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Healthy Living

Living in the Sandwich Generation

By Sheryl Kraft

Created: 06/14/2011
Last Updated: 08/02/2012

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If you're both raising a child and caring for an aging parent, you might feel as if you're stuck between a rock and a hard place—otherwise known as the sandwich generation. One out of eight Americans between the ages of 40 to 60 is playing a juggling act between the younger and older generations. And that number is expected to rise as baby boomers edge toward retirement age and life expectancy of the elderly climbs.

This is not a new phenomenon, but perhaps it is one that is creating extra stress because it is coinciding with kids either getting ready to enter or come out of college, unstable employment and adult children (and their parents) facing tougher economic times. Add to that the fact that families are smaller than they once were, so there might be fewer siblings with which to share the burden. And with more women in the workforce than in previous generations, having the extra responsibility of yet another person or persons to care for squeezes their time even more.

Caregiver burnout is rampant. It's stressful enough caring for another person, but when you're in the sandwich generation, squeezed between simultaneous demands of your own children and your parent or parents, it's even tougher. Even if you don't live with your parent, you may be needed for personal care, household or financial assistance and/or errands for your parent.

It's happening to me—and all around me. Where conversations used to be all about exciting things like college admissions and empty nests, now they frequently are dominated by another topic: aging parents. Recently at a dinner party with a bunch of other boomers, our conversations quickly turned to our parents.

One woman, herself an only child, waxed poetic about how excited she was to be at the party, totally burned out from being the sole caretaker for her 85-year-old mother (who has been living with her for 10 years), on top of caring for her own children, 10- and 12-year-old boys. Another complained that her parents were becoming more and more infirm and demanding. She was in the process of researching assisted living facilities, all new territory for her. She was justifiably concerned over their cleanliness and reliability of care.

Is everyone in this situation walking around stressed, anxious, depressed and frightened? Many are.

That's why I reached out to Dr. Kathy Johnson, CMC, Certified Geriatric Care Manager, Founder and Chief Executive Officer of Home Care Assistance, North America's leading provider of in-home senior care. Dr. Johnson has also coauthored a book, The Best Kept Secrets to a Long and Happy Life, based on the groundbreaking Okinawa Centenarian Study. The book offers information on what it takes to delay or escape Alzheimer's and other chronic diseases, as well as how to slow the aging process. (Want to win a copy? I'll choose a name at random. All you have to do is leave a comment at the end of this post. Please remember to include your email address for contact purposes. The contest will end on June 17, 2011, at 11 p.m. EST. The winner must be a resident of the United States and respond within 48 hours of receiving a notification e-mail; otherwise another winner will be selected. Good luck!)

Q. Many children feel emotionally or financially obligated to care for their parents inside their own home, rather than send them to an outside facility. How can an adult child best accommodate their home and schedule to the needs of aging parents?

A. Before an aging parent appears on your doorstep, have a frank, realistic discussion with your spouse and family. Regardless of how much free time you have, you cannot do this alone. It is highly likely that your parent will eventually need help with basic daily tasks including meals, shopping, cleaning, laundry and medical appointments—probably more than any one person can handle.

Caring for a dependent parent is an emotionally-charged issue. It is psychologically hard for most adult children to see their formerly vibrant parents suffer from chronic disease or watch as parents decline. So right from the start, you should be sure to involve others in your parents' care. Don't be afraid to seek out help from friends, family and the community.

Set ground rules before your parent moves in. Discuss everything—from who will pay for the extra costs of food and do all the related chores to help you will need to guard your privacy. Then share these rules with all involved parties.

There are a few simple things you can do that will keep your parents safe once they are in your home. For example, installing bathroom grab bars is a necessity. A grab-bar can prevent accidents that might occur in a wet environment. These bars will also reduce the strain on your parents' hips and knees. Also, consider purchasing a PERS (personal emergency response system) device, so your parents are safe even when you are out of the house.

Q. Women of the sandwich generation are more likely to be married, according to a government report. This is likely to create tension within their marriage and even within their relationship with their own children. What can families do to deal with this possibility?

A. Communication is key. Call a family meeting and discuss needs and expectations. Make sure everyone in the family has a chance to share their feelings. Tasks should be assigned to every member in the household.

Be realistic about what you can do. Don't expect too much of yourself, either emotionally, physically or financially.

Ask for help. Contact family members, friends or community resources like your local Office on Aging or senior center. Some hospitals or churches might also offer classes in caregiving for elderly parents with certain physical conditions or limitations.

Make time for yourself. Even if it's just a 10-minute walk around the block or a quick soak in the tub before bed, don't lose touch with yourself.

Laughter is the best medicine. Keep a sense of humor about the situation, and always try to look on the bright side of things.

