Care Does Not Arrive on Your Calendar

Why employers lose their most experienced people to caregiving, and never record it that way. Notes from Episode 107 of Informed Aging with Robin Rountree.

The call comes on a Tuesday.

It is not dramatic. A neighbour, or a brother, or a nurse with a careful voice. Something about a fall, or a diagnosis, or a bill that has not been paid for four months.

Nothing on the calendar changes. The eleven o’clock still happens. She is in it, and she is good in it, and afterwards nobody in the room could tell you that anything had occurred.

But something has just been reorganised, and it will stay reorganised for years.

This is what I mean by a care shock. Not the slow, expected arrival of an ageing parent — the sudden one. The Tuesday.

What the organisation records

Follow that person forward eighteen months and you will usually find one of three outcomes. She has stopped putting herself forward. She has moved to a role beneath her capability, and everyone has agreed to call it a choice. Or she has left.

Here is the part that interests me. In none of those three cases does the organisation record what happened.

The file says stepped back. It says decided not to pursue the role at this time. It says left for personal reasons, which is the most honest of the three and the least useful.

So the most consequential demographic force acting on your senior workforce leaves no trace in any system you own. You are losing people at the exact point their judgement is worth most — twenty years in, when they know where the bodies are buried and how the thing actually works — and it appears in your numbers as ordinary attrition.

You cannot manage what you do not measure. You also cannot measure what you have agreed not to name.

Three ways of looking at the same Tuesday

Robin Rountree and I circled this from a few directions on Informed Aging, and I noticed I kept answering as three different people who do not entirely agree with each other.

The architect. Workplaces are not weather. They are designed — the hours, the floor plate, the door that needs a badge, the meeting that is always at five. Every one of those was a decision somebody made, usually decades ago, about a person with nothing waiting for her.

If caregiving feels disruptive in your organisation, that is not a fact about caregivers. It is a fact about a system that was specified without them, and specifications can be rewritten. That is the whole of my optimism, and it is a narrow one, but it holds.

The arithmetic. I am not an economist and I will not pretend the numbers are settled. But I can tell you where the caregiving signal is hiding, because it is hiding inside figures you already collect: your senior attrition, your promotion acceptance rates, the gap that opens in your pipeline somewhere in the forties, your unexplained absence and the harder-to-see hours where someone is present and elsewhere at once.

None of those are labelled care. All of them contain it.

What backup-care vouchers and resource guides do is real, and I would not take them away from anyone. But they answer a question about money and time. The Tuesday is also a question about structure — about whether a person can hold two responsibilities at once without one of them quietly costing her the other.

The daughter. My father lives with dementia, and I did not learn any of this from research.

Care reorganises time. It reorganises attention, which is worse, because attention is what you are actually paid for. And it reorganises ambition, in a way that is difficult to explain to people who have not had it happen: not a loss of appetite, exactly, but a permanent recalculation running underneath everything else.

I am not going to make that sound noble. It is mostly logistics and tiredness, and there is nothing improving about it.

What I will say is that the people carrying it are not diminished versions of the colleagues they were. They are often the most capable people in the building, running two complicated systems at once and being appraised on one.

Not an accommodation

The word that does the damage is accommodation.

An accommodation is something granted to an exception. It sets the shape of the conversation before anyone speaks: here is the norm, here is the person who cannot meet it, here is what we will generously do about that.

But across a working life that now runs sixty years, caring for someone is not an exception. It arrives at nearly everyone, usually more than once, and often at the two moments an organisation most needs the person it is arriving to — early, when a child is small, and again in the middle, when a parent is not.

A structural condition handled through exceptions produces exactly what you would expect. Flexibility becomes a favour, and a favour can be withdrawn. It attaches to the manager rather than the institution, so it leaves when he does. And it is granted unevenly, which is one of the quieter reasons the pipeline narrows where it does.

The alternative is duller than a policy launch. It is asking, early — in the brief, in the operating model, in what the space is required to do — what has to be true for a person a cargo of someone else to stay and to rise.

Some of that answer is contractual. Some of it is spatial: proximity, hours a building is actually open, whether care sits within a walk of work or forty minutes the wrong way down a motorway. Hybrid spaces of care, where early-years and daytime elder support sit near the working day rather than across town, are not a benefit. They are a question about where things are.

Whether they will lead

We are not waiting for this. Longer lives, teams spanning four generations, rising dementia diagnoses, a care economy expanding faster than the institutions meant to hold it — all of that is present tense.

So the question for employers is no longer whether to respond.

I would put it more plainly than will you lead, which is the kind of phrase that lets everyone nod and change nothing. The question is narrower: do you know how many of your senior people left last year because of care, and would you be able to tell?

Most organisations cannot answer. That is the whole diagnosis. Everything else follows from it.

Where to listen, and how to continue

The full conversation is Episode 107 of Informed Aging, “Care at Work: Why Employers Should Pay Attention to Caregivers”, with Robin Rountree.

If you are trying to answer that question inside your own organisation or you are building somewhere that will have to hold four generations at once,  I would like to hear about it. You can write to me. I answer.

Care is not an obstacle. It is a load, and every building carries loads. The only question is whether you calculated for it.