What the Guidance Really Says About Caregivers and Work

Key takeaways

• Family and Medical Leave Act: up to 12 weeks a year of unpaid, job-protected leave for eligible employees caring for a spouse, child or parent with a serious health condition
• State laws: some states add paid family leave or broader protections
• Most useful single change: Talk to HR about FMLA eligibility before you need the leave.
• Commonest mistake: Leaving work before exploring leave and flexible options.
• See a doctor if any of the signs under "When to speak to a doctor" below apply to you.

What it is

Combining paid employment with unpaid caregiving. It sits within Carers Health. The table below gives the figures guidance actually works from.

The numbers, in one place

What helps

The advice below comes straight from the guidance cited at the foot of this page.

• Talk to HR about FMLA eligibility before you need the leave
• Ask about flexible hours, remote work or a reduced schedule in writing
• Check whether your state has paid family leave
• Use your employer's employee assistance program if there is one

What to avoid

The common mistakes, including the ones that sound sensible.

• Leaving work before exploring leave and flexible options
• Assuming you have no protections because the caregiving is unpaid
• Waiting until a crisis to tell your employer

In depth

Millions of Americans combine a paid job with caring for a family member. Balancing the two can mean using vacation days for appointments, taking calls from care providers during work hours, arriving late after a difficult morning, or losing concentration because of worry. Over time, many caregivers reduce their hours, turn down promotions or leave work altogether, which can affect income, retirement savings and health insurance.

Some of these losses could be avoided. Federal law, through the Family and Medical Leave Act, gives eligible employees up to 12 weeks a year of unpaid, job-protected leave to care for a spouse, child or parent with a serious health condition, and that leave can often be taken in blocks or intermittently. Some states go further with paid family leave or broader definitions of family. Many employers offer flexible schedules, remote work or employee assistance programs, but these are often unknown to employees until they ask.

Approaching work as part of your caregiving plan, rather than something to manage around it, can help. Knowing your rights, talking with your employer early, and using available benefits can make it possible to keep your job and income while providing care.

Signs and symptoms

• Using sick leave or vacation days regularly for caregiving
• Frequent interruptions from care-related calls during work
• Difficulty concentrating or falling behind on tasks
• Turning down projects, travel or promotions because of caregiving
• Thinking about reducing hours or quitting
• Feeling exhausted at work after nights of caregiving

Causes and risk factors

• Unpredictable care needs and emergencies
• Medical appointments scheduled during work hours
• Lack of affordable paid care or respite
• Limited knowledge of workplace rights and benefits
• Workplace cultures where caregiving is not discussed
• Inflexible jobs, such as shift work or customer-facing roles

How it is checked

Assessing the impact of caregiving on work starts with a clear picture of what you are doing. Track how many hours of work you are missing, what tasks fall during work hours, and what is causing the most disruption. This helps you decide what changes to request and whether outside help could fill the gaps.

Check your eligibility for FMLA. In general, it applies if your employer has 50 or more employees within 75 miles of your worksite, and you have worked there for at least 12 months and at least 1,250 hours in the past year. Your HR department can confirm, and your state labor department can tell you about any state leave laws that apply.

Treatment and support options

Family and Medical Leave Act

FMLA allows eligible employees to take unpaid, job-protected leave to care for a spouse, child or parent with a serious health condition, and your group health coverage continues during the leave. Leave can be taken in a block or intermittently, such as for appointments or flare-ups. Your employer may ask for certification from the family member's doctor, so request the form early.

State paid family leave

A growing number of states have paid family leave programs that provide partial wage replacement while you care for a family member. Some also cover a wider range of relatives, such as grandparents or siblings. Rules and benefits vary, so check your state labor department's website or ask HR what applies to you.

Flexible work arrangements

Many employers will consider flexible hours, remote work, compressed workweeks, job sharing or a temporary reduction in hours. Put your request in writing, explain how the work will still be done, and suggest a trial period. Being specific about what you need and for how long makes it easier for managers to say yes.

Employee assistance programs

Employee assistance programs often provide free, confidential counseling, legal and financial consultations, and referrals to eldercare or childcare services. Some employers also offer backup care, dependent care accounts or caregiver support services. Ask HR what benefits exist; caregivers often discover help they did not know about.

