The Growing Costs and Burden of Family Caregiving of Older Adults: A Review of Paid Sick Leave and Family Leave Policies

Many family caregivers of older adults suffer from a high burden of care and struggle with the balance of jobs and caregiving tasks. However, the United States is the only developed country without paid sick leave policies for all workers and their families. The purpose of this article is to review the federal Family and Medical Leave Act (FMLA) and empirical studies about paid sick policy, propose policy recommendations, and provide a starting point for future research. The result has shown that the FMLA only applies to certain employees and the provided leave is unpaid under the act. Working women, Latinos, low-wage workers, and less-educated employees are less likely to access paid sick leave and family leave. Obviously, social injustice exists in the FMLA and paid sick leave policies. This article proposes that the Family and Medical Leave Act coverage should be expanded to protect all workers, especially for primary family caregivers of older adults, regardless of family relationships. Also, paid sick and family leave laws should be passed, and requirements to contribute to a family-friendly workplace added to relieve the growing burden of family caregiving of older adults. Policy recommendations including the exemplar of the San Francisco Paid Sick Leave Ordinance, and suggestions for more comprehensive policies are proposed for federal, state, or/and city legislation.