As Deborah Koehneke sees it, she has two full-time jobs. One is director of medical clinics in Hillsdale, Michigan. The other is caregiver to her 87-year-old mother with chronic lung disease.

Koehneke’s mom lives 90 minutes away; it’s the long distance caregiving that’s tough. Koehneke calls to make sure she’s okay. “Today Mom emailed me to say her breathing was not so good. I will call her several times a day to make sure she is okay and I can hear her breathing,” says Koehneke. “I’m so stressed, it’s like a constant panic attack. Today I feel like I am 63 going on 90!”

Koehneke’s mom stays with her two weeks a month. “It’s much easier when she’s here,” says Koehneke. “I tend to worry less.” She works just a mile away and can dash home at lunch to check on her mom.

Koehneke realizes taking care of her mother has impacted her work. She has a demanding job and major staff needs. She knows how lucky she is that her boss allows her to juggle her personal and professional demands.

Does Koehneke’s stressful struggle managing her career and the well-being of her mother sound familiar?

Know that you’re not alone. A 2015 Caring.com survey finds that nearly 40% of working family caregivers spend more than 30 hours a week helping Mom, Dad or a spouse. Here we’ll address flexible work options as well as strategies for balancing your work and caregiving responsibilities.

Working Caregivers of All Ages

Another 2015 study, by the National Alliance for Caregiving and AARP study, shows that 61 percent of working caregivers have had to change their work schedule. Here’s how it breaks down:

  • 49% have to go to work late or leave early or take time off
  • 15% have had to take a leave of absence
  • 14% reduce their hours or take a demotion
  • 39% of caregivers leave their job to care for a family member or friend.
  • 34% quit because their job does not provide flexible hours.

Many employees are in their prime earning years. Not only do they lose their wages, but often health insurance and other job benefits. This reduces their retirement savings and Social Security benefits.

And let’s not forget about the multiple responsibility working caregivers may have. At the same time that they may be overseeing their parents, they might also have kids at home—some who haven’t left and others who—surprise!—have moved back in.

It’s not just the 50+ demographic that has caregiving responsibilities. Millennials (ages 22-39) make up nearly 25 percent of adult caregivers.

Workers of all ages are often scared to tell their employers that they are caregivers. They fear they will be viewed as uncommitted, unreliable or passed over for a promotion or project. But there’s good news!

Work Flexibility Can Help Businesses

Employers are finding that offering caregiver support services and policies is a good investment, translating into more loyal, focused and productive staffers.

Seasoned staff know their field and the company history and culture. Businesses also don’t want the headache, expense and lost time of advertising, interviewing, training replacements and getting new workers up to speed.

Companies also know ignoring the needs of working caregivers can be costly. Gallup research reported that lost productivity due to absenteeism among full-time working caregivers cost employers $25 billion a year and part-time workers, $28 billion.

Know Your Options as a Working Caregiver

Inevitably, you will have the ‘caregiver talk’ with your boss. Make it your business to know what some companies offer caregivers. Does yours or could you propose any of these?

  • Flextime: you work a schedule according to your needs. If you have to take Mom to adult day care, you might come in at 10 a.m. and stay later or work four longer days instead of five
  • Telecommuting: work from home some days
  • Supportive services: perhaps a free consultation with a geriatric care manager to assess your parent’s needs, create a care plan and monitor services. Or, educational information and referrals, including lunch seminars, caregiver support groups or access to local resources
  • Financial help: subsidies, vouchers or discounts that might include respite care or back-up care. Employee assistance programs (EAP) might offer individual or family counseling
  • Paid time off (PTO) programs: Rather than designated vacation or sick days, personal days you can use for caregiving

Smart Strategies for Working Caregivers

Experts, human resources (HR) departments and bosses share effective caregiver tactics:

Decide What You Need

What will make work and caregiving manageable? Is it flextime? A leave of absence or time away? Telecommuting part of the week? Cutting back or switching schedules? Do you need resources? Help with brainstorming or logistics?

High Tail It to HR

Before approaching your boss, find out what your company offers. Some businesses will allow an employee who has used up all his or her leave time to have fellow workers donate their time so the caregiving employee gets paid while away.

HR will know your legal rights (i.e. do you qualify for time off through the federal Family Medical Leave Act or a state counterpart?). How do they suggest you approach your supervisor?

Know What the Boss Wants

It’s pretty simple. Your boss wants to make sure you get your work done and not make extra work (or a lot of it) for him or his staff. “Your job is to make your employer feel they have total confidence in you and that you have a plan,” says Jane Matlaw, who recently retired as Director, Community Relations at Beth Israel Deaconess Medical Center in Boston. That plan may include collaboratively coming up with the best course of action or trying something and agreeing to tweak it if it’s not helpful.

When Matlaw’s widowed, then 91-year old father, ended up in a Hartford hospital, and then rehab, for three months, she met with her boss Kate Reed. “I was open and transparent,” says Matlaw.

The arrangement worked. “Jane was judicious in her time off, communicated well and always kept her job as a priority,” says Reed. Reed does have some caregiving deal-breakers, such as calling in sick when you aren’t and not being a straight shooter. “Be upfront and say, “This is what’s going on,” advises Reed. “’I am fully committed to my job but I need some flexibility to help my mom or dad.'”

Even though the crisis has abated—Matlaw’s father is now 94—she recalls the profound tug between her two worlds. “When I was at work, I was always aware of that knot in my stomach and felt the inability to be with him.”

“Worrying about my dad was a little like those first few weeks when I had to leave my sons in daycare,” says the social worker by training. “But it also felt different: kids might catch a bug but it is short-lived. With aging parents, there’s the not knowing how long you will be out and what it will entail. It’s often not a quick fix so it is hard to know what to tell your boss.”

Balancing caregiving and work is unquestionably challenging. There’s not enough time to devote to your job, your own family or yourself. Of course, you want to do both well. That’s why discussing your situation, and your options, with your company, is paramount. Let this be your guide—or at least a good starting point.