Prevention

• Learn your leave rights before you need them
• Talk to your manager or HR early, before a crisis
• Schedule appointments outside work hours where possible
• Line up backup care for emergencies
• Keep records of leave requests and approvals

Day to day

Balancing work and caregiving often requires ongoing adjustments. Regular check-ins with your manager about workload and schedule can prevent misunderstandings. Shared calendars, clear handover notes and setting boundaries around when you are reachable for care-related calls can help both roles run more smoothly.

Consider the long-term financial impact of reducing work. Cutting hours or leaving work can affect Social Security benefits, retirement savings and health insurance. Before making major changes, talk with HR and, if possible, a financial adviser about the consequences and alternatives.

For specific groups

Hourly and shift workers

Workers with fixed shifts may find it harder to adjust schedules. Ask about shift swaps, predictable scheduling and state protections. Some local laws provide additional rights to schedule changes or paid sick time that can be used for family care.

Self-employed caregivers

Self-employed people are not covered by FMLA but may be able to opt into state paid leave programs in some states. Planning finances and building flexibility into client commitments can help.

Caregivers of in-laws or other relatives

FMLA covers care for a spouse, child or parent, but not in-laws, siblings or grandparents, except in limited circumstances. Some state laws are broader, so check your state's rules.

Questions to ask your doctor

• Can you complete FMLA paperwork for my family member's condition?
• Can appointments be scheduled early or late in the day?
• Could some follow-up visits be done by telehealth?
• Is my own health being affected by the stress of work and caregiving?
• Can you document my own health needs if I need leave for myself?
• What services could reduce the time I need off work?

More questions, answered

Can I be fired for taking FMLA leave?

FMLA protects eligible employees from being fired or retaliated against for taking qualifying leave. When you return, you are generally entitled to the same or an equivalent job. If you believe your rights have been violated, you can contact the US Department of Labor.

Is FMLA leave paid?

No, FMLA leave is unpaid, although your employer may let or require you to use paid vacation or sick leave during it. Some states have paid family leave programs that provide partial pay while you care for a relative.

Can I take FMLA leave a few hours at a time?

Yes, when medically necessary. FMLA allows intermittent leave or a reduced schedule, for example for appointments, treatments or flare-ups. Your employer may ask for certification from the family member's doctor.

Does the ADA protect caregivers?

The Americans with Disabilities Act prohibits discrimination against employees because of their association with a person with a disability. It does not require employers to provide accommodations for caregivers, but some employers offer flexibility anyway.

What if I do not qualify for FMLA?

Check whether your state has its own leave law or paid family leave program. Ask your employer about flexible work, unpaid leave policies or using vacation time. Employee assistance programs can also help.

Should I quit my job to provide care?

Leaving work can have lasting effects on income, savings, insurance and Social Security. Explore leave, flexible arrangements and outside help first, and get financial advice. Many caregivers find it possible to keep working with the right support.

Related topics

• Returning to Work After Illness: What Published Guidance Supports (Workplace Health)
• The Evidence on Occupational Health, Without the Hype (Preventive Care)
• The Evidence on Back Pain at Work, Without the Hype (Back and Posture)
• The Evidence on HSAs and FSAs, Without the Hype (Health Insurance and Costs)

Where to go next

• Making Sense of Caregivers and Work
• Caregivers and Work: A Practical Checklist
• Caregivers and Work — the reference entry
• Caregiver Health: The Complete Guide
• When Caring Ends: What the Evidence Actually Says
• What the Guidance Really Says About Recognizing Yourself as a Caregiver

When to speak to a doctor

See your doctor if caregiving and work together are affecting your health; your doctor can also complete leave paperwork if your own health is involved. If you feel overwhelmed or have thoughts of harming yourself, call or text 988, and call 911 in an emergency.

Where this comes from

• Family Caregiver Alliance — Work and Eldercare
• HHS — 2022 National Strategy to Support Family Caregivers

How this page was put together

Every figure, recommendation and warning above is taken from the guidance named in Where this comes from. Nothing on this page is inferred, summarized or generalized beyond what those bodies publish: where they give a number, it is their number, and where they are silent, so are we. Pages are rebuilt whenever the underlying record changes. Sign-off by a named clinician, where it has happened, is shown at the top of the page along with the date.

Medical disclaimer

This article is general information, not medical advice. It cannot account for your own history, medication or circumstances. Always speak to your doctor, pharmacist or another qualified health professional before making changes that affect your treatment, and never delay seeking medical advice because of something you have read here. In an emergency, call 911.