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About 59% of caregivers also work or have worked at an outside job while providing care for an adult. Life for them is a daily balancing act, and they are often forced to report late to work, miss days, or give up work entirely. Besides financial hardship, caregivers risk teetering into stress, exhaustion, illness, and family discord. Thanks to legislation and enlightened employment practices, the American workplace is gradually becoming a more supportive environment for employees who are also caregivers.

The Family and Medical Leave Act

The cornerstone of caregiver rights in the workplace is the Family and Medical Leave Act (FMLA). This landmark legislation allows employees to take up to 12 weeks of unpaid leave each year to care for themselves or an immediate family member with a serious health condition, such as MS. Leave can be taken intermittently instead of continuously—say, 1 day per week. The employee’s job (original or equivalent) and health insurance benefits remain legally preserved. For those who prefer not to disclose the exact condition, it does not need to be stated explicitly on the forms required to take leave. For example, “neurologic condition” can be used instead of “multiple sclerosis.”

Workers have made use of the FMLA more than 100 million times since its enactment, but its protections are not perfect. It provides for only unpaid leave; covers caregiving only for a spouse, child, or parent; and extends only to public workplaces and to private workplaces with more than 50 employees. The employee must have worked at the workplace for more than 12 months and for at least 1,250 hours. The first-ever amendments to the FMLA were signed into law in January 2008. To the benefit of many families, the update expands coverage for employees caring for military members hurt in the line of duty. However, the update also gives general workers less time to notify their employers of the need for leave, and makes it more difficult for them to use paid vacation time while on FMLA leave.

Mental Health Parity and Addiction Equity Act

Mental health problems, including depression and anxiety, are a known consequence of the MS disease process and its unwanted impact on living. Caregivers are themselves at risk of mental health problems due to stresses inherent in “caregiver burden.”

Adequate mental health insurance plays an important role in keeping caregivers and care recipients functioning at home and in the workplace. The traditional restrictions placed on mental health benefits by group health plans came to an end when an amendment to the Mental Health Parity Act of 1996 took effect on January 1, 2010. The amendment requires all plans with 50 or more employees to ensure that deductibles, copayments, out-of-pocket expenses, and number of visits for treatment are no more expensive or restrictive for mental health benefits than they are for the plan’s medical and surgical benefits. Health plans are not required to offer mental health benefits, but if they do, they must now put mental health and medical benefits on equal footing.

The Adaptable Workplace

Employers have learned in recent decades that creating a workplace that promotes a good work–life balance helps to promote the satisfaction of their workforces. Flexible policies have resulted in enhanced productivity, reduced absenteeism, reduced costs, and higher profits.

Flextime—One strategy for caregivers is “flextime” programs, which allow workers to vary their work times within a specified range of hours or days. For example, the employee might arrive any time between 8:00 and 10:00 a.m. and work for 8 hours, allowing him/her to start or end the workday earlier or later. Alternatively, a flexible workweek might consist of 4 workdays of 10 hours each.

Telecommuting (aka Work-at-home or “Flexplace”)—Telecommuting options allow employees to work at home or elsewhere for one or more days per week. Telecommuting typically requires a telephone and computer at minimum; other telecommunications devices and office equipment will likely be necessary. Still, creating the right worksite at home may be extremely worthwhile for caregivers looking to balance their work–life tasks.

Job Sharing—Job sharing programs enable 2 employees to share 1 full-time position. Usually the employees receive proportional shares of both salary and benefits.

Reduced Time—If working part-time, employees should receive proportionate salary and benefits as well as credit for experience needed for promotions or training.

Scheduled Overtime—This system allows employees to sign up in advance for overtime, so that they have time to arrange for caregiving help. Early posting of regularly changing work schedules is also helpful for caregivers.

Reasonable Use of Sick Leave—Many employers allow their workers to make use of sick leave to care for family members (even though the FMLA does not require this). Employees should understand how much leave is acceptable and under which circumstances, so that they are not unwittingly taking advantage of the policies at their workplaces.

The goal of both legal rights and workplace adaptations is to ensure that employees who are also caregivers are not forced to forfeit their work life and careers to fulfill their personal responsibilities.