Health Calls

Caring for Double-Duty Caregivers

Episode Summary

Do you know what a “double-duty caregiver” is? Chances are that if you work in health care, you know a few of them… and you may even be one yourself!

Episode Notes

Do you know what a “double-duty caregiver” is? Chances are that if you work in health care, you know a few of them… and you may even be one yourself!

Betsy Taylor, editor of Health Progress, and Debra Kelsey-Davis, co-founder of Nourish for Caregivers and Sagacity.Care, join the show to discuss Kelsey-Davis’s recent article for the fall issue of Health Progress. They discuss how COVID-19 impacted the stress levels of double-duty caregivers, raising awareness and how Catholic health systems can better care and advocate for the double-duty caregivers working in the ministry.


Read Debra Kelsey-Davis’s article, “Double-Duty Caregiving: Clinicians Caring for Others at Work and Home Need Support” for Health Progress

Visit the Nourish for Caregivers website

Episode Transcription

Brian Reardon (00:00):

Hey Betsy. Good to see you.

Betsy Taylor (00:01):

Hey Brian. Good to see you.

Brian Reardon (00:03):

We are enjoying. We're just commenting on what a lovely autumn we're having here in St. Louis, and I guess this is the time of year we gear up for the holidays. Are you ready for the holiday fun?

Betsy Taylor (00:12):

I'm getting there. It's gingerbread latte season, so that's always a step in the right direction. Yeah, looking forward to it.

Brian Reardon (00:19):

Yeah, time with family and friends and actually speaking of family and caring for those that we love, that's the topic for this episode. So you ready to go?

Betsy Taylor (00:28):

I am.

Brian Reardon (00:29):

Let's do it. This is Health Calls, the podcast of the Catholic Health Association of the United States. I'm your host, Brian Reardon, and joining me as she does quite frequently as Betsy Taylor. She's editor of Health Progress for CHA. Again, welcome Betsy.

Betsy Taylor (00:48):

Thanks Brian.

Brian Reardon (00:49):

And in just a moment, we're going to have Debra Kelsey-Davis. She is co-founder of Nourish for Caregivers and She's a nurse and author and a double-duty caregiver. And the topic is to discuss Debra's article, Double-duty Caregiving, clinicians Caring for Others at Work and Home Need support, which appears in the current fall issue of Health Progress. So Betsy, I want, before we bring in Debra, I want to just spend a couple of minutes with you talking about this article that comes from the fall issue. Again, improving the patient experience is the overall theme, and obviously the patient experience caring for patients is so foundational to Catholic health care. What I like about this article is it recognizes the daunting, I think, responsibilities that so many of our colleagues face, both in their professional and personal lives. So maybe just to set the context, give us some insight why this particular issue and article was chosen to be in this edition of Health Progress.

Betsy Taylor (01:48):

Sure. I think it's not lost on us that this is something that people face, right? That they're in an environment at work where they're caring for people and then when they're not at work, they may have kids or parents or other loved ones they're looking after. What really struck me about this article was that I hadn't really seen much that explored this topic in depth in terms of what that means because there's just a lot of complexities here. We talk about burnout a lot and we talk about caregiving, but maybe hadn't explored so much that something like round the clock caregiving can lead to burnout. And I think just the specifics of you have a professional set of skills and then you're going home and it's to someone directly involved in your life who is one of the closest love relationships you have. And so what does that mean? How does it translate when you're in the different environments providing care? So we wanted to look at some of those issues and as the article says, clinicians caring for others at work and home needs support. So we just wanted to explore that topic.

Brian Reardon (02:50):

And I think it's so important when we talk about the patient experience because, and we've talked about this in other episodes and other conversations, is that the care we are able to give is only as good as how we care for ourselves. So recognizing, again, the challenges that a lot of our colleagues, and I know Deb's going to provide a lot of insight into the challenges that are out there with double-duty caregiving, but in order to really be effective caregivers, we have to recognize those challenges and make, I guess, some accommodations or really acknowledge that in the care that they provide when they're in a professional setting.

Betsy Taylor (03:23):

Yeah, I'm sure Deb will get into that, but she has some good thoughts here on what our workplaces can do to support these employees.

Brian Reardon (03:30):

So let's bring in Debra Kelsey-Davis. Again, she's a nurse and author and she's also co-founder of Nourish for Caregivers and And most importantly, she's a double-duty caregiver. So Debra, welcome. Thanks for being with us.

Debra Kelsey-Davis (03:44):

Thank you, Brian. I'm so glad to be here with you and Betsy today.

Brian Reardon (03:47):

Yeah, and I guess the first question is what is define what a double-duty caregiver is?

