Recognizing the Challenges of Multiple-Duty Caregivers

November is National Caregiving Month. We respectfully take time to honor our professional caregivers. We also recognize our equally important unpaid caregivers. Especially during the ongoing COVID-19 pandemic, we pay tribute to these frontline workers. But what about those people who are double—or even triple—duty caregivers?

Who are multiple-duty caregivers?

Double-duty caregivers are those individuals who are professional caregivers during the day—be it as home-health aides, nurses or other medical professionals—and additionally care for an older loved one at night. Triple-duty caregivers add the extra layer of childcare into this already packed caregiving agenda.

Multiple-duty caregivers are most often women who are trying to balance established duties at work with their often unscheduled and short notice responsibilities at home. Studies show that these women face strong pressure from their families to assume their “natural” role of family caregiver, not only because of their health care expertise, but also because of their gender (Nicole DePasquale et al. Combining formal and informal caregiving roles. In The gerontological Society of America, 8/25/14). These women in many cases agree to this added role out of a sense of family obligation rooted in tradition, culture and moral values. Many also feel responsible because they believe that “nobody else will do the work.” Thus, they face expectations from family members to coordinate and provide care, while at the same time setting high standards for themselves around the care they deliver at home. This can happen even when they do not have access to the resources and support available to them in their professional setting. 

In fact, multiple-duty caregivers often perform tasks that are not normally taken on by unpaid caregivers. If they do not have the medical expertise they think they need or ultimately make a poor medical decision, they are often further tormented by self-imposed guilt, feeling powerless and helplessness (Depasquale et. al). And, if it so happens that their loved one’s health deteriorates under their care, it can “erode confidence in the [caregiver’s] identity as a health-care professional” (Catherine Ward-Griffin. Blurred boundaries: double duty caregiving. In Canadian Nurse, 6/1/2013).

What are the challenges of multiple-duty caregivers?

It is not hard to imagine that multiple-duty caregivers can often be tired and stressed. After all, they rarely have any downtime, and little to no breaks during the day when someone does not need their assistance or attention. Life can become a continual negotiation of professional and personal role boundaries, and these lines can often blur or erode completely. As one nurse commented, “The healthcare providers were talking to me as a nurse, but how can I be clinical when this is my mother!?” (Catherine Ward-Griffin. Compassion fatigue within double duty caregiving. In The online Journal of Issues in Nursing, Vol 16, No. 1.) 

The stress of work builds upon the stress at home and vice-versa. No longer is there energy for hobbies or personal pursuits. No longer is there time for friends. At the same time, productivity at work may suffer, and multiple-duty caregivers may be less attentive to patient care. Studies confirm that these caregivers suffer even poorer mental health, more emotional exhaustion and bring even more stress into the workplace than not only single-duty caregivers, but also the double-duty caregivers whose unpaid caregiving focuses on children rather than older adults (Depasquale et. al).

What steps can be taken to ease the burden on multiple-duty caregivers?

For employers of these caregivers, the first step is to recognize staff who have assumed the role of caregiver, not only at work, but at home as well, and then to provide the workplace supports they need. Such supports may include access to family-friendly benefits, customizable work schedules and individual support that encourages self-care. Health care employers may also want to consider ways to enhance the workplace environment to ensure employees that they will not be penalized for utilizing these benefits. The goal, of course, would be to reduce employee turnover, increase job satisfaction, improve overall employee health and well-being and ensure a top-down commitment to work-life balance.

As multiple-duty caregivers, there are also steps that you can try to help ease the burden that you feel:

•    Utilize the benefits that are available to you through your workplace.
•    Finds ways for work to fulfill social needs and to ease social isolation.
•    Allow the satisfaction of work to balance the struggles of caregiving at home.
•    Validate the strengthened family relationships that may come from this dual role.
•    Focus on good sleep habits.
•    Remind yourself to prioritize self-care.
•    Try to treasure these moments with your older loved ones. 

Ultimately, for both employers and caregivers alike, it is so important to ask for help. Services like WeCare...Because You Do provide support and assistance to help caregivers manage the stress of caring for an older loved one while empowering employers with the tools they need to support their workforce. WeCare…Because You Do recognizes that everyone’s caregiving needs are different. The program thus strives to reduce caregiver burden – and thereby maximize caregiver effectiveness -- through a customized approach to care while reinforcing how important it is for caregivers to take care of themselves so that they can care for those who need them most.