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Sandwich Generation caregivers

Posted at 12:52 PM on April 17, 2008 by Nanci Olesen (3 Comments)

"I can hold her hand and you can feel that there's something much deeper than words can ever express, so that's how we communicate. But she's slipping away."

Mary Louise Clary is describing what it feels like to be with her mom. Her mother has had Alzheimer's disease for more than 6 years. She still recognizes Clary, and they spend time together every day, holding hands.

Several years ago, Clary helped her mom and dad move from their home on Cape Cod back to Minnesota. Soon after that, she found a nursing home for her mom and helped her dad start his solo life at a townhouse across the yard from Clary's home.

Clary has a son in high school and one in college. She's recovering from breast cancer. She quit her job so that she could attend to her parents and be there for her boys. She's trying to take care of everyone and yet let them have their independence too.

Although she doesn't want to interfere with her dad's privacy every minute, Clary needs to know that he's okay. He gets Meals on Wheels every day. The meals come to a cooler that her dad puts out by his back step each morning. Clary can see the back door of her dad's townhouse from her kitchen window.

"So every morning I look out to see if the cooler's out there to see if he's okay so that I don't impose on him by constantly calling saying 'Dad, are you all right? Did you get up this morning?' But the cooler is the message," says Clary, "I know if the cooler's out, he's okay."

There are often tough decisions that caregivers need to make, while trying to help their parents feel like they're still in charge. Women like Mary Louise Clary are called Sandwich Generation caregivers. They are women in their forties and fifties, who are sandwiched between caring for their own kids, caring for their elderly parents, and often holding a full time job.

It's mostly women who are "sandwiched," according to Kathryn Ringham, a care coordinator for Eldercare Partners.

"Even when men are involved it's the women who tend to do the most challenging tasks related to caregiving," says Ringham, "The men typically get involved with the finances. They may be in the position to do some of the care coordination, whereas women are doing the dressing, the feeding and the more challenging personal care tasks."

When people start caring for their parents, they often underestimate how long the commitment will last. Kathryn Ringham says that many people imagine it will just be a year or two that they'll be helping their parents. But often it's four years, or eight years, or more.

In order to manage the extra time and energy involved in caring for elderly parents, social workers and professionals who work with caregivers want sandwich generation caregivers to seek out the resources that they need to stay healthy.

One of the strongest issues that's emerging is just the physical and emotional long-term consequences of being a caregiver," says Kathryn Ringham, "Caregivers have a higher percentage of alcoholism, of use of psychotropic drugs and medications. They experience higher anxiety, higher stress."

Ringham wants caregivers to know that they can find help with many of the physical needs that their parents have: a home health care nurse, or Meals on Wheels. They can also get counseling and support for themselves AND for their parents. They can get help with their parents' finances. Many of these services are based on ability to pay.

Within the next twenty years, one in five Americans will be 65 or older. And they will need care. 80% of care to elders is provided by family and friends, according to The National Alliance for Caregiving.

According to The National Institute on Aging, the U.S. will need a 40% increase - 20,000 additional - social workers who are trained in the needs of elders and their caregivers.

Professionals recommend that each family devise a caregiving plan. They say the conversation can begin casually, at the next family gathering, or by email.
And they say that caregivers need to recognize that they need help.


Help Starts Here: from The National Association of Social Workers--(includes resource directory)

National Alliance for Caregiving

National Alliance for Caregiving: resource page

Eldercare Partners --services, intake and live phone staff, M-F business hours

Family Caregiving Center: University of Minnesota

AARP: Family Caregiving

Survey of Social Workers Finds Families Ill-Prepared for Care of Parents

The work of taking care of family produces stress on time, finances and emotions: Kate Hughes/ The Independent

Generation juggles children, parents: essay by Anne McGraw Reeves: Newhouse News Service: March 4, 2008

Working Couples Caring for Children and Aging Parents: Effects on Work and Well-Being

Caring for Your Parents: a PBS documentary (April 2008

Comments (3)

This is a huge issue. Thank you for raising it here.

"Sandwiching" bring up so many policy questions: when and if to take out long term care insurance; public policy on funding for elder care facilities/home health care; and in an echo of the new parents' dilemma--the cost of "free" labor provided by stay at home parents caring for babies and small children. No wages, no social security, no benefits, no matching IRA, no tax credit for caregiving work.

I think the well-known Hubert Humphrey quote is fitting: "It was once said that the moral test of Government is how that Government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and the handicapped."


Posted by Kris Berggren | April 21, 2008 3:53 PM

I learned about the many resources available to caregivers and to elders as I worked on this story.

Interesting quote from Humphrey.

Thanks for sharing it.

Posted by Nanci Olesen | April 21, 2008 10:57 PM

My sister and I have officially reached the stage of coming to terms with the rapid aging of our parents. While I am only half a sandwich (no kids), the urgency I feel in my heart to DO something is huge! There are other beings for whom I provide care and nurture, plus just the day to day necessities of self-care, and it all becomes overwhelming. It's comforting to know there are resources out there and, frankly, that at its simple base it's a fact of life. Our togetherness in the human condition gives me courage. Thank you for being real and concerned about this.

Posted by Barbara | May 3, 2008 10:10 PM