Q. Can you say something about advance planning? For example, long-term care insurance: is this something that will help with a lot of the emotional and financial strain of caring for elderly parents? What is the best way to look into this type of insurance?

A. The cost of long-term care is the top challenge facing seniors and their families. Average costs for a nursing-home stay, an assisted-living facility or home care services can easily reach $100,000 a year or more. Sadly, government benefits do not cover many of the costs associated with aging. So, yes, long-term care insurance is a wonderful thing to have for your parents and for yourself. Most long-term care insurance pays for home care, assisted living and nursing care. For many people it is a lifesaver.

It is best to have a frank discussion with your parents about their financial situation. Find out what insurance policies are in force and if they have long-term care insurance. There is also a veterans benefit that helps with the cost of care for war vets. Ask your parents if they have any savings that they can use to cover the costs of care. You can find out more by visiting the National Clearinghouse for Long-Term Care at www.longtermcare.gov/LTC.

Q. Because of the demands of caring for others, many women are liable to forgo their own health, both mentally and physically. What are some warning signs of caregiver burnout?

A. Caregiver stress is real and often leads to serious health problems. The number one step caregivers can take to protect their own health is to closely monitor their stress levels. This is important because your level of personal stress can have an impact on your health; high stress levels have been shown to lower resistance to disease, lead to fatigue and depression. According to Psychology Today, warning signs of burnout include:

  • Feeling overwhelmed
  • Sleeping too much or too little
  • Gaining or losing a lot of weight
  • Feeling tired much of the time
  • Losing interest in activities you used to enjoy
  • Becoming easily irritated or angered
  • Feeling constantly worried or sad
  • Having frequent headaches, bodily pain or other physical problems
  • Abusing alcohol or drugs (including prescription drugs)

Q. What strategies can you recommend for family caregivers to keep their stress levels in check and avoid burnout?

A. Here are some tips:

  • Attend a support group.
  • Vary the focus of caregiving responsibilities if possible (rotate responsibilities with family members).
  • Exercise daily and maintain a healthy diet.
  • Establish quiet time for meditation.
  • Hire a caregiver from a reputable home care agency to provide respite care.

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My parents are aging, and aging fairly well, fortunately. Even with several siblings, it can occasionally still be a real challenge. I can't tell you how much I appreciated your mentioning "Exercise daily and maintain a healthy diet." I'm not perfect, but I am trying....We only complicate matters when we don't help ourselves, too.

Thanks for chiming in. It's always nice to 'see' a new face. When parents age fairly well, it is truly a blessing - both for them and for the people that care for them. And I agree that there are still inevitable challenges that surround that, even though their health is good.

As a veteran caregiver for my elderly parents, now deceased, I can attest to the validity of so many points in this interview. What I would add is that caring for my mother, at the end of her life, was a life-changing experience, one I would not have missed for the world, and that the most difficult aspect for me was being awakened at all hours of the night once she lost her sense of time at 96. We were fortunate that she had hospice for 7 moths before she passed away due to her extreme age and being bedridden for the last year of her life.

Your mother was so lucky to have you to care for her with such compassion and love. It had to be very difficult for you to be awakened in the middle of the night; I'd imagine that had to only add to the stress. When your sleep is interrupted, it's difficult to function for sure.

Facing this on two fronts, with one elder in assisted living but on a steep decline and another still in a home but requiring daily assistance, I can attest to the strain ... emotional, physical, and FINANCIAL ... beyond costs of things, it's having a great impact on our ability to work and earn what we really need.

I don't have kids to care for as well, so I'm not sure I qualify as a sandwich person ... but I sure do feel squished.

I've been in the sandwich generation. Now I'm trying to figure out what generation I'm in as the mother of a high schooler and caregiver for my 56-year-old husband. You can read my blog on www.caregiving.com.

I don't know what generation that is, but all I can say is it has to be a very difficult one. Thanks for sharing.

Another aspect of this is women who have aging parents, adult children and grandchildren for whom they are primary babysitters. My mom was in this situation when my grandparents were ailing. It was hard on her because she made a commitment to babysit and wanted to do so, but also needed to care for her parents. I guess that's a triple decker sandwich generation!

I so relate, as I'm totally sandwiched between my 87-year-old mom and my kids and hubby. I'm really, really fortunate that I have three siblings and their kids, and we all live within a ten-mile radius of my mom. It would be SO tough if I didn't have so much family around. Plus, my mom is a total sweetie.

Thanks for this post, Sheryl, and the recognition. Boy is it tough when you have to start parenting your parents!

I appreciate Kerryjoh's comments. It's important to make sure to take care of yourself so that you're able to care for someone else too. So far my parents are in excellent health but my grandmother is having a tough time recently and having those open conversations, well, that's been tricky.

