The care of sick children often presents a dilemma for working parents, and it is a problem faced by increasing numbers of families in recent decades as the number of two- income and single-parent families has risen. There are three main reasons why working parents find caring for their sick children difficult.

First, parents rarely have the advantage of advance warning of when they will need to arrange care for a sick child; this lack of warning is exacerbated by the lack of leave that is available at short notice for the care of sick children.

Second, it is not uncommon for children to become sick. It has been estimated that parents of children in formal child care can expect an infant to be ill nine to ten times a year, and other preschool-aged children to be ill six to seven times a year (Loda et al. 1972).

Third, when a child is sick, the usual formal child care arrangements generally cannot be used, since such settings as child care centres and schools are either unable or reluctant to care for an ill child. Those parents relying on relatives, friends or other informal carers for the usual care of their preschooler may find that the ill child wants the company of the parent; further, the parent may feel that he or she must provide that company and care. Thus parents often may feel that they have no option other than to take time off.

In the recently completed Dependent Care Study, a national sample of 2642 employees was interviewed. To be eligible for participation in the study, employees had to be either a single parent or part of a two-income couple, and be employed at least 15 hours a week. Of the respondents, 1500 had dependent children; the amount of time working parents took off work to care for their sick children was one of the issues examined in the study. The study's findings are reported in the recently published Institute Monograph, When Roles Overlap: Workers with Family Responsibilities (VandenHeuvel 1993). This article summarises that report's main findings regarding time off work for sick children, and extends the research in this area by examining the characterises of those parents who were most likely to take time off to care for sick children.

SENDING SICK CHILDREN TO SCHOOL OR CHILD CARE

When parents were asked if they had needed to send a sick child to school or a child care centre in the previous 12 months, one in seven (15 per cent) said that they had. Mothers (18 per cent) were more likely to do this than fathers (7 per cent), and workers who were single parents (24 per cent) were more likely than those who were part of a two-income family (14 per cent) to do so. The age of the child also made a difference, with parents of preschoolers (18 per cent) being more likely than parents of school-aged children (14 per cent) to send a sick child to child care or school.

These figures suggest that on occasion, employed parents lack any alternative to deal with the sickness of their child and thus must send the child off to schoold or child care centre. It is unlikely that such a 'solution' is satisfactory to parent, child, or regular carer.

TAKING TIME OFF WORK

Forty-six per cent of parents reported that they had taken days or part days off work to care for sick children in the 12 months prior to the interview. Consistent with earlier Institute research (Glezer 1991; Ochiltree and Greenblat 1991), there was a significant difference between time taken off by mothers (52 per cent) and fathers (31 per cent) over the year to care for a sick child. It should be noted that while these figures show mothers are more likely than fathers to take time off, they also show that some fathers, three in ten, had taken time off work to care for sick children.

The average amount of time taken was 3.5 days. There was a significant difference by sex of the parent, with mothers taking an average of 3.8 days and fathers an average of 2.5 days. Thus, in general, the number of days taken off work to care for sick children was fairly small. Table 1 summarises the number of days all parents took off to care for sick children.

ARRANGING TIME OFF

The types of arrangements used by employees were grouped into three categories: paid leave, unpaid leave and flexible work arrangements (for example, making up hours later, using rostered days off). This is shown in Table 2. Since employees with permanent status are more likely than others to have access to various forms of leave, this factor is taken into account.

The majority of parents with permanent jobs used some form of paid leave. Of the various forms of paid leave available, most parents (37 per cent) used their own sick leave to care for their sick children. Ten per cent used special leave - a leave available to a minority of (mostly public sector) workers, that can be used to deal with family emergencies or illnesses.

The use of flexible work arrangements was also quite popular: more than one in three permanent employees used such arrangements, the most common being to make up the hours at a later time. Only 18 per cent of permanent employees used unpaid leave to care for sick children.

In contrast, the majority of contract and casual workers (57 per cent) relied on unpaid leave to take time off for sick children. Paid leave was rarely used, largely reflecting the lack of access of contract and casual workers to such leave. These employees were just as likely as permanent employees to have used a range of flexible work arrangements, of which, again, the making up of hours at a later time was most popular.

