The sandwich generation

Caring for your children and parents simultaneously

The term "sandwich generation" was first coined in the 1980s by sociologists Dorothy Miller and Elaine Brody to identify people in their 30s and 40s who were taking care of their children as well as their elderly parents or extended family members.

According to the Pew Research Center, approximately 54% of Americans in their 40s have both children under the age of 18 and parents older than 65. Of these Americans, 24% of them are in the sandwich generation, meaning they are actively caring for both their children and their parents (or other older adults in their lives). This phenomenon is complex and is caused by myriad factors such as an aging population, increased overall lifespan and couples delaying parenthood in favor of careers. While opportunities to have children later and to live longer are ultimately pros for humankind overall, they can create caretaking sandwiches for some of us in the middle.

Two-thirds of the sandwich generation caregivers are women, due to the gender pay gap as well as societal pressures on women to be caregivers. According to a study by the University of Michigan School of Medicine, sandwich generation caregivers are more likely than their peers to report emotional difficulty and twice as likely to report financial difficulty. Nursing homes, assisted-living facilities and home health aides are often private pay, sometimes to the tune of thousands of dollars per week. Even if an older adult qualifies for assistance – which is not always the case – someone has to be in charge of organizing and arranging all of those intermediaries.

According to the U.S. Census, the number of Americans ages 65 and older is projected to increase by 47% by the year 2050. While the majority of Americans will not need long-term care until they are much older than 65 (and some will not need it at all), about 70% of us will age until we need either full or partial assistance. It is a lot to think about and to plan for.

If you identify as a member of the sandwich generation, you are probably a little overwhelmed at this point. First of all: Take a breath. You are doing a beautiful job. We see you. Hopefully you have some friends and family to confide in and to spend time with. Hopefully you have some time to recharge.

To the extent that it is appropriate, it is all right to be straightforward with your children about what is going on. It is likely that your children already know what is happening, and at the very least, they definitely hear you on the phone discussing your loved one with doctors or family members. They may even experience a grandparent moving in or moving nearby. If age-appropriate, it is okay to ask your children to do more around the house. Most importantly, try not to feel guilty about bringing some of this heavy stuff around your kids. Often, we want to shelter our children from tough topics, but ultimately our job as parents is to teach our kids how to be good humans. These caregiving situations offer some of humanity's most important lessons.

If you are reading this and thinking that you are not yet part of the sandwich generation but may be someday, it may behoove you to have a frank and honest conversation now with the people you'll be caring for. Ensure that you have all of the information needed to advocate and care for your relatives before the moment comes. If your relatives are reluctant to share this information with you yet, simply ask them where you might find it in case of an emergency. All that said, if you are an adult child, you may have to accept that your parent or loved one is not ready to have this conversation with you. Ultimately, you have to respect their position.

If you are reading this and thinking that you may someday require care from your adult children, I would recommend that you go ahead and add your trusted caregiver's name to your records with agencies such as your insurance company, your physician or pharmacy, Medicare, Medicaid and/or your financial entities. You don't even need to let your caregiver know that they have been granted the ability to interface with these agencies, but doing this early will allow your caregiver advocacy permissions should the time come unexpectedly. If you don't have powers of attorney or advance directives set up, do so. Even though this may feel uncomfortable, it is ultimately a major grace to your caregiver if they know your wishes and can advocate for you appropriately.

For caregivers, future caregivers and those receiving care, remember this: Your people are people first and foremost, and everyone is trying their best. Although this is fraught, hopefully your relationship is a positive one and you are able to recall all of the generous gifts of time and care that your loved ones have poured into you so that you can now do the same in return.

Pamela Savage is a freelance writer living in Springfield who is also part of the sandwich generation.

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