Debra Kelsey-Davis (03:51):

Well, thank you for asking because the one thing I've found is I've traveled throughout the health care industry is that it's a term that's not well understood or even used. So a double-duty caregiver is someone who's caring at work in their job as a caring professional and then goes home, turns around to care for a family member or someone who's either aging ill or disabled.

Brian Reardon (04:13):

I was struck by this in the article you write that employers across all industry segments are waking up to the realization that up to 73% of their workforce has a secret second job, which is caregiver to a family member. I was surprised by that number. Is that something that most people realize that it's that large of a population that is doing this double-duty care?

Debra Kelsey-Davis (04:35):

No, and honestly, it wasn't really until the pandemic, during the pandemic that employers really started paying attention to this. And then we turned to look at health care, the caring professions, nurses, doctors, aides, technicians, therapists, chaplains, all those who care, body, mind, and soul. The people who have a passion for caring, well, guess what? They are also going home to care for their loved ones. And though we don't have an exact number right now, we're estimating that somewhere between 80 to 90% of all of that health care workforce out there is a double-duty caregiver to varying degrees.

Brian Reardon (05:10):

And I think varying degrees. It could be a more full-time job. It could just be checking in on maybe a great aunt. So it does sort of vary, right? It's not that everybody has kind of got a second full-time job, but I would imagine as the population continues to age, that the amount of time that our caregivers are spending outside of, again, a clinical setting or outside of their profession, is probably going to keep growing, right?

Debra Kelsey-Davis (05:36):

It is. And in fact, the issue itself has been present since I became a nurse in the late 1970s. And at that time I was the double-duty caregiver caring for my grandmother. I was involved in that care. My caregiving has ebbed and flowed and so do so many others. The aging population, it's growing, it's growing fast, and it's going to double in the next 20 years. So the aging population, people with disabilities, persons with disabilities, we're seeing now a 362% increase from the late 1990s in persons with disabilities and chronic illnesses on the rise. So if you think about it, double-duty caregiving has always been happening behind the scenes quietly, but the needs of the population of our loved ones are actually increasing at such exponential rates. And I see it my own family, at one point I was a triple-duty caregiver, sandwiched, if you will, if you've heard of the sandwich generation.

Brian Reardon (06:37):

And you mentioned Covid, and I think another factor is the workforce and the challenges. We've heard this from our members. I think it's pretty universal across health care and really the economy at large, there's, it doesn't seem like there's enough workers to meet the demand for services, particularly in health care. So how should we look at that as being a factor in putting more pressure on individuals in caring for loved ones?

Debra Kelsey-Davis (07:05):

So you're absolutely right. We're actually seeing early retirement amongst doctors and nurses. There's been the double-duty caregiving phenomena that I don't think a lot of people really understand, Brian, is the fact that many of these health care professionals need to either cut back on their hours or leave their job altogether because of the demands of the care that's required at home for their loved one. So again, creating shortages across the entire health care workforce, it's an issue that's really become one that people are now starting to pay attention to most likely because of the impacts on, as Betsy was saying earlier, in patient care, the patient experience and being able to have the resources in place to care for those patients as well as what's happening to these caregivers who are simply burning out. I

Brian Reardon (07:53):

Think what we really want to now get into some insights from your perspective is you've kind of done a good job setting the challenge that's out there. Again, more people are providing this care. A lot of 'em, again, work in health care obviously because they're so inclined to do so. And then you've got the other external pressure of few and fewer workers who can care for loved ones. So what is this doing again to the individuals who are in those roles of double-duty caregiving? In the article you say, Hey, they're struggling to juggle work life and that directly impacts virtually every aspect of their lives, the people they care for, their jobs, their peers, and the many relationships they value. So how much recognition are we or attention are we providing to these double-duty caregivers in the challenges they're facing? And are we providing them enough support, I guess is the first question?

Debra Kelsey-Davis (08:39):

It's a great question. I think stress and burnout and even some of the mental health impacts we're seeing today in our health care workforce can be attributed to many varying different types of scenarios that are arising. But I will say that in speaking with health care leaders, this notion of maybe probing a little bit deeper when an employee is struggling or employee needs to be away from work into are you caring for someone outside of work, beginning to understand perhaps some of the underlying factors that go along with double-duty caregiving? Because stress is in the red zone. I will share with you that we've seen through studies, but also through my own personal experience that over 80% of double-duty caregivers are in the red zone in terms of their stress and the impacts on their mental health. And don't forget too, that with all of this, there's financial impacts to these double-duty caregivers who are trying to juggle all of this and keep everyone moving forward and caring for everyone.