The differences in arrangements used by permanent and other workers point to the fact that regardless of eligibility for paid leave, many parents must take time off work to care for sick children. How they arrange that time off, be it through the use of paid leave, unpaid leave, or other means, depends on such factors as access to paid leave and the flexibility of their workplace towards accommodating employees' family responsibilities.

PARENTS MOST LIKELY TO MISS WORK

What characterises a parent who is most likely to take time off work to care for sick children? An obvious response is that they would be parents with younger children, since young children get sick more frequently than older children. However, there are other factors involved including, for example, the nature of the employees' job, the employees' income in relation to the spouse's income, and views on gender roles. (The availabliity of other carers, such as grandparents, is likely to be a factor as well, but his cannot be tested with the availalbe data.)

Since there are many possible factors related to missing work to care for sick children, multivariate data analysis techniques were used to test which factors are related, while taking into account other factors. The dependent variable in the model is whether or not the employee missed work in the past year to care for sick children. Since this variable has only two categories, the data analysis technique called logistic regression was used. The independent variables that were used in the model are described in Table 3. Note that because some of the variables relate to the employees' partner, single parents were excluded from the analyses.

Factors that were significantly related to the likelihood of parents missing work for the care of sick children are shown in Table 4.

For mothers, the age of the youngest child was most strongly associated with taking time off: compared with mothers of children aged 14 to 17 years, mothers of younger children were four times more likely to have missed work over the 12-month period to care for sick children.

How mothers viewed the assistance and sympathy of their employer towards work and family issues was also related to taking time off. Those mothers who felt their employer was more responsive to workers' family responsibilities were less likely to miss work to care for sick children - an aspect that will be discussed later.

Although the occupational status of the mother was not significant, the wife's occupation in relation to that of her husband's occupation was significant. Contrary to expectations that a mother with a lower occupational status than her husband would be more likely than other mothers to take time off, the opposite was found - mothers with a higher relative occupational status were more likely than other mothers to miss work. It is possible that a mother with higher status has more freedom and flexibility in her job than her husband in his job, and is therefore more likely than other mothers to have missed work to care for sick chidren. But further study on the effects of relative occupational status is required.

For fathers, the age of the youngest child was also significant. Compared with fathers of dependent children above the age of 13 years, fathers of younger children were twice as likely to have missed work to care for sick children.

A second significant factor for the fathers was relative occupation of the wife to the husband: fathers who held jobs with higher occupational status than that of their wife were less likely than other fathers to have missed work. Relative income was significant as well: fathers who had relatively higher incomes than their wife were less likely than other fathers to have missed work.

The final factor that was significant for fathers was shift work, with those working evening and weekend shifts being less likely than other fathers to have missed work to care for sick children.

DISCUSSION

For both mothers and fathers, the likelihood of taking time off to care for sick children is not closely related to the nature of their jobs - employment sector, occupation, and permanency of the job were not factors. This emphasises the point that, regardless of the type of job parents hold, and the leave benefits they receive as part of their job, the need to take time off to care for sick children exists.

The one factor related to the nature of the job that was important is evening and night shift work (rather than regular days), since fathers who worked regular days were more likely than night shift workers to have missed work to care for sick children. This can be explained in two ways. First, shift workers are likely to be available during the day to care for sick children; thus, rather than needing to take time off work to provide the needed care, they are in a position to forgo their sleep or other daytime activities instead. As one shift worker stated, 'Night workers are called upon far more often for family matters, and they can't take leave to catch up on sleep'. Second, in the case of couples where one partner works shifts, often the other partner works regular hours. Thus, one parent is generally available to care for sick children, so reducing the need to miss work.

The finding that part-time employment hours was not related to taking time off for sick children may seem surprising at first, but two explanations can be offered. First, by design, only employees working a minimum of 15 hours a week were included in the sample, and so the potential for the overlap of working hours with having to care for a sick child is not insignificant for any of the workers. Second, children's illnesses do not necessarily occur conveniently at those times when the part-time employee is not scheduled to work; therefore, when a child is sick and the parent is scheduled to work, it is irrelevant whether the parent works part-time or full-time.

Although the number of children in a family was not a significant factor in whether or not parents took time off work, the age of the youngest child certainly was. Younger children get sick more frequently than older children and are less able to care for themselves when sick. Also parents are likely to feel more reluctant to leave sick young children rather than sick older children with other carers.

