Dual caregiving can be stressful and expensive. The seemingly non-stop demands on ‘sandwich adults’ can be overwhelming, but no escape because you have filial obligations and child rearing responsibilities. Women who plays the roles as mothers and daughters who care for both children and ageing parents often feel overextended, but they can manage stress by identifying triggers, self-care, and asking for support. As social gerontologists, we both came across many ‘confused’ people sandwiched between aged parents and their own children.
Are you juggling the care of your parents and kids while trying to focus on your job too? If so, you are probably in the caregiving sandwich and you’re not alone. Almost half of adults aged 40-59 find themselves caring for both an aging parent and a child, often while maintaining a presence in the workforce. Can sandwich generation caregivers, whether daughters, sons, spouses, or partners, effectively manage these demands without feeling overwhelmed and guilty? The answer is yes, but it requires guidance and support, both at home and in the workplace. If you find yourself caught in the middle, don’t miss this vibrant and dynamic article. Discover crucial caregiving strategies and ways to prioritise self-care. Here we give some tips to overcome the unpleasant situations which might sprang up.

  • Judith S Parnes, Sowmya Lakshmi

Suresh Subramonian (name changed), is the typical ‘sandwich adult’. He was the CFO of the best run TATA company but flummoxed by the new role of the sandwich adult. He took over the loss making company and turn it around and in the corporate circles his was a miracle. But in the home front he is in a crisis and in a dilemma whom to support and how to create a win-win situation.

Being the only son, he has no other choice but to bring his aged mother from Mettur (TN) where his father was settled. His father was a government doctor serving the villages and after retirement he decide to stay on in the same place. Few years back his father passed away and mother continued to stay there with minimal support. After some years into widowhood, advanced age and diminished faculties made life unsustainable for the mother for a secluded life. Despite stiff resistance, Suresh have somehow convinced his mom to come to Bangalore to live with him. The decision to bring the mother to his house is his own and others (wife and two grown up daughters) were not happy with this arrangement.

‘On a typical day, I make two phone calls each in the morning and afternoon. One is to my home to check in on the family. And the other is to my parental home for much the same purpose. My first home is the one I live at with my wife and my two teenage daughters. And my second is my parental one, where my 83-year-old wheelchair-bound mother still lives under the care of a part-time aide. No kidding, it’s a stressful living, 24/365.’ Suresh continues.

‘As it is, the work life is hectic, over and above the daily attention to both these houses tells you a little about the balance I have to strike in life. Yes, I’m a member of what’s been dubbed the “sandwich generation”. 54 year old Suresh is not cribbing; but he reminds us of the responsibility, the population of middle-aged adults who are caught between taking care of their children and taking care of their parents.

Suresh has a unique problem. His family is not supportive and they are against keeping the grandma in their home. This ‘hostile’ environment is what bothers him a lot. ‘Grandma is nosey and makes life miserable’, children complains; we cannot get along. Though his wife seems to be unperturbed, he thinks that it is she who instigates the children and plays the role of a villain. Caught in an unpleasant situation, suresh sought our help. Suresh explains further.

‘I should say openly that I consider myself one of the unfortunate one. My kids and wife are not understanding the fact that I have filial obligations to my aged parents. And my mother is in generally good health beyond the mobility problem (and some mild cognitive issues); plus, she’s got a solid pension (thankfully, she gets family pension) and a reasonably solid nest egg, so money is not a major issue in her life.’

‘Though I said money is no issue, some worries about the money aspect can’t be completely ignored. Even if things appear financially stable right now, I have to remember that my both daughter’s college years are around the corner and my mother need for additional at-home care is a likely possibility. I don’t pretend to have all the answers as to how to deal with all these issues. But in the past few years, I’ve learned a few things about living the sandwich life. And I’ve also talked to experts like you about your take on caring for children and parents simultaneously.

Many baby boomers like Suresh are experiencing a new dimension in middle age. Life may not be the only thing you’re in the middle of—you may have realised you’re also in the middle of caring for both your children and parents. Rough estimation says one-third of the population who are providing financial assistance are also serving as a caregiver to another adult in their family. The weight of these dual responsibilities can be heavy and tiresome and it goes beyond finances.We use three words to describe the ‘sandwichers’; Frantic, frazzled and frustrated because they have to juggle between time, logistics and money.

In 1981, social worker Dorothy Miller coined the term “sandwich generation” to depict individuals who work full time while concurrently caring for their children and aging parents, a situation that characterises over half of people in their 40s and 50s in the United States. However, for older adults situated between advanced elderly parents, adult children, grandchildren, or even great-grandchildren, a new term has surfaced: the “club sandwich”! Family structure changed in the last two three decades and in today’s families, one in three includes four generations. This is a world wide phenomenon. Lot many adults are now in the cusp of extending care giving to grandparents as well.

A prime moment to shed light on the club sandwich generation, individuals navigating a multi-layered caregiving existence. Aarathi’s case serves as an illustrative example. At 42, married, and a mother of two young children, she spent the past year working as a full-time teacher while simultaneously caring for her family. Additionally, she tended to the needs of her seriously ill and now deceased mother and two grandmothers. While initially classified within the widely acknowledged “sandwich generation” – midlife adults supporting a dependent child under 18 and a dependent parent over 65 – Aarathi also falls into the club sandwich generation. This group extends its caregiving responsibilities to include grandparents, adding another layer to an already full plate. Aarathi reflected on this evolving phenomenon.

Aarathi’s experience resonates with our insights to the unexpected role of grandparents in the lives of today’s midlife adults. Grandparents have emerged as a stabilising force for many midlife adults for both good and bad reasons. On the brighter side, older generations live longer and in better health than ever before, and thus spend more and higher quality time with younger generations. Our understanding showed that intergenerational caregiving “arrangements spread well-being up and down the family tree—almost always in the direction of need” whether from grandparents to grandchildren or the reverse later in life.

