Shifting Demographics Intensifies Pressures on Family Caregivers - 'Sandwich Generation' Juggles Responsibilities

Imagine juggling the responsibilities of caring for your parents, raising your children, and maintaining your career simultaneously. Many individuals unexpectedly find themselves as caregivers, struggling to balance financial and health challenges alongside these duties.

The media often focuses on generational demographics like baby boomers and millennials. Yet, another generation is increasingly under the spotlight due to the stress they face around the clock.

According to an October 2021 survey by the Pew Research Center, nearly a quarter (23%) of U.S. adults now form what's referred to as the "Sandwich Generation." These individuals have at least one parent aged 65 or older while also raising a child under 18 or financially supporting an adult child.

The Challenges of the Sandwich Generation Grow The complex task of simultaneously providing care for a parent, supporting children, and managing other familial responsibilities is becoming an increasingly common challenge for many Americans. 

More People Find Themselves ‘Sandwiched’

The 40s demographic is most likely to find themselves in this sandwiched situation, with 54% having a living parent aged 65 or older and raising a minor or providing financial aid to an adult child within the past year.

Dr. Amy D'Aprix, a life transition expert and gerontologist, quoted in an article on care.com, said that sandwich-generation caregivers are often so focused on the needs of their loved ones that they neglect their own health and well-being.

They may experience chronic stress, anxiety, depression, burnout, and increased risk of chronic diseases. It is vital for them to practice self-care, seek support, and explore available resources to cope with the challenges of caregiving.

This group of people is actually caught in the middle, trying to help both older parents and children. Many in this generation have careers at the same time. The stress is hard to imagine unless you have been in their shoes yourself.

Worldwide Aging Creating a Crisis for Families

With a booming population of over 54 million adults aged 65 and older, the U.S. is witnessing a significant shift towards later parenthood. The average age for first-time mothers in the United States has risen to 26, which aligns with patterns in other developed nations, where the average age for women becoming mothers for the first time has reached 31.

The term "Sandwich Generation" was first introduced in 1981 by social worker Dorothy A. Miller. She employed this phrase to define adults simultaneously tasked with caring for their aging parents and their own children.

Tami Anastasia is an author and Alzheimer's and dementia counselor. Speaking in a webinar hosted by Belmont Village Senior Living explained that the emotional and physical struggles associated with prioritizing care should not be overlooked. 

Resentment doesn't occur right at the beginning of the caregiving journey but is rather built up over time. This provides a significant dilemma among the 'Sandwich Generation' as they often feel they must handle care on their own without professional help or help from friends and family. A common example is the tendency of family members to resent other family members who receive overt praise for doing what they perceive in their eyes as the bare minimum. 

Caregivers Have Multiple Responsibilities

Assuming the role of a caregiver for an older parent is an arduous task. However, it's rarely the caregiver's sole responsibility. The added pressures can take a toll on both the caregiver and the care recipient, who often grapples with the guilt of imposing such burdens on their family, thus exacerbating feelings of depression stemming from their increased dependence.

While no one relishes the thought of becoming a burden, many families find themselves unprepared for an inevitability that life brings - aging. Assistance with daily activities may become necessary for various reasons, ranging from illness and accidents to the natural frailties of aging. In the absence of prior planning, this need can precipitate a family crisis, with adult children left to balance the demands of caregiving with their parental responsibilities.

Even with financial resources to hire professional care, someone must oversee these caregivers and bridge any gaps in care. As professional care costs continue to rise across the country, personal finances may be stretched thin, often culminating in family members stepping into caregiver roles despite initial plans.

In this complex ballet of care, roles blur, and boundaries shift, painting a compelling portrait of the multifaceted, emotionally charged world of caregiving. The Sandwich Generation, balancing caregiving and parenting, embodies resilience and selfless love while underscoring the pressing need for more comprehensive, accessible, and affordable long-term care solutions.

Coping is Vital When Being a Caregiver

Being able to cope with the stress and physical demands of being a caregiver and a member of the 'Sandwich Generation' will make the journey easier.

Anastasia talks about a powerful set of "S.A.C.R.E.D.©" coping tools – a memorable acronym and self-care guide for "Sandwich Generation" families comprised of the following tenets:

• Stop "should-ing" yourself. Don't give in to self-defeating thoughts about what you "should" do. Instead, replace "should" with what you can, will, and want to do as a caregiver.

• Acknowledge your own feelings and emotions and the ones of those around you to gauge how you're doing emotionally and recognize ways to be proactive.

