Caregiving and the Sandwich Generation

Sandwich Generation

The term sandwich generation refers to young to middle-aged adults who are simultaneously raising children and supporting their aging parents. More than one in 10 parents in the United States also care for an adult, spending about three hours each day on caregiving duties between their children and parents. Being a sandwich generation caregiver can be exhausting, expensive, and emotional; juggling it all isn’t easy, but there are ways to make it easier. 

Fast Facts

Sandwich Generation Types

• The Sandwich Generation – the estimated one million caregivers (28% of all caregivers) provide unpaid care to an adult while also caring for children in the home.
• The Club Sandwich Generation – Older adults in their 50 or 60s who are wedged between aging parents, their adult children, and possibly grandchildren. This term can also refer to younger adults in their 30s or 40s who have younger children, elderly parents, and aging grandparents.
• The Open-Faced Sandwich Generation – Anyone who’s non-professionally involved in elder care, which is an estimated 25% of individuals at some point in their lives.

The typical sandwich generation caregiver was born between 1965 and 1980 and is more ethnically diverse, and younger. Roughly a third of sandwich generation caregivers report a high level of emotional stress and a fifth report high levels of financial and physical strain.

Dr. Suzanne Koven, a primary care internist at Massachusetts General Hospital, a Boston Globe correspondent, and family caregiver, writes that many of her middle-aged patients who are taking care of their parents all have one thing in common: a feeling of guilt that stems from the fact that they don’t think they’re doing enough.

And it’s not just coming from within. “Age, pain, and dementia sometimes make people irritable and demanding, which may cause those trying to help them feel unappreciated. This in turn, can cause guilt,” Koven writes.

Of course, one of the biggest things people feel guilty about is seeking outside help from places like continuing care retirement communities. These are communities that offer independent living, assisted living, and skilled nursing to ensure residents receive the proper care according to their health needs.

Although you may think all these feelings are valid, it’s important to take a step back, set your emotions aside, and look at it from a practical standpoint.

Little to No Personal Time

Parenting and caring for an aging parent both take a lot of time and energy on their own – when you’re in the middle and trying to do both, it can feel impossible to make time for anything other than caring for others. Sandwich generation adults are more likely than other adults to say they are pressed for time, but it is possible – and crucial – to reserve time for yourself. 

• Prioritize getting (and staying) organized– the seemingly constant demands can feel overwhelming, so plan regular family meetings to talk about upcoming commitments, delegate tasks, and get everyone on the same page. 
• Don’t be afraid or intimidated to ask for help – you’ll likely be surprised by how many people are happy to support you and aren’t sure what you need. Call on friends and neighbors when you need a break. 
• If you have siblings, ask them for help with costs, hands-on care, and spending time with your aging parent so that your role as a caregiver doesn’t take over your entire life. 

Family Discord

Providing care for an aging parent is often stressful – while it can be a time for siblings and other relatives to come together and provide mutual support, the transition often brings out intense emotions. You’ll probably find yourself having disagreements with other family members about parental care decisions, financial responsibilities, and even bringing up old childhood disputes. 

• Be honest and direct about your feelings– approach caregiving conversations with as much patience and grace as possible and let your other family members know that their help is both wanted and needed. 
• Be realistic about what help others can provide and be clear on your expectations from them (and ensure you understand their expectations). 
• Try to see things from each other’s points of view, respect differing opinions, and compromise where you can. If the situation is particularly tense, arrange for a conversation with a mediator (like a therapist, social worker, or other trusted third party) who can make sure that everyone is heard and respected. 

Dealing with Complex Emotions

While you may be your parent’s caregiver now, you’re still their child. Experiencing the role reversal so directly can bring about a lot of big feelings. You might be experiencing anticipatory grief – anxiety, dread, or sadness as you await their passing. You may also feel a sense of loss of your independence as you’re increasingly needed as a caregiver, which can bring up feelings of guilt. Anger and resentment are common, too. All of these feelings are normal when facing such challenging circumstances.  