In the ‘club sandwich’ generation, caregiving commenced early in life, with support flowing from grandparents to grandchildren. Over 80% of primary caregivers, aged 30 to 50, had experienced grandparent involvement during their early years, and more than half of them lived in close proximity. They associated the presence of a grandparent with the development of a shared family identity and the definition of their extended family’s private rituals, particularly those related to holidays. A considerable number, admitted grandparents played an even more significant role in their upbringing. Almost 20% of respondents lived with a grandparent for part or all of their childhood, either due to disruptions in a parent’s marital or employment situation, the parent’s substance abuse, incarceration, or simply for convenience. In short, the presence of a grandparent created a stable home and refuge.

As grandchildren mature, their care requirements diminish, while the care needs of their grandparents increase. Intergenerational care relationships from earlier times translated into the anticipation and fulfilment of reciprocal care. Taking on the responsibility of caring for a grandparent was rooted in a profound sense of gratitude for the care and support received during childhood. For instance, Susan’s grandfather raised her and her two siblings after their father’s untimely passing, while their mother grappled with alcoholism and a lifestyle unsuitable for parenting.

Susan’s story is dramatic but resonates with many of the financial and emotional sacrifices made by mid-life adults to accommodate the needs of parents, minor children, and grandparents. She will do anything for her grandfather as he supported all the three till their college days. Looking back, her stay with grandfather was not so pleasant, as step mother always asked her and her siblings to go back to our alcoholic mother. Somehow, grandfather resisted and declined.

Identifying as an “outside child,” a term she coined for herself, she actively participated in caring for her grandfather during his battle with cancer. This involvement extended to transporting him to chemotherapy sessions and maintaining a bedside vigil during his last week. Juggling these duties, she also provided support to her financially and emotionally unstable mother, attended to her two teenage daughters, and cared for an infant granddaughter—adding yet another generational layer to the club sandwich of responsibilities. Isn’t it too much?

As social gerontology practitioners, we specialise in family transitions, and from years of observation, we infer that, majority of informal caregivers are women, and ideally speaking it shouldn’t just be the woman’s job alone. In our work consulting with caregivers and writing about the struggles of the sandwich generation, we advise strengthening the intergenerational relationships between ageing parents/grandparents and children to gain support. Unlike in the case of Suresh, It’s good to let grandparents and grandkids spend time together to learn and draw from each other. If there is a cordial relationship between grandparents and grandchildren, It can help alleviate and consolidate the dual obligations of the sandwich generation.

If you are aged between 40 plus and 60, (sandwich generation) and are not caregiving yet for your children and parents simultaneously, it is best to be prepared. If you take steps now in preparation for the inevitability of life, then you should be able to tackle the stress when it comes your way. Preparing the family members, finding the community resources, and proper allocation of finances will help you navigate later years. As the saying goes, “Forewarned is forearmed.”

Half of your problems can be solved if you have sufficient financial back up. Financial planning is vital if you know in future you confront a day when you are sandwiched between parenting your children and parenting your parents. When the day sneak in and actually you are caring for your children and parents, it can become a huge financial drain. Better to prepare for this eventuality. Whenever we conduct ‘Retirement Lifestyle Planning’ for corporates, we emphasise this aspect of financial planning. Don’t put it off, but instead think ahead for your retirement from the workforce. Unless you plan for retirement and finances, you can put yourself, and possibly your children’s future in financial jeopardy.

Family dynamics is very important, as the responsibility to your parents is not yours alone. Your siblings are also obligated to involve. Sometimes the family dysfunction don’t allow for open and honest discussion among siblings. However, when it comes to discussing the care of your parents in the future tense, put aside any hard feelings and make it happen. Don’t automatically take on the care of parents alone, because the other sibling or relatives can blame you for the unilateral decisions. Share the responsibility and develop a plan whereby you each take a particular role in caregiving. If you have adult children, seek their assistance and they make great resources to offset the responsibilities of caring for ageing parents.

Once you start caring your aged parent, it is a heavy burden to feel like you are never doing enough for the people you love. It can be daunting and you feel exhausted because you are pulled from different directions. Emergency situations can happen at any time and may continue to prolong for longer periods. And sometimes there is no end in sight. Contrary to raising children where the children grow up, elderly parents become less independent and not able to do things on their own. Caring for an ageing parent can last many years, and it can have a tangible impact on family life including your marriage.

When the tasks are overwhelming, and you feel you are not able to do justice to your aged parents as well as to your children, you better opt for institutional care. Suresh in the story, told by us in the beginning, took our advice and thanked us for the timely suggestion. In Suresh’s case, mother also liked to move out as she understood she was not ‘welcome’. Once institutionalised, we created a win-win situation for all the ‘stakeholders’. As your aged parent get into very old age, ‘ageing in place’ may not be feasible. If you continue to keep the aged parent who has several chronic conditions, you ultimately do more harm by inflicting inferior care. Because of the time constraints, you cannot do justice to both parties (aged parent and young children).

Most elders have a distaste for assisted living or skilled nursing home. Raising the topic, can be a difficult conversation to have with your parents, but a necessary part of planning for the future. Knowing your parent is living as independently as possible, and is thriving in a community where they are learning, managing, and making friends, can give you peace of mind. It also sets your parents up for independent living and peace. Perhaps they don’t need to move right now, but they will have to take this step in the next five to 10 years. Start the process now, so it isn’t a crisis later. Whether it’s an independent living in a retirement community, assisted living community, or skilled nursing home, you want to feel assured that it is the best fit for your mother or father. Think ahead, plan now, and seek help.