In addition to the age of the youngest child, other family-related variables were also important. For mothers, relative occupation was significant, but not in the expected direction. For fathers, both relative occupation and relative income were important, and in the expected direction. These findings provide some support for the notion that the parent with the higher status or the higher income is the one least likely to stay home to care for sick children (Kahn and Kamerman 1987). However, the fact that this held true only for fathers and not for mothers suggests that further investigation is required on how decisions are made between working parents as to which of them looks after the sick child.

Although gender role attitudes were not significant, how mothers rated their employer was significant. As we have seen, mothers who viewed their employer as being sympathetic to work and family issues were less likely than other mothers to miss work to care for sick children. Possibly, employers who are viewed as being 'family-friendly' (concerned about their employees' work and family responsibilities) may encourage their employees to miss less work for family reasons. Such employees may be more willing or able to seek alternative care arrangements for their sick child (for example, through employer-supported child care facilities), or they may have access to more work flexibility (for example, flexible working hours or being able to work from home) that allows them to care for their sick child without missing work. However, this explanation cannot be tested with the data being available, and the finding deserves further study.

WHAT PARENTS SAY

It is clear that the conflict between the need to care for their sick children and to fulfil their employment duties is a troublesome one for a large proportion of parents, and it is interesting to note what parents in the Dependent Care Study said would help them cope with such conflict.

Alterations to existing leave policies was a high priority for many parents. Their comments highlight both their frustration with not having leave they could use to care for their sick children, and the discomfort involved with using their own sick leave and sometimes having to lie to their employers about what it was used for.

'I have to use my own sick leave for the children when they're sick and then when it comes to taking it for myself, I don't have any left.'

'I want some special leave. If you have to do things for family matters, then you shouldn't have to pretend it is sick leave. We all do it and pretend we don't.'

'I need to have a certain number of days that can be used when the children are sick, so that I don't have to lie about using my sick leave.'

'There should be a policy that sick leave can be used when your children are sick, or else special leave should be provided.'

'I just want to be able to say when my child is sick that she's sick, and that I need time off to care for her.'

Other parents mentioned the need for more child care that could be used specifically when children were mildly ill or recovering from a more severe illness.

'If there was a creche at work, we wouldn't have to take as much time off when children are sick.'

'It would help if there was a full-time carer and a 'sick room' at work which could be used to care for children when they are sick.'

Some parents also saw the need for more flexibility in the organisation of their working hours, particularly in their starting and finishing times, or being able to work from home. Others wanted to be able to make up, at a later time, work hours that were lost due to the need to care for sick children.

'They could make it easier for us to make up the time we have to take off when our children are sick so we don't have to feel so guilty.'

'If I could make up the hours that I use to care for sick children, I wouldn't have to use sick leave or leave without pay.'

'I want to be able to work from home when I need to care for a sick child. It would make it so much easier.'

'I need more flexibility in my working hours so that I can leave in a hurry when I need to go care for sick children.'

CONCLUSIONS

In 1990, the Australian Government pledged to create an environment that allows for people with family responsibilities to have full access to employment opportunities; this pledge came about with the ratification of International Labour Organisation Convention 156, 'Workers with Family Responsibilities'. To create such an environment, change is needed regarding how employed parents can more easily cope when their children get sick. As reflected by the parents' comments, there are three major avenues for change:

• the provision of leave that can be used specifically for issues such as the care of sick children;
• increased child care services for children who are sick;
• increased flexibility in the workplace and on the part of employers.

Regarding the first of these, there is currently no mandated leave in Australia which gives parents time off to deal with illnesses of children. Some employees do have access to special leave, allowing them to take three days off work to deal with family emergencies and illnesses, but the percentage of employees with access to such leave is small (VandenHeuvel 1993). To provide care for sick children, many parents must resort to taking unpaid leave, or their own sick leave. The need to take such leave may disadvantage these workers in comparison with other workers who do not have dependent children.

Numerous options for providing employees with leave that can be used to care for sick children are feasible; Mathews (1992) provides a useful summary of such options. Most simply, special leave that can only be used to deal with family responsibilities could be provided to all employees. The required number of days of such leave can be guided by data from the Dependent Care Study (VandenHeuvel 1993): of those employees who took time off work for family reasons, a median of five days were taken per year to deal with their family responsibilities. Thus the number of days of special leave that would need to be provided to serve the 'average' employee is not large.

