Sandwich Generation

Depending on which statistics you read, either 10 million or 20 million families are raising children and caring for an aging parent or two. The catchy name for this group – sandwich generation – has already morphed into “generation sand” and “sandgen.”

It is always defined negatively as being a burden and a struggle, “caught between competing demands on your time.”

“...a constant series of no-win choices like: 'Do I go to my kid’s ballgame, or do I go and make sure Dad eats his dinner?'”

The New York Times, 11 August 2008

“Most feel stretched thin at best and are often left wondering how they can help alleviate the growing burden of caring for their parents.”

Senior Journal, 2 March 2009

“Many of these couples face major stress in their finances, emotions, and relationships.”

About.com: Marriage (no date)

There is an unmistakable poor-me quality to the sandwich generation. It would be nice if parents got old without needing help or at least had the grace to wait until the children are grown before succumbing to ailments of age. But events rarely move that conveniently.

Aside from the people wanting to "alleviate the growing burden of caring for their parents," whom I'd like to smack, I fail to see the problem. The kid won't be warped if you miss a ballgame now and then. Unless you sleep through life, stress is normal - stuff happens.

There was a time when multi-generational households were the norm. Half my friends, when I was growing up, had a grandparent or two living with them. Some were healthy and a few grandmothers ran the house while mothers worked. Others were sick and the kids were as much caregivers as the adults in the family. It wasn't uncommon for friends to tell me they couldn't go bike riding today because they had to stay with gramps while mom went shopping.

Of course, I was not privy to the strains on the families of my friends, but I knew those kids and I knew their parents and I hung out in their homes as they did in mine. They wore their cares lightly in those days, making the best of what life dealt them. Maybe it makes a difference that these parents of my friends were people who, like my parents, grew up during the Great Depression. Whatever the burdens, the post-War years were better.

I'm not saying it's easy to fold an older generation into one's family life whether caring for parents at home or dealing with their needs in assisted living or nursing communities. But in the period of my lifetime, we seem to have lost (if the public discussion of the sandwich generation is not just hype), the idea that families share the exigencies of life of which caring for one another when needed, at every age, is one.

The whining of the sandwich generation has so annoyed me when I run across it that I've given it a good deal of thought. It could be that, left to their own devices, families caring for aging parents would be fine with their circumstance. Instead (not unexpectedly in our over-analyzed era), an industry has grown up that repeatedly warns of the turmoil multi-generational families are experiencing which they cannot survive without professional help.

One way to make money is to invent an otherwise non-existent problem, give it a name everyone can remember and then cash in. There is now a good-sized service sector specializing in the sandwich generation - support groups, instant experts, psychologists, care managers and financial advisers prowling talk shows, holding conferences and seminars, writing magazine and newspaper stories.

Books invariably follow and Amazon has a range of them from Stuck in the Middle to Soul Food for the Sandwich Generation: Meditation Morsels for Caregivers. Can a reality TV show be far behind?

[At The Elder Storytelling Place today, Carol Gardner tells us about dreaming of gray hair in Dome Light is On.]

Comments

[kenju]

My mom died when my kids were still in school, so I escaped that "sandwich" situation early. I know that it is hard for some people, and especially the ones with grown kids, but very elderly parents who become more intractable as the months roll on. My dad remarried at age 88, so his final years were stolen from me, and I wish I had them back.

[Nancy B]

Funny, I was just going to do a blog on feeling like jelly squeezed between slices of bread. I don't consider the sandich generation or gen between a negative. There are whiners among us for every single aspect of life and living.

For me, I don't care about the name or label, I care about what I like millions of others feel. It's not about not wanting to care for our parents or feeling burdened by them; it is about stress, and the emotional expenditure one feels when trying to help those you love, no matter what their age.

Sometimes, due to family circumstances, there aren't many family members left to help out in situations where elders and young people need help from a person, a caregiver, a mom, dad, brother sister, who is between the 2 events/persons needs and has needs of their own.

I will use me as an example: I work full time in a job I love, with no hope of retiring anytime soon even though by age I could; by finance I can't. I have 1 brother here who works part time. I have a 95 year old mother who just went to an assisted living (her choice) because we were running out of money and choices for her care when we could not be around. I have 2 children; 1 who is pregnant and on bedrest for the past 2 months.

