Cindy Mayer, 60, is photographed in her late parents’ living room on Aug. 17, 2018, with a photo at center behind her of her parents, Antonie and Henry Radom. She cared for her father for 13 years until he died in January. (Abel Uribe / Chicago Tribune)

Mayer, whose mother died 13 years ago, felt she had little help caring for her father, who suffered macular degeneration. In addition to taking him to myriad doctors, keeping track of his pills, making his meals, taking him to the bank, and other daily tasks, she served an important role as his companion.

“You have to do all this without looking rushed, you have to act like everything is in control,” she said. “Then you get in the car and scream your head off.”

Despite the stress, Mayer felt honored to care for her dad, and grateful she was able to keep working.

Having the financial resources to pay for help makes family caregivers’ lives easier.

Stacey Ross, 63, of Evanston, feels fortunate her 97-year-old father, an engineer, planned ahead before retiring at 95. He lives in his Wilmette home with round-the-clock live-in health aides who help with cooking and cleaning, care that costs $3,900 every two weeks, Ross said.

Ross, who travels for her job in product development, has left meetings and rescheduled business trips to be with her dad, and “there is always this underlying anxiety that everything is all right,” she said. But mostly she can just enjoy their time together when they go to church on Sundays and have dinner during the week.

Not everyone is so lucky.

Jeryn Laengrich, chief services officer at Cariloop, was caring for her 6-month-old son when her father was diagnosed with Parkinsons and, a few years later, her grandmother was diagnosed with dementia.

“My blood pressure went from normal to 150,” she said. Laengrich, who at the time worked as director of a hospital rehabilitation department, went part-time and started telecommuting, which affected her earnings and savings, she said.

The compromises can be costly for business as well. MetLife has estimated the cost of lost productivity from family caregiving at $17 billion to $34 billion.

Employers most commonly accommodate caregivers with flexible hours, part-time schedules, counseling and services that help them find specialists or assisted-living facilities, Laengerich said. Some offer educational resources around how to navigate a loved one’s cancer treatment or have difficult conversations about wills and whether mom should stop driving.

Surveys, however, show that employees value paid family leave over other benefits, and companies are increasingly offering it.

Deloitte in 2016 expanded paid family leave to 16 weeks and made it available for for elder and spousal care as well as the arrival of a new child. It can be taken in three-day increments to allow for the “ebbs and flows of caregiving,” said Jen Fisher, Deloitte’s U.S. well-being leader.

More than 5,000 employees have used the program and have reported a lift in morale, Fisher said. A key has been creating a culture that makes people feel they actually can take advantage of the benefit, she said.

Professional services firm PwC last month implemented four weeks of paid time off that employees can use to care for a spouse, parent or child with a serious health condition. Energy company Exelon last year instituted two weeks of paid time off to care for a critically ill family member. Silicon Valley’s tech juggernauts have similar programs.

At Facebook, employees can take up to six weeks of fully paid leave to care for any family member with a serious illness, which is separate from the four months of paid leave available to new parents.

The company last year also doubled its bereavement leave, to 20 days for the death of a spouse, partner or child, and to 10 days for parents and extended family, a decision driven in part by the experience of COO Sheryl Sandberg, who lost her husband suddenly in 2015. Employees can take the bereavement leave intermittently over the course of a year — an acknowledgement that the need lingers far beyond the funeral.

Renee Albert, Facebook’s senior benefits director, used four weeks of the paid caregiving leave when her husband underwent surgery for cancer. She knows from personal experience what the benefit can do for employee loyalty.

“The reason I am at Facebook is because they took care of me, so I will take care of them,” she said.

Current progress in employer paid leave, while positive, perpetuates disparities because the workers least able to afford unpaid time off are also least likely to have access to paid leave, said Katherine Eyster, deputy director of workplace programs at the National Partnership for Women and Families.

The majority of Americans are able to take only unpaid leave to care for an immediate family member through the federal Family and Medical Leave Act. FMLA, which guarantees 12 weeks of unpaid leave to employees with at least 12 months tenure at companies with at least 50 workers, covers about 60 percent of the workforce.

Just 13 percent of private-sector employees have access to paid family leave, according to a 2017 Bureau of Labor Statistics survey, up from 10 percent in 2010. People who work in construction and leisure and hospitality are least likely to have the benefit.

