For My Patients, Family Caregiving Has Made All the Difference

After three decades of practice as an oncologist, I’ve seen what families go through to manage serious illnesses. Too often, patients must go it alone because their children, spouses or other relatives cannot be there with them for treatment and recovery — or at the end of their lives. As a California physician, though, I am fortunate to see something different — the positive impact that paid family leave has on both patients and their caregivers.

I remember all too well the case of Millicent, a 73-year-old feisty retired county hospital nurse who developed breast cancer and went through surgery, radiation and hormonal treatments. When her cancer recurred after several years, she chose to try chemotherapy. Her daughter, Kristina, also a nurse, applied for intermittent family leave so she could take her mother to her chemotherapy appointments and stay with her for a day or two after each treatment. Unfortunately, after several months it was apparent that the treatments failed to control Millicent’s cancer and she chose to join a hospice program rather than try additional treatment.

When it was clear that Millicent needed continuous care and did not have much time to live, Kristina applied for family leave to provide continuous care for her mother. Had Kristina not been there, Millicent would have been placed in a nursing home or would have had to hire home health aides, possibly at her own expense. And although she may have had a very well-qualified caregiver, the care she received would not have been as personal or customized to her individual needs and values. Kristina took exquisite care of her mother and also had the chance to share memories and stories that she could cherish. When Millicent died six weeks later, Kristina returned to work full time in her regular job, grateful that she had been able to have meaningful time with her mother during her final days.

Millicent and Kristina were fortunate to live in California, one of three states that currently provide family leave through affordable, sustainable and longstanding statewide programs. (The other two states are Rhode Island and New Jersey, and New York will join them next year.) These states are the exception — workers in 46 states are on their own to navigate treatment and care when serious medical needs arise and a loved one needs care.

Some individual companies offer paid family leave benefits to their employees, but most do not. Eight-six percent of workers in the United States do not have access to paid family leave through their employers, and more than 60 percent do not have paid medical leave through an employer’s temporary disability insurance policy.

For lower wage workers, access to paid family and medical leave is even more rare and financial needs more acute. Without this critical protection, workers struggle to work while ill or while family members who need their help are suffering. Shockingly, nearly one-quarter of new mothers return to their jobs within two weeks of giving birth. Most of them have low-paying positions and cannot afford to take unpaid time away from their jobs.

The United States is an outlier when it comes to paid family and medical leave, lagging far behind other high-wealth countries in ensuring working people can take time away from their jobs when a new child is born and when serious personal or family medical needs arise. We owe it to ourselves to support the establishment of federal and state family leave. We will all need it some day.

Access to paid leave should not vary by zip code, job or employer. The status quo costs working people, the loved ones who rely on them, businesses and our economy dearly. The costs of inaction are staggering.

America can do better. We need a national paid family and medical leave standard that is affordable, comprehensive and sustainable and meets working people’s needs. Congress must pass the Family And Medical Insurance Leave Act (FAMILY Act), which would create such a program, without delay. We cannot afford to wait.