Another option is to alter existing leave provisions in terms of days available and the use to which they can be put. The possible permutations regarding this option are extensive. For example, all forms of paid leave for which workers are eligible could be grouped together, enabling workers to use these days to meet their individual needs. Or the days of paid leave could be grouped but a core number be reserved for use only for the employee's own illness, leaving the remaining days to be used at the worker's discretion. Examples set by 'family-friendly' companies which already have in place progressive leave policies could serve as good role models for other companies; examples of such policies are described in Adie and Carmody (1991).

Second, care in the child's home by the child's parent is generally considered to be the most preferred option for sick children (Jordan 1986; van Eyk 1992), but such an arrangement is not always possible. Thus arises the need to increase the extent of services available to parents to help them deal with the care of ill children. At least three options for such services exist: care in the home by trained health workers, care within the context of the child's regular care program or the employees' workplace, and care at a central location, serving families at the community level (Jordan 1986). As suggested in various studies (Fredericks et al. 1986; van Eyk 1992), care for sick children is best when provided in a place where the child feels comfortable, and/or by a familiar person.

Movement towards providing these necessary services is being made by the Federal Government. Their 1993 'Child Care Policy Statement' stated that the Government will provide more than 15 million dollars over four years to support child care options for parents with mildly ill or recuperating children. These funds will be used for such things as subsidising employers to establish special care facilities, and expanding separate care facilities and existing care centres.

The third avenue for change involves alterations in workplace practices, giving parents more options when faced with the dilemma of having to care for a sick child during working hours. Examples of such changes are allowing workers to deal with the care of sick children by making up lost hours of employment at a later time, using time off in lieu, having flexible rostered days off, working from home, and bringing the child to work. Integral to such changes in workplace practices are changes in attitude on the part of many managers and employers. There needs to be greater recognition that confronting the issue directly would be more useful than dealing with it covertly - not formally recognising the issue will not make it disappear. As we have seen, employers who are perceived as being 'family-friendly' may find that their employees miss fewer days of work for family responsibilities.

In conclusion, the issue of the conflict between work and caring for sick children is not one that can easily be resolved. There are complexities, including the fact that not only do satisfactory solutions vary between individuals, workplaces, and communities, but also over time for parents as their family situations change. But regardless of complexity, there is growing recognition in Australia that solutions must be found. Innovative practices and changes to existing leave policies are urgently needed.

APPENDIX 1

APPENDIX 2

REFERENCES

• Adie, J.A. and Carmody, H.I. (1991), Families at Work: Practical Examples from 140 Businesses, Council for Equal Opportunity in Employment, Melbourne.
• Fredericks, B., Hardman, R. Morgan, G. and Rodgers, L. (1986), A Little Bit Under the Weather: A Look at Care for Mildly Ill Children, Work/ Family Directions , Boston, Mass.
• Glezer, H. (1991), 'Juggling work and family commitments', Family Matters , No.28: pp.6-10.
• Jordan, A.E. (1986), 'The unresolved child care dilemma: care for the acutely ill child', Reviews of Infectious Diseases, Vol.8: pp.626-630.
• Kahn, A.J. and Kamerman, S.B. (1987), Child Care: Facing the Hard Choices, Auburn House, Dover, Massachusetts.
• Loda, F.A., Glezen, W.P. and Clyde W.A. Jr. (1972), 'Respiratory disease in group day care', Paediatrics, Vol.49, pp.428-437.
• Mathews, I. (1992), Work and Family Issues: Guidelines for Enterprise Bargaining, Australian Council of Trade Unions, Melbourne.
• Ochiltree, G. and Greenblat, E. (1991), 'Mothers in the workforce: coping with young sick children', Family Matters, No. 28, pp. 18-23.
• VandenHeuvel, A. (1993), When Roles Overlap: Workers with Family Responsibilities, AIFS Monograph No.14, Australian Institute of Family Studies, Melbourne, and Work and Family Unit of the Department of Industrial Relations, Canberra.
• van Eyk, H. (1992), Caring for Sick Children: How Working Mothers Cope, Children's Services Office, Adelaide.

NOTE:

The Dependent Care Study was commissioned by the Work and Family Unit of the Department of Industrial Relations, and was jointly funded by the Work and Family Unit and the Australian Institute of Family Studies.