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07.07

The Sandwich Generation

By Terrance Malkinson

“Sandwich Generation” does not refer to people who like the commingling of gourmet breads and cheeses; it is a term that refers mostly to middle-aged caregivers who juggle the care of their own children with that of other family members, often an elderly parent. The caregiver is “sandwiched” between responsibilities for two or more generations of individuals important to them.

The number of Americans responsible for caring for elders while at the same time raising their own families is expected to grow as life spans lengthen and the population ages.

The responsibility juggling act extends often combines elder care with child care, and  employment responsibilities to boot. This already difficult situation is compounded if the elderly individual is not in good health, is disabled, or suffering from the early stages of dementia. It is further compounded by the increasing cost of long-term care facilities and growing numbers of uninsured and inadequately insured Americans. All of these responsibilities can place a considerable amount of emotional, logistical and financial strain upon the caregivers.

Caregivers have less time for themselves, their families and their careers. It may mean having no personal time, giving up promotions at work and opportunities for travel, and in some cases giving up your job to take care of family members who need help.

A caregiver’s life can be a challenging one, often feeling overwhelmed and burdened by the weight of all of the responsibilities. Following are some strategies to help ease the burden on sandwich generation caregivers:

• Seek guidance and counseling from your family physician and community public health centers. Experienced professionals can provide a wealth of information on local services, and provide understanding and emotional support. Many communities have family caregiver centers that provide a wealth of tools to reduce stress and build coping skills.

• Avoid caregiver burnout. Monitor yourself for signs of stress, depression and loss of interest in activities that were once pleasurable. Should these occur immediately, take the steps necessary to maintain your own mental and physical health. No matter how difficult, you must take time for yourself. Even just a few minutes a day when you can take time to care for no one but yourself and your immediate family can make a huge difference.

• Accept your feelings. It is normal to experience many conflicting emotions — anger, sadness, depression — during this time. Recognize that others are going through similar challenges. Perhaps form a support group where you can gain strength from each other. Humor always helps to put things into a positive perspective.

• Ask for and accept help offered from friends, family and professionals. You cannot do everything yourself. Caring for others, young or old, takes time and energy. You may even be able to recruit a trained volunteer to help with caregiving.

• Clearly define and share household and caregiving responsibilities so that no one person carries an unreasonable burden for the care of the individual in need. Balance helps to bond families together. Structure your day. A consistent schedule makes life easier for you and those you are caring for.

• Investigate legal responsibilities. Seek advice from an attorney who has expertise in eldercare custody. This is especially important should the individual be confused or demented. Clearly understand what is meant by "abuse of elders." Elder abuse is doing something or failing to do something that results in harm to an elderly person or puts a helpless older person at risk of harm. This includes physical, sexual and emotional abuse; neglecting or deserting an older person you are responsible for; or taking or misusing an elderly person's money or property. Elder abuse can happen within the family and also in settings such as hospitals or nursing homes or elsewhere. All states have laws against elder abuse.

• Discuss your situation with your employer on a confidential basis so that they understand why you might need special consideration. Recognize that this is a temporary situation at this phase of your life. Perhaps consider a leave of absence, flex time, or a work-at-home option. For many caregivers, flextime is their most important need because of the difficulty in predicting when you might need to take some time off.

• While they are healthy, discuss with your parents any provisions that they have made for their future. Ensure that they understand that even though in the future they may have need for your time, you also have a duty to your own children. Ensure that they have created a last will and testament, and encourage them to set up a Power of Attorney for financial and health care decisions, as well as a living will with instructions on life support. Discuss all of your expectations in advance.

• Your own children might be feeling the effects of your situation more than you think, especially when they are young and are most in need of your attention. Share with them why it is an important family responsibility to care for their elders. Involve them as appropriate in the caregiving. Old wounds may be healed and family ties may be strengthened.

• Finally, plan for your own elder years. Ensure that you will be financially prepared, and take steps to maintain your own good health. Planning ahead gives you the opportunity to take the wishes of the entire family into account and reduce disagreements in the future.

Many are caught in the middle of complex multi-generational family obligations and concerns resulting in enormous stress and personal sacrifice. It is not easy to witness your parents growing old, but this is the natural progression of everyone’s life. Maintaining balance and recognition that the situation is temporary are critical if you want to avoid feelings of resentment and regret. Share the responsibility and satisfaction resulting from being a “sandwich generation” person when you care for others important to you, while caring for yourself.

Terrance Malkinson is a communications specialist, business analyst and futurist. He is an elected Senator of the University of Calgary, a Governor of the Engineering Management Society, international correspondent for IEEE-USA Today's Engineer Online, editor-in-chief of IEEE-USA Today's Engineer Digest, editor of IEEE Engineering Management, and associate editor for IEEE Canadian Review. His work appears in more than 300 publications, and he is also an accomplished triathlete. The author is grateful to the Haskayne School of Business Library at the University of Calgary. He can be reached at todaysengineer@ieee.org.