Brian Reardon (09:46):

And we've cited some statistics throughout the conversation, but one of the things you point out in the article, there really isn't enough data and is that because these caregivers are not reporting that they're doing double-duty or where are some of the challenges in really getting our arms around how big of an issue this is?

Debra Kelsey-Davis (10:04):

We see this everywhere. I, for example, in myself, I'm a nurse. I do not wear a label that says I'm also a caregiver. And most caregivers, informal family caregivers, they don't necessarily do that. You know why? Because they see it as being a daughter, a loving daughter, a loving son, a loving wife or spouse or friend. We don't necessarily use that term caregiver even in our own definition of ourselves. So if you think about it, identifying as a caregiver is not something that most people are voluntarily going to do. I think in the article I spoke a little bit about in interviewing double-duty caregivers, there's even a reluctance to step up and say, I'm a double-duty caregiver because of perhaps some of the stigma or anticipation around needing time off or not being able to perform my job as well is a concern amongst some of these double-duty caregivers to know. They don't necessarily identify themselves as such, but there are things that we can do.

Brian Reardon (11:07):

Such as?

Debra Kelsey-Davis (11:07):

So Brian, one of the things you were talking about, you asked, gee, how can we wrap our arms around this? And I know that HR inside of many health organizations are juggling how do we really help our employees who are struggling? Asking the questions, certainly to get to some of the underlying factors is important, but what about some of the ways that we can help people self-identify in a way that's very positive? So for example, November's National Family Caregiver Month, an entire month that the president has declared, we honor those who are caring for others and in February every year, next year is going to be February 16th, we observe National Caregivers day. How about we think about lifting up these caregivers, honoring them, drawing attention to the amazing work that they do? We can begin to identify these caregivers amongst us that are serving in so many different capacities and caring simply by raising up in a positive light to look at them, to honor them, and then to support them to come behind them and support them.

Brian Reardon (12:12):

And you mentioned stigma, other ways to address the stigma, because I could see that of somebody saying, I don't want to come out as saying, oh, I'm so overwhelmed with all the responsibilities I have both at work and when I leave work to go home are other strategies for letting eople know it's okay to talk about it.

Debra Kelsey-Davis (12:31):

Creating those safe spaces, right? Let's talk about it and then let's problem solve. It's a culture awareness that I think begins amongst the manager, frontline managers, creating the awareness there. I've actually heard some amazing stories of staff rounding that includes looking at things more from a whole person perspective and understanding things in that realm, but also especially with tough cases as a nurse, I remember dealing with end of life issues and our team coming together to talk through how do we really help both the patient who's experiencing the end of life journey, but also the family? Well, if we start to look at these double-duty caregivers, myself included, I journeyed with my dad on his end of life journey, guess what? We bring additional expertise and personal experience to the equation. We can start to even in our team discussions on the units to draw personal experiences that we can bring to bear on how to help families and patients navigate some of their situations that we're caring for right there inside of that health care facility.

Brian Reardon (13:37):

And I want to get to what I would call maybe some of the positives that, again, double-duty caregivers can bring. But going back to the sort of stigma question or how to bring this up, do you have any advice for managers, for leaders who have teams and really finding a way to discover whether somebody has these obligations outside of the workplace and doing it in a way that doesn't? I think people worry as managers that they're prying people's personal business. So how do you navigate that as a manager?

Debra Kelsey-Davis (14:06):

When I was talking about the awareness at the manager level, several health care leaders I've had the opportunity to sit down with, I've actually encouraged their managers to share their own experiences. Remember, we were saying 80 to 90% of the workforce is a double-duty caregiver. I guarantee you the managers themselves more than likely have that experience personally themselves. And I think if as a culture we can begin to start sharing first as managers with our teams and creating this level of understanding of what I would call constantly being pulled in multiple different directions and the stress that can bring to the job and the stress that creates because we're not getting enough sleep or taking care of ourselves. I think that kind of sharing, starting with managers can be very helpful. The other thing that I know many of the health care leaders I've had the opportunity to sit down with as well are doing is they're starting to through their HR departments, looking at asking questions specific to needs. So again, not necessarily self-identifying, but looking at needs such as, and I know we called these out in the article things like, are you in need of helping to provide adult daycare, child daycare, transportation services? Are there things that are needs of yours that we as an employer could make your job easier? So there's a number of ways we can start to come at this.