I think reading how others are coping is also very helpful. I recommend the book THE MIDDLE PLACE which is a positive look at being in the sandwich, and perhaps a good place to start.

As much as I thought I'd be prepared to care for an elderly parent while raising a pre-teen as well,and working full time, the reality was alot different! Having my 89-year-old dad living with us for the last year has been both joyous and difficult as well--and something I would never give back. One of the ways of avoiding stress and burnout is by making sure that all family members are on board, and that the caregiving husband and wife are able to get breaks and spend time together alone. So much is involved in caring for an elderly parent and raising a child (or children) that the core relationship can start to fall by the wayside. We caregivers need help and support to maintain our health and our relationships.

Though both my parents are in good health and I hope they'll continue to be, this topic is so frightening for someone who lives 8 hours away from the rest of her family. I don't know if we're ready to have that family talk about what might need to happen...

My parents lived in Florida when they got ill, I live out west and it was very difficult taking care of them. You MUST have a plan of what to do when your parents get seriously ill.

Under state law in Florida, if a person is in a rehab/nursing home facility, and on Medicaid, they are allowed to stay in the facility if they need to move to the nursing home wing after rehab. I was told that my dad had to leave once his rehab was finished and once they learned he was on Medicaid. I did research and found out they werent telling me the truth. So, do your research, read up on requirements for Medicaid if you should need it and try and stay positive. Enjoy the time you have with your parents.

Excellent interview!

Caregiver stress is important to recognize early and to whenever possible decrease or avoid it. Being caught in a sandwich generation-caring for parents and children is not easy.

Want to definitely check out Dr. Johnson's book.

What Are Simple Steps to Decrease My Caregiver Stress?

I am taking care of my mom and dad both are not in good heath at all so there is alot of DRs and meds..I also have a 11 year old daughter..im a single mom. and have been showing not one but all the signs of stress / depression some days not sure if i can do it anymore. there seems like never enough money or time.reading all this has helped me see im not alone..im 41 and happy to see there is someone out there i can talk to..

I just had the same 'dinner conversation' experience with a group of friends who have gotten together since our kids were in kindergarten. Both of my parents have now passed, but my heart goes out to the friends who are still struggling with the right next steps for their parents. Reading about other people's experiences is very helpful.

Thanks for an interesting article. I have to totally agree about your comments on preplanning. I was very blessed that my senior parents did just that and it has helped me tremendously as I have come alongside them to help with my senior dad when he was in the advanced end stage of his Parkinsons Disease. Our family would have had a much harder time dealing with all the issues that arose, while working through the grief of his going into the hospice program if we hadn't already talked through everything they wanted during the period before he passed away.

Now I am caring for my senior mom and, as I write about at SandwichINK.com, we continue to follow the plans they set up and communicated to me and it really makes a positive difference.

Thanks again for a great article.

You there, this is really good post here. Thanks for taking the time to post such valuable information.I hope that I will get some more super articles like this one! Fifa 15 Coins

Thanks for chiming in. It's always nice to 'see' a new face. When parents age fairly well, it is truly a blessing - both for them and for the people that care for them.fifa coins.

I don't know what generation that is, but all I can say is it has to be a very difficult one. Thanks for sharing such a beautiful post..

I've put in years as member of sandwich generation, and wound up with heart attacks as result of stress. Finally learned ways to recognize harmful thoughts and weed them out before they did harm.
Then learned how to locate new ways of looking at situation to find healthier way to handle it!
Did plenty of study and wrote down the findings in plain English, in familiar images.
B.S.Detecting, the Flip Side of Success-Possible Communicating. 5 star reviews! On Amazon, Kindle, for price of a latte and a bun, $8.99.

I am the mother of 3 small children (7 year old, 4 year old, and 4 month baby), and taking my 76 year old mother (in assisted living with dementia) puts a lot of stress on me. Since I have to work full time to support my children and my own household, finding time to run errands for her or take time off of work to take my mother to the doctor is almost impossible. When I am around my mother, I feel like I am taking care of 4 children, but my mother is the most difficult, as I cannot just pick her up and carry her, and I am so worried about her falling. She is overweight and has difficulty walking and getting in and out of my car. I feel like the burden of taking care of her takes away from my time with my own children. My entire life, including my childhood, she was always a negative/depressing person, always putting her own feelings ahead of everyone else's and never happy. As a result, I resent her and dread being around her. But because she is my mother, as long as she is on this earth, I know I am responsible for her. I wish I could be a better daughter to her, but with 3 small children, also with which I feel the need to protect from her negative verbal outbursts, its difficult for me to be a good mother and a good daughter at the same time.


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