Caring for a parent with dementia while working full time

Caring for a parent with dementia while working full time is possible, but only if you stop trying to cover every hour yourself. Your job becomes care manager: you make the decisions and set up the help, and paid aides, an adult day program, siblings and neighbors cover the hours you're at work. If you qualify, the federal FMLA lets you take up to 12 weeks a year of unpaid, job-protected leave to care for her, in pieces as small as a few hours. Paid leave depends on your state and your employer.

What follows is the plan: the law, the conversation with your manager, the help that covers the workday, and the questions to answer before you quit.

Caring for a parent with dementia while working full time: change the job title

Dementia care tends to creep. Groceries on Sunday become pills, appointments, bills and 6 a.m. calls, and they all land on whoever said yes first. A full-time job and a full-time caregiving load don't fit in one week.

So split the work. A few things need you: medical and money decisions, being the contact for her doctor, noticing when she's different than last month. Many things don't:

• Rides to routine appointments.
• Sorting pills. Ask the pharmacy about packing them by day and delivering.
• Meals. Her Area Agency on Aging can tell you about home-delivered meals near her.
• Bathing. An aide often has an easier time of it than her daughter.
• Paying bills. Set up autopay, or hand it to a sibling who lives far away. The guide on siblings who don't help has the scripts.

FMLA for caring for a parent

The Family and Medical Leave Act is a federal law. According to the Department of Labor, you're eligible if all of these are true:

1. You've worked for your employer for at least 12 months.
2. You've worked at least 1,250 hours in the 12 months before the leave starts.
3. You work at a location where your employer has at least 50 employees within 75 miles.

Private employers are covered if they have 50 or more employees. Public agencies and schools are covered regardless of size.

If you qualify, you get up to 12 workweeks of leave in a 12-month period to care for a parent with a serious health condition. The leave is unpaid, but your employer has to keep your group health insurance going on the same terms. When you come back, you get your same job or an equivalent one with the same pay and benefits.

A few details that matter for dementia care:

• You can take it in pieces. The DOL says leave can be taken all at once or, when medically necessary, in separate blocks of time or as a reduced schedule. That means a morning for a neurology visit, or a shorter workday for a month.
• "Caring for" is broad. Fact Sheet 28F includes help with basic medical, hygiene, nutrition, safety and transportation needs, physical care and psychological comfort.
• "Parent" means a biological, adoptive or step parent, or someone who stood in as your parent when you were a child. It doesn't include parents-in-law.
• Your employer can ask for a certification from her doctor. Fact Sheet 28G says you generally have 15 calendar days to return it, with more time if you're making a good-faith effort and the doctor's office is slow.
• Your employer may require you to use paid vacation or sick days during FMLA leave.
• Give notice as soon as you can. If you think your rights were violated, the Wage and Hour Division takes calls at 1-866-487-9243.

Paid leave varies by state

The DOL's Women's Bureau says there's no federal law guaranteeing paid family and medical leave for private-sector workers. It also says 13 states and the District of Columbia have laws that create paid family and medical leave programs. Who qualifies, how much it pays, when benefits start and whether it covers caring for a parent are set by each state.

To find out what you have:

• Look up your state's program on the Women's Bureau paid leave map, or on your state labor department's website.
• Read your employee handbook for paid family leave, sick time you can use for a family member, and remote work policies.
• Ask HR whether there's an Employee Assistance Program. The Family Caregiver Alliance notes that HR and EAP staff can point you to community services, care managers and leave policies.

Talking to your manager

Do it before the next emergency does it for you. You don't owe anyone her diagnosis details. Tell them what they need to plan around, and bring a specific ask.

The Family Caregiver Alliance lists the flexible arrangements caregivers most often use: shifting hours, such as 10 to 6 instead of 9 to 5, compressed weeks like four ten-hour days, part-time work, job sharing and working from home. Pick the one or two that would solve your actual problem.

More lines that work:

• To HR: "I'd like to request intermittent FMLA leave to care for my mother, who has a serious health condition. What certification form do you need from her doctor?"
• When your manager asks how long this will last: "I don't know. That's why I'm asking for a trial period with a check-in date."
• When you have to leave mid-day: "I need to step out for a family matter. I'll be back online by two."
• To a coworker who asks too much: "It's a family health thing. I'd rather not get into it at work."

Take Dana, a project coordinator whose mother started calling her at work six times a day. Dana asked her manager for two late-start days and moved her mom's appointments onto those mornings. She also booked an aide for the hours after lunch, when the calls came most. Her manager approved the schedule for 60 days, then made it permanent.

Help that covers your work hours

Leave and flexible hours only go so far. Someone has to be with your mom while you work.

• Adult day programs, usually on weekdays, with activities, meals and supervision while you work. Expect a rough first few weeks before she settles in.
• In-home aides from an agency or hired directly. Agencies cost more but send a backup when someone calls in sick.
• Respite stays when you have a big deadline or a work trip. The respite care guide explains how to find and pay for each type.

Give her neighbor and the aide each other's numbers, so the next 10:40 a.m. call goes to them first.

Should I quit my job to care for my parent?

Sometimes it's the right call. Make it a decision, not something that happens to you after a bad month. The Family Caregiver Alliance points out that caregivers who leave work lose more than their paycheck. They also lose Social Security and pension income later in life. Many also lose employer health insurance.

Before you resign, answer these:

1. Have you asked for FMLA, a reduced schedule or remote work, in writing?
2. Have you priced an aide or adult day program for the hours you work?
3. Have you talked to an elder-law attorney or financial planner about your own retirement, and about paying yourself from your parent's money through a written caregiver agreement?
4. Have your siblings been asked, specifically, to pay for some of the help?
5. Will your mom's needs keep rising until home care stops working anyway? If so, read when it's time for memory care first.

Set your limits now, while you're calm. For example: "If I miss more than four workdays a month for two months, we add paid help or start touring memory care." Send it to your siblings.

Questions caregivers ask

Does caring for a parent qualify for FMLA?

Yes, if you're eligible and your parent has a serious health condition as the FMLA defines it. Her doctor fills out the certification that shows it. Parents-in-law aren't covered.

Can I use FMLA a few hours at a time?

Yes. When medically necessary, FMLA can be taken in separate blocks or as a reduced schedule. Many caregivers use it for appointments and crisis days.

Can you work full time and still be a carer?

Yes, if the care plan doesn't depend on you being available every hour. That usually means paid help or adult day during your working hours, a sibling or friend as backup, and a schedule your manager has agreed to in advance.