• Comfort and compassion are critical. You're more likely to feel caring and compassionate for others when you afford yourself the same. Find ways to incorporate comfort and compassion in your own self-talk.

Ways to Make it Easier

Anastasia offers advice for those caring for their aging parents. These suggestions were developed over many years of counseling the elderly, helping those who need long-term health care and suffer from dementia.

• Resources are required. Ensure resources are readily available for aging parents and children and reach out to close friends, family, and professionals when you feel overwhelmed.

• Establish an emergency plan. Have medical, prescription, legal (including will and trust), POLST, or DNR/AND (do not resuscitate/allow natural death) related matters in place and ready for immediate access. Coach family members on what to expect in an emergency and keep them informed and prepared.

• Delegate tasks and ask for help because one person can't possibly do everything on their own. This is a special time when stress can peak.

Handle Stress Before Stress Handles You

Caregivers must manage multiple responsibilities. Being a family caregiver leads to many issues, including a weakened immune system, stress from job loss, marital instability, various home-life struggles, coping with family concerns, and more. 

The stress and anxiety that results from being a caregiver are not good for your physical or emotional health and well-being. The constant state of heightened alert that these caregivers experience can often lead to depression, illness, burnout, and unexpected emotions like resentment. 

The emotional and physical struggles associated with prioritizing care for the older adult and the rest of your family should not be overlooked.  

"Resentment doesn't occur right at the beginning of the caregiving journey but is rather built up over time. This provides a significant dilemma among the 'Sandwich Generation' as they often feel they must handle care on their own without professional help or help from friends and family. A common example is the tendency of family members to resent other family members who receive overt praise for doing what they perceive in their eyes as the bare minimum," Anastasia explained.

Proper coping mechanisms can be lifesaving.

Self-care, even just 10 minutes a day, is the single most important thing you can do. The better you take care of yourself, the better you will survive this journey.

Planning Helps Avoid the Crisis

While these recommendations are invaluable in a crisis, the question arises: can we preemptively avert such situations? Experts consistently endorse the necessity of a long-term care plan to tackle the financial and logistical challenges of aging and declining health.

Yet, candid conversations about aging often remain elusive or get reduced to humor. It's not uncommon for parents to jest about not wanting to end up in a nursing home while their children counter with lighthearted remarks about being the ones to choose the nursing home when the time comes.

However, a serious discourse seldom takes place. The reality is that most long-term care today is not nursing home-based but is provided at home (or a child's home), assisted living facilities, or memory care centers.

Families often realize too late that health insurance and Medicare cover a minimal portion of these long-term health care services. While Medicaid can finance long-term health care for those with limited income and assets, this is not a viable option for everyone.

Regrettably, many people are either unaware of Long-Term Care Insurance or postpone its purchase, assuming they can do so in their later years. They are often caught off guard when they discover their health conditions make them ineligible. Since Long-Term Care Insurance involves medical underwriting, it's typically acquired when individuals are in their 50s and comparatively healthier.

A family discussion about future long-term care planning should ideally occur when one is younger and in good health, before a crisis emerges. This proactive approach benefits all family members and can potentially alleviate the stress and emotional burden associated with caregiving in the future.

Seek Help

If you are already a caregiver, find the appropriate help either from other family members or from professionals. Professional caregivers can either provide respite care or provide half-time or even full-time care if the resources are available. 

Professional caregivers can either come into your home, or you can use adult day care centers as a way to provide the family caregiver with relief. 

These guides from LTC NEWS can be helpful -

• Finding Quality In-Home Care | LTC News

• Adult Day Care Centers (ADCCs) | LTC News

• Assisted Living and Memory Care Facilities | LTC News

• Finding a Quality Nursing Home | LTC News

If your parent has a Long-Term Care Insurance policy, use the benefits. Sometimes families think it is better to hold off activating the policy. That usually is not a good strategy and just adds to the stress. Accessing quality care will benefit your older parent if they get it right away.

If you need help in starting the process of a Long-Term Care Insurance claim, LTC NEWS can help. LTC NEWS provides free assistance with no obligation to help you or a loved one complete the claims process with a Long-Term Care Insurance policy. 

Even if they do not have an LTC Insurance policy, this service will help you design an appropriate care plan as you access quality care options. 

Aging is a reality, and we will face declining health, mobility problems, and even dementia as we get older. Thinking about these problems before they become problems will keep you in control and reduce the pressures otherwise placed on those you love.