I love all of them for different reasons. For some, I am one of a few who can provide assistance. It's not the physical time it takes; its not an emotional burden. It sometimes is just that time and commitments must be juggled. Some of us cannot maintain the balls in the aire for long periods of time without feeling tired and drained. I think that is normal. It's not burden, it's real life and sometimes real life hurts and vocalizing that hurt is good. Let it out. I guess that's all I have to say.

[Pamela]

Here's an example of cashing in on a need that in UK is covered by the voluntary sector - http://www.guardian.co.uk/society/joepublic/2009/mar/09/students-befriending-elderly-people. The sons of discredited Lord Stevenson, the HBOS Chairman, trying to create another niche. You couldn't make this up.

[mary jamison]

The problem of eldercare is a very real and brutal problem.
The big difference between elder care now and elder care when the Depression-era children were caring for their parents is simply this: most often, the parents died after a relatively brief illness. 70-year-olds who had strokes were sent home to wait to die, which, like my grandmother, they did within a convenient year or two. When my grandfather was found to have heart trouble at 82, again, with no fanfare, they sent him home; there was no question of treating him, and he died within a couple of days.
Unmarried women were at home; all my grandparents had adult children at home to care for them. Single-parent households and blended households were the exception, not the norm. The norm was a husband bringing home the paycheck and a stay-at-home wife and mother whose full-time job was caregiving. One middle-class paycheck could support a family.
And, most importantly, people died before Alzheimer's and other dementias set in. My aunt, who lives alone and is suffering from dementia, would have been dead if it were the 1940s or '50s or '60s, but as it is she had major heart surgery at 75. Between that and the blood thinners that have, so far, prevented the stroke that killed both her parents, she is on track to die after several more years of Alzheimer's, not knowing who we are, where she is, what year it is.
The stress is due to the long, long stretch of caring for someone with a chronic illness that would have killed them off much more quickly 40 years ago.
If my mother had had a nice simple terminal condition--"you have six months or a year before X illness kills you," my sister and I would have cared for her in her home or ours. But with an open-ended diagnosis of Parkinson's Disease (which was wrong) and her inability to be left alone or to walk, she spent more than 7 years in institutions--institutions for which I am profoundly grateful. I'm grateful not only because they relieved my sister and me of 7 years of 24-hour-care; I'm also grateful because the time we did spend with my mother was time we spent enjoying her company, not serving as her maids.

[Carol]

As our lives improved after the Great Depression and WWII, families wanted "something better" for the next generation. While trying to protect the young from some of life's realities, opportunities were lost.
While growing up, circumstances placed me in the role of parent to my own parents, which often included handling the needs of my grandparents. We just did what needed to be done in those days. As you said, Ronni, "we seem to have lost . . .the idea that families share the exigencies of life of which caring for one another when needed, at every age, is one." I recognize, but do not yearn over missed opportunities and feel peaceful and happy. How did we bypass the whine? Were we all too oblivious to introspect sufficiently?

[Sophronia]

I pretty much escaped the "sandwich" syndrome, because my kids were raised and out on their own when my elderly mother became too ill to live on her own.

However, I do sympathize with the "sandwich" people. My mother is difficult to manage, and we are lucky to be able to have her in assisted living. She has done so much better in that environment than I expected!

But even though I do not provide day to day care, I do manage her finances. I think that the increased complexity of medical care and financial obligations is a burden to me. I feel it acutely in Nov. when I have to decide which part D insurance to put her in. I feel it now, during tax season, when I have to have her taxes done. I felt it when I had to decide about pulling money out her savings to meet her increased needs.

My sister lives in the same city as my mother, and on her falls the burden of making and keeping doctor's appointment, keeping contact with institutional caregivers, shopping, etc. She continues to work as well. Neither of us is exactly young.

If I had to do all of this for my mother, and had to also finish raising my kids, as well as work full-time, I really would be quite stressed. In fact the needs of my mother pulled me from work for several weeks in the final year before I retired.

