Part 2: How to Keep a Five-Generation Workforce Happy

People beyond their career midpoint want to feel supported through big transitions—even those once considered off-limits at the office.

Note: This is Part 2 in a two-part series. Read Part 1 here.

With five generations at work for the first time in U.S. history, HR execs are charting a growing constellation of roles, identities, and life stages in their benefits plans and experiences.

The good news? The call for flexibility and help taking care of loved ones is “just as applicable” for people past their career midpoint as it is for those who’ve recently joined the workforce, says Gregg Nevola, vice president and chief of total wellbeing at Northwell Health, which has over 85,000 team members across 21 hospitals and more than 850 outpatient facilities throughout New York.

As we spend more of life’s seasons at work, that means supporting employees through big transitions—in their relationships, careers, and beings—even those once considered taboo office topics. Things like how to navigate strife and feelings of selfishness in caregiving choices, bodily changes from menopause, and continued connection to a valued work community in retirement.  

“How do you normalize those types of conversations, and make it be acceptable, and take that responsibility, that stress, off of team members?” Nevola asks.

For HR leaders, it’s by scaling systems that provide personalized support at those inflection points and help people say the quiet parts out loud.

“If you just happen to share some time with folks in those circumstances, and when they get that relief valve, it’s really a 180 for them in terms of their engagement and their ability to focus on what they need to focus on,” Nevola says.

Get personal

For Nevola, one of the most interesting developments in benefits over the past three years has been the “concentrated effort to find areas that we could do better in terms of the health of different segments of our population.”  

Because women make up 70% of Northwell Health’s workforce, Nevola’s team partners with the system’s women’s health network, the Katz Institute, to shape resonant benefits.

It’s a tight working relationship.

Recently, Nevola “physically handed” a benefits plan document to the head of the institute and asked, “If you were in my job, what would you change?”

His team ended up implementing all 20 of her recommendations, which ranged from nutritional coverage for pregnancy to diet programs centering on holistic wellness rather than drug regimens.

This deep, ongoing collaboration is core to Nevola’s approach. “Get as many voices as possible to help frame the strategy,” he advises.

It’s a familiar refrain: A sophisticated listening ecosystem shapes a stellar employee experience.

Northwell Health builds and refines their benefit program based on the demographics and perceptions of their people, which they collect through dedicated engagement and benefits surveys. “Spend a lot of time talking to them, understanding how they think, and what they’re looking for in their programs,” Nevola says. “Try to tailor that.”

Often, these efforts will surface opportunities to implement what Nevola calls “a forgotten type of benefit”—that is, a form of support for a life milestone, event, or circumstance that employees have traditionally had to shoulder in silence. His team is currently validating plans to offer bereavement days for miscarriages, which they hope to roll out next month.

To develop benefits that stick, ensure the right people are plugged in, Nevola says. Beyond the Katz Institute, he’s tapped clinical specialists to ensure prospective benefits like miscarriage bereavement reflect the patient’s perspective. Additionally, his team partners with finance “from the beginning, so there are no budget surprises at the end of the day.”

Once new benefits launch, keep listening to make sure they’re actually landing. “Sometimes they don’t work,” Nevola says. “If it’s not a fit, it’s not a fit. Put it to the side and find something similar or new that your resources are better spent at.”

Support relational transitions

Nevola is the executive sponsor for Northwell Health’s caregiver business employee resource group (BERG). To account for the range of needs in this arena, the group has carved out two problem-solving tracks: one focused on children and the other on aging loved ones. The sandwich generation benefits from both.

In some ways, the childcare question can be “a little bit easier” because “it’s a pathway that’s well traveled,” Nevola says. When it comes to the other end of the spectrum, “parents are living longer, and we have all the relationships outside of our traditional parent relationships—aunts, uncles—that we have just as strong a bond with,” he explains.  

A dedicated, representative group can help “normalize caregiving for a parent, grandparent, a family member” just as we “worked hard as a society to normalize that relationship with our children,” he says. 

Northwell Health’s caregiver BERG is creating and emanating a culture where employees “feel more comfortable” sharing and solving their challenges together. Through their EAP program, they’ve facilitated hour-long sessions where people can voice their experiences and offer affirmation, support, and best practices.

It’s created “an environment of trust and, in some cases, healing,” Nevola says. “It was very, very raw when they had some of these conversations, and they were relieved to find out that people were going through the same thing, that it’s okay to feel like you’re not being successful. It’s okay to feel like there’s more you can do. It’s okay to take time for yourself.”