• Sharing what you’re going through is often one of the best ways of healing. You can do this in whatever way feels right to you – with a support group, a therapist, a trusted friend, or in a journal that no one will ever read – but putting your thoughts and feelings into words is a great way to start processing them. 
• Make sure you’re attending to your own needs; while your child and parent may need you, you’re in a highly emotional situation and deserve to let yourself grieve. 

Feeling Like A Failure

It can be impossible to live up to your own standards when you have so much on your plate. As a sandwich generation caregiver, you might feel like you can’t be the parent you want to be to your children or the caretaker you want to be to your parent – there’s only so much you can do in a day, and perfection just isn’t achievable. 

• Try not to be too hard on yourself – you are in a very uniquely challenging situation and doing the best you can looks different each day. 
• Pay attention to avoid black-and-white thinking; just because you didn’t do something exactly the way you intended doesn’t mean it wasn’t worth doing or that you failed. 
• Acknowledge all that you have done and know that if you’ve fallen short on some things here and there, following through on the big things is what matters. 

Navigating Cultural Expectations

Different cultures and families have varying norms and expectations when it comes to older adult care. BIPOC individuals are more likely to consider caregiving to be a cultural expectation, and for many, there’s no real decision to be made about whether to take on caregiving responsibilities – it’s simply a given. If you’re a caregiver in this situation, you may feel more alone than others, especially if your workplace, friends, or other support systems don’t understand your obligations. It’s also common to feel some resentment or bitterness about feeling pushed into this role. 

Lean on your family or other members of your cultural community during times like this – it’s likely they’ve been in a similar situation and experienced that same feelings that you’re dealing with now. Make time to connect with your parent as their child – go for a walk, run non-care-related errands, or do something else that doesn’t have your caregiver identity front and center. 

Taking Care of Yourself

Caring for an aging parent and parenting your own child simultaneously is heavy – a lot of emotion, energy, and coordination go into each independently, and it can be especially difficult to try to manage both simultaneously.

If you’re doing your best to manage as a sandwich generation caregiver and you consistently feel like you can’t stay afloat,

• Talk to your doctor; have a complete medical exam.
• Complete a mental health screen to determine if you’re dealing with symptoms of a mental health condition. 
• See counseling with someone who has experience working with caregivers.
• Join a support group.

Sources

1. Mental Health America. https://mhanational.org/caregiving-and-sandwich-generation
2. Livingston, G. (2018, November 29). More than one-in-ten U.S. parents are also caring for an adult. Pew Research Center.
3. org https://www.seniorliving.org/caregiving/sandwich-generation/
4. The Guilt of Caring for Elderly Parents, Dr. Suzanne Koven, Internist
5. Benedictine https://www.benedictineliving.org/about/
6. https://www.pewresearch.org/fact-tank/2018/11/29/more-than-one-in-ten-u-s-parents-are-also-caring-for-an-adult/
7. National Alliance for Caregiving & Caring Across Generations. (2019). Burning the Candle at Both Ends: Sandwich Generation Caregiving in the U.S.https://www.caregiving.org/wp-content/uploads/2020/05/NAC-CAG_ SandwichCaregiving_Report_Digital-Nov-26-2019.pdf
8. National Alliance for Caregiving & Caring Across Generations. (2019).Burning the Candle at Both Ends: Sandwich Generation Caregiving in the U.S. https://www.caregiving.org/wp-content/uploads/2020/05/NAC-CAG_ SandwichCaregiving_Report_Digital-Nov-26-2019.pdf
9. Parker, K. & Patten, E. (2013, January 30). The sandwich generation: Rising financial burdens for middle-aged Americans. Pew Research Center. https://www.pewresearch.org/social-trends/2013/01/30/the-sandwich-generation/

Edited by Zanda Hilger, M. Ed., LPC

We hope this information is helpful to you in the important work you do as a family caregiver.
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