We love our mother. We do for her what she did for us when we were young--that is, we are taking care of her. But I do sympathize with those who are stretched so tightly between generations.

[Syd Halet]

Some advice to the "Sandwich Generation":

Try growing a scented geranium or two. They are easy for those with supposedly "black thumbs" to grow. Just read the directions that come on the little plant stakes or look them up on your computer. Now for the IMPORTANT part: TAKE 10 MINUTES A DAY TO STOP AND SMELL THE DELICIOUS FRAGRANCESAND THINK ONLY ABOUT THEM! You'll be surprised at how your stress lessens.

[Paula]

Oh, Ronni!

I hate to say it, but you're wrong on this one.

While I personally escaped a lot of sandwich pressure, it was a near-run thing.

Here's what different between now and the halcyon days of stoically accepting "the exigencies of life":

1) Both parents must work. The basics--housing, education, and health care--cost many times more.

2) Older family members live decades longer, often with dementia or extreme frailty or both, needing 24/7 attention.

3) The social contract has broken down to where the public provides essentially nothing to help ordinary people live their lives--schools that parents find frightening for one reason or another, suburbs without transit, health care usually hanging by a thread.

What's left is one stressed out woman holding up a wobbly and an isolated world of sick parents, ceaseless driving, children unable to do anything alone (too inaccessible or dangerous), and a full-time job.

In my experience, that woman probably also works for a youngish-man who has no clue and views her as a prime candidate for downsizing, at least in part because of her "family responsibilities."

I am so glad not to be that woman, but I know there are many of her.

[Miki Davis]

My mom died suddenly in 1984 (at age 74) and I dropped everything, sold and gave away everything, sent my two sons back East on a bus and left three days later by plane to go to my Dad -- who was falling apart. I was an only child, and frankly didn't give it a second thought. I was raised in West Virginia and just "knew" that this is what one did -- we ran to each other when we were needed. I took care of Dad, finished raising my sons through 3 years of high school and college, and worked full-time. It didn't give me angst, grey hair, or an ulcer. My sons had three glorious years with their Grandad and I had three cherished years with my Father, until at 79 he fell off the roof of the garage where he was trying to repair storm damage.

[ktsimo]

Nine years ago my husband and I proposed setting up a multi-generational home to my father-in-law. We saw the need for him to not live alone any longer and we had the opportunity to renovate a home to accommodate all 6 of us. After setting some ground rules--how expenses were to be shared, household chore division, discipline and behavior of our 3 children, and discussing every one's expectations, we decided to do it. My father-in-law was healthy and completely self-sufficient, but the activity of our family would solve his loneliness and isolation issues.
We all have benefited...my kids (now in high school and jr. high) have a greater understanding and appreciation of their grandfather, my husband and I continue to hone our listening and conflict resolution skills and it has given us the chance to gradually take more of a care giving role. While he is still active and generally self-sufficient, we are now helping him more with driving, shopping and household responsibilities. I suspect we will have more serious health issues to deal with this year and we will all (kids too) need to pitch in.
I encourage other families to do it--if the dynamics are right; the best thing we did was talk about every one's expectations--before moving in together. As we face more challenges my hope is to continue to involve the kids and keep our sense of humor.

[Elaine of Kalilily]

Everyone's family situation is different, and few are ideal. When I was a child, my extended family all lived within several blocks of each other, so when my grandparents became ill, everyone took turns caring for them.

These days, for all kinds of reasons, it can be a soul wrenching experience to try to make sure a disabled parent gets the care he or she needs, especially if you have to battle one more siblings who don't agree. I've been blogging about my struggle since I moved my mom near me in 2000 and then moved into an apartment across the hall from her, retired early from a well-paying job, and slowly but surely lost whatever life I had apart from taking care of my mother

Today is my birthday. I am 69. I recently moved in with my daughter and family, leaving my mother with my brother, who controls her assets. Yesterday I called Social Services to ask them to investigate because he is not taking adequate care of her -- physically or emotionally. My mother is 93 and has severe dementia. I want to put her in a nursing home five miles from where I live. But it's out of my control.

Every situation is different, but ever one is painful and exhausting, for both that parent and the child.