Some employers of lower-wage workers are making efforts.

Starbucks, which offers six weeks of paid parental leave to employees, last month instituted earned sick time that can be used to care for ill family members. A part-time hourly employee working 23 hours a week would accrue five days of sick time over the course of a year, Starbucks said.

Eyster commends Starbucks’ step, but said serious health conditions often require longer-term leave. One in 7 working caregivers reduce their hours or take a demotion to care for their loved ones and 6 percent stop working altogether, according to AARP.

While Eyster thinks employers can do more on the issue, she urges a policy solution to make paid leave more affordable for employers. Her organization endorses the Family Act, introduced last year by New York Democratic Sen. Kirsten Gillibrand, which would create a shared fund through a small payroll tax so workers could receive 12 weeks of partial income while taking time off to address a serious illness. Five states — California, New Jersey, Rhode Island, New York and Massachusetts — plus Washington, D.C., have adopted similar social insurance models. Legislation in Illinois has not made it out of committee.

But hopes are not high that lawmakers in Washington will pass paid leave legislation. So for now, some say, the responsibility rests with employers.

“Companies that can be role models for what communities and other organizations can do, I think, are really doing a service not only for their own workforces, but the people at large,” said Maureen Corcoran, vice president of health, life and inclusion at Prudential Financial.

Prudential, which is considering extending paid family leave to nonparent caregivers, has a suite of benefits geared toward caregiver needs. Among them are a reason-blind system for requesting flexible work arrangements, steep discounts on in-home care providers and a service that provides second opinions for medical diagnoses and treatment plans.

“It is costly,” Corcoran said of the perks. “It is not more costly than losing employees early to disability, to early retirement, to presenteeism (when employees show up for work but don’t get much done).”

For every dollar invested in flex time, employers can expect a return of at least $1.70 and for telecommuting the return is at least $2.46, according a 2016 report from AARP and ReACT, a coalition of employers seeking to reduce the impact of employing informal caregivers.

Alvaro Obregon works on a tablet Aug. 9, 2018, while waiting with his mother, Felicitas Obregon, 86, left, and aunt, Elena Gaytan, 77, for appointments at a medical clinic on the Southwest Side of Chicago. Alvaro Obregon says his job gives him the flexibility to be a caregiver. (John J. Kim / Chicago Tribune)

To some working caregivers, the most valuable benefit is having an understanding employer.

Alvaro Obregon — who is the primary caregiver of his mother, who has rheumatoid arthritis, and aunt, who is undergoing chemotherapy to battle leukemia — doubts he could handle the stress if he worked anywhere but AARP Illinois.

“If something comes up and you have to get up and go, no one looks at you and says, ‘What are you doing?’” said Obregon, 51, associate state director of advocacy and outreach.

Obregon, who lives with his extended family in a Pilsen three-flat, has found a rhythm in his juggle. He spends a lot of time on his laptop in doctors’ waiting rooms, answering work emails and doing other administrative tasks.

His boss, Ruby Haughton-Pitts, urged him to take time off when he seemed overwhelmed, because she, too, understands. Haughton-Pitts, 62, of Bronzeville, used AARP’s two weeks of paid caregiving to help her sister through cancer surgery and chemotherapy.

“The pressures of life should not have to take you under if you have help,” she said.

Blythe Szafoni, 48, a first-grade teacher at a school in north suburban Kenilworth, is grateful her employer allowed her to take off every Friday for two months when she had a caregiving crisis with her parents, who are in their 80s.

Shortly after her parents moved from their longtime home in Lansing, Ill., to live closer to Szafoni in Rogers Park, her father fell and cracked his vertebrae, requiring months of visits to the Rehabilitation Institute of Chicago downtown. Her mother, meanwhile, had been diagnosed with dementia.

In addition to the support from her school, Szafoni said she manages thanks to a patient husband, friends who help with her kids, ages 10 and 6, and a sister who shares the caregiving duties.

The hardest part, Sfazoni said, is “struggling because you don’t feel like you’re putting 100 percent into everything.” She’s tired, has gained weight from lack of exercise and feels guilty taking time out to get a haircut.

But her employer “has been fabulous,” and she plans to repay the kindness.

“That’s why I say I’m retiring at this school,” she said.