The Parent Trap
Published Jul 1, 2008 8:02 AM
In millions of U.S. homes, middle-aged moms and dads bear a double burden — tending to an aging parent while still rearing their own kids. This is the Sandwich Generation: stressed out emotionally, financially, legally and physically. Here are some tips on how to make it all work.
Regardless of the year in which they were born, many Americans take their turn as members of the Sandwich Generation — a term Merriam-Webster added to its dictionary two summers ago to describe people who are caring for their aging parents while still rearing their own children. For baby boomers, the dual burden is more common and likely to last longer than it did for their predecessors. The Pew Research Center estimates that 1 in 8 middle-aged Americans are both raising a child and caring for a parent, while another 7-10 million are assisting their parents from afar. In an era in which more people delay childbirth and more parents live into old age — and, thus, become subject to chronic, debilitative diseases and the effects of dementia — the ranks of the sandwiched are soaring.
The double-duty status often comes without warning and exacts stress on many levels. At the height of their earning powers, sandwichers often must cut back on their work schedule so that they can be more available to assist their parents with appointments and activities of daily living. Those unable to take the time from work may be forced to hire caregivers or consider assisted living facilities or nursing homes, both of which carry a hefty price tag. Difficult legal issues present themselves, including the need to establish advanced directives for end-of-life care. And as they seek to navigate one tough decision after another, members of the Sandwich Generation are confronted with the raw emotions that come with watching a parent decline, complicated by the need to keep it together for their own children. Feeling the pull from both generations, many become casualties themselves.
"These are people who are trying to balance their desire to be there for their kids with wanting to be there to help their parents, while in many cases also maintaining their work responsibilities," says Dr. Jeffrey Mariano, a UCLA geriatrician. "Studies have found that more than half of them suffer from depression, though it often isn't diagnosed."
Most Sandwich Generation members are unaware of their membership. "They typically don't identify themselves as caregivers," adds Esther Koch '73, a gerontologist and elder-care adviser whose San Mateo, Calif.-based firm Encore Management assists boomers with a range of Sandwich-Generation issues, and whose book, The Barnes & Noble Elder Care Guide, is being published later this year. "They will simply say it's their responsibility to take care of their parent, and their responsibility to take care of their children."
Here, then, are seven common-sense tips from Dr. Mariano and Koch to make a Sandwich Generation lifestyle a whole lot easier to handle:
Age and Answers
Get answers to a wide variety of subjects related to aging at www.aging.ucla.edu. Visit the National Association of Area Agencies on Aging at www.n4a.org. The Alzheimer's Association also offers support, guidance and actionable information at www.alz.org. And learn more on caring for aging parents from gerontology expert Esther Koch at www.encoremgmt.com.
Help your parent remain functional for as long as possible. Adult children need to become medical advocates for their aging parents. Accompany your parent to doctor's appointments, ask a lot of questions and speak up to make sure that chronic medical conditions are stabilized and medications routinely revisited. Be proactive about removing meds that aren't providing any real benefit and may be contributing to a cognitive decline or ability to function.
Plan ahead. Difficult issues ranging from living arrangements to durable powers of attorney for health care and finances are much more easily faced well in advance. And decisions such as when the parent should stop driving and what alternative transportation provisions can be put in place are better addressed early, rather than waiting until it gets to the point where the keys need to be taken away.
Don't go it alone. Many caregivers are reluctant to accept offers of help, much less ask for it. Delegating certain tasks — grocery shopping, child care, or simply checking in on the parent — to a spouse, siblings, friends and older children can benefit everyone.
Take advantage of community and governmental resources. If you don't have the means to pay for the high cost of a private caregiver or don't qualify for the in-home support services offered by Medicaid, respite care provided by assisted-living facilities can give you a much-needed break. Information and referrals to support groups and other community options are available through many organizations.
Keep communication channels open. Hold family meetings in which the needs of the parent, children, spouse and caregiver are identified and prioritized, and a game plan is established. Having priorities also serves as a reminder that you can't be all things to all people — and shouldn't feel guilty about that.
Take care of yourself. In an airplane, we're told that if the oxygen mask is released in the event of an emergency, we should put our own on before strapping on our child's. In the same way, caregivers who neglect their own physical and mental health aren't doing anyone any favors.
Embrace the moments of joy. It's easy to become so caught up in Sandwich-Generation burdens that we fail to appreciate the moments of beauty, from shared laughter to intergenerational bonding. Be in the present with your parents and include your children and spouse wherever possible.