There never has been an easy solution to my "sandwiched" situation. And so it is with many of my peers. We do the best we can, sometimes putting our own health at risk.

While I wait for my appointments with a variety of medical specialists, do I feel "poor me" today? You bet.

I have given my daughter instructions to relieve herself of my care when the time comes and put me in a nursing home. I would never want to put her through what I have gone through.

[mary jamison]

A great deal of what determines whether a situation such as ktsimo describes is viable depends on all parties being--and staying--relatively healthy, especially cognitively. The pity is that, the worse the cognitive abilities become, the less able the person is to see it. My Mom died at 90; my aunt is 86. They were both healthy in their 70s.

[Betty]

Whining is just something you can expect from the "me generation".

[eStanley]

What a wonderful website of information to share with older adults

[Alexandra]

Home care may not be for everyone, but I must object to Mary Jamison's reference to family caregivers as "maids." The home care of my elderly mom was not easy but at no point did I feel like a maid. My 96-year-old mom was in a rehabilitation center for three weeks before we brought her back home. The center was the very best one on Cape Cod. Well, I got a chance to see how the inmates were treated and decided it was not what I wanted for a loved one. I regret that my own children seem to have lost this sense of responsibility. Perhaps the children of the sandwich generation will learn it again?

Sometimes I look back and think how could I have devoted 10 years of my life to my mother, when I could have put that time to better use for myself? This mood doesn't last long. I saw what needed to be done, realized I was the best person to assume the caregiver role, served my time. But then she wasn't sick. It would have been so much harder if disease had figured into the picture. Actually, caring for my mother was one of the most special periods of my life, especially the final seven months when she had hospice. SO REWARDING! It taught me not to fear death, among other things.

[candace]

Ronnie

You have outdone yourself on today's and yesterday's posts. Universal issues affecting us all sooner or later, written with an eye to the past, the view of today and trends for the future.
Quintessential Time Goes By.

[chancy]

My mother lived with my husband and me for 13 years. We had 3 young children at the time and they liked having "Nanny" around.
For the last 4 years of her life, due to frailty, she had to be in assisted living but I was still the caregiver who visited her often and took care of her affairs.
Sure it was difficult sometimes for all of us but she was family and we loved her dearly.

[Marion Karpinski]

I appreciate reading these eloquent responses about the pressures faced by the sandwich generation as they care for family members. I was a home care nurse for many years and witnessed first hand the difficulties faced by family members when they were suddenly expected to provide hospital-level care at home without any training. In the past, family members were not expected to monitor and hang IVs or operate sophisticated electronic devices. This creates a high level of anxiety and frustration for inexperienced caregivers. Because of this, I felt inspired to develop educational materials to help support family caregivers, and started doing that in 1995. I've created DVDs on essential caregiving skills that give caregivers more confidence. These programs are available to view online at www.medifecta.com. Learning nursing skills is not a magical cure for the challenges of caregiving, but it certainly does increase confidence, lessen anxiety and assure safer conditions for both the caregiver and care recipient.
--Marion Karpinski RN

[Cynthia]

These are interesting posts to read. My 80 year old mother and I live together along with my disabled brother, who is basically my mothers caregiver while I am at work. My mom is not easy to take care of, she is very much overweight, she has COPD, diabetes, and congestive heart failure. My mother no longer cleans up after herself, she wears depends and soils them constantly and leaves them in the bathroom for others to pick up. I suggested getting a home health aide to come in 2 times a week to help out, both my brother and I are burnt out and need some kind of relief but she will not have it. She says things like "you'll all be happy when I am dead and gone" I have other siblings who live near, when they come by, they get so mad and annoyed that they leave rather quickly. I have one grown daughter who recently had her first child, I can hardly spend time with my grandson because I have to cook for my mother, or assist her with bathing. It is a real burden because if she tried, I think she could do some of this stuff herself. I understand that she has some illnesses but she is not bed ridden. This stress is starting to take a toll on me physically and making me sick. When I share with her how I am feeling, she tells me all about her illnesses, like mine don't matter or hers are worse. It's ridiculous, I have started keeping my feelings to myself. I hope to not be like this with my children/grandchildren.