Brian Reardon (15:33):

No, I like that. It's about giving them permission to talk about it. If you're a manager and you're talking about it, that sort of sets the tone. So that's a great tip. The other thing I think is important too, and you mentioned the recognition, the February date, the month of November. In your article, you talk about being a double-duty caregiver. So if you are caring for a parent, a loved one, and that's kind of who you are in your personal life, that helps you bring a perspective into the workplace, that can be very positive. Can you talk a little bit about that?

Debra Kelsey-Davis (16:05):

Yes. So we call it balance with blessings and there are blessings, the blessings and caregiving. I mentioned the end of life. I spoke with one of the double-duty caregivers who had gone on a long journey end of life and with her parents, and then turns out within the workplace was helping her own team with how to approach the family and how to support that family during their end of life journey with their loved one while they're in the hospital, in the facility. The other thing is we have many double-duty caregivers who themselves have personal experience dealing with someone with memory loss, communication challenges, even the personal experience of family dynamics, which we see play out every day inside of a health care setting. Right? Well, as we think about some of these experiences and being able to draw on that knowledge that we've gained, we can bring that into the professional experience at work and being able to provide greater support for those patients and their family members and set them up in a way that truly brings to bear the mission and the ministry of the Catholic Health Organization.

Brian Reardon (17:14):

Nice. Yeah. And my last question that I don't want to bring, Betsy back in, you just mentioned Catholic health care. Is there a spiritual component of double-duty caregiving that you think could be better nourished?

Debra Kelsey-Davis (17:26):

So as a Catholic health care leader, one of the things that I hear over and over again is this commitment to whole person, so body, mind, and soul. And we know that 75% of caregivers pray daily to cope. So if you think about the resources that tap into spiritual care, prayer, reflection, workshops that are really targeted to things like compassion fatigue, those are important. I think also that one of the things I hear is that if we focus in on helping our double-duty caregivers renew their sense of purpose in meaning and caring, help them to self-discover where they've found and made a difference, small ways, big ways, where do they see God today in their caring? All of these pieces that Catholic health care does so well to equip their mission. Those are the very same resources that can nurture the body and mind and soul and healing of those double-duty caregivers who really, truly are seeking compassion and understanding and a community to be wrapped around them.

Brian Reardon (18:28):

Yeah, that's great. Debra, you gave us really a lot to think about here. I want to bring Betsy back in, Betsy reflections on this conversation, any questions you might have?

Betsy Taylor (18:36):

I think one thing that struck me while listening to the conversation is that a lot of the things we discuss, it's going to require a little bit of a culture change. The systems are going to have to think about, Hey, we want to know this information because sometimes I think it's easier if you don't know it, then you can, oh, we didn't know. Sorry. So I think thinking about how you could gather this information, so I see sort of a larger need there. I was thinking it's about culture, but it's also about sort of choosing your moments because I think in a sort of fast-paced health care environment, you have a lot of people who are used to being superhuman or at least the perception of being superhuman. And so when you're trying to power through your day and handle things at work and you maybe have a little bit more of that professional persona on it does make you think, Hey, is my manager going to ask me about my ill parent? Or, so I think finding those quiet moments maybe in the workplace or I know the article talks about the creation of support groups, so maybe it's over someone's lunch hour where people who are doing double-duty caregiving can get together with each other and share ideas or just offer each other a shoulder to lean on.

Brian Reardon (19:49):

Debra, any final advice for those who are caring both in the workplace and at home, and for those that work with them,

Debra Kelsey-Davis (19:58):

Be kind to yourself. Be patient with yourself. Know that you're doing the work of God. You're carrying out and caring. You're passing along and your love for one another, and that is what really matters in the end is how you care, and that is what we need to carry forward with us. And you're not alone. You're truly not alone.

Brian Reardon (20:21):

Nice. Thank you. Again, that was Debra Kelsey-Davis. She is a nurse, a double-duty caregiver, and the author of double-duty Caregiving, clinicians Caring for Others at Work and Home Needs Support, which is in the fall issue of Health Progress. Thank you, Debra, for being with us.

Debra Kelsey-Davis (20:40):

Thank you so much, Brian and Betsy for having me.

Brian Reardon (20:43):

And for Betsy Taylor, editor of Health Progress. I'm Brian, your host of Health Calls, the podcast of the Catholic Health Association of the United States. You can listen and download Health Calls wherever you find podcasts on your favorite apps, or you can visit the CHAwebsite, You can access not only this episode, but also the related article and other materials on that podcast page. As always, appreciation goes out to Josh Matejka. He's the producer of Health Calls and our engineer, Brian Hartmann here at Clayton Studios. And if you are on an app and downloading and visiting these episodes, be sure to give us a rating. If you can hit that fifth star, we'd really appreciate it. As always, thanks for listening.