and retirees in 2008, continues to invest in wellness, though it has cut expenses in other ways, including layoffs.

In 2004, it introduced financial incentives for employees to participate in initiatives such as a 12 week physical fitness program - and spent more than $133 million on incentives through 2008.

While it can be difficult to determine a definite return on investment, IBM tapped into the Health Management Research Center at the University of Michigan to try to analyze the program's returns. Results showed that it saved about $80 million in reduced health claims, says Joyce Young, IBM's director of well-being.

Pepsi Co has invested heavily in well-being. Its Purchase, N.Y., headquarters offers pilates, yoga and spinning classes as well as a free laundry service for those who don't want the hassle of washing their sweaty gym clothes.

Senior legal counsel Megan Hurley says that Pepsi Co's $20-a-month gym has not only helped her to stay in shape but led her to tackle marathons and triathlons. In addition to using the gym, she visits the on-site medical department for flu shots and skin-cancer screenings.

Keeping healthy employees such as Hurley fit - and productive - is vitally important to a company's success, says Dee Edington, director of Michigan's Health Management Research Center. The cost of an ailing worker goes beyond just medical expenses, he says. There's also the monetary cost of paying for disability leave, as well as the strain on productivity if an ill person isn't effective at work.

Employee incentives

While some employees are enthusiastic about wellness programs many are sitting on the sidelines.

"A big issue is getting noticed and getting employees to participate," says LuAnn Heinsen, National Business Group on Health vice president.

Workers - stressed by the economic downturn - are often more focused on work and finances than eating right and exercising.

Nearly half of employees surveyed by the National Business Group on Health in July said work demands prevent them from having a healthier life. That poll was taken before the full brunt of the economic downturn was felt.

Almost 60% of those surveyed by the American Heart Association in March said the economy has affected their ability to take care of their health. Many are delaying preventive-care appointments, not taking medications, skipping the dentist or canceling gym memberships.

To boost buy-in, companies are offering perks that include everything from gift certificates to discounts on their insurance premiums.

They're also penalizing folks.

In 2008 Pepsi Co introduced a $600 surcharge for smokers. It already offered a smoking-cessation program, but that year, it enhanced it by adding nicotine-replacement therapy such as patches and gum. "The combination of those two elements led to a tenfold increase in participation and increased the quit rate from 20% to 34% in 2008 over 2007," says Greg Heaslip, benefits vice president.

The incentive of cold hard case worked at IBM. Its offer of a rebate of up to $300 a year "got everyone's attention" and helped to ramp up participation in its programs, Young says.

By Laura Petrecca, USA Today

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America's Secret In Plain Sight

The American Institute on Domestic Violence reports that the stress of economic hard times has increased the incidence of domestic violence across the nation. The Institute reports that 5.3 million women have been abused in the past year and 1,232 women have been killed by a spouse or intimate partner. The problem spills into the workplace as well, where 18,700 incidents of violence were committed by a current or former spouse, partner or boyfriend. Another grim statistic was recently released by Liz Claiborne, Inc. which found that 44% of teens in families with economic problems had seen their parents abusing each other and 67% of these same teens reported some sort of violence or abuse in their own relationships.

Vera House, Inc., an organization based in Syracuse, NY, provides crisis and educational services in response to domestic violence and offers the following insights based on actual case histories of women they've assisted:

• Controlling someone is not merely a precursor to abuse; it is abuse and must be addressed before it escalates to physical violence. If someone prevents his partner from seeing certain people, belittles her in public, controls her finances, tells her what to wear and when to be home - that's abuse.
• Intense jealousy is a classic sign of control - a way to make someone a possession of the other person.
• Choking someone is as much an act of physical violence as punching her.
• The most dangerous time in an abusive relationship is the six months after one partner says she's leaving. The victim should not return home after leaving unless she has a police escort.

Victims often become invested in hiding the frightening realty of their abuse. Linda Neely was such a person. To her friends she was the epitome of gentleness and joy, a delight to be near. But at home she lived in fear and a constant state of vigilance to protect herself and her family. On October 21st, 2006, Linda was stabbed in the heart by her husband, who is now serving 25 years to life in a state prison. Following her death, a log was found documenting the many nights that she and her children fled their home to find safety. The family of Linda Neely now maintains a website, which is packed with links to valuable resources and also contains actual lesson plans for educating students in grades 7 through 12 about domestic violence.

According to the American Institute on Domestic Violence, the workplace is affected as well, with 94% of corporate security directors ranking domestic violence as a high security risk while 78% of human resource directors rank domestic violence as a substantial employee problem.

If you wish to discuss your personal situation, your EAP is a good place to start.