In addition to connection, Northwell Health has invested in resources to help employees navigate caregiving stressors like determining whether to put a parent’s house into an estate and how to deal with inter-caregiver conflicts. “Those are really high-tech types of issues that there was no answer for before, and people just struggled with them,” Nevola explains.

To provide some clarity, his team partnered with a vendor to create a resource hub, where employees can now access discounts on estate attorneys, webinars on navigating social security and Medicare options, and telehealth services that allow team members to accompany loved ones to appointments regardless of their geographical proximity.

The organization also increased communication around existing benefits, like at-home PT and lab work. It’s a strategy Nevola returns to again and again: “Find pockets of people” who are likeliest to benefit from a given offering, and keep them in the loop through email, text message, and other creative means.

Listening data can inform the specific channels and timing. Consider, for example, whether it might be helpful to point team members to retirement planning resources before they turn 65, or to push educational material to employees about a benefit they’ve looked up on the intranet.

Support bodily transitions

Menopause benefits, which have already begun gaining ground in places like the U.K., are now starting to take root in the U.S. This evolution is thanks in part to the June 2023 passage of the Pregnant Workers Fairness Act, which requires covered employers to “provide ‘reasonable accommodations’ to a worker’s known limitations related to pregnancy, childbirth, or related medical conditions,” according to the U.S. Equal Employment Opportunity Commission’s (EEOC) website. 

Despite what the legislation’s title might suggest, the EEOC’s interpretive guidance considers “the entire arc” of reproductive health, from fertility and pregnancy to perimenopause and menopause, says Nonnie Shivers. She’s a shareholder at labor and employment law firm Ogletree Deakins, where she partners with HR executives as part of the healthcare, employment law, and diversity and inclusion groups, among others.

“There’s still a lot of mystery surrounding that menopause, perimenopause stage,” Shivers says. So benefits should provide proactive support, while education should focus on “demystifying” and reducing stigma surrounding experiences “that affect over half our workforce”—and that some employees may still see as fair game for poking fun and exacerbating stereotypes, she explains. Offerings should be codified in policies on diversity, equity, and inclusion; equal employment opportunity; or non-discrimination, she adds.

Last year, Northwell Health partnered with virtual care startup Upliv to roll out a menopause program for the 80,000 participants in its core health plan, following a successful pilot with nurses (who make up the largest part of the system’s female workforce). It’s an effort to sharpen focus “on women’s health in an area that too often has been ignored,” Nevola says.  

The program, which the Katz Institute helped develop, offers participants appointments with clinicians who specialize in menopausal care, as well as sessions with coaches who provide tactical support in navigating change. “It’s not something you just have to endure,” Nevola says. “That has made all the difference in the world.”

Shivers concurs that insurance coverage should be “expansive enough to include thoughtful care” and “perhaps even functional medicine.” Other benefits might include hormone level and blood testing, along with education on what changes to expect and guidance on how to address them, she says. Also be ready to offer workplace modifications, such as temperature adjustments and later start times.

Although it’s too early to share specific outcomes from Northwell Health’s program, Nevola says they’re seeing “very, very high satisfaction scores,” as well as reduced PTO days and medical bill expenses stemming from symptoms.

Support career transitions

For established professionals craving flexibility, create space for experimentation. Many people approaching retirement want to “wind down a little bit from their career … and think about where they want to be in the next stage,” Nevola says. That could mean moving to a four-day work week or to a role “where they could share their value in a different spot than they traditionally have.” If the transition includes a downshift in work hours, consider updating benefit programs to keep these veterans covered, he advises.

For team members in clinical roles and other demanding positions, “make, reference, and reinforce” well-tread and emerging paths, Nevola suggests. Nurses, for example, often progress from roles at the bedside to ones in revenue cycle and quality management. Consider how to create similar trajectories for physicians and other clinicians.

Paving such “a pathway of choice” is well worth the upfront legwork. “It increases the longevity of people staying with your organizations,” Nevola says. “It retains a lot of that very valuable institutional knowledge, that very valuable clinical knowledge, within the organization and really sets you up for success.”

And don’t sleep on the team members who’ve already retired or otherwise moved on from the organization. Northwell Health is sharpening a “two-way value proposition” for its alumni program.

To make the relationship mutually beneficial, they offer alumni the opportunity to volunteer or informally mentor current staff, as well as retain affiliation through a flexible staffing agency. They’re also exploring how to reward alumni who remain engaged with continued access to Northwell Health’s wellness platform and discount programs, which “are very popular with our active employees,” Nevola says.

Figuring out how to support team members throughout the seasons of career and life is “part of what’s really fascinating about our roles,” Nevola says. “We have to challenge ourselves to be sure that we’re providing the same cutting-edge technologies and programs to our team members that we are providing to our communities.”