Case Study: Care-related Supports – AOK Hessen, Germany
Company / organisation name
Profession and Care Service
About the company / organisation
The General Local Health Insurance Fund (Allgemeine Ortskrankenkasse, AOK) is comprises the largest health insurers in Germany, serving 24 million customers. They are corporations under public law, not private companies, and operate in regional organisations. Hessen is one of 16 German federal states (Länder), located in the middle of Germany. It has six million inhabitants and Frankfurt is its largest city.
The AOK Hessen has 3,700 employees and 1.5 million customers, with a market share of 29.6%. It has 54 establishments all over the state, which differ considerably in size. Some of them have less than ten employees, others more than 100.
The AOK Hessen’s Profession and Care Service (Beruf and Pflege) was launched in 2007. It is part of the central Diversity Management Unit, which also runs four other initiatives: equal opportunities, reconciling work and family, generation diversity, and cultural diversity. Three people are employed in the Profession and Care Service: the head of unit, Mrs Sonja Lambert, and two part-time employees. This makes up only part of their work programme.
The initiative comprises four types of services for employees with care obligations: information, consultation, intermediation, and training.
Information is made available in several ways:
- a flyer summarises the service and its objectives and there is a dedicated site on AOK Hessen’s intranet;
- individualised information is provided on the phone or personally, on issues such as different ways of care and alternative residential care suppliers;
- the AOK ‘care navigator’ (Pflegenavigator) is an online search engine for care facilities all over Germany, available at http://www.aok-pflegenavigator.de.
The ‘care navigator’ can be freely used by anyone, not only by AOK Hessen employees. While AOK Hessen’s employees are not usually given internet access, they can access this website.
The Profession and Care Service also provides a paper-based emergency care file. This is intended to prepare employees for a ‘sudden need’ of relatives, due to an accident, disease, or care requirements. Employees are advised to keep this resource in their home. It includes the following details: personal data; medical data authorisations for specific health and care conditions; living conditions of the person’s home; pension information, life insurance, liability insurance, finance; memberships; and a checklist in case of death. It is very popular; 1,000 files have been handed out already.
The Diversity Management Unit provides consulting services, with a view to assisting the process of developing individual solutions for private care. This can be useful in cases where relatives have differing views on issues such as care options for parents, or in choosing a residential home. There were 67 consultations in 2009.
In relation to intermediation, an external company is contracted to help employees find specific care facilities, when the need arises. There was one such intermediation in 2009.
The training module comprises five parts, each of them offered twice a year:
- need of care / types of care;
- financial and legal issues;
- the recognition and treatment of depression in old age;
- practical support in everyday care.
This training is provided free of charge for employees and is conducted by an external trainer. Employees can choose the parts they wish to attend. The training is offered in cooperation with other companies because the AOK Hessen alone would not have enough participants to offer cost-effective courses. Participating companies include the BHF Bank, the Commerzbank, the DZ Bank, Merz, Deutsche Telekom, and IG Metall (trade union for metal workers).
Services are offered to employees with different types of care obligations, not just those caring for older people. For example, some employees have to care for chronically ill children or disabled spouses.
The AOK Hessen offers flexible work arrangements to workers with care duties, including part-time work, flexible work, telework, and unpaid vacation. These options are not only for working carers, however; they are offered to any employee when a specific need arises.
Rationale and background of the initiative
The Profession and Care Service aims to prevent or reduce the double burden of work and care for working carers. It also seeks to prevent issues such as reduced performance and productivity at work, frequent absences from work, and ‘career slumps’. As the head of the unit noted, ‘as demands from work are ever increasing, employees need support to decrease private burdens’. .
The services offered by the unit were introduced proactively by the management as a top-down measure. Together, the Diversity Management Unit and the company’s board of directors acted as a driving force for them. The initiative was launched in 2002 due to concerns about the company’s projected demographic profile. At that time, most employees were in the age group of 36-45 years, and most of them were women. It was predicted that when these employees become older, a considerable share of them may face care responsibilities for their parents.
Results and assessment
According to Ms Sonja Lambert, the objectives of the service were met and so far there have been only positive experiences of it. One reason may be the success of the unit, since 2002, in promoting subjects related to work and family.
The service is highly appreciated by staff, including some young personnel. Employees feel that they are not alone with their practical and emotional needs as working carers. It is of particular significance that the employee council have raised no concerns about it.
The Profession and Care Service cooperates closely with the company’s employees’ council, which is very appreciative of the service. This cooperation is very important for successfully marketing the service because employees take issues more seriously when they are recommended by the employee council. In turn, members of the employee council can use the service when required.
The success of the service also draws from support from the company director. Both managers and employee council members need to be continually involved in communications about work and care issues, if the service is to be maintained and to expand.
Issues, challenges and lessons learned
Occasionally, other companies have shared reservations about taking part in work and care training. Some companies were concerned about cost of related services. However, basic services do not need to be expensive – for example, each emergency file costs €3. Furthermore, costs may be higher if employees suddenly have to arrange care.
Three concrete measures are planned to further improve and expand the service in the future. Firstly, a sixth training module entitled ‘care in partnership’ was introduced in 2010. Employees’ partners will be allowed to attend these training sessions, as spouses often care together.
Secondly, a new networking event was introduced in 2010. This facilitates the exchange of information and experiences about caring among AOK employees. Thirdly, work and care issues are proposed to be included in management training.
Another relevant issue is the expansion of training services to rural areas. This would be important because people in rural areas are much more likely to care for relatives at home, which may lead to a greater personal burden in this regard. Despite this, it can be difficult to find cooperating companies for training offers outside of large cities.
One important lesson is that private care obligations are, as Sonja Lambert describes it, a ‘taboo issue’; employees do not like to talk about this issue. Consequently, work and care services need to be communicated and marketed in a professional manner. Creating a platform for talking about it enabled many people look for support. Ms Lambert did not recommend the provision of work and care initiatives solely on the level of demand suggested in staff surveys. She stated, ‘This would not reveal actual demand because at the point of time of the survey, care may not be an issue for the employees, or care is arranged, or employees may not want to tell their employer about private matters. However, need for care may arise suddenly.’
Case study author:
- Dr Stefan Lilischkis, empirica.
- Sonja Lambert, AOK Hessen, Diversity Management Unit, Head, conducted on 1 March 2010.
- Erika Fischer, AOK Hessen, Deputy Chairwoman of Joint Employee Council, 26 April 2010.
- Website of AOK Hessen: http://www.aok.de/hessen
Written material not available online:
- Flyer, ‘Beruf und Pflege